Posts Tagged ‘lasik’
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
Posted in lasik, Uncategorized | No Comments »
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
Posted in Uncategorized | No Comments »
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
Posted in lasik, Uncategorized | 1 Comment »
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
Posted in lasik, Uncategorized | 3 Comments »
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
Posted in Uncategorized | No Comments »
Sunday, March 13th, 2011
CustomVue technology actually increases patient night vision satisfaction.
- Night glare and starbursts are a potential side-effect of any eye surgery.
Many people who have never had eye surgery, if they are careful observers, can notice some starburst, halo, glare, or shadows in their vision under low light conditions, especially if they need to wear glasses or contact lenses. It is common to notice one or more of these after LASIK eye surgery, especially during the early postoperative period. These side effects generally diminish with time but some patients will notice one or more of these even with excellent correction, sometimes for a long time or even indefinitely. Of those patients who do notice these side effects, most will find them annoying and it is possible that some patients may feel they cause mild to serious visual impediments.
The LASIK procedure creates a change in curvature in the central part of the cornea. If changing the corneal curvature also results in distortion of the cornea then aberrations in vision quality may result. These aberrations in vision may be most noticeable at night, when the pupil opens wide. This can result in seeing a halo type effect or perhaps just a decreased contrast or sharpness of vision. Regardless of how it is described, there are some patients who feel that their night or reduced light vision is poor even when their uncorrected vision is good or excellent in normal lighting. This may be a significant issue for some patient for night driving, playing tennis or baseball at night or other similar activities, even before refractive surgery is performed. A technology developed by AMO/VISX termed CustomVue and utilized in the iLASIK procedure was developed in an effort to improve night vision. The CustomVue technique makes use of a wavefront analyzer to measure and correct visual aberrations. Clinical studies show that more patients are actually satisfied with their night vision after LASIK when this technique is used. The wavefont guided CustomVue technique should not be confused with the wavefront optimized technique utilized by the Wavelight/Allegretto laser. Only the CustomVue technology associated with iLASIK results in better night vision.
Tags: customvue, glare, halos, ilasik, lasik, night vision, side-effects, starbursts, wavefront
Posted in lasik, Uncategorized, wavefront | 1 Comment »
Saturday, March 5th, 2011
One of the most common phrases we hear is “I’d like to have my vision corrected but I’m afraid to have LASIK”. Patients verbalize a fear of having an eye procedure because they are afraid of the risk of vision loss. There is not much worse fate one can imagine than to have to go through life blind or with greatly diminished vision. Some patients may even relate the story of “a friend of an acquaintance” that they ‘heard’ had vision loss from a LASIK procedure but yes, everyone that they know who had LASIK seems to be doing just fine. Just like many urban legends, the details of this alleged vision loss are not really known by the reporter.
Yes, there are cases of patients who have lost vision from LASIK; but those cases are exceedingly rare, and, with advances in technology, becoming rarer. Most patients are surprised to hear that the risk of vision loss is actually greater from contact lens wear than from LASIK. You mean you can lose vision from contact lenses? Yes, and every year patients, some of who were afraid to have LASIK, lose their vision from contact lens associated corneal infections.
So, if you don’t want to wear glasses or find they interfere with your ability to function in your job or leisure activities, making the transition from contact lenses from LASIK really does not increase your risk of vision loss. And, as numerous studies bear out, actually saves you money in the long run.
How then do you maximize your chance and minimize your chance of vision loss from a LASIK procedure? Well, first make sure you actually are a good LASIK candidate. Go to a surgeon who can offer more than just LASIK. If you are not an excellent LASIK candidate,just don’t have it: do something else like implantable contact lenses or advanced surface ablation. If you are a good candidate, make sure you are being offered the best and safest technology. IntraLase LASIK has been shown to be the safest LASIK technology for the great majority of patients so insist on this. The decision to have vision correction is one of the most important decisions you will make in your lifetime so why would you go to someone who offers only LASIK and worse yet, why would you choose someone because they offered the lowest price? Over the years, thousands of Raleigh are patients have chosen Dr. Dean Dornic of the Laser Eye Center of Carolina. His opinion can be trusted because he can offer more than just LASIK. To make an appointment for a free, no obligation consultation just call 1-888-376-EYES and we’ll get you started on the road to visual freedom.
Tags: contact lenses, fear, infection, intralase, lasik, raleigh, safest, vision loss
Posted in lasik, Uncategorized | 1 Comment »
Monday, February 14th, 2011
Medicine is a rapidly changing field. LASIK eye surgery has changed a lot since I was first trained in this technique 13 years ago. Back then, LASIK flaps were all made with bladed instruments either on gears or rails and surgeons had to be adept at centering the laser on a moving pupil with a joystick device. Over the years the technique, technology, our understanding on who is a good candidate and management of side-effects have all evolved. As a result, the procedure has been made safer, side-effects have been minimized and the overall quality of vision along with patient satisfaction all have increased. A LASIK eye surgeon who fails to keep up with the changes in the vision correction field does a disservice to his patients by cheating them out of the tremendous improvements in results and safety. One of the ways of achieving continued competence is through reading: and there is a tremendous amount of articles written and available in books, professional journals and on line. On-line bulletin boards and forums are another way to share and gain valuable information. One of the best ways to advance knowledge is through professional meetings or “conventions”. Such meetings allow innovators to present their work and allow attendees to question and challenge presenters.
But attendance at such meetings requires time away from the office. An efficient way to minimize practice down time is to combine continuing education with vacation time and that is precisely what I did this Valentine’s weekend. You see, Valentine’s is a special time for my wife and I. Our first date was on Valentine’s Day. As a young college student, I finally got the nerve to ask my wife out. I prepared a home cooked meal and took her to a $2 movie on campus. This weekend, we celebrated with a long weekend in St. Thomas where there just happened to be a great ophthalmology meeting: the Caribbean Eye Meeting. So I woke up early and attended courses and lectures from 7AM until noon, then spent the rest of the day enjoying the island. I took home some great new information on LASIK and other eye surgeries plus I got my batteries recharged. How did I find time to write this blog? Well, I’m writing this well waiting for my flight from Miami to Raleigh. Hope you enjoyed your Valentine’s Day as much as we did.
View from our hotel window
Tags: lasik, meetings, raleigh, safer, side-effects
Posted in lasik, Uncategorized | No Comments »
Monday, February 7th, 2011
The first step of the LASIK procedure is to create a “flap”. The flap can be created by several different instruments including a microkeratome which is an instrument with a blade to cut a thin sheet of the cornea or a femtosecond laser which creates a flap through photodisruption and tissue separation. The creation of a flap does not contribute to the correction of refractive error. The LASIK flap simply serves as a lid under which the reshaping of the cornea takes place. Although the creation of a flap with a microkeratome (blade) is generally safe and for many years was the only way a LASIK flap was made, if a complication occurred during a LASIK procedure, it almost always was related to this first step of flap creation.
The IntraLase femtosecond laser was introduced as a safer way to create a flap several years ago. It offers unparalleled safety because it offers more precise thickness settings, is more customizable, is unaffected by the shape of the patients cornea, allows the surgeon to visualize flap creation and offers a “second chance feature” In addition the flap parameters can be adjusted to create a “manhole” configuration that causes the flap to fit snug decreasing the risk of flap slippage.
Raleigh LASIK patients may be confused by “cut-rate” LASIK centers offering blade-free or All-Laser Z-LASIK assuming this is the same as IntraLase. While Z-LASIK is indeed blade-free and does offer precise thickness settings like IntraLase, it offers none of the other safety features ie customization, lack of variability related to an individual patients starting cornea shape, the surgeon can not watch the flap being created and there is no second chance feature: basically you have only one chance to get it right.
Another important difference between the two types of flap-making lasers used in the greater Raleigh area is that a Z-LASIK flap is a single plane cut just like that created by a microkeratome blade whereas the IntraLase has a customizable side cut by which the surgeon can create a “lock-top”. This means the IntraLase flap is more secure against displacement from eye rubbing, squinting and squeezing during the first several hours after the procedure. The flap is also more secure from trauma in the months and years after the LASIK procedure.
So don’t be fooled into thinking all LASIK procedures are the same or that all Blade-Free LASIK procedures are the same. Many patients seek out our services over cheaper providers because they took the time to study the difference in technology and value their safety over a couple hundred dollars in savings.
The Intralase flap fits more securely.
Tags: flap, intralase, lasik, microkeratome, raleigh, Z-LASIK
Posted in Uncategorized | No Comments »
Sunday, January 23rd, 2011
Like many medical procedures, LASIK eye surgery has evolved and improved with time. Many patients are surprised to find out just how long LASIK has been around.
In 1949 a Columbian ophthalmologist by the name Barraquer performed a corneal procedure to correct refractive error termed automated lamellar keratoplasty (ALK). ALK involved the use of a microkeratome to create a flap and remove a disc of corneal tissue in order to decrease nearsightedness.
With the introduction of the excimer laser to the ALK procedure the name of the procedure was changed to LASIK. The excimer laser made the procedure more precise and resulted in more widespread acceptance but this was, by no means, the only important advance in vision correction technology. Over the years, a number of innovations such as eyetrackers, iris registration, wavefront technology and introduction of the IntraLase laser have improved safety and outcomes.
Today, the safety of LASIK exceeds that of contact lens wear and the risk of such side-effects as night halos is reduced to such a low level that most patients will actually experience an improvement in night vision.
Of course, patients should be aware that there are different technologies available all with different safety profiles and success rates. Some of the more important innovations: IntraLase and CustomVue are associated with increased costs but if you’ve been holding off on LASIK waiting for the procedure to get better, the increased costs may well be worth it.
Tags: complications, Cusomvue, excimer, halos, intralase, lasik, safety, side-effects, wavefront
Posted in Uncategorized | No Comments »
