|
Laser Vision (LASIK) Correction Welcome to the Cornea-Genetic Eye Institute's Laser Vision (LASIK) Correction home page. Learn how just about any refractive error can now be corrected by laser surface reshaping of your cornea and reduce your dependence or eliminate your need for glasses or contact lenses for most activities. While most refractive errors can now be corrected with LASIK, there are some exceptions. To learn about the appropriate procedure for your problem, merely click on your refractive problem.
The following additional information could be useful in helping you make a decision regarding Laser Vision (LASIK) Correction. The Laser | The Microkeratome | PRK vs. LASIK | The Surgeon | The Hospital If you would like additional information regarding Laser Vision Correction, please call our Refractive Surgery Coordinator, Aracelli Ortega at (310) 423-9643 to receive a complimentary informational package, view an informational video or schedule a complimentary screening. Patients who have myopia can usually see things close up, but objects in the distance remain blurry. Patients are myopic usually for one of three reasons: the cornea is too steep, the lens is too thick (as in cataracts) or the eye is too long. Depending on the amount of myopia there are different options for surgical correction of refractive error. The amount of myopia is usually measured in Diopters (D). Myopia 3D or less - can be corrected with LASIK,LASEK, PRK, or INTACS* Myopia 3D-12D - can be corrected with LASIK (laser in situ keratomileusis), depending on the thickness of the cornea Myopia 12-25D - can be corrected with phakic IOLs *INTACS - is a non laser safe and potentially reversible procedure for low myopes who do not want to take the risk of laser surgery (for more information on INTACS, click here www.getintacs.com) Photorefractive Keratectomy (PRK) This procedure uses a cold laser beam to reshape the front surface of the cornea and typically takes 30 to 60 seconds depending on the patient's refractive error. Either nearsightedness and astigmatism or farsightedness and astigmatism can be corrected during the same sitting. The VISX STAR excimer laser and the Autonomous LADARVision tracking lasers are both available at our institution, can correct up to 12D of myopia, 6D of hyperopia and, 6D of astigmatism. Typically the patient enters the laser room, a speculum is put in the eye to prevent the patient from blinking. The patient is then asked to fixate on a red light and the doctor helps the patient by steadying their head. The top layer of the cornea is gently peeled off and the patient fixates on the red light while the ablation is being performed. The ablation is performed on the center of the eye and flattens the cornea thus shortening the eye. Topical anesthetic is put in the eye so the procedure is totally pain free. At the end of the procedure the eye is washed out with cold water, an antibiotic, an anti-inflammatory drop and a bandage contact lens is put on the eye. The patient is prescribed pain medication in case it should be necessary. The patient is seen by the doctor the following day. The first day after the procedure, the eye feels a bit scratchy and is light sensitive. This improves rapidly and by the third to fourth day, the eye feels very comfortable and the bandage contact lens is removed. Patients typically see improved vision immediately after the procedure, but for maximal vision, it may take 2 to 8 weeks. A new procedure called LASEK is a modification of the PRK technique. In this procedure the top layer of the cornea is gently peeled of in one piece with alcohol and replaced in its original location, once the laser treatment is complete. The potential advantages of this procedure is quicker visual recovery and less postoperative discomfort. For more information on LASEK please click here.
