LASIK (laser in situ keratomileusis) is a popular surgical procedure that combines the use of the excimer laser with the techniques used in ALK to treat the inner tissue of the cornea and reduce refractive errors with amazing results.

LASIK is done on an outpatient basis only. There is no need for an over night stay in the hospital. The first step in LASIK surgery is to anesthetize the eye with special eyedrops. Injections or full anesthesia is unnecessary. An instrument called a microkeratome is used to create a flap in the outer layer of the cornea. The flap is pulled back and the excimer laser is used to remove small layers of the internal corneal tissue. The flap is then laid back into it's original position. Because the cornea has natural bonding qualities, stitches are not required to hold the flap back in place. Actual surgery time is about 15 minutes but with pre-operative preparations total surgery may take up to an hour.

Since LASIK is a relatively new procedure there has been little published data compared to other vision correction procedures. It's rapid adoption though has shown very good results and statistics have shown that LASIK has proven to be a safe procedure. As with all surgeries though, there are some risks involved and it is important to know those risks before you decide to have LASIK surgery. Possible risks:

Irregular astigmatism: Sometimes after LASIK surgery, the cornea heals with a wavy configuration. This leads to distorted images similar to astigmatism. Most of these cases within a year after surgery heal correctly by themselves. If irregular astigmatism is still present then contact lenses may have to be worn.

Temporary pain right after surgery: There is usually minimal to no post-operative pain after LASIK surgery. In some cases, soreness may be felt and a feeling of something in the eye may be present, but by the next the morning these sensations will be gone.

Night vision effects: Night vision effects can also occur after surgery. Halos around bright lights. Some night time contrast sensitivity may be lost. The amount lost is rarely significant and can be easily overcome by wearing night time vision glasses.

Infection: Infection is a rare occurrence in any refractive surgery, but if it happens it can easily be treated with antibiotics. It is important to know the risk that sight may be lost. Although this is extremely rare, the patient must be made aware of the possibility.

Others: Undercorrection, overcorrection, and light sensitivity.

Usually within a day after surgery significant improvements in your vision are noticeable. Many patients prefer LASIK because the post-operative care for the operated eye is easier than other refractive surgeries. The process does not end after surgery though. You must have follow-up examinations by your ophthalmologist to make sure that your eye is healing correctly and to get the proper medical treatment and care for your eye.

You must be 18 years of age or older and your eyes must be free from eye disease or any abnormality in the eye. Before surgery, you must have a full eye examination by an ophthalmologist. Your ophthalmologist will do a complete physical on your eye and determine the correction needed, and whether or not you are a good candidate for surgery. Contact us for details.

Photorefractive Keratectomy

     Photorefractive Keratectomy (PRK) is a surgical procedure that reduces myopia using the excimer laser. The laser is used to remove thin layers of the cornea thereby reducing the refractive error.

     There is no need for an over night stay in the hospital. The first step in PRK surgery is to anesthetize the eye with special eyedrops. Injections or full anesthesia is unnecessary. Using the excimer laser, the surgeon precisely sculpts the cornea by removing very thin layers of the cornea. The excimer laser does not penetrate the eye and leaves other eye structures (iris, lens, retina) undisturbed.

     PRK surgery is performed on one eye at a time. The second eye can be treated if all goes well and vision stabilizes without complications or adverse reactions. Surgery of the second eye is usually done three months after the first eye, if needed. Both eyes can be done at the same time, but you must discuss this with your ophthalmologist to make sure that this is the best option.

     Since it's introduction, over 300,000 PRK procedures have been performed. In that time many refinements have been made to improve precision and predictability. It's popularity as a laser vision correction procedure has grown rapidly due to it's good results and overall dependability and safety record over the years. PRK is a safe procedure, but as with all surgeries though, there are some risks involved and it is important to know those risks before you decide to have PRK surgery. Possible risks:

Pain and discomfort after surgery (temporary): Some pain and discomfort will be experienced right after surgery. Usually the pain is mild and not significant. Regular pain medication can be taken to treat this but if pain is significant the ophthalmologist will prescribe the proper medication. You may also be sensitive to bright lights in the first week after surgery. This is temporary and after a week sensitivity should decrease and dissipate altogether.

Others may include: Sensitivity to light (temporary), corneal deposits, haze, or scarring; significant regression, infection, and night vision effects, possible glare ("halos")

     After surgery, some patients have complained of a corneal haze. This occurs in about 3-4% of the patients, less is lower ranges of corrected diopters. The corneal haze tends to fade out in time over a year to the point where it is no longer noticeable. If the patient has recurrent corneal haze a follow-up procedure can correct it in most patients. Regression can also occur, usually in the same 3-4% of patients who have corneal haze. This can be fixed with follow-up procedures. Infection in PRK is an extremely rare occurrence.

