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1 A Center for VisionCare 4418 Vineland Avenue, Suite 106 North Hollywood, CA / Alan I. Mandelberg, M.D. Donald I. Goldstein, M.D. Glossary of Refractive Surgery Terms Aberration: An irregularity or departure from the norm. In this context, an imperfection in the eye affecting vision. Ablate in surgery, is to remove. Ablation zone the area of tissue that is removed during laser surgery. Accommodation the ability of the eye to change its focus from distant objects to near objects. AK: An acronym for Astigmatic Keratotomy, a refractive surgical procedure using a blade rather than a laser for the correction of astigmatism. Acuity clearness, or sharpness of vision. Astigmatism a distortion of the image on the retina caused by irregularities in the cornea or lens. Bacterial conjunctivitis: An eye infection commonly known as pink eye; caused by bacteria. BCVA: An acronym for Best Corrected Visual Acuity, a measure of the best vision you can attain from glasses or contact lenses. Blepharitis: Inflammation of the edge of the eyelid. Broad-beam: A laser with a relatively large (6-8mm) diameter beam that can be manipulated to reshape the cornea in a refractive surgery procedure. Broad-beam laser: A laser with a relatively large diameter beam (6mm - 8mm) that can be manipulated to reshape the cornea in refractive surgery procedures. Cornea the clear, front part of the eye. The cornea is the first part of the eye that bends (or refracts) the light and provides most of the focusing power.

2 CUSTOMCORNEA : The branded name for the first FDA-approved customized laser vision correction procedure that addresses both higher- and lower-order aberrations to create truly customized vision correction. Diopter the measurement of refractive error. A negative diopter value signifies an eye with myopia and positive diopter value signifies an eye with hyperopia. Dry Eye Syndrome a common condition that occurs when the eyes do not produce enough tears to keep the eye moist and comfortable. Common symptoms of dry eye include pain, stinging, burning, scratchiness, and intermittent blurring of vision. Endothelium the inner layer of cells on the inside surface of the cornea. Enhancements: A follow-up procedure or retreatment. LASIK is sometimes performed a second time if the results were not satisfactory after the first procedure. Speak with your doctor to understand this process more fully. Epithelium the outermost layer of cells of the cornea and the eye's first defense against infection. Excimer laser an ultraviolet laser used in refractive surgery to remove corneal tissue. Farsightedness the common term for hyperopia. FDA the abbreviation for the Food and Drug Administration. It is the United States governmental agency responsible for the evaluation and approval of medical devices. Flap & Zap a slang term for LASIK. Ghost Image a fainter second image of the object you are viewing. Glare scatter from bright light that decreases vision. Halos are rings around lights due to optical imperfections in or in front of the eye. Haze corneal clouding that causes the sensation of looking through smoke or fog. Higher order aberrations refractive errors, other than nearsightedness, farsightedness, and astigmatism, that cannot be corrected with glasses or contacts. Hyperopia the inability to see near objects as clearly as distant objects, and the need for accommodation to see distant objects clearly. Inflammation the body's reaction to trauma, infection, or a foreign substance, often associated with pain, heat, redness, swelling, and/or loss of function. Informed Consent Form a document disclosing the risks, benefits, and alternatives to a procedure. PAGE 2

3 In Situ a Latin term meaning "in place" or not removed. IntraLase: The first blade-free laser technology for performing the critical first step in the LASIK procedure: creating the corneal flap. Prior to IntraLase, this first step was done manually using a hand-held device with an oscillating metal razor blade, called a microkeratome. Iris the colored ring of tissue suspended behind the cornea and immediately in front of the lens. Keratectomy the surgical removal of corneal tissue. Keratotomy a surgical incision (cut) of the cornea. Keratitis inflammation of the cornea. Kerato prefix indicating relationship to the cornea. Keratoconus a disorder characterized by an irregular corneal surface (cone-shaped) resulting in blurred and distorted images. Keratomileusis carving of the cornea to reshape it. LASEK: An acronym for Laser Assisted sub-epithelial Keratectomy, a refractive surgical procedure which uses an instrument called a trephine to remove the surface cells (epithelium) of the cornea prior to laser treatment. Once the laser ablation is completed, the surface cells are replaced over the reshaped area. LASER the acronym for light amplification by stimulated emission of radiation. A laser is an instrument that produces a powerful beam of light that can vaporize tissue. LASIK the acronym for laser assisted in situ keratomileusis which refers to creating a flap in the cornea with a microkeratome and using a laser to reshape the underlying cornea. Lens a part of the eye that provides some focusing power. The lens is able to change shape allowing the eye to focus at different distances. Lower order aberrations: A collective term for a series of common vision problems including myopia, hyperopia and astigmatism. Microkeratome a surgical device that is affixed to the eye by use of a vacuum ring. When secured, a very sharp blade cuts a layer of the cornea at a predetermined depth. Monovision the purposeful adjustment of one eye for near vision and the other eye for distance vision. Myopia the inability to see distant objects as clearly as near objects. PAGE 3

4 Nearsightedness the common term for myopia. Ophthalmologist a medical doctor specializing in the diagnosis and medical or surgical treatment of visual disorders and eye disease. Optician an expert in the art and science of making and fitting glasses and may also dispense contact lenses. Optometrist a primary eye care provider who diagnoses, manages, and treats disorders of the visual system and eye diseases. Overcorrection a complication of refractive surgery where the achieved amount of correction is more than desired. PRK the acronym for Photorefractive Keratectomy which is a procedure involving the removal of the surface layer of the cornea (epithelium) by gentle scraping and use of a computer-controlled excimer laser to reshape the stroma. Presbyopia the inability to maintain a clear image (focus) as objects are moved closer. Presbyopia is due to reduced elasticity of the lens with increasing age. Punctal plugs: A device that may be inserted into your tear ducts to preserve tears and keep corneas moist. Pupil a hole in the center of the iris that changes size in response to changes in lighting. It gets larger in dim lighting conditions and gets smaller in brighter lighting conditions. Pupilometer :This instrument allows the technician to amplify light to see how small your pupil becomes in bright light as well as uses infrared light to see how large your pupils become in dark light. In this way the surgeon can decide what an appropriate treatment zone might be for your specific situation. This measurement and planning will help ensure that you get the best possible results for your eyes. Radial Keratotomy commonly referred to as RK; a surgical procedure designed to correct myopia (nearsightedness) by flattening the cornea using radial cuts. Refraction a test to determine the refractive power of the eye; also, the bending of light as it passes from one medium into another. Refractive Errors imperfections in the focusing power of the eye, for example, hyperopia, myopia, and astig Refractive Surgery: Any surgical procedure performed to change the eye`s refractive error. matism. Refractive Power the ability of an object, such as the eye, to bend light as light passes through it. PAGE 4

5 Retina a layer of fine sensory tissue that lines the inside wall of the eye. The retina acts like the film in a camera to capture images, transforms the images into electrical signals, and sends the signals to the brain. Sclera the tough, white, outer layer (coat) of the eyeball that, along with the cornea, protects the eyeball. Small-spot laser beam: At less than 1 mm in width, this type of beam allows a LASIK specialist to perform corneal shaping in fine, gradual, precise increments, creating a smooth corneal surface. Spherical aberration: A visual disorder reflecting a change in curvature between the center and edge of the pupil. This creates multiple focal points and can cause halos in your vision. Starbursts: Flares of light seen around a lighted object that may appear like a star. This symptom is similar to halos and may occur after surgery. Sterile interface inflammation: An inflammatory reaction underneath the corneal flap after LASIK surgery that is not due to bacteria. This condition may result in vision loss. Snellen Visual Acuity Chart one of many charts used to measure vision. Stroma the middle, thickest layer of tissue in the cornea. Undercorrection a complication of refractive surgery where the achieved amount of correction is less than desired. Vitreous Humor the transparent, colorless mass of gel that lies behind the lens and in front of the retina and fills the center of the eyeball. Vaporization: The process by which the laser breaks the bonds of chemicals between individual molecules with little or no damage to surrounding cells. This process is also called photoablation. Visual Acuity: Another phrase for visual clarity, a measure of the eye`s ability to distinguish the shape of objects. Visual acuity is measured with a traditional eye chart, with the goal traditionally being 20/20. Wavefront Device: A sophisticated measurement device, which passes a narrow ray of eye-safe light through the optical system and measures the optical distortions as the light exits the eye. With the LADARVision system, the resulting wavefront maps are used to provide fully customized vision correction, to address both lower- and higher-order aberrations, through the CUSTOMCORNEA procedure. Wavefront Mapping: A sophisticated way to represent visual disorders, these maps are created by passing a narrow ray of eye-safe light through the optical system and measuring the optical distortions as the light exits the eye. With the LADARVision system, the resulting wavefront maps are used to provide fully customized vision correction, to address both lower- and higher-order aberrations, through the CUSTOMCORNEA procedure. PAGE 5

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