In the normal eye, light rays of an image pass through the cornea and the lens and are focused directly on the retina to produce a clear image.

In a myopic (nearsighted) eye, the light rays pass through the cornea and lens but the point at which they converge (focus) is in front of the retina. This configuration allows clear images of near objects, but not those that are far away. When myopes are young, they can use their glasses for far and near tasks since their lens accommodates for near vision. After approximately 40 years of age, the human lens looses its elasticity so they frequently have to remove their glasses while reading or use bifocals.

In a hyperopic (farsighted) eye, the light rays do not converge or focus by the time they reach the retina. Younger hyperopic patients can focus on more distant objects and images that are close. As hyperopic patients age they lose the ability to accommodate and then have difficulty seeing distant and near objects. They will often require glasses for both distance and near (bifocals) in their forties.

 

Laser Vision Correction Procedures

 

LASER IN-SITU KERATOMILEUSIS (LASIK)

LASER IN-SITU KERATOMILEUSIS (LASIK) is a procedure that uses a microkeratome (surgical instrument) to create a hinged corneal flap on the front surface of the eye to access the inside of the cornea. The surface epithelial layer is left intact, allowing for not only faster visual recovery, but improved comfort. The excimer laser is then used to remove an inner layer of corneal tissue. This reshapes the inner part of the cornea, thereby changing its optical characteristics. The corneal flap is then replaced in its original position. Because of the cornea's extraordinary natural bonding qualities, healing is rapid and does not require stitches. 

LASIK surgery is performed as an outpatient procedure in the comfort and convenience of the excimer laser surgical suite. The entire procedure takes approximately fifteen minutes and both eyes are usually treated the same day. The procedure is performed using topical anesthesia (eye drops). During the first few hours, some patients may temporarily experience a slight foreign body or burning sensation and blurry vision. 

Patients usually see a dramatic improvement in their vision within the first day. Most patients return to their normal activities within a day or two. LASIK patients are placed on an antibiotic and anti-inflammatory drop for about 1 week. Patients are instructed to wear a protective eye shield while sleeping for 7 days to prevent accidental eye rubbing during the early healing period. 

 

CUSTOM LASIK

CustomVue™  LASIK is the newest FDA-approved procedure developed by VISX. It provides your doctor with the tools to precisely measure your specific optical pathway, like a "fingerprint" of your vision. This custom "fingerprint" enables your eye surgeon to customize the LASIK procedure to your unique visual requirements.

This Wavefront technology provides an additional level of precise data about your eye to truly personalize your vision correction. A device called a wavefront analyzer measures the way light travels through your optical pathway and compares it to the way light travels through an optically perfect eye. This device then creates a WavePrint™ , a map of the detected irregularities of the visual system. This map displays irregularities that cannot be measured any other way.

Several types of visual imperfections, referred to as lower- and higher-order aberrations, exist within the eye and can affect both visual acuity and the quality of vision. To date, only lower-order aberrations (such as nearsightedness, farsightedness, and astigmatism) could be measured and treated. But these irregularities do not account for all potential vision imperfections. Higher-order aberrations can also have a significant impact on one's quality of vision and are often linked to visual glare and halos that may cause night vision problems. Higher-order aberrations cannot be corrected with glasses, contact lenses or conventional LASIK treatments.

Using wavefront technology to generate the WavePrint™ , a detailed, personalized map of your unique vision, surgeons now have the diagnostic tools to measure and ultimately correct both lower- and higher-order aberrations. This WavePrint™  information can be used by surgeons to either optimize traditional LASIK or treat patients with CustomVue™ LASIK.

Conventional LASIK is very successful. It appears that Custom LASIK significantly increases the number of patients who may achieve 20/20 or better vision and/or may perceive better quality of vision.

VISX, Incorporated conducted a multi-center, FDA clinical study to assess the safety and efficacy of their WaveScan guided laser vision correction, also known as the VISX CustomVue™ individualized laser vision correction procedure for the treatment of nearsightedness and astigmatism. One year after VISX CustomVue™ procedure, 98% of participants could see 20/20 or better without glasses or contacts and 70% of participants could see 20/16 or better. Only Twelve eyes of the 351 studied had enhancements during this time period.

 

LASER ASSISTED SUB-EPITHELIAL KERATOMILEUSIS (LASEK)

LASER ASSISTED SUB-EPITHELIAL KERATOMILEUSIS (LASEK) is a slight variation of the LASIK procedure. This procedure also uses the excimer laser to reshape the cornea under a thin flap of the superficial epithelium, or surface skin cells, of the cornea. This thin epithelial flap is not created using a microkeratome as in LASIK. Instead an instrument marks the surface of the cornea and the epithelial cells are gently pushed aside. After the treatment the epithelial skin cells are replaced. A bandage soft contact lens is placed on the eye until the epithelial flap re-adheres to the underlying cornea (usually 3-4 days). 