     Individual results after surgery cannot be precisely predicted, but extensive data has been gathered on the results of PRK. PRK has been shown to be especially effective for those who's refractive errors are in the low range, but it has also been shown to be more effective in the higher areas of correction compared to RK. Here is a chart of statistics for the correction that is achieved after the initial surgery.

After the initial surgery, in order to achieve the highest correction possible, it is sometimes necessary to do additional follow-up correctional procedures.

     With PRK results come relatively quickly. Usually within a few days after surgery significant improvements in your vision are noticeable. The process does not end after surgery though. You must have follow-up examinations by your ophthalmologist to make sure that your eye is healing correctly and to get the proper medical treatment and care for your eye.

     You must be 21 years of age or older and your eyes must be free from eye disease or any abnormality in the eye. Before surgery, you must have a full eye examination by an ophthalmologist. Your ophthalmologist will do a complete physical on your eye and determine the correction needed, and whether or not you are a good candidate for surgery. Please contact us for more details.

Intacs

     Intacs, also known as Intrastromal Corneal Ring Segments, are a new FDA approved surgical procedure for the correction of myopia. Two semi-circle lenses are threaded into the cornea outside of the optical zone. The varying thickness of the implanted lenses serves to reduce the refractive error.

          

     Like other refractive surgeries, the implantation of Intacs is done on an outpatient basis. Before surgery is started, the eye is anesthetized with eyedrops. The surgeon places a mark on the eye to use as a guide for placement of the ring. A small semi-circular incision is made into the cornea where the implant will be placed. The two sections of the corneal ring are then inserted into the opening created by the incision. Once in place, the incision is closed with a few sutures. The sutures will be removed a month after surgery.

     As with all surgical procedures, there is a possibility of complications or side effects. Infection, astigmatism, and other visual effects are possible, but extremely rare. It is important to know the risks of surgery before undergoing it. Talk with your eye doctor to find out more information about this.

     The Intacs procedure is usually performed on those whose refractive error is mild to moderate. Based on preliminary clinical studies the implantation of Intacs shows stable results.

     Improvement in vision is almost immediately seen after surgery. Stability in vision occurs about six weeks postoperatively. The process does not end after surgery. You must have follow-up examinations by your ophthalmologist to make sure that your eye is healing correctly and to get the proper medical treatment and care for your eye. .

Radial Keratotomy

     Radial Keratotomy (RK) is a surgical procedure that reduces myopia (nearsightedness) by correcting the shape of the cornea with microscopic surgical incisions in a radial or spoke-like pattern. When the incisions heal it flattens the cornea and the refractive error is reduced.

     There is no need for an over night stay in the hospital. The first step in RK surgery is to anesthetize the eye with special eyedrops. Injections or full anesthesia is unnecessary. A mark in a spoke-like pattern is then impressed upon your cornea. This is temporary and is used for marking where the surgeon will make the incisions. The marks are based upon a formula determining your prescription, age, and the amount of correction needed. The surgeon will then make several incisions (keratotomies) in the cornea using a microscope and a microscopic surgical instrument that has a diamond tip. This diamond instrument has a safeguard which prevents it from penetrating into your eye. The actual surgery time takes about 5 minutes but with pre-operative preparations it can take up to an hour. It is recommended that each eye be done in different sessions, but it is possible to have both eyes operated on in the same session. You must consult your ophthalmologist to make sure that this is your best option.

     Since RK's introduction into the United States in 1978 many refinements have been made to the technique and it has been improved greatly. It is estimated that over 2 million surgeries have been performed since it's introduction in this country alone. RK is a time tested and safe procedure. As with all surgeries though, there are some risks involved and it is important to know those risks before you decide to have RK surgery. Possible risks:

     Fluctuating vision: Initially after the surgery the patient may experience some fluctuation in vision. This is usually referred to as AM to PM fluctuation. This fluctuation is more prominent for those who have had a higher amount of correction done. Over time patients find that the fluctuation dissipates to a level where it is no longer noticeable. Some pain may also be felt right after surgery. For about 24 hours after surgery the eye may be sensitive and there could be some mild to moderate pain. Normal over the counter pain medication (Tylenol, Aspirin, etc.) can be taken for the pain. A very small percentage of patients may experience significant pain but it is rare in Radial Keratotomy.

     Others may include: Temporary pain right after surgery, progressive hyperopia, weakened cornea, difficulty in fitting contact lenses, night vision effects, and infection.

     Individual results after surgery cannot be precisely predicted, but extensive data has been gathered on the results of RK. RK has been shown to be especially effective for those who's refractive errors are in the low range, usually the 1.00 to 5.00 diopters range. Here is a chart of statistics for the correction that is achieved after the initial surgery.

After the initial surgery, in order to achieve the highest correction possible, it is sometimes necessary to do additional follow-up correctional procedures.

    With Radial Keratotomy results come relatively quickly. Usually within a day after surgery significant improvements in your vision are noticeable. The process does not end after surgery though. You must have follow-up examinations by your ophthalmologist to make sure that your eye is healing correctly and to get the proper medical treatment and care for your eye.

Astigmatic Keratotomy

Astigmatic Keratotomy (AK) is a surgical procedure that reduces astigmatism by correcting the shape of the cornea with microscopic surgical incisions in a curved pattern. When the incisions heal it causes the cornea to relax and become more rounded reducing the refractive error.

There is no need for an over night stay in the hospital. The first step in AK surgery is to anesthetize the eye with special eyedrops. Injections or full anesthesia is unnecessary. A mark in a spoke-like pattern is then impressed upon your cornea. This is temporary and is used for marking where the surgeon will make the incisions. The marks are based upon a formula determining your prescription, age, and the amount of correction needed. The surgeon will then make several incisions (keratotomies) in the cornea using a microscope and a microscopic surgical instrument that has a diamond tip. This diamond instrument has a safeguard which prevents it from penetrating into your eye. The actual surgery time takes about 5 minutes but with pre-operative preparations it can take up to an hour.

Since RK/AK's introduction into the United States in 1978 many refinements have been made to the technique and it has been improved greatly. It is estimated that over 2 million surgeries have been performed since it's introduction in this country alone. AK is a time tested and safe procedure. As with all surgeries though, there are some risks involved and it is important to know those risks before you decide to have AK surgery. Possible risks:

Fluctuating vision: Initially after the surgery the patient may experience some fluctuation in vision. This is usually referred to as AM to PM fluctuation. This fluctuation is more prominent for those who have had a higher amount of correction done. Over time patients find that the fluctuation dissipates to a level where it is no longer noticeable. Some pain may also be felt right after surgery. For about 24 hours after surgery the eye may be sensitive and there could be some mild to moderate pain. A very small percentage of patients may experience significant pain but it is rare in Astigmatic Keratotomy.

Others may include: Temporary pain right after surgery, weakened cornea, difficulty in fitting contact lenses, glare or starburst around lights, halos, infection.

AK has been an effective procedure for treating low amounts of astigmatism. For most patients, functional vision without the use of corrective lenses is almost always achieved.

After the initial surgery, in order to achieve the highest correction possible, it is sometimes necessary to do additional follow-up correctional procedures.

With Astigmatic Keratotomy results come relatively quickly. Usually within a day after surgery significant improvements in your vision are noticeable. The process does not end after surgery though. You must have follow-up examinations by your ophthalmologist to make sure that your eye is healing correctly and to get the proper medical treatment and care for your eye.

Automated Lamellar Keratoplasty

Automated Lamellar Keratoplasty (ALK) is a surgical procedure that uses an instrument called a keratome to create a flap in the cornea and then remove corneal tissue to reduce refractive errors.

There is no need for an over night stay in the hospital. The first step in ALK surgery is to anesthetize the eye with special eyedrops. Injections or full anesthesia is unnecessary. With an instrument called a keratome, the surgeon creates a flap in the cornea. A thin layer of corneal tissue is removed and the flap is then replaced. Stitches are not necessary to hold the flap in place because of the natural bonding qualities of the the corneal tissue. The actual surgery time takes about 5 minutes but with pre-operative preparations it can take up to an hour. It is recommended that each eye be done in different sessions, but it is possible to have both eyes operated on in the same session. You must consult your ophthalmologist to make sure that this is your best option.

ALK was developed in the late 1940's. It has been refined and improved greatly since that time. As with all surgeries, there are some risks involved and it is important to know those risks before you decide to have refractive surgery. Possible risks are

Irregular astigmatism, temporary pain right after surgery glare, difficulty/inability in fitting contact lenses, night vision effects and infection.

Some pain may be felt right after surgery. For about 24 hours after surgery the eye may be sensitive and there could be some mild to moderate pain. Normal over the counter pain medication (Tylenol, Aspirin, etc.) can be taken for the pain.

After the initial surgery, in order to achieve the highest correction possible, it is sometimes necessary to do additional follow-up correctional procedures.

With ALK results come relatively quickly. Usually within a day after surgery significant improvements in your vision are noticeable. The process does not end after surgery though. You must have follow-up examinations by your ophthalmologist to make sure that your eye is healing correctly and to get the proper medical treatment and care for your eye.

Orthokeratology

Orthokeratology is an alternative for those who want to correct their vision without having surgery. First developed in 1962, orthokeratology uses special high tech rigid gas permeable contact lenses to safely and effectively change the curvature of the cornea to reduce refractive errors such as myopia (nearsightedness) and astigmatism.

Orthokeratology works by changing the curvature of the cornea with specially fitted lenses contoured to the shape of your eye. This is done by taking a photograph of the entire corneal surface using a computerized corneal topographer. The image taken gives the eye doctor detailed information about the shape of the patient's cornea which is then used to determine the shape of the lenses used on the patient. Several sets of lenses are then made for different stages of the procedure.

Once they are made, a series of lenses are fitted and worn in progressive stages. Lenses are changed every 2-8 weeks with regular examinations with your eye doctor in between until the maximum amount of correction is achieved. Retainer lenses are then worn in order to stabilize the new shape of the cornea. Once vision is stabilized with the retainer lenses they only have to be worn a few hours a day or week, depending upon the characteristics of the patient's eye.

Orthokeratology is time tested procedure with over thirty years of use and thousands of satisfied patients. Several studies done by universities and independent research facilities have shown orthokeratology to be as safe as wearing regular contact lenses.

Most of the improvement in vision occurs rapidly in the first few days and weeks of treatment. As the procedure progresses in lens changes, improvement in vision comes at a slower pace. The total program length varies between 3 to 6 months depending upon the amount of refractive error being corrected. Retainer lenses are then worn to stabilize the cornea. Lower to moderate amounts of myopia can be corrected up to 20/20 or 20/30 vision. Higher degrees of myopia can show significant improvements in vision so that functional vision can be achieved without using full-time lenses. Astigmatism can be improved greatly. Perfect 20/20 eyesight cannot be guaranteed, but with orthokeratology almost all patients can achieve functional vision without having to wear contact lenses or glasses full-time.

Orthokeratology is a safe and effective vision correction procedure that requires no surgery. If you are unsatisfied with the results it is a completely reversible procedure. All you have to do is take out the retainer lenses and no longer wear them.

Lensectomy

Lensectomy is a surgical procedure that is commonly used to treat patients with cataracts. The procedure has been modified to also correct myopia (nearsightedness) in the high diopter range and most ranges of hyperopia (farsightedness).

Lensectomy, like other refractive surgical procedures, is done on an outpatient basis. Before surgery is started, the eye is anesthetized with eyedrops. The natural lens (crystalline lens) is extracted and an artificial lens similar to a contact lens is implanted. The power of the artificial lens is determined preoperatively during a full eye examination by an ophthalmologist. After the artificial lens is inserted the lens is allowed to heal in with the surrounding tissue of the eye, not requiring any stitches. Surgery time is about 15 minutes but because of preoperative preparations total time spent in the operating room will be about an hour.

Lensectomy as a surgical procedure has previously been used to correct eyes with cataracts. The use of this procedure in refractive surgery is relatively new, but studies have shown it to be a reliable means of correcting refractive errors.

This procedure is generally done on patients whose refractive error is out of the range of other refractive surgeries. Most refractive surgeons do not perform LASIK and other procedures on eyes with 14 diopters or more because of the possibility of taking too much of the corneal tissue away. Lensectomy is usually not performed on anyone under the age of 40 either because the implanted lens can cause difficulty focusing in on close objects, similar to presbyopia (aging eye). It is likely that reading glasses will be required following surgery.

Individual results for any refractive surgery cannot be precisely predicted. Lensectomy is used for correcting myopia (nearsightedness) in the high diopter range (14+ diopters) and also hyperopia. Studies have shown that functional vision can be achieved with stable results.

After surgery, many patients can see well and visual recovery can be very rapid. Reading glasses will most likely be necessary following surgery. The process does not end after surgery though. You must have follow-up examinations by your ophthalmologist to make sure that your eye is healing correctly and to get the proper medical treatment and care for your eye.

     You must be 21 years of age or older and your eyes must be free from eye disease or any abnormality in the eye. Before surgery, you must have a full eye examination by an ophthalmologist. Your ophthalmologist will do a complete physical on your eye and determine the correction needed, and whether or not you are a good candidate for surgery. The ophthalmologist will need your full eye history. Please contact us for more information