admin | Shapiro Laser

Flexible Spending Accounts (FSA), or Cafeteria Plans, Allow Patients to Use Pre-Tax Dollars to Pay for LASIK — But Funds Need to Be Used by the end of the Plan Year.

admin — Mon, 14 Dec 2015 14:49:55 +0000

A flexible spending account can be set up with your employer to allow you to use pre-tax dollars to pay for LASIK or PRK laser vision correction eye surgery at the Shapiro Laser Eye Center. A Flexible Spending Account (FSA) also is referred to as a Flex Plan, a Reimbursement Account, Flex 125 Plan, Tax Saving Plan, Medical Spending Account, a Section 125, or simply a Cafeteria Plan.

A flexible spending account can be set up with your employer. It is a type of Cafeteria Plan (a Cafeteria Plan is a separate written plan maintained by an employer for employees that meets the specific requirements of and regulations of section 125 of the Internal Revenue Code). As such, a flexible spending account is available only with job-based plans. It allows you, as an employee, to set aside a portion of your monthly earnings to pay for “qualified” expenses. Beginning in 2013, there is a $2,500 cap per plan-year (previously many employers had a $5,000 cap). Qualified expenses can be medical expenses (“medical FSA”) or even other types of expenses such as dependent care (“dependent care FSA”). Qualified medical FSA expenses include health insurance co-pays, some over the counter drug expenses, medical equipment such as crutches, diagnostic devices, and procedures such as LASIK or PRK laser eye surgery.

Earnings that are put by your employer into an FSA are not subject to payroll taxes. This has two positive tax-related implications: your overall taxable income is made lower and pre-tax dollars can be used to pay for LASIK. Funds in FSA accounts, however, need to be used before the end of the plan year in which they were set aside (the “use it or lose it” rule). Some employers, however, add language to their FSA plan to allow a 2 1/2 month “grace period” after the plan-year has ended in which to still use your FSA funds. Each year, over 30 million people actually forget to use up their money in their FSA by year’s end, meaning this money is lost to them, so it is important to keep track of deadlines.

It is important to note, by the way, that a flexible spending account (FSA) is different from a health savings account (HSA).

The Shapiro Laser Eye Center, through our offices in Ventura, Santa Barbara, and San Luis Obispo, has extensive experience working with patients using flexible spending account (FSA) money to pay for their LASIK or PRK laser vision correction eye surgeries. Please feel free to contact us with any questions either by using the contact form on this website or calling our office at 805-339-0566.

Professional Golfers Who Have Had LASIK Laser Vision Correction Eye Surgery

admin — Mon, 14 Dec 2015 14:46:37 +0000

Many famous professional golfers in the PGA and LPGA have undergone LASIK to enhance their vision and their golf game. Golf is a game that requires particularly good eyesight and over the years I’ve done LASIK on hundreds of very serious golfers, both pros and amateurs. According to Bleacher Report, many of the most respected professional golfers have undergone LASIK laser vision correction eye surgery to give them an edge in their competitive golf performances. Here is their list of professional golf athletes who have had LASIK:

PGA Tour Golfers

Allen, Michael Austin, Woody Baddely, Aaron Beem, Rich Begay, Notah Browne, Olin Byrd, Jonathon Cheesman, Barry Clampett, Bobby Clark, Michael Cochran, Bobby Cook, John Funk, Fred Gay, Brian Henry, J.J. Hoch, Scott Johnson, Zach Kelly, Jerry Kribel, Joel Langer, Bernhard Marino, Steve McCumber, Mark Nobilo, Frank Nolan, Keith O’Hair, Sean Parnevik, Jesper Pernice, Tom Pride, Dicky Singh, Vijay Urlich Johannson, Per Wadkins, Bobby Weir, Mike Wood, Willie Woods, Tiger

LPGA Tour Golfers

Ash, Nadine Atsedes, Lori Bell, Michelle Bouse, Tami Bowie, Heather Bunch, Ashley Caponi, Donna Chuasiriporn, Jenny D’Allessio, Diana Dee, Sally Early, Liz Feldott, Jennifer Fukoshima, Akiko Gibson, Ellie Goetze-Ackerman, Vickie Golden, Kate Gowan, Carolyn Hurst, Pat Iverson, Becky Jeray, Nicole Johnston-Forbes, Cathy Jordan, Patty Lim, Siew-Ai Macosko, Anna Noble, Karen Peterson. Katie Philo, Laura Read, Amy Riley, Rhonda Rittenhouse, Lenore Sinn, Pearl Stupples, Karen Sugg, LaRee Walton, Robin Wendels, Michelle Whitehead, Barb Wicoff, Erica Wilkins, Donna Will, Maggie

As you can see, those whose careers depend on the most exacting vision often turn to LASIK for optimal competitive performance.

LASIK, Nursing, and Pregnancy

admin — Mon, 14 Dec 2015 14:43:36 +0000

I do not recommend having LASIK until eight weeks after pregnancy and nursing since vision can change during pregnancy and it is best not to expose the baby to absorbed eye drops. A woman from Thousand Oaks called our office today asking if she could have LASIK now that she had found out she was pregnant. We advised her to wait to come in until she was at least eight weeks past pregnancy and breast feeding.

There are several reasons why it is wise not wait to have LASIK if you are pregnant. First, your prescription actually can change during pregnancy and we would want to wait until it returns to its “true” state once pregnancy and nursing are completed and hormonal levels have returned to normal. Generally your prescription will return to what it was before surgery, but sometimes the changes that occurred during pregnancy can be permanent, giving you a new prescription.

Another factor is that we place dilating drops and anesthetic drops in your eyes during your pre-operative consultation in order to do a thorough eye exam and make sure you are a good candidate for LASIK. Both before and after laser vision correction eye surgery you are put on several eye drops, including antibiotic drops and anti-inflammatory drops such as steroid eye drops. Certainly, during pregnancy it is wise to minimize any medications being given to the mother and even though eye drops are not systemically absorbed in the body to a significant degree, it just makes more sense to avoid giving any medicines that might be transmitted to the baby. The same is true for nursing since eye drops could end up in microscopic amounts in breast milk.

Eight weeks after pregnancy and nursing, hormonal levels should be relatively back to pre-pregnancy baseline levels and your prescription should be back to its baseline state as well. At that point, it makes good sense to have LASIK to help you see without glasses or contact lenses during all those times you have to wake up in the middle of the night to take care of your new baby!

LASIK Laser Eye Surgery and Ocular (Eye) Acne Rosacea

admin — Mon, 14 Dec 2015 14:41:11 +0000

Acne Rosacea can cause dry eyes (“ocular rosacea”) which, in turn, can affect LASIK. Patients with ocular rosacea often can have LASIK if rosacea dry eye is treated before surgery. Acne rosacea is a skin disorder which affects the nose, cheeks,chin and forehead. In this condition, the skin becomes oily, bumpy and red. Small red blood vessels called telangiectasia can become noticable and in advanced cases the nose can appear red and bulbous.

There are four subtypes of acne rosacea. Erymatotelangiectatic rosacea is associated with permanent redness with a tendency to blush and flush easily. Prominent small blood vessels appear on the skin and the skin actually can burn or be irritated. Papulopustular rosacea has an element of permanent redness, but also has red pumps, some of which are filled with pus. Phymatous rosacea has rhinophyma, which is an enlargement of the nose. Finally, about half of rosacea patients also have ocular rosacea. In ocular rosacea, the eyes are irritated and light sensitive, with associated burning and stinging.

The root problem in ocular rosacea is that the oil, or lipid, layer of the tears is of poor quality. The tears on the eyes have the job of coating and protecting the cornea. There are three layers to the tears and each layer must be of proper make up. The inner layer, which contacts the cornea, is called the mucin layer and is made of proteins. The mucin layer is produced by the conjunctiva. The middle layer is the watery layer called the aqueous layer. The top layer is the oil or lipid layer. It is made by glands in the eyelids called meibomian glands. The job of the lipid layer is to float to the top of the tears to prevent evaporation and to improve coating of the surface of the cornea.

In ocular rosacea, there is a problem with the composition of the lipid layer and it does not work properly. Patients with ocular rosacea have dry eyes as their tears are unable to adequately perform their job. Paradoxically, because the eye is dry, the body may try to make more tears to counteract the problem, so ocular rosacea patients may have watery eyes that sill are dry and irritated.

Many patients with ocular ance rosacea still can have successful LASIK or PRK laser vision correction eye surgery. However, careful attention must be given by the surgeon to optimizing the quality of the tears by improving the lipid layer before surgery. Treating dry eye caused by ocular rosacea before surgery is very important to achieve the best possible outcomes from LASIK.

There are several things that can be done to improve the lipid layer of the tears in patients with ocular rosacea. Perhaps our best tool is the off-label use of an antibiotic drop called Azasite. Azsite appears to bind directly to the oil layer and change its boiling point. Essentially, it changes the oil layer from Crisco to olive oil, which is what we want to improve function.

Azasite improve lipid based dry eye by a second mechanism as well. In ocular rosacea, there often is a build up of poor quality, thick oils in the meibomian glands that make the oil. Bacteria love to grow in these glands and eat this thick and gooey oil. The excess bacteria tend to produce enzymes called lipases which break down the thick oil into soap like chemicals which are quite irritating to the already irritated dry eyes seen in ocular rosacea. Azasite drops tend to be absorbed into these glands and the help kill off the bacterial overgrowth of the glands that is contributing to irritation and dryness of the eyes.

Other treatments for ocular rosacea that are aimed at improving tear quality include taking oral omega-3 nutrition supplements before LASIK (including flax seed oil and fish or krill oil), taking oral antibiotics such as minocycline, tetracycline, or doxicycline, hot compresses, and lid scrubs, particularly with tea tree oil. Another promising treatment for meibomian gland problems associated with ocular rosacea is the LipiFlow System. Finally, light based skin therapy for acne rosacea, such as controlled spectrum light therapy or intense pulsed light may be able to help reduce symptoms of ocular rosacea by treating the underlying overall rosacea condition of the skin.

LASIK Satisfaction: Physicians As LASIK Patients are Satisfied

admin — Mon, 14 Dec 2015 14:37:42 +0000

Study: When physicians (medical doctors) have LASIK on their own eyes, satisfaction rates are very high. Physicians, or medical doctors (M.D.’s) represent the a very knowledgeable and even skeptical group of patients. Physicians also have a particularly high demand for outstanding vision. I personally have performed LASIK and PRK (“flapless LASIK”) on quite a few local Ventura, Santa Barbara, and San Luis Obispo County physicians and have found satisfaction rates to be very high. It was with great interest, therefore, that I read a recent study from the Cleveland Clinic Laser Eye Surgery Center on their results over the years when performing LASIK or PRK on Cleveland Clinic physicians of all specialties.

This study looked at LASIK and PRK performed at the Cleveland Clinic on 226 Cleveland Clinic physicians between 2000 and 2011 (representing 429 eyes that had laser eye surgery). Because this study was conducted over an 11 year period, it included various forms of LASIK and PRK as laser technology and technique evolved and included both conventional and well as customized wavefront LASIK and PRK. A variety of laser platforms and technology were used.

Of the Cleveland Clinic physicians who underwent laser vision correction over this 11 year period, 89% had LASIK and 11% had PRK. 63% of the physicians treated were male, 37% female, and the average age was 38 years old. Nine of the 429 eyes were farsighted. Of the 420 eyes that were nearsighted, the average degree of myopia (nearsightedness) was -4.50 diopters, with the most nearsighted eye having -11.50 diopters of nearsightedness.

The researchers at the Cleveland Clinic who carried out the study mailed a physician-specific survey to the physician-patients. Of the 226 physicians surveyed, 132 responded. 28% were surgeons, 43% were non-surgeons who performed procedures and therefore still had strong vocational needs for exceptionally good eyesight, and 29% did not perform surgery or non-surgical procedures. Physicians who responded about their experiences as laser eye surgery patients included cardiac surgeons, neurosurgeons, ophthalmologists, and other specialists.

It is important to remember that this Cleveland study represented LASIK and PRK often not done with what is today the very best and latest technology.

Results showed that, of the Cleveland Clinic physicians surveyed, 95.3% said they were either satisfied or very satisfied with their surgery. 96% said they would repeat the surgery again based on their experience and knowledge of their outcome.

These very high patient satisfaction numbers are quite impressive given the fact that many of these patients did not have what would today be considered the very best laser vision correction technology and that, as physicians, these patients have very demanding visual needs and tend to be quite critical. Of course, LASIK and PRK both have an element of risk. Yet, this study confirms that, even in a very difficult patient population, LASIK and PRK provide results that produce outstanding patient satisfaction rates.

Preventing Nearsightedness (Myopia) from Developing in Children

admin — Mon, 14 Dec 2015 14:35:04 +0000

Study shows increased outdoor activity in children reduces the development of nearsightedness. While LASIK and PRK laser vision correction eye surgery are highly effective in correcting nearsightedness — or myopia — in adults, it would be nice if we could stop nearsightedness from developing in the first place.

A recent study from Taiwan gives us a glimpse on how to stop nearsightedness from developing. In this study, two suburban schools of similar composition and similar socioeconomic status were compared, reflecting a total of 600 students ranging in age from 7 – 11 years. Both schools provided 80 minutes of recess daily. In the first school, children were allowed to play outside or stay indoors during recess. In the second school, children were not allowed indoors during recess, but had to play outdoors. By one year, children in the second school already were showing lower degrees of nearsightedness. Outdoor activity seemed to slow the overall rate of progression of myopia. Interestingly, outdoor activity seemed to halt myopic development in non-nearsighted children but did not stop the progression of nearsightedness in already myopic children.

Punctal Plugs for Dry Eye Before or After LASIK

admin — Mon, 14 Dec 2015 14:32:43 +0000

In preparing the eye for LASIK, punctal plugs should be considered only as part of a larger strategy for addressing any dry eye before LASIK.

Before a patient undergoes either LASIK or PRK laser vision correction eye surgery, it is important for the surgeon to address any dry eye issues. This attention to dry eye before surgery is called “optimizing the ocular surface” and is critical to achieving the best possible outcomes after LASIK or PRK.

Too often, surgeons will simply place punctal plugs as a first and only strategy for addressing dry eye either before or after LASIK. It is important, however, to understand that punctal plugs should be viewed as one component of a larger overall strategy when preparing an eye for surgery and, in my experience, usually are not necessary.

When thinking about getting the eye ready for LASIK or PRK laser vision correction eye surgery, it is important to realize that there are two factors affecting tears and dry eye: 1) tear quantity (are there enough tears overall?) and 2) tear quality (regardless of the volume of tears, are the tears the correct composition so they can properly do their job?). Too often, surgeons and patients focus only on the first factor: tear quantity. There is a tendency to think of dry eye too simplistically: are there enough tears or not? It turns out the issue is much more complex. Most often, dry eye is caused by the tears not properly doing their job due to a tear quality problem that is independent of whether or not there are enough tears.

In my experience, it is much more important to first address tear quality as there typically is more room for improvement in this regard. Only after tear quality has been addressed and the eyes still are dry should attention be turned to punctal plugs, which effectively increase tear volume.

The tears are made of three layers. The bottom or “mucin” layer, adheres to the cornea and the surface of the eye and is made of proteins. It is produced by cells called goblet cells located in the conjunctiva. The middle layer, known as aqueous layer, is composed mostly of water and is made by the lacrimal gland. The top layer is called the “lipid layer” and is made of oils.

Each layer of the tears must be of the proper composition to function properly. If even one layer is abnormal in its composition, then the tears have poor quality and cannot coat and moisten the surface of the eye as well, regardless of how much tear volume there is. A problem with one or more of the layers of the tears is called a qualitative tear problem.

Therapies to treat qualitative tear problems are directed to the specific quality problem. For example, many people, due to a combination of diet and genetics, have a deficient lipid layer. The job of the lipid layer is to prevent evaporation. Patients with a quality problem in their lipid layer may have enough tears, but the tears do not properly stay on the eye during period of heavy use with decreased blinking, such as prolonged computer use. Other patients, particularly post-menopausal women, have chronic inflammation of the surface of their eyes which reduces the quality of all three layers of their tears.

Punctal plugs purely address tear quantity and not tear quality. It turns out that there are two “drains” by which tears leave the surface of the eye — an upper and a lower drain. Each drain is called a “punctum” and is located at the margin of the upper and lower eyelids towards the nose. Approximately 2/3 of the tears leave via the lower punctum while 1/3 leaves via the upper punctum of each eye.

Putting plugs into the puncta essentially plugs the drain so tears cannot exit. Plugs can be placed either on a temporary or a permanent basis. Often dissolvable plugs are used as temporary plugs and can last from a day to a couple of months, depending on the type of plugs used. Because the drain system is either partially (just lower plugs) or completely (upper and lower plugs) blocked, the tears essentially back up onto the eye and increase tear volume. Remember, though, plugs do not change the composition of the tears. If a patient has poor quality tears, the plug simply backs up more poor quality tears on the eye.

If someone has a tear quality problem, it is very important to first address that before plugs are place. Otherwise, plugs might be of little help or may actually make things worse. For example, if a post-menopausal woman has dry eye, the root cause may be inflammatory. Placing punctal plugs might just end up putting more inflammatory chemicals that are in the tears against the surface of the eye. The correct approach is to try to get tear quality as good as possible first. Only then, if necessary, should plugs be considered. In may practice, plugs always come after a thorough treatment directed toward tear quality.

There are several steps that can be taken to improve tears quality. Restasis is an FDA approved prescription medicine that essentially is an anti-inflammatory drop and helps the body make better quality tears by reducing surface inflammation (it also improves tear quantity for the same reason). Azasite is a drop that, on an off-label basis, can be used to directly treat lipid layer problems of the tears. Oral omega-3 nutritional supplementation also can improve tear quality. Other treatments that can improve tear quality include hot compresses on the eyelids and even oral doxicycline, tetracycline, or minocycline. Even light based skin treatments which treat acne rosacea can help improve tear quality.

If a patient’s eye still is dry despite these treatments, then it often is useful to add punctal plugs to the strategic approach. While I am in no way opposed to punctal plugs (they often are quite helpful) I just do not think they should be the first line of approach.

In general, though, getting the eye ready for LASIK is a critical part of the surgery. Each patient needs to be approached individually and for some, but not for most, punctal plugs are a helpful addition to the treatment strategy in my experience.

Peripheral Vision in LASIK and PRK Laser Eye Surgery

admin — Mon, 14 Dec 2015 14:29:21 +0000

Laser vision correction eye surgery — and contact lens wear — typically do not limit peripheral vision. Glasses, by contrast, do tend to limit peripheral vision in proportion to the power of the prescription.

A patient from Santa Barbara recently told me that he loved his peripheral vision with his contact lenses, but felt he lost his peripheral vision when he wore his glasses. I was able to reassure him that after LASIK, his peripheral vision typically should be much more similar to his contact lens vision than to his glasses vision.

The reason that LASIK and contact lenses both typically do not affect or limit peripheral vision is that they both sit directly on the cornea itself — the front layer of the eye. Glasses, by contrast, sit off the eye and produce several distortions simply because they sit away from the eye. Think of the difference between holding a magnifying lens close to your eye and then moving it away. Clearly distance causes optical changes.

Glasses tend to limit peripheral vision since, of course, there is no correction off to the side of your vision. In addition, glasses require you to look through their optical centers — the “sweet spot” in the lens. If you look away from this center point, the lens produces distortion. Therefore, if you are looking straight ahead, your peripheral vision to the side of this straight ahead point is looking through this distortion. So, depending on how far peripheral to center you are considering, glasses either distort peripheral vision or simply do not provide any peripheral correction at all.

Glasses also tend to change image size. Nearsighted glasses minimize the image and farsighted glasses magnify the image — both at a rate of approximately 2 percent per diopter of correction.

For these reasons, the optical downsides of glasses when compared to either contact lenses or successful LASIK, are greater the higher the degree of prescription.

Many patients who are considering LASIK only wear contact lenses and never wear their glasses simply because they do not like the quality of glasses vision. Unfortunately, it is necessary to leave the contact lenses off long enough for the cornea to resume its normal shape as contact lenses mold the cornea. While many of my patients truly dislike having to wear glasses while the cornea “gets a breather” and recovers its true shape before LASIK, this is a step that is well worthwhile to allow us to get the most accurate measurements of the cornea in order to give the best possible LASIK results.

LASIK in Thyroid Disease (Hyperthyroid, Hypothyroid)

admin — Mon, 14 Dec 2015 14:27:03 +0000

LASIK can be performed in patients with hyperthyroidism or hypothyroidism but only careful attention to dry eye issues.

A patient from Santa Maria recently asked me if LASIK can be performed on people with thyroid problems. The answer is a qualified yes, as long as careful attention and consideration is given to dry eye issues. Some thyroid eye disease patients are not candidates for LASIK or PRK, however.

I have performed LASIK on hundreds of patients with thyroid disease over the years with excellent outcomes — but only after careful preoperative screening. Of course, there are several types of thyroid problems. It is important to keep in mind that having thyroid problems is not necessarily the same as having true “thyroid eye disease”. In general, though, the main consideration in thyroid disease is dry eye — and some patients with thyroid disease have eyes that do not respond well to medical treatment for dry eyes and therefore are not good candidates for surgery. Interestingly, many thyroid problems are autoimmune diseases in which the body’s immune system attacks both the eyes and the thyroid.

In the case of Graves Disease (or “thyroid eye disease”), the main underlying problem causing dry eye is incomplete eye lid closure due to proptosis — the tendency of the eye to protrude outward and the eyelids to be retracted back in this autoimmune condition. If a patient’s eyelid closure is inadequate to completely cover his or her eye, this person would not be a good candidate for LASIK or PRK laser eye surgery as both procedures require good blinking and spreading of tears on to the surface of the eye. In general, patients with true thyroid eye disease should be approached with great caution when considering laser vision correction surgery and usually are not optimal candidates.

Beside the mechanical basis for dry eye seen in patients with thyroid eye disease due to the inability of the lids to adequately wet the eye, dry eye in systemic thyroid disease such as hypothyroidism or hyperthyroidism also can be from a direct autoimmune effect on tear production in which the body’s immune system attacks the lacrimal glad, which is the gland that makes the watery layer of the tears. Additionally, thyroid hormone itself — the hormone that is produced by the thyroid gland –can be found at abnormal levels in the blood in patients with thyroid disease. Beside regulating many metabolic and biochemical systems in the body, thyroid hormone is involved in regulating the production of the oil layer of the tears by the meibomian glands in the eyelid. If thyroid hormone levels are abnormal due to thyroid disease, this could disturb the oil layer and make tears more prone to evaporation, producing “evaporative dry eye.”

Patients with thyroid disease need to treated successfully for dry eye syndrome both before and after their LASIK or PRK laser vision correction eye surgery. Restasis can work very well on some of these patients as it suppresses chronic inflammation produced by autoimmune thyroid disease affecting the surface of the eye. Oral omega three supplements and topical Azasite drops can help improve the oil layer of the tears. Some patients with an inadequate watery layer of the tears (inadequate tear volume) can benefit from punctal plugs before and after laser eye surgery. If dry eye can be successfully controlled and there is no evidence of true thyroid eye disease with proptosis and lid involvement, many of these patients with thyroid problems otherwise can have LASIK.

Some patients with advanced Graves Disease and thyroid ophthalmopathy (protrusion of the eye, retraction of the lids) can benefit from plastic surgery to improve lid function, but generally these patients are not good candidates for LASIK or PRK.

If careful attention to dry eye is made at the time of surgery, patients with thyroid disease can enjoy excellent results after LASIK or PRK if there is no evidence of true thyroid eye disease with proptosis and lid retraction. However, whether or not surgery is performed, patients with chronic thyroid disease need to know their eyes still could become more dry over time due to the underlying autoimmune nature of thyroid disease.

In general, the decision to have LASIK should be approached carefully in patients with thyroid disease.

New Phakic Intraocular Lens (ICL Implantable Lens) For Correcting High Myopia (Extreme Nearsightedness) May Be Safer

admin — Mon, 14 Dec 2015 14:24:29 +0000

A New Version of the Staar ICL (Implantable Collamer Lens) or “Implantable Contact Lens” Performs Well in New Study. For patients who are not good candidates for laser vision correction either in the form of LASIK or PRK — or for those who have extremely high degrees of myopia (nearsightedness) outside the range of laser vision correction, the phakic IOL can be a good option.

There are several brands and specific models of the phakic intracoluar lens or “phakic IOL”. These lenses are sometimes referred to as “implantable contact lenses” which actually is a bit of a misnomer. Unlike LASIK or PRK which correct vision at the outside surface of the eye, the phakic IOL involves inserting a lens into the inside of the eye. Because this is an intra-ocular (inside the eye) procedure, the risk of sight threatening complications traditionally is considered higher than an extra-ocular procedure like LASIK or PRK.

One of the most well known and, in the United States, widely used phakic intraocular lens is the Staar Implantable Collamer Lens (ICL). This lens is inserted behind the iris. One possible complication of insertion of this lens is the development of an acute attack of glaucoma caused by the lens pushing the iris outward from behind. This is called “pupillary block glaucoma.” In order to minimize the risk of this event, it is common practice for a surgeon to use a laser to punch a permanent hole in the iris (the colored part of the eye) to act as a sort of escape valve.

Staar has recently developed a new phakic intraocular lens which has a hole in the lens itself, which make it no longer necessary to place a hole in the iris (a laser “iridotomy”). This is, in theory, a big step forward and one that would improve the safety profile of the lens.

A recent study conducted in Spain looked at the performance of this new phakic intraocular lens. This study examined 138 eyes of 70 patients who had implantation of the new Staar ICL Implantable Collamer Lens for an average nearsightedness correction of -8.73 diopters, a fairly high degree of myopia. The new phakic intraocular lenses all had a hole in the lens and no laser holes were placed in the iris. In the study 92.1% of eyes achieved 20/20 or better vision. There were no episodes of glaucoma and the intraocular pressure remained normal in all patients at each exam.

This early study is very encouraging. Removing the need for a laser hole (peripheral laser iridotomy) make the procedure a more efficient and elegant procedure with a potentially better safety profile.

My preference stillis to perform either LASIK or PRK in patients who otherwise still are good candidates for these laser procedures, but for patients who are outside the range of correction for laser vision correction, implantable phakic intraocular lens technology continues to improve.

admin | Shapiro Laser

Flexible Spending Accounts (FSA), or Cafeteria Plans, Allow Patients to Use Pre-Tax Dollars to Pay for LASIK — But Funds Need to Be Used by the end of the Plan Year.

See Also

Professional Golfers Who Have Had LASIK Laser Vision Correction Eye Surgery

See Also

LASIK, Nursing, and Pregnancy

See Also

LASIK Laser Eye Surgery and Ocular (Eye) Acne Rosacea

See Also

LASIK Satisfaction: Physicians As LASIK Patients are Satisfied

See Also

Preventing Nearsightedness (Myopia) from Developing in Children

See Also

Punctal Plugs for Dry Eye Before or After LASIK

See Also

Peripheral Vision in LASIK and PRK Laser Eye Surgery

See Also

LASIK in Thyroid Disease (Hyperthyroid, Hypothyroid)

See Also

New Phakic Intraocular Lens (ICL Implantable Lens) For Correcting High Myopia (Extreme Nearsightedness) May Be Safer

See Also