Refractive Surgeries Overview

LASIK

LASIK stands for “laser in-situ keratomileusis” or “laser within the cornea to reshape it.” In LASIK, a thin, horizontal flap within the cornea is created that remains attached on one edge. This flap is lifted and placed aside, and the excimer laser is used to sculpt the cornea beneath the surface. The laser reshapes the cornea precisely, without damage or heat, and can safely and effectively treat nearsightedness, farsightedness, and astigmatism. The flap is then replaced and stays in place without stitches.

LASIK Flap

The procedure is done with anesthetic eyedrops, and usually a simple sedative like oral Valium. Visual recovery is typically a day. Patients usually return to normal activities after their follow-up visit the next day. It is important to use prescription drops for about a week, and to protect the eyes from vigorous rubbing or injury for about 5 days. As with any surgery, complications are possible, but rare. We will discuss them at your refractive consultation.

In order to have LASIK, you must have a good thickness and shape to your cornea. We recommend LASIK to about 80% of our patients.

INTRALASE or Blade-free LASIK

IntraLase is a femtosecond laser used to perform the first step in the LASIK procedure: creating the corneal flap, without a blade. The IntraLase method uses tiny, rapid pulses of laser light that pass through the top layers of the cornea to create microscopic bubbles at a precise depth and position within the eye. Just prior to applying laser vision correction, the corneal flap is created by separating the tissue where the bubbles have formed. In some other centers, this flap is still created with a bladed microkeratome.

LASIK Checklist

• Education and Training – Fellowship-trained, educated at Yale and Cornell
• Experience – Extensive and awarded. Dr. Mandava is there for every step, including pre-op and post-op
• Technology – Bladeless LASIK and Custom LASIK, on-site
• Trust – Uncompromising screening process, your best interest at heart
• Staff and environment – Compassionate and accommodating to our patient’s needs
• Commitment – Well-established practice boasting a new, state-of-the-art facility.

PRK and SURFACE ABLATION

PRK stands for “photorefractive keratectomy,” or “removing a portion of the cornea with laser light to change its refractive power”. In PRK, the surface cells of the cornea are painlessly brushed away after anesthetic drops, and then the excimer laser is used to sculpt the surface of cornea. The amount of tissue removed is usually less than the width of a human hair. A bandage contact lens is placed by us and removed by us in 4-5 days. Activities such as driving will be limited during this time, and maybe for a few days after. Since the eye responds to the loss of these surface cells with a strong healing response, there is some initial discomfort and slower visual recovery, but the end result is very similar to LASIK.

The term “Surface Ablation” encompasses PRK, Epi-Lasik, and LASEK. Instead of the surface cells (epithelium) being brushed away, a special device or technique removes the epithelium in a smooth sheet.

PRK is an excellent alternative when there is a contraindication to LASIK, such as certain corneal conditions, including thin corneas and surface problems or scars. It is also an excellent choice for those with moderate to severe dry eye, or those at risk for eye injuries. As with any surgery, complications are possible but rare, such as slow healing or infection. We will discuss this thoroughly at your refractive consultation.

CATARACT SURGERY and REFRACTIVE LENS EXCHANGE (RLE)

New and exciting advancements in ophthalmology are now available to patients being evaluated for cataract surgery. Research and development involving cataract surgery has undergone an amazing transformation over the past few years. With the introduction of new materials, innovative mathematical approaches and advanced technology, cataract surgery has been transformed from a purely medical procedure to one of refractive or “vision correcting” qualities.

If cataract surgery is the the best possible treatment for you, there are premium lens implants that are able to give you the best possible visual result. Premium intraocular lens implants (IOLs) and surgical methods for the correction of astigmatism now allow many cataract patients the possibility of reducing or completely eliminating their need for glasses for distance, near and/or intermediate.

Consistently at the forefront of these developments, Dr. Mandava specializes in the mathematics of IOL lens power calculations and in offering cataract patients options only recently available. Dr. Mandava manages difficult and unusual cases and uses the latest technology in order to provide our patients with the most precise data possible, facilitating optimal vision correction and customizing solutions to suit your specific eye care needs.

PHAKIC Intraocular Lens

This is an operation done in an OR setting to place an IOL in the eye to treat high amounts of nearsightedness, especially when the degree is too high to safely have LASIK. Because the cornea is not significantly altered, it can be offered in cases of thin corneas. Also, the IOL can be removed if the effect needs to be reversed. The risks are more complex and potentially more serious than LASIK, and a careful evaluation and discussion are required.

LIMBAL RELAXING INCISIONS and ARCUATE INCISIONS

LRIs and AKs are surgical treatments usually done in the setting of cataract surgery, Phakic IOLs, or Refractive Lens Exchange. Precisely located incisions in the periphery of the cornea are created, either manually with a diamond blade, or with a femtosecond laser. The incisions cause relaxation of the steep part of the cornea, creating a more round and less-astigmatic cornea.

CONDUCTIVE KERATOPLASTY (CK)

CK is an FDA approved procedure to treat presbyopia temporarily. We offer it sparingly for specific cases where patients desire better near vision or less hyperopia with a safe procedure that may not last.