Category Archives: Current News

Eye-opening facts on cataract surgery


I REFER to the letter “Laser procedure involves extra cost and time” (The Star, March 6), expressing concerns over the report “Cataract surgery safer with laser” (The Star, March 4). The concerns focused mainly on the writer’s disbelief that Femtosecond Laser Assisted Cataract Surgery (FLACS) is safer or faster than the conventional Phacoemulsification Cataract Surgery (Phaco).

I have been an eye surgeon since the early 1990s. Over the years, I’ve witnessed the emergence of many surgical technologies in Asia including FemtoLASIK, Implantable Contact Lenses (ICL) and various cataract surgery technologies.

Though Phaco would become the standard of cataract practice worldwide after its introduction in 1967, much has changed since then. Phaco involves the surgeon manually creating cuts, openings and breaking the cataract with metal blades and instruments, which was ironically explained to patients as “laser” eye surgery.

FLACS resulted from the success of femtosecond laser technology used in laser eye surgery (Lasik) to create Lasik flaps in 2001. Similarly, when first introduced for Lasik, disbelieving surgeons continued to use blades to make Lasik flaps. Now, however, most Lasik centres use femtosecond laser technology for Lasik procedures, becoming the gold standard for it worldwide.

Approved for use in cataract surgery in 2009, FLACS effectively replaces some key steps performed manually by the surgeon during Phaco. This includes creating corneal incisions, opening the anterior lens capsule (capsulotomy) and dividing the cataract into smaller portions (lens fragmentation). FLACS is also able to correct astigmatism, the major cause of blurred vision.

Emergence of FLACS has changed cataract practice worldwide, allowing the surgeon to perform cataract surgery in a more predictable and precise manner. This increases the likelihood of getting the best outcome and safety, especially with complex cases.

More importantly, most of the procedure is completed before the surgeon even attempts to go into the eye – which is only possible with a laser.

In over 4,000 cases performed in my practice alone, FLACS proved to be highly beneficial for both surgeons and patients and without any significant complications or side effects. FLACS continues to improve alongside technological advancements, shortening the learning curve for surgeons and improving its outcomes.

Many of the reported risks stated in the aforementioned letter were transient (temporary) and mostly resolved now. FLACS incisions are rendered more accurate, predictable and reproducible. Moreover, the new-generation low pulse energy femtosecond laser enables the surgeon to easily open the corneal incision without a surgical blade (hence the term “no-blade cataract surgery”).

Though Phaco may take 15 minutes for experienced surgeons, the majority of cases may be longer, depending on the type of cataract and other factors. A surgeon may require minutes to break a mature cataract into pieces before its removal, but the laser is able to do it within seconds. In our practice, experienced surgeons have averaged around 15 minutes per surgery with FLACS.

In terms of complications and side effects, both FLACS and Phaco share similar incidences. However, FLACS remains a safe procedure for cataract treatment even for glaucoma patients. Prospective and randomised studies show that although there is a rise in intraocular pressure (IOP) when using a vacuum suction cup during FLACS, the effect was transient and well tolerated (not dangerous).

Furthermore, newer FLACS platforms have not only lowered IOP elevation rates but also reduced incidence of eye inflammation after surgery.

Advancement in FLACS technology has also enabled surgeons to create smooth-edged cuts, minimising the risk of radial tears. Additionally, with the liquid immersion interface, incidence of incomplete capsulotomies are eliminated, further reducing the risk of capsulotomy breakages.

With the OCT, capsulotomy has been rendered more precise and centred, resulting in better visual results especially for premium lenses such as multifocals and, more recently, trifocals.

Many clinical studies incorporating advancements in technology, techniques and data in FLACS have emerged to verify the efficacy and benefits outlined above. Scientific literature on FLACS has provided over 250 peer-reviewed articles including randomised controlled trials, cohort studies, case reports and editorials by reputable experts and research bodies. This ensures balance and objectivity in the analyses of FLACS.

This is important as the use of any one study, without taking into account their design and/or sampling methods, may result in potentially misleading impressions and/or conclusions.

For example, the letter quoted the 2016 European Registry of Quality Outcome for Cataract and Refractive Surgery (EUREQUO) study as the largest in the world comparing FLACS and Phaco to date. In truth, this registry-based EUREQUO study compared only 2,814 FLACS eyes and 4,987 Phaco eyes (total of 7,801) and not 20,000 patients as stated.

After an even larger study (9,400 FLACS vs 8,779 Phaco cases), renowned ophthalmic surgeon Dr Thomas Kohnen reported in February 2017 to an international ophthalmology conference that FLACS does have better visual results and overall superior safety profile.

As the number of younger patients increases, expectations of their cataract surgery have also increased significantly. Mostly still working and more knowledgeable, their desire for spectacle-independence, better surgical results and faster recovery drives them to search for better technology and treatments.

While new technology comes with added cost, nonetheless we need to weigh it against the benefits it brings. Furthermore, as with any technology, there will be continuous improvements that render it even more effective and accessible to all.

Though most surgeons in Malaysia still use conventional Phaco, it does not mean they don’t agree that FLACS has its advantages. The major barrier to ultimately accepting FLACS is the high investment in time and money needed to implement it. In a time of evolving technology, it is our responsibility as medical advisers to guide patients with proper, updated and appropriate information to allow them to make informed decisions.

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How Long Does LASIK Last?

A patient undergoes LASIK surgery. BSIP/UIG Via Getty Images

If you’ve ever been saddled with eyeglasses so thick that the lenses look like Coke bottles glasses, you’ve probably considered LASIK surgery (laser-assisted in situ keratomileusis, to give it its full name), a fast, safe procedure that began proliferating throughout the United States in the 1990s. In just a few minutes, LASIK can correct eye problems like myopia (nearsightedness — you can only see up close), hyperopia (farsightedness — you can only see far away) and astigmatism (blurred vision). But some patients notice that months or years later their vision seems to worsen again. So how long does LASIK really last?

First, a little on how it works: In a LASIK procedure, a surgeon uses a high-precision blade called a microkeratome or an ultra-fast femtosecond laser to slice a corneal flap into the eye. Then, she lifts the flap to expose the corneal tissue, while an excimer laser reshapes the cornea by removing unwanted tissue. The flap settles back into place and heals within a few weeks. In the meantime, the patient immediately enjoys improved vision.

“The great thing about LASIK is that the results are permanent in the great majority of cases,” emails Eric Donnenfeld, M.D., an ophthalmologist, who has performed many eye surgeries, including LASIK. “Assuming a stable prescription, patients can expect their vision correction to last until age-related visual changes occur – typically after the age of 45 or 50, when most people will need reading glasses.” But, he said, medical conditions associated with aging, such as cataracts, may change vision many years after LASIK.

In a minority of cases, changes within the patient’s eyes – which would likely occur with or without LASIK – cause a reduction in visual acuity (sharpness of vision). This is called myopic regression. Those changes might happen within a year of the operation, or decades later. A quick touch-up procedure (called LASIK enhancement) often restores visual acuity.

There aren’t a lot of studies on myopic regression. Within a year or two of LASIK surgery, maybe 2 percent of patients need an enhancement procedure, according to the American Refractive Surgery Council. After about a decade, perhaps 10 percent of patients will need an enhancement procedure. Eric Donnenfeld notes that “patients with high refractive errors (very thick glasses) have a greater chance of needing an enhancement.”

According to Dr. Chris Blanton, medical monitor and consultant with Johnson & Johnson Vision, if your surgeon is using an advanced procedure called custom LASIK or wavefront LASIK, there’s a 98 percent chance that you’ll need just one procedure, and that’s it. Wavefront technology creates a 3-D image of the eye to use a guide in doing the LASIK surgery.

Touch-ups aren’t risk-free. “Like any surgical procedure there are risks, for example abnormal healing or infection,” says Blanton by email. But only a tiny number of patients encounter complications.

The eyes of younger patients tend to change more over time, and they’re more likely to notice a bit of blurriness as they age, even if they’ve had LASIK. Older patients’ eyes, and the surgical results, are often more stable, with the exception of presbyopia, the decline in close-up vision that naturally occurs with age and forces many middle-aged folks to wear bifocal glasses. Note that presbyopia comes as a result of changes to the lens of the eye, not to the cornea, which is what LASIK operates on.

Doctors say it’s not realistic to expect your laser-focused eyes to remain perfect for the rest of your life. After all, every part of the human body ages and changes, and the eyes are no exception. If you suffer regression after LASIK, and you don’t want to undergo (or pay for) a touch-up procedure, you’re not alone. Many people opt to wear prescription glasses for driving or reading. And of course, whether you’ve had LASIK or not, a yearly eye exam is a good idea to keep your health and your vision at its best.

Original Source:

Original Date: April 5 2018

Original Author: Nathan Chandler


Remembering the first laser vision correction procedure on its 30th anniversary

Thirty years ago, on March 25, 1988, Marguerite B. McDonald, MD, performed the first laser vision correction procedure on a normal-sighted human eye in Louisiana.

The PRK procedure had been studied in thousands of plastic test plates, both animal and human cadaver eyes, as well as living rabbit and monkey eyes, but had not yet been tested in a living human. However, Alberta Cassady, a 62-year-old woman with cancer of the orbit who needed the eyeball and contents of the eye socket removed, volunteered to allow the team to experiment with the procedure before she lost her eye.

LSU Eye Center used the vivarium at the Delta Primate Center in Covington, Louisiana, and due to the urgent nature of the case, the FDA allowed McDonald to rush Cassady past the monkey cages and perform the surgery on her, according to a press release from Ophthalmic Consultants of Long Island, McDonald’s current practice.

Marguerite McDonald performs PRK surgery on a monkey.

Marguerite B. McDonald performs retinoscopy on a PRK postop monkey.
Photo provided by Marguerite McDonald, MD.

“We watched her heal on a daily basis, right up until the exenteration 11 days later,” McDonald said in an email to “The refractive and clinical results were excellent, and the pathology report showed the healing pattern that we now know so well.”

The surgery and its postop evaluations went so well that the FDA allowed McDonald and her research team, which included Stephen Trokel, MD, Charles Munnerlyn, PhD, and Stephen Klyce, PhD, to immediately start the blind human trials (blind eyes with normal corneas).

Since that initial surgery, PRK and other laser correction procedures have come a long way, evolving dramatically and becoming popular the world over.

“Looking back on the procedure we performed on Mrs. Cassady so many years ago, I am so proud and excited to see how far laser vision correction has come,” McDonald said in the press release.

Cassady lost her battle to cancer, and despite the fact that research centers are usually named after rich donors, McDonald and her team lobbied for the laser facility at Louisiana State University to be named after her.

“Her remarkable bravery and generosity in the face of such tragedy gave us vital information that allowed the FDA to accelerate the approval process,” McDonald said in the email correspondence. – by Rebecca L. Forand

Original Source:

Original Date: March 25 2018

Thoughts On This New Technology?

EyeQue Insight lets you test your vision at home with your smartphone

Originally starting out as a Kickstarter campaign, the EyeQue Insight visual acuity screener is now available for purchase. With the device, you can test your vision whether you’re at home, in school, or on the go.

In 2016, the company released the EyeQue Personal Vision Tracker, which also allows users to test their eyesight with an app and a tool. Rather than goggles, the Personal Vision Tracker consists of a small microscope that you attach to your smartphone.

Due to the global rise in myopia, the company felt it was important to make a device like the EyeQue Insight available to the public. By having access to it at home, parents are able to check their child’s eyesight on a more frequent basis.

“What’s happening is that people, especially kids, are spending a lot of time with their smartphones and it’s close-up. They’re also indoors, so when you have all those things together it’s actually making people more nearsighted,” EyeQue co-founder and Chief Technical Officer John Serri told Digital Trends.

By consulting with different eye doctors, Serri was motivated to find a convenient way for parents to test the visual acuity of their children. With the EyeQue Insight, parents can potentially detect the onset of Myopia from the comfort of their homes.

The device doesn’t tell you exactly what your prescription is, but gives you an estimate of how clearly you can see at 20 feet. Depending on your results, you can then decide whether or not you need to visit an optometrist for further testing. It’s especially useful for those who wear glasses or contacts and want to see if it’s time to update their lenses.

Original Source


LASIK Eye Surgery Market Highlights | Industry Dynamics | Business Overview | Iconic Revenue and 2022 Insight

LASIK Eye Surgery Market Synopsis:

The Worldwide LASIK eye surgery market is expected to improve massively over the projection period of 2018-2022. Experts believe that the market will grow at a CAGR of around 5.9%. At present this industry is valued at a staggering USD 1.4 billion and is projected for growth in near future.

The high growth rate of this market can be attributed to a number of drivers. The rising figures of people getting affected with eye diseases are a major growth factor amongst others. If reports are to be trusted, it is said that above 284.6 million people across the globe suffer from optical disorders. These people get eye diseases due to constant computer exposure, atmosphere changes & modern lifestyle.

LASIK Eye Surgery Market Division:

The global LASIK eye surgery industry is divided into four portions end users, vision errors, types & geographies. On the basis of end users, the market is segmented into eye care clinics, LASIK centers & hospitals. The vision errors section comprises of astigmatism, myopia & hyperopia. Astigmatism is further bifurcated into mixed astigmatism & hyperopic astigmatism. The myopia segment is separated into degenerative, acquired, psuedomyopia & nocturnal. On account of types the market is fragmented into all laser, wave front boosted, topography-guided & wave front guided.

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Regionally the market for LASIK eye surgery spans across many countries. Some of the major ones include America, Europe, Asia Pacific, Middle East & Africa & Rest of the World. Amongst these, Americas is at the forefront in terms of market share. It is because of heightened use of technology, higher number of eye-disease sufferers & better healthcare set ups. After this region, Europe is second in command. Furthermore, the Asia Pacific region is also expected to grow steadily in the coming years.

LASIK Eye Surgery Market Segmentations:

The global LASIK Eye Surgery market is segmented on the basis of types, vision error and end user.

On the basis of the type, it is segmented into the wavefront optimized, wavefront-guided, topography guided, all laser.

On the basis of the vision error, it is segmented into myopia, hyperopia, astigmatism, and others. Furthermore, myopia is sub-segmented as simple, induced or acquired, pseudomyopia, nocturnal, degenerative, and others. Hyperopia is also sub-segmented into physiologic hyperopia, pathologic hyperopia, and others. Astigmatism is sub-segmented into myopic astigmatism, hyperopic astigmatism, mixed astigmatism, and others.

On the basis of the end user, it is segmented into hospitals, eye care clinic, LASIK centers, and others.

LASIK Eye Surgery Market Regional Analysis:

The Americas dominate the Global LASIK Eye Surgery Market owing to well-developed technology, increasing population affected with vision problem, high healthcare spending, and increasing government support for research & development. Furthermore, increased R&D activities and the concentration of major companies in this region have fuelled the growth of the market. Major players in this market have their focus to capture a huge share of the emerging markets such as India and China.

Europe holds the second position in the global LASIK Eye Surgery market owing to the government support for research & development and availability of funds for research. This is expected to continuously drive the European market over the forecasted period. For instance, countries like Germany and France are increasing their investments in the healthcare domain.

Asia Pacific is the fastest growing LASIK Eye Surgery Market owing to the presence of rapidly developing healthcare technology, huge patient population, and high healthcare expenditure. Moreover, increasing demand for new treatment methods in countries like India and China is likely to emerge as the fastest growing market across the globe.

On the other hand, in the Middle East and Africa, hold the least share of global market owing to limited ignorance of diseases, and poor access to treatment.

Major TOC LASIK Eye Surgery Market:

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2. Market Introduction

2.1 Definition

2.2 Scope of the Study

2.2.1 Research Objective

2.2.2 Assumptions

2.2.3 Limitations

3. Research Methodology

3.1 Introduction

3.2 Primary Research

3.3 Secondary research

3.4 Market Size Estimation

4. Market Dynamics

4.1 Drivers

4.2 Restrains

4.3 Opportunities

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Anthem Says Eye Surgeons Should Monitor Cataract Anesthesia Themselves

Royal Australian Navy Lt. Elizabeth Livingstone and Singapore Army Maj. Paul Zhao perform cataract surgery aboard the hospital ship USNS Mercy during a visit to Quy Nhon, Vietnam in 2010.

Mass Communication Specialist 2nd Class Eddie Harrison/U.S. Navy

If you need cataract surgery, your eye surgeon may have to do double duty as your anesthetist under a new policy by health insurer Anthem. In a clinical guideline released this month, the company says it’s not medically necessary to have an anesthesiologist or nurse anesthetist on hand to administer and monitor sedation in most cases.

Some ophthalmologists and anesthesiologists say the policy jeopardizes patient safety, and they are calling on Anthem to rescind it.

“The presence of anesthesia personnel is one of the key ingredients in the patient safety and effectiveness of cataract surgery today,” says Dr. David Glasser, an ophthalmologist in Columbia, Md., who is secretary for federal affairs at the American Academy of Ophthalmology, a professional group for eye physicians and surgeons. “An ophthalmologist cannot administer conscious sedation and monitor the patient and do cataract surgery at the same time.”

Anthem, which offers commercial insurance plans in 14 states, says anesthesia needs vary and so should coverage. According to a statement from the company:

“Anthem’s Medical Policy and Technology Assessment Committee, a majority of whom are external physicians, reviewed the available evidence addressing the use of general anesthesia and monitored anesthesia care for cataract surgery. According to the literature reviewed, there is no one definitive approach regarding the use of anesthesia for cataract surgery and patient-specific needs should be taken into consideration as well as potential risk of harm to individuals who are sedated during surgical procedures.”

Medicare, the health care program for people age 65 and older, covers cataract surgery, including anesthesia services.

A cataract, typically related to aging, is caused by clumps of protein that cloud the lens of the eye and can distort vision. During a cataract operation, the surgeon makes an incision in the surface of the eye with a laser or blade and then uses a tool to break up the clouded lens, pull it out and replace it with an artificial one.

Cataract surgery is common. More than half of Americans have either had a cataract or had cataract surgery by the time they reach age 80, according to the National Eye Institute.

Surgery is typically performed on an outpatient basis and takes less than an hour. Though drowsy while sedated, patients are generally conscious during the procedure and can hear what’s said to them and speak if necessary.

Eye surgeons often have an anesthesiologist or a nurse anesthetist present to administer intravenous drugs to help keep the patient relaxed and ensure they don’t move during the operation as well as monitor their vital signs and adjust medication as necessary.

Anthem’s new policy states that this type of monitored anesthesia care is medically necessary only if the patient is under 18 years old, or is unable to cooperate or communicate because of dementia or other medical conditions, can’t lie flat, has known problems with anesthesia, or if a complex surgery is anticipated.

But some ophthalmologists and anesthesiologists disagree.

“I wouldn’t even consider doing a cataract surgery without an anesthesiologist or nurse anesthetist in the room,” says Dr. David Aizuss, an eye surgeon who is president-elect of the California Medical Association. “If you’re working inside the eye it’s a very confined space, and if the patient gets agitated and starts moving around you have to get the equipment out of the eye very quickly.”

Although Anthem posted the new policy online, providers are seeking clarification from the company about the timing of its implementation in their states, physicians said.

Until then, some practices are taking no chances. At the Freedom Vision Surgery Center in Encino, Calif., where Aizuss practices, Anthem patients who come in for cataract surgery are asked to pay $400 out-of-pocket upfront for anesthesia services.

Professional groups representing California eye physicians and anesthesiologists have written to Anthem requesting the policy be rescinded. In addition, the California Medical Association has lodged complaints with state regulators.

This isn’t the first time Anthem has come under scrutiny for changes to its clinical guidelines that some have charged help the company’s bottom line at patients’ expense. Last year, the company said it would no longer pay for emergency department visits it later determined were not emergencies. Then in September it said it would no longer pay for imaging tests like MRIs in many cases if patients got them at hospital-owned centers rather than independent imaging centers.

Last week, Modern Healthcare reported that the company says it was modifying its ER rule so that certain types of visits would always be paid for, including those by patients who are directed to the emergency department by their provider or have recently had surgery.

Some safety experts say they were concerned about Anthem’s new policy, even for routine cataract surgeries.

“If you’re putting a knife in my eye, that’s not routine for me,” says Leah Binder, president and CEO of the Leapfrog Group, a nonprofit organization that advocates for improved safety and quality at hospitals. Noting that anesthesiologists and nurse anesthetists were pioneers in the patient safety movement, she says there are better ways for Anthem to save money than shutting them out of the operating room.

“How about identifying the surgeons who have the highest complication rates, and letting patients know about them?” she suggested.

Original Source:

Original Date: Feb 20 2018

Written by: Michelle Andrews

Why I changed what I tell patients about refractive surgery

Consultation discussion should evolve just like laser technology has evolved

In the contact lens-only group, 54 percent of contact lens wearers responded after three years they “strongly agree” with the statement, “I would recommend my current method of vision correction to a close friend or relative.” This compares to the two LASIK groups in which 88 percent of those who previously wore contact lenses and 77 percent of those who previously wore glasses responded they would “strongly” recommend LASIK.

About 1 percent of respondents in each group at each time period responded they “strongly disagree” with the statement, “I would recommend my current method of vision correction to a close friend or relative.”

Researchers also surveyed subjects about night driving, starbursts, dry eye, and eye infections. In the contact lenses-only group, the percentage of patients who respond they had no difficulty driving at night remained virtually the same over three years. Some 36 percent of respondents had no night driving difficulty at baseline, and 37 percent had none at three years.

For the contact lens to LASIK group, 60 percent had no problems driving at night at baseline; at the three-year mark more than 60 percent had no night driving problems. Glasses wearers who did not suffer from night driving problems improved from 44 percent to 57 percent. As compared to contact lens wearers, LASIK patients reported better vision while driving at night.

Dryness happens

Dry eyes are the most common side effect of LASIK, but opinions of patients who have had LASIK vary about the dryness of their eyes three years after surgery.5 The control group remained the same from baseline to the three-year reporting period with 29 percent indicating they do not feel dry at all. In the contact lens group, there was improvement from 44 percent not feeling dry eye at baseline to 50 percent at three years. The glasses group went from 51 percent to 42 percent at three years and significantly fewer patients reported dryness than the group who remained in contact lenses.

For both the contact lens-only group and the contact lens to LASIK group, 1 percent reported feeling dry “all the time” at all reporting periods. For the cohort of patients, patients who felt the driest in their contact lenses did not have surgery. After surgery, the LASIK patients felt better than the contact lens patients.

When asked about experiencing eye infections in the past year, 8 percent of contact lens-only patients and 3 percent of both LASIK groups said yes. A similar trend was shown for questions about ulcer and abrasion. The risk of an eye infection is low but appears less likely with LASIK over time.

Ask the right questions

Laser vision correction is not for everyone, and eye surgery may be scary for many patients. It is worth your time and a benefit to your patient to ask, “What are you fearful of with surgery?” I ask this question often, and the most common answer is, “I do not know, it is just scary.”

New technology has reduced the risks and complications of laser vision correction. Understanding a patient’s subjective symptoms of glare, halos, night driving, and dryness before surgery go a long way in determining what symptoms will be after surgery. Ask your patients the right questions when they inquire about surgery—it will help to deliver “20/happy” patients.

Original Date: January 29, 2018
By Jim Owen, OD, MBA, FAAO

Too Young for LASIK? Children can use a Contact Lens Alternative.

Glasses and contact lenses can imped a person’s ability to enjoy many activities, especially for children. Running, swimming, and playing sports can be difficult if wearing glasses or contacts, and while LASIK (laser in-situ keratomileusis) is often a perfect solution to these issues, children can not have the procedure until they are older than 18 years of age.

“In order to qualify for LASIK, we want our patients to be at least 18 and have had a stable prescription for one year, so children spend their childhood hampered with glasses or contact lenses. But this doesn’t have to be the case,” said Marc S. Werner, M.D., one of the experienced ophthalmologists at Stahl Eyecare Experts on Long Island and in New York City. “Parents complain that their child loses or breaks their glasses, or is uncomfortable in their contacts, and believe there is no other option available. There is – it’s CRT (Ortho-K) Orthokeratology. Your child can wear a specially designed therapeutic lens at night while sleeping to reduce astigmatism or nearsightedness by reshaping the corneal surface.”

CRT is a non-surgical method of vision correction that allows patients to experience clear vision without the use of glasses or contact lenses throughout the day. After wearing the therapeutic lens at night, they remove the lens in the morning and experience clear, natural vision for the full day. “Orthokeratology has also been shown to slow the progression of myopia in children, meaning their prescription doesn’t change as quickly,” added Werner. “At our office, we use Paragon’s FDA approved specially designed oxygen permeable contact lenses to reshape the eye. Improvement in vision is seen within the first few days of initiating treatment and patients achieve optimal vision within 10 to 14 days.”

CRT lenses are similar in size to a soft contact lens and are not any more difficult to insert or remove. Since these lenses are worn while sleeping, they eliminate any discomfort one may experience with contact lenses worn during the day. CRT is also completely reversible, so when the child is old enough they can easily have LASIK surgery to permanently correct their vision.

The doctors at Stahl are truly experts in the fields of ophthalmology and LASIK — they have performed more than 50,000 procedures throughout Long Island and in the five boroughs of New York City, and Stahl Eyecare Experts has been on the cutting edge of ophthalmology for more than 50 years. For more information on CRT and LASIK surgery for children, visit

Original Source:

Original Date: Feb 15 2018

Thinking of having laser eye surgery? Here’s all you need to know

Considering laser eye surgery? Lisa Salmon looks at who the procedure is suitable for, how it’s done, and what the risks and benefits are

You’re most likely to be suitable for laser eye surgery if your glasses prescription is within specific ranges

IF YOU’RE sick of wearing glasses or contact lenses, the only other option to achieve clear vision is laser eye surgery – a procedure now thought to account for around 75 per cent of UK surgical procedures.

Such operations, which are also known as refractive surgery or laser vision correction (LVC), correct eye problems such as short sight, long sight and astigmatism, using a laser to reshape the front of the eye, which improves the ability to focus.

It’s an increasingly popular option for people with sight problems – the Royal College of Ophthalmologists (RCOphth) says more than 100,000 refractive surgery procedures are performed every year in the UK.

However, surgery to correct the need for glasses or contact lenses isn’t currently available on the NHS, and it also isn’t covered by private health insurance.

Private clinics charge from £595 up to £2,175 per eye, depending on the type of procedure, so it’s a big investment that needs careful, well-informed consideration.

:: Who is laser eye surgery suitable for?

Most people aged over 18 can have laser eye surgery, as long as they’ve had a stable spectacle prescription for at least two years. Short sight typically stablises by late teens or early twenties.

Around 99 per cent of people in a large recent study published in the Review of Ophthalmology said they were satisfied with the result of their laser treatment, and for the small minority of patients with a poor outcome, revision treatment is normally effective.

You’re most likely to be suitable for laser eye surgery if your glasses prescription is in the range of :

:: Up to –10.00D of myopia or short sight

:: Up to +4.00D of hyperopia or long sight

:: Up to ±6.00D of astigmatism.

Patients may not be suitable for LVC if they have other eye conditions including cataracts, or problems with their eye surface.

:: Other surgical options

Allan explains that implant-based techniques may be more suitable for some patients.

Lens implantation techniques have two main categories: refractive lens exchange (RLE), which is identical to cataract surgery where the natural lens is replaced with a lens implant, and phakic intraocular lenses (PIOLs), where artificial lenses are implanted in front of the natural lens without replacing it. This is often used in younger patients where the spectacle prescription is outside the normal range for laser eye surgery.

:: How do you choose a clinic?

The Royal College of Ophthalmologists (RCOphth) advises potential patients to think carefully before having refractive surgery. The RCOphth has a helpful

checklist on its website ( that you can use in the consultation with the refractive surgeon.

Patients are strongly advised to choose a surgeon on the General Medical Council’s specialist register in ophthalmology (, or who has the Cert LRS qualification, which can be checked via the Royal College of Ophthalmologists.

Also, make sure the hospital or clinic is regulated with the relevant regulator for the area of the UK it’s based in.

The clinic should be clear from the start about the total cost of the procedure. This normally includes follow-up clinic visits and treatment for any problems resulting from surgery. Additional laser treatments to fine-tune the visual result, for two years after surgery, are normally included in the initial cost.

:: What happens during the surgery?

The treatment is usually carried out on both eyes during the same visit, and takes a around 30 minutes, although the laser is applied for only a minute or two. All procedures use anaesthetic drops to keep patients comfortable, and a spring clip is used to hold the eyelids apart.

Patients will be asked to look up at a target light during the treatment to help keep the eye in the right position, and lasers are then used to remove a lens-shaped piece of tissue to reshape the cornea beneath. While the three available treatments involve slightly different methods, all have similar results.

Patients can go home on the same day as surgery, with antibiotic and anti-inflammatory drops to help the eyes heal.