Currently, LASEK is considered an "off-label" use of an approved medical device (excimer laser). Off label usage of an FDA approved device is a common practice done without interference from the FDA. It falls under the definition of "Practice of Medicine" and allows physicians to practice medicine in a manner they feel most benefits their patients. LASIK was also originally "off-label". 

LASEK preserves more corneal tissue, on average, than a typical LASIK procedure. Therefore, for patients who have thin corneas, LASEK may offer a safer alternative than LASIK. Compared to LASIK, this procedure is more uncomfortable because of the disruption to the surface of the cornea. 

The end result, however, is the same as LASIK. LASEK patients are placed on an antibiotic drop for about 1 week and an anti-inflammatory drop for 2-3 months. The Ophthalmologists at the Fort Lauderdale Eye Institute were some of the first to perform this procedure in South Florida (featured on ABC's local news).

 

PHOTOREFRACTIVE KERATECTOMY (PRK) 

PHOTOREFRACTIVE KERATECTOMY (PRK) was the first procedure using the excimer laser to change the curvature of the cornea to improve vision. The FDA first approved the excimer laser for PRK in October 1995, though safety and clinical data on the first PRK surgeries date back to 1990. 

Prior to the laser treatment the superficial layer of epithelial surface cells are removed. These typically regenerate over the next 4-7 days post-operatively. A bandage soft contact lens is placed on the eye until this epithelium has healed in. Like LASIK and LASEK, PRK only takes about fifteen minutes to perform, and the surgery itself is painless. 

There is typically more discomfort during the healing process for PRK, and it takes a bit more time for the patient to see clearly, but the eventual outcome for LASIK, LASEK and PRK are identical in low to moderate refractive states. However, with higher levels of myopia, there is an increased risk of corneal haze with PRK and LASEK. There are some medical conditions that make PRK more suitable and the PRK procedure can actually cure those conditions. PRK patients are placed on an antibiotic drop for about 1 week and an anti-inflammatory drop for 2-3 months. 

 

EPI-LASIK   

EPI-LASIK is a slight variation of the LASIK procedure. This procedure also uses the excimer laser to reshape the cornea under a thin flap of the superficial epithelium, or surface skin cells, of the cornea. This is similar to LASEK and PRK.  This thin epithelial flap is created using a blunt microkeratome blade instead of a sharp blade as with LASIK. The difference between EPI-LASIK and LASEK / PRK is that no alcohol is placed on the eye to cause the epithelium to loosen.  The blunt microkeratome blade does the separation without the need to use an alcohol solution. After the treatment the epithelial skin cells are replaced. A bandage soft contact lens is placed on the eye until the epithelial flap re-adheres to the underlying cornea (usually 3-4 days). 

Currently, EPI-LASEK is considered an "off-label" use of an approved medical device (excimer laser). Off label usage of an FDA approved device is a common practice done without interference from the FDA. It falls under the definition of "Practice of Medicine" and allows physicians to practice medicine in a manner they feel most benefits their patients. LASIK was also originally "off-label". 

The EPI-LASIK preserves more corneal tissue, on average, than a typical LASIK procedure. Therefore, for patients who have thin corneas, EPI-LASIK may offer a safer alternative than LASIK. Compared to LASIK, this procedure is slightly more uncomfortable because of the disruption to the surface of the cornea.  Because no alcohol is used to loosen the epithelium as in LASEK and PRK, the EPI-LASIK procedure leads to quicker healing with less discomfort than LASEK and PRK.

The end result, however, is the same as LASIK, LASEK, or PRK. EPI-LASIK patients are placed on an antibiotic drop for about 1 week and an anti-inflammatory drop for 2-3 months.

VISX  Excimer  Laser

The Ophthalmologists at the Fort Lauderdale Eye Institute perform laser vision correction using the VISX Star S4 excimer laser. VISX pioneered the development of excimer laser systems and remains the industry leader in quality and innovation. Ophthalmologists have performed over 5 million procedures using VISX Systems. 

The VISX excimer laser system is currently the most widely used in the United States. The VISX STAR S4 ActiveTrak™ eye-tracking laser is the most advanced laser of its kind in the world. For Custom LASIK we utilize the VISX CustomVue™ instrument technology including the WaveