Archive for the ‘Uncategorized’ Category
Sunday, January 22nd, 2012
Today we use centuries old technology to determine what eyeglasses to prescribe eyeglasses and contact lenses for patients. A series of different powered lenses are held in front of a patient’s eye and the patient is asked to judge, subjectively, which lens makes their vision clearer. “Which is better, one or two?”. The patient guides the doctor to the prescription that allows them to see best in medicine’s version of “hotter or colder”. Most of the time, the result is successful, but occassionally the result is a prescription that the patient can’t wear. In this scenario, glasses are simply remade. But this ancient technique of determining prescriptions is also used in standard and wavefront-optimized LASIK eye surgery. The result of an incorrect prescription determination used in LASIK eye surgery is also a “remake”, but this remake is a second eye surgery. This aspect of pre-operative planning before LASIK eye surgery points out but a couple of advantages of wavefront-guided LASIK over conventional or wavefront-optimized LASIK.
In wavefront-guided LASIK, a wavefront analyzer is used to determine the treatment. This takes away the subjective nature that can be affected by patient fatigue, fogged lenses, rash or hurried judgement or indecisiveness. How much better is wavefront analysis over conventional means of determining prescriptions? Twenty five times more accurate. And the affect on “do-overs”? About four times less likely. Wavefront-guided LASIK yields better results than wavefront-optimized LASIK. Don’t be fooled by confusing by centers that advertise “wavefront LASIK”. Insist on wavefront-GUIDED LASIK.
How good are you at determining which is better?
A wavefront analyzer is used to determine treatment in a wavefront-guided LASIK.
Tags: lasik, wavefront-guided LASIK, wavefront-optimized LASIK
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Sunday, January 8th, 2012
Someone has to offer the best product. But everyone has competition. And, no one has a monopoly on products and services. So if there is always a best, how do competitors continue to stay in business? By distracting the consumer by focusing on some other factor other than quality such as price or convenience and unfortunately at times, by misrepresenting or making false statements.
We have seen some of our competitors make the claim that they offer the best LASIK technology at the lowest price. Obviously if this was true, we would be out of business.
The two things most important in LASIK is safety and results. We have invested in the technology that has proven to be the safest with the lowest risk of complication. In addition, our technology offers the highest rate of 20/20 vision results. So if these two facts are true, what criterion is a competitor using to claim “being the best”?
We will readily admit that it is possible to offer a lower price by using less expensive technology and a lesser level of service but we challenge any competitor to back up their claims of being better with hard data. We have the proof and authoridative data to back our declaration of superiority. All they have are hollow assertions.
Would you buy a Rolex from this man?
Tags: lasik
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Sunday, September 18th, 2011
LASIK may not be your best option.
Some patients are great candidates for LASIK: they have an eyeglass prescription associated with a high success rate, they have no contradictory conditions and they have reasonable expectations. Other patients may not be a candidate for vision correction surgery and another, third group of candidates may be described as “iffy”. We’ve seen a number of these patients over the years. Many are seeking a second opinion or may have some misconceptions about LASIK eye surgery and need to be educated on why they are not ideal candidates.
The unfortunate truth is that LASIK cannot correct every vision malady. There are some prescriptions that cannot corrected with final good optical quality and there are some eyes for whom LASIK is not suitable and can even be dangerous. Most reputable LASIK providers will not offer surgery to patients when it is clearly contraindicated. Of course, there are various shades of gray. Some eyes may have a reasonable chance of having good results from LASIK but may not be ideal. Now suppose you are a “LASIK-only” provider dependent on high volume in order to be financially viable. Chances are you will be tempted to offer LASIK to a patient with less than perfect credentials under the assumption that the odds are in your favor.
But what if you were the patient? Wouldn’t you want to know that you were a less than ideal LASIK candidate and be interested in hearing about other procedures offering a safer side-effect profile and higher success rate? Today there are numerous options, besides LASIK, that are available to reduce dependence on glasses. Some of these options include PRK, OmniLase, Implantable Contact Lenses, CK and Refractive Lens Exchange. To insure you are offered all available vision correction options, our advice is to seek the opinion of a surgeon offering various procedures. Listen carefully to the risks and side effects of each option. If LASIK is “iffy” you might just want to cross it off your list and choose a procedure more suitable to you and your particular vision problem.
Tags: complications, Implantable Contact Lenses, lasik, OmniLase, PRK, side-effects
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Sunday, July 24th, 2011
Most patients appreciate the improved safety afforded by the IntraLase laser in creating the flap during the LASIK procedure. An additional benefit of the latest model of IntraLase laser is the reduction in both severity and duration of dry eyes after LASIK.
Our last blog post discussed the mechanism of dry eye production from LASIK. Dry eye symptoms result from the severing of corneal nerves during the procedure. So how can the iFS minimize dry eye? By limiting the number of severed nerves and promoting quicker healing of the cut nerve fibers.
An Oval LASIK flap with a wider hinge will help to minimize dry eyes from LASIK
Like all lasers used to create corneal flaps, the iFS has the ability to create very thin flaps which helps to limit the number of cut corneal nerves. The IFS, in addition, has a unique surgical planning dashboard and customization features not available on other lasers. Surgeons using the iFS have the capability to create oval shaped flaps with wider hinges that are just large enough to cover the dilated pupil. This insures that an unnnecessarily large number of nerve fibers are not cut thus minimizing dry eye symptoms.
In additon, the iFS has the ability to create an inverse beveled flap edge assuring near-perfect alignment of the flap. Because the two ends of the cut nerve are apposed closely to each other, the nerve has only a short distance to grow before healing back together.
Thinner smaller flaps and wider hinges minimizes the invasiveness of the LASIK procedure which in turn minimizes the severity and duration of dry eye symptoms from LASIK. Dry eyes often last several weeks after a LASIK procedure and are an almost universal side-effect. If you are concerned about dry eyes and wish to limit its severity choose thin-flap LASIK with the iFS laser. And if you live anywhere near Raleigh NC there’s only one place to get this procedure: the Laser Eye Center of Carolina.
Tags: dry eye, ifs, intralase, lasik, NC, raleigh
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Thursday, July 14th, 2011
The LASIK procedure may cause many patients to experience dry eye symptoms after their surgery. This is especially true if there was 
tendency toward dry eyes before LASIK. But why do so many patients experience dry eyes after LASIK? The first step of the LASIK procedure is the creation of a corneal flap, a thin layer of tissue under which laser pulses are applied to reshape the cornea in order to correct nearsightedness, farsightedness and astigmatism. Anatomically, when the flap is created, the very fine cornea nerves may be severed as part of the LASIK procedure. These nerves detect how wet the eye is and signal the lacrimal gland to produce tears. So, sometimes, the temporary interruption of the corneal nerve impulses can actually cause a lesser amount of tears to be produced, resulting in dry eyes after LASIK. If the Dry Eyes after LASIK are moderate or severe, your vision may actually be blurry due to the tear film instability. Because normal sensation may not be present as a result of severed corneal nerves patients may not feel the sandy, gritty sensation normally associated with dry eyes. Fortunately, virtually all dry eyes symptoms after LASIK are temporary and gradually decrease over time as the corneal nerves grow back. Most patients will have a resolution of dry eye symptoms within a few months of having their LASIK procedure. In some extreme cases, symptoms may persist for over one year. All LASIK patients will need to use lubricating drops frequently during the first few weeks after their LASIK procedure. Other measures are occasionally necessary to improve comfort and visual clarity. These include the use of oral Omega 3 supplements, punctal plugs and prescription eye drops such as Restasis. During your consultation it is important to disclose any symptoms you may have of dry eyes and to disclose any medications you are taking that might predispose you to dry eyes after your LASIK procedure. Your LASIK surgeon can then take the necessary steps to prepare you for your LASIK procedure and minimize the severity of dry eyes from LASIK. Working together with your surgeon will maximize your chances of a smooth post-operative course and allow you to obtain the best possible results from your LASIK procedure. Watch this blog for further tips on how to minimize symptoms of dry eyes after LASIK.
Tags: dry eyes, lasik, omega 3, restasis
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Sunday, July 3rd, 2011
Consider LASIK Alternatives
This Independence Day got me to thinking about patients and their desire to be independent of their eyeglasses. For patients seeking LASIK, often there is a ‘tipping point’ such as a contact lens related problem or it’s time to go in for their exam with the prospect of exam fees, contact lens fitting fees and the purchase of new glasses or contact lenses. Sometimes the patient just got back from a vacation or participated in an event where glasses got in the way. Or maybe the patient just got tired of pushing their glasses up their nose, putting in their contact lenses every morning or waking up unable to see. This is the point where they come in to see me. Often they are happy with what I tell them but a significant number are disappointed to learn that LASIK may not offer them everything they are looking for or is just not advised.
LASIK is a great procedure and has been around for a number of years. However, there remains a very specific ‘subset’ of patients for which LASIK is ideal. This subset includes patients between the ages of 18 and 40 without pre-existing dry eye problems, keratoconus or certain other eye diseases. The patient may have small amounts of farsightedness, or nearsightedness and/or astigmatism below a certain amount. Now don’t misunderstand me, almost half of my LASIK patients are not in this ideal category (usually because they are over the age of 40) but what I am saying is that patients who are not ideal may want to consider LASIK alternatives like Visian Implantable Contact Lenses, PRK or refractive lens exchange. The alternative is to accept certain compromises: an example might be the need for reading glasses.
The Laser Eye Center of Carolina offers more than just LASIK because LASIK is limited in who can benefit from the procedure and what it can offer. If you have a desire to become independent of glasses, consider all your options: not just LASIK.
Tags: contact lenses, eyeglasses, independence, Laser Eye Center of Carolina, lasik, PRK, visian
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Thursday, June 9th, 2011
An inverted bevel can only be created by the iFS laser. It is the most secure flap for LASIK.
This is a BIG deal! We’re proud to announce that we are the proud owners of the first iFS femtosecond laser in North Carolina. The iFS laser is a fifth generation IntraLase laser. IntraLase lasers are now commonly used in LASIK eye surgery. The iFS model of IntraLase laser has some unique capabilities applicable to LASIK but also to other types of eye surgery.
IntraLase lasers have revolutionized LASIK eye surgery by replacing an oscillating metal blade with a laser to create the corneal flap: the first step in the LASIK procedure. Use of the IntraLase laser has dramatically reduced the incidence of LASIK complications. Clinical studies performed by the Department of Defense using the IntraLase laser has led to the acceptance of the LASIK procedure by the military for combat troops, pilots and even astronauts. The IntraLase method is now the dominant method for performing refractive surgery by US physicians making up an estimated 61.1 percent of all U.S. LASIK procedures.
The iFS laser is a significant upgrade to its predecessors with more advanced capabilities. It is faster with the ability to cut complex shapes. We will be using the iFS to perform LASIK as well as other eye surgeries including corneal transplants. A unique capability of this laser is the ability to create matching incisions that form ‘lock-tight’ or ‘zipper’ closures. This ultimately leads to a safer procedure and better results.
Of course we’re no strangers to innovation. Our medical director, Dr. Dean Dornic, has been performing LASIK eye surgery and corneal transplants in the Raleigh-Durham NC area since 1998. He has been performing IntraLase all-laser LASIK procedures since 2005 and is acknowledged as the first Raleigh area ophthalmologist to perform IntraLase. Dr. Dornic has adopted newer technology as soon as clinical benefits were demonstrated. In the case of the iFS clinical studies prove that this technology leads to maximum flap stability and a lower incidence of certain side-effects such as dry eye. Patients also demonstrate better outcomes and quicker vision recovery.
Tags: Dr. Dean Dornic, femtosecond, ifs, intralase, lasik, NC, raleigh
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Wednesday, May 25th, 2011
LASIK will save you money over the cost of contact lenses.
One of the most common barriers to vision correction sited by patients interested in LASIK is cost. But LASIK eye surgery, compared to contact lens and eyeglass correction of vision is actually a more cost effective option. Consider the cumulative cost of contact lenses and extra office visits/contact related fitting fees as well as backup eyeglasses over the course of several years and it can be astounding how quickly the total price tag of vision prosthetics adds up. Over the course of a decade or more of vision correction, the cost differential between LASIK eye surgery and contact lens correction can amount to thousands of dollars. Of course, the younger the patient, the more impressive the savings but, even older individuals can benefit financially. And, the cost differential included in this article include only direct costs: they don’t take into account the cost of time spent in doctor’s offices, purchasing lenses and glasses, inserting and removing contacts or lost time related to contact lens related infections or other difficulties. If you have a productive business or career, time lost from income producing endeavors translate into even more lost dollars than the examples illustrated here.
How much money are we talking about? Well, for a patient in their forties, LASIK vision correction surgery, on average, will save the typical patient $10,000. A patient in their twenties will save even more: about $25,000. AMO has developed a savings calculator that you can use to estimate the cost effectiveness of LASIK eye surgery compared to contact lenses.
Now, let’s say you’re convinced of the financial wisdom of correcting your vision rather than monthly “rent” of vision through the purchase of contact lenses and related services. Even the most convinced investigator may simply not have the $4000-$5000 necessary to pay for LASIK eye surgery at their disposal. Does that mean you should continue expenditures for contact lenses until you can accumulate the total necessary to pay for the procedure? For most people the answer is no. Consider applying what you normally are paying for contact lenses and related services and applying that amount toward your LASIK eye surgery. If your credit is reasonably good, most LASIK surgeons can arrange financing for your procedure: and, as illustrated earlier, the sooner you can stop paying for contacts, the more your savings.
Hesitant to take on more debt? Well, while we admire your frugality, the argument about avoiding debt really only holds water when talking about certain luxury items. Most people will not continue paying rent until they can afford to pay cash for their house because it does not make financial sense to do so. The same is true for LASIK eye surgery if you view it as an investment designed to save you money over years.
So if you’ve been considering vision correction surgery, cross “cost” off your list of excuses for postponing your procedure. Contact us for a free consultation and we’ll help develop an affordable plan for losing your dependence on glasses and contact lenses. The sooner you have LASIK or other vision correction procedure, the more you’ll save and the sooner you can begin to enjoy visual freedom.
Tags: contact lenses, cost, lasik
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Sunday, May 1st, 2011
There is no such thing as any medical procedure that is completely risk free. If you are considering vision correction, obviously your number one concern is safety. But how do you make sure you have done everything possible to minimize the risk of LASIK? And why do some patients suffer from complications?
The first thing to understand is that the risks of LASIK are not the same for every patient. Some patients may inherently have a higher risk of certain complications such as infection, flap complications, healing problems, dry eye and night time driving difficulties. It is important that you have a preoperative evaluation by a qualified physician experienced with the LASIK procedure to insure that pre-existing conditions that increase the risk of a LASIK procedure be identified. For some patients, the risks can be minimized with preoperative measures such as initiating Restasis therapy before the procedure. For other patients, the risks associated with the procedure may just be too great. There are several alternative procedures, such as implantable lenses or refractive lens exchange that may be a better fit.
The other thing to know is that not all LASIK surgeons and LASIK technology are equal. Optimizing your chance of success requires choosing an experienced surgeon and choosing the technology associated with the lowest risk. There are two steps to the LASIK procedure and there now exists technology designed to improve the safety of both steps. The IntraLase laser to make the LASIK flap is the safest way to achieve this step. The IntraLase laser decreases the risk associated with flap creation and in addition decreases the risks after flap creation (such as flap displacement and dry eye). CustomVue technology by AMO is the cornea reshaping technology designed to maximize vision quality and decrease the risk of night time glare and halos. When IntraLase is combined with CustomVue, the resulting LASIK procedure is termed “iLASIK”. Potential LASIK patients can therefore minimize the risks associated with a LASIK procedure by 1. Insuring they are evaluated by an experienced surgeon who performs alternative procedures to LASIK and 2. Looking for a surgeon who performs “iLASIK”. Looking for someone in the Raleigh area that meets these requirements? See Dr. Dean Dornic at the Laser Eye Center of Carolina. iLASIK Procedure on YouTube
Tags: Dr. Dean Dornic, ilasik, intralase, Laser Eye Center of Carolina, lasik, LASIK complications, Lasik Risks, raleigh
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Sunday, April 17th, 2011
“When I went for my consultation they told me I might have LASIK or I might have PRK depending on what the surgeon says,” said the exasperated patient sitting in our exam chair. That’s because when the patient went for their consultation, they didn’t actually meet with the surgeon: they met with a technician who was not qualified to make a decision as to the suitability for LASIK. We have heard similar stories of patients who were canceled or had their procedure abruptly changed on the day of the procedure when the surgeon recognized that their patient, scheduled for LASIK, was actually a poor LASIK candidate. This type of scenario is much more likely to play out at a discount LASIK center where LASIK is performed on everyone unless a specific contraindication is detected.
But today there are a number of refractive surgery procedures and the best strategy is to select the procedure that is safest and most likely to result in a successful outcome. Sometimes a patient is a good candidate for more than one procedure and a discussion of different potential side-effects, expected longevity of the procedure and costs would be appropriate. Obviously it is poor form to operate on a patient never examined by the surgeon as this increases the possibility that something might be missed. In addition, the patient may be placed at a disadvantage if the procedure to be performed on them is sprung on them moments before the scheduled surgery time.
Our advice? Meet the surgeon. This gives you the opportunity to evaluate and feel comfortable with the individual who will be performing surgery on your eyes. You will have the assurance in knowing that a qualified doctor was able to judge the appropriateness of your eyes for surgery and had an opportunity to select the best treatment for your particular vision problem. It will also give you the opportunity to ask questions and feel comfortable that you are fully informed of your choices, risks, side effects and expectations. At the Laser Eye Center of Carolina, we perform a number of different vision correction procedures and every patient is personally examined by Dr. Dornic. Before you leave the consultation, you will have a thorough understanding of your options and have an opportunity to digest the information before making a final decision. Second thoughts or forgot to ask something during the consultation? Every patient gets Dr. Dornic’s email address and, of course, phone calls or return office visits are always welcome. We want you to feel just as good about your decision to have vision correction as we feel confident in our ability to deliver excellent results.
Tags: contraindications, fully informed, lasik, meet, options, PRK, surgeon
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