:: Risks and side-effects

Permanent loss of vision is rare after LVC, and the main risk is that further surgery may be needed for optimum results – up to one in 10 patients require some form of additional surgery.

In the early period after surgery, patients may see glare, halos, starbursts and ghost images, but such problems usually resolve within a few months. There may also be intermittent blurring, temporary red blotches on the eyes, and dry eye symptoms, which can be treated with artificial tears, and should get better within a few months.

:: What results can you expect?

Most patients are satisfied with the outcome of surgery. Although glasses may still be needed for some activities after treatment, particularly for reading in older patients, Bruce Allan, consultant ophthalmic surgeon at Moorfields Eye Hospital in London, says: “A reasonable expectation is to have vision at the same level as you get in soft contact lenses, but without having to wear them.

“Another way of putting it is that you should see at least as well as a normal non-spectacle wearer.”

Original Source:

Original Author: Lisa Salmon

The Latest Laser Eye Surgery Innovation Shaking Up The Health Industry – And Anyone Can Do It

One of our most cherished senses has to be the gift of sight. For a start, you’d not be reading this article without it. But as any glasses wearer will tell you, how nice it would be to not always worry about ensuring you have two heavy rims filled with glass hanging off your face all day. Then there’s the additional concern of leaving them behind when you’ve had to take them off for whatever reason.

These were all things that haunted me as a glasses wearer. I’d only discovered I needed to wear them at the age of 26 (about four years ago) after trying on a friend’s pair of specs as a joke, and hastily realising I could see the world in HD. Really.

While I didn’t actually mind wearing my glasses all that much in terms of how they looked on me, I did find it irritating to have to keep them on my face to watch TV in the evening after wearing them all day. My nose used to ache bang on schedule around the 7pm mark, and then whenever I wanted to do exercise I’d just leave them in the gym locker room, making sure I was at the front of the exercise class so I could see everything the instructor was doing.

ReLEx SMILE laser eye surgery will destroy all myths associated with the procedure


The only real alternative to not needing to wear glasses is contact lenses. These, for me, weren’t really an option, though, as I had tried them many times with no success. Most likely because I was quite squeamish when it came to going anywhere near my actual eye ball (something that is required more than once a day when wearing contacts, ergh) and I felt sick every time I went to put them in. My natural reaction was to flinch and move away when my finger got close to my face. As you can imagine, contacts for me were therefore not a suitable alternative to wearing glasses.

The only other option, then, was laser eye surgery. Gulp. And probably not a great idea for someone who is squeamish when it comes to the eyes.

Laser eye surgery has been around for quite some time now, and has become such a low risk and relatively easy-to-execute procedure that it can be conducted relatively quickly, and recovery is limited to around a month. However, if you look around you’ll find generally the procedure is still rather invasive. The most common practice – LASIK, or “laser-assisted in situ keratomileusis” – involves having flaps cut by the laser on each eye, and the shape of the cornea altered in order to “correct” you of your bad vision. This is not an option for those that are a little delicate when it comes to touching the eye area. And for this rather gruesome-sounding reason, many glasses-wearers are put off going under the laser to rid them of their glasses for life.

And then there’s also plenty of myths surrounding the procedure that still exist from yesteryear, which doesn’t help with peoples’ perceptions, even now. As pointed out by Prof. Reinstein, here are 16 of the most common myths associated with laser eye surgery in general:

1. it’s still very new and the field is still developing so it’s worth waiting

2. It doesn’t work very well; you still need glasses after the procedure

3. It cannot correct long-sightedness

4. It cannot correct astigmatism

5. It cannot correct the need for reading glasses as you get older – Presbyopia

6. You could end up blind

7. It hurts

8. If you blink or move during the procedure it can go wrong

9. If something goes wrong there is nothing that can be done

10. It doesn’t last very long and needs redoing

11. We don’t know about the long-term safety

12. Prescription has to be stable

13. If you get a cataract later on in life, you can’t have that done anymore

14. Contact lenses are safer than laser eye surgery

15. Night vision is harmed by laser eye surgery (it can be fixed by laser eye surgery)

16. My prescription is too high to be corrected (98 percent of all prescriptions can be corrected)

And guess what. None of these are true.

Original Source:

Original Author: Lee Bell

Written Date: Jan 25 2018