Laser-in-situ Keratomeliusis (LASIK) Approved by the FDA to treat up to 12D of myopia, 6D of Hyperopia And 6D of astigmatism. This procedure is very similar to PRK, except the top layer of the cornea is modified with a microkeratome, a highly sophisticated motorized device, which is applied to the cornea with suction under pressure. A corneal flap is created. Laser ablation is then performed as in PRK. The flap is then put back in place and irrigated to remove debris from the interface. Antibiotics and anti-inflammatory drops are also given to the patient. No bandage contact lens is necessary. The patient is seen the next day. Typically the patient sees very well soon after surgery and has less discomfort than after PRK. Vision typically stabilizes after two months. The advantages over PRK are that vision returns quicker, there is less discomfort, it can correct higher degrees of nearsightedness and there is less chance of scarring. The disadvantage is that because a flap is created, there is a slightly greater risk of complications such as decreased best-corrected vision, interface problems and flap problems causing astigmatism. This procedure is thus more dependent on the individual surgeon's experience. In the hands of Dr. Rabinowitz, a LASIK Los Angeles surgeon, the complication rate is extremely low and is the procedure of choice for over 98% of our patients. For vision enhancement without a laser beam, consider INTACS™ to treat mild myopia (-1 to -3D). This is a safe reversible alternative technology for those with mild corrections who do not want to take the risk of LASIK surgery. INTACS distributed by Addition Technologies, involves the insertion of two plastic ring segments into the outer edges of the cornea. The ring segments exert enough pressure on the flexible cornea to change its shape. Different size ring segments are used to treat different degrees of myopia. INTACS, unlike laser surgery, is a reversible procedure. If you aren't happy with the results, or if your vision changes, the implants can be surgically removed and/or replaced. Furthermore, INTACS leaves the center of the cornea - the most important part for clear vision - untouched. Not every patient will be a good candidate for INTACS. It is important to meet with Dr. Rabinowitz, a leading specialist in Los Angeles keratoconus treatment to see if you are a candidate. After INTACS have been inserted, they require no maintenance. After the early post-operative period, the patient usually cannot feel them in the eye. In clinical studies, 74 percent of the patients achieved 20/20 vision and 97 percent achieved 20/40 vision or better one year after the procedure. For more information on INTACS click here. Patients who are hyperopic have problems seeing objects clearly both near and in the distance. This usually happens because the eyeball is too short or the cornea is too flat. Depending on the amount of hyperopia there are different treatment options available. The amount of hyperopia is measured in units called Diopters (D). Hyperopia 2.5D or less - LASIK, LASEK, PRK or Holmium laser thermokeratoplasty (LTK)* Hyperopia 2.5 to 5D - LASIK, LASEK or PRK Hyperopia >5D - Phakic intraocular lens *LTK is a new 3 second no touch laser technique for individuals with low hyperopia who do not want to take the risk of laser surgery. Hyperopic procedure This procedure uses a cold laser beam to reshape the front surface of the cornea and typically takes 30 to 60 seconds depending on the patient's refractive error. Both farsightedness and astigmatism can be corrected during the same sitting. Currently the VISX STAR excimer laser and the Autonomous LADARVision tracking lasers the ones used at our hospital can correct up to 6D of hyperopia and 6D of astigmatism. Typically the patient enters the laser room, a speculum is put in the eye to prevent the patient from blinking. The patient is then asked to fixate on a red light and the doctor helps the patient by steadying his or her head. The top layer of the cornea is gently peeled off and the patient fixates at the red light while the ablation is being performed. The ablation is performed on the periphery of the eye and steepens the cornea thus lengthening the eye. Topical anesthetic is put in the eye so the procedure is totally pain free. At the end of the procedure the eye is washed out with cold water, an antibiotic, and anti-inflammatory drop and a bandage contact lens is put on the eye. Patients typically see improved vision immediately after the procedure, but for maximal vision to be achieved it may take two to eight weeks.
Patients who have astigmatism see objects distorted both at near and in the distance. The reason for this is that their eyes are shaped like a football. Different regions of curvature result in light not falling on the same spot on the retina as it does in a normal eye. Patients who have both astigmatism and nearsightedness can usually be corrected with LASIK (Laser-in-situ Keratomeliusis), LASEK (Laser Epithelial Keratomileusis), or Excimer Laser PRK (Photo refractive Keratectomy). Sometimes, depending on the patient's refractive error, all that is needed to correct their astigmatism is an Astigmatic Keratotomy (AK). Astigmatic Keratotomy (AK) is an extremely safe and simple procedure to correct astigmatism and has been performed for over twenty years. Since there are many patients with astigmatism the laser cannot correct, AK may be the only option for these patients. This procedure involves making microscopic accurate cuts with a diamond blade under a high-powered microscope in the area of the astigmatism. It is extremely safe because the cuts are made outside of the visual axis, thus posing no threat for damaging the center of the cornea. The procedure is done under topical anesthetic, is pain free, and is done in the doctor's office typically taking five to ten minutes. The procedure may have to be repeated several times to attain optimal vision (enhancement). Enhancements involve either adding additional cuts or deepening existing cuts. Improved vision is noted immediately, but for maximal vision to be attained, may take from two to six weeks. The major risk of this procedure is perforation of the cornea with resultant infection. In experienced hands this rarely occurs and even when it does occur, can be prevented if treated promptly. Presbyopia (reading glasses with age) Presbyopia typically occurs when we reach our mid-forties requiring us to need glasses for reading. The reason this occurs is because we have a muscle that allows us to accommodate (increase the curvature of our own lens) as we bring things close to the eye to read. As we get older, this muscle becomes stiffer and we lose our ability to accommodate, thus see things close by and we need glasses to help us overcome this problem. For individuals who can tolerate monovision, this is an excellent solution to overcome this problem. This involves performing Hyperopic LASIK (PRK or LASEK) on the non-dominant eye. This makes the non-dominant eye nearsighted by steepening the cornea. The nearsighted eye is then used for reading. The treated eye can still see well in the distance but not as good as the non-treated eye. The brain then uses one eye for distance and one eye for reading, i.e., when you look into the distance, the brain sees the way the better eye sees, ignoring the nearsighted eye. When you look close by, the brain sees the way the near eye sees and ignores the distance eye for reading. While this might seem confusing, surprisingly most patients cope very well with this kind of correction. To determine whether this treatment is for you, you can come into our office for a screening and we will fit you with a contact lens to simulate this type of correction. If after using the contact lens for two to four weeks and you feel you can cope quite well with this solution, you can then go ahead and plan for permanent correction with the Excimer Laser.
Laser Thermokeratoplasty (LTK) The laser time
for the The LTK procedure is approved for +.75D to +2.5D and is an ideal safe alternative to LASIK for those who fear the effects of laser surgery on the center of the cornea and are concerned about the flap created by LASIK. Patients who are over age 40 with mild farsightedness and who have difficulty with reading vision are ideal candidates. How
The Sunrise LTK™ Procedure uses laser energy to gently reshape the cornea without touching the eye. It differs from currently available procedures because no scalpel incisions or laser ablations are used to cut or remove corneal tissue, and it differs from intracorneal ring and intraocular lens procedures because no objects are inserted into the eye. Instead, a holmium:YAG laser utilizing a patented process for shrinking collagen applies two concentric rings of eight simultaneous spots of laser energy to the periphery of the cornea (not the visually important center of the cornea that you see through) to gently heat the corneal collagen and steepen its shape, thereby improving its refractive (focusing) power. Because no tissue is cut and the eye is not touched by any instruments, the possibility of intra-operative complications, postoperative infections, or risk of healing irregularity that may affect vision is minimized. Keratoconus or conical cornea is a condition in which the cornea progressively thins over time with age resulting in both nearsightedness and irregular astigmatism. We do not know the cause of this problem but believe genetic factors may be involved. We are currently involved in one of the largest clinical studies in the world to determine Genetic Factors in Keratoconus. The best treatment for keratoconus are rigid contact lenses which confers high quality vision for many patients for many years at very little risk. For patients who are contact lens intolerant, cornea transplants are the best option. Because the cornea is avascular, this procedure is highly successful (96-98% success rate) in keratoconus. Other incisional procedures are strongly contraindicated in keratoconus, these include Radial Keratotomy (RK), Astigmatic Keratotomy (AK), Automated Keratomeliusis (ALK) and Laser-in-situ Keratomileusis (LASIK). Disastrous results have been observed and reported in patients with keratoconus undergoing these incisional procedures. We recommend all patients considering PRK or LASIK in Santa Clarita, Lancaster, Los Angeles and the surrounding area undergo screening with corneal topography to rule out early forms of keratoconus, since they may be unhappy with the outcomes of their surgery if these conditions go undetected. We are currently performing a small clinical trial to determine the efficacy of Excimer PRK in patients with "early keratoconus". To qualify for this study you have to be over 40 years of age, have had no change in refractive error for 5 years, no slit-lamp signs of keratoconus, be contact lens intolerant, understand that you are at increased risk of scarring, no guarantee of improved vision after surgery and may need a cornea transplant after surgery. To determine if you qualify call to schedule an appointment with our study coordinator Diana Remba at (310) 423-9642 or visit www.keratoconus.com This study is
being performed based on preliminary results from For patients
who do not want to assume the risk of a cornea transplant we are performing
INTACS. With this procedure the shape of the cornea may be modified in such a
way as to make a contact lens intolerant person more contact lens tolerant.
Recent studies in
At Laser Eye
Associates, The Sunrise LTK Holmium laser is designed specifically for individuals with low hyperopia and those needing glasses for reading and does not touch the eye or the center of the cornea. In addition, we offer INTACS a reversible procedure for patients with low myopia and Keratoconus avoiding any surgery on the center of the cornea. Most laser centers use a blade in the microkeratome to create the flap. This device costs $60,000, we have 3 different ones. Despite this we invested in a laser which costs $500,000 to create the flap because we believe this will bring added safety to your procedure. Centers who don't offer this technology will try and talk you out of it merely to save money, we believe that when it comes to the safety of your eyes money should not be the issue. For more information about this advanced bladeless technology, visit the LA IntraLase page. It is often a difficult choice for any patient to decide which is better, PRK or LASIK, each patient has different needs and depending on your needs it is best to discuss the options with your surgeon and jointly decide which is best for you after the pros and cons of each procedure have been explained to you. We perform both procedures routinely in our facility and would be happy to discuss the best option for you. Most patients tend to choose LASIK because of the quick recovery and absence of pain. Those with low corrections and scared of the potential complications of LASIK can choose either INTACS (for low myopia) or the Sunrise LTK procedure (for low hyperopia). Dr. Rabinowitz is a very experienced refractive surgeon who also helps Lancaster, Santa Clarita and Los Angeles corneal transplants patients. As chief of Ophthalmology at Cedars-Sinai, when LASIK was first FDA approved, he has had extensive experience with all the lasers and has taught many other doctors how to use these lasers and new equipment. Dr. Rabinowitz has performed refractive surgery for the past thirteen years since completing his Refractive Surgery fellowship at USC in 1989. For more information about Dr. Rabinowitz, click here. Cedars-Sinai has built its reputation on quality care and research and is now
recognized both locally and internationally as one of the finest medical
institutions in the world. The first Laser Vision Correction procedures in
the
The results have been excellent. 20/40 vision is the vision required to get a drivers license and perform most daily functions without the aid of glasses or contact lenses. In our practice more than 99% of our patients get 20/30 or better vision and 75%-80% get 20/20 or better vision. Most people who are corrected for distance vision will need glasses for reading when they reach their mid-forties. Monovision is a solution to overcome this problem so that you won't need reading glasses when you get to this age. I recommend this to all my patients over age 40 and 9 most tolerate it very well. This involves under-correcting the non-dominant eye and leaving it a little nearsighted, just good enough for reading while correcting the dominant eye fully for distance. The nearsighted eye is then used for reading. This eye can still see well in the distance but not as good as the dominant eye. The brain then uses one eye for distance and one eye for reading, i.e., when you look into the distance, the brain sees the way the better eye sees ignoring the nearsighted eye and when you look close by, the brain sees the way the near eye sees and ignores the distance eye for reading. While this might seem confusing, surprisingly most patients cope very well with this kind of correction. To determine whether this type of treatment is for you, you can come into our office for a complimentary screening and we will fit you with a contact lens to simulate this type of correction. If after using the contact lens, you feel you can cope quite well with this solution, you can then go ahead and plan for permanent monovision correction with the Excimer Laser or with the Holmium Laser (LTK procedure). We understand that for many people who want Laser Vision Correction, money is a major obstacle since insurance does not cover this procedure. While we do not discount our prices, we offer several attractive financing plans independent of your other credit to make this procedure affordable. We often finance directly through our office with no interest and laser eye surgery can be done for as little as $99 per month. For financing options click here. We have operated on many different types of athletes and have found individual needs different depending on the type of sport played. For instance, tennis players prefer not to have monovision while policemen who shoot as a hobby tolerate monovision very well.
Email contact: rabinowitzy@cshs.org |
|
Laser Eye Surgery Web Marketing powered by Ceatus Media Group LLC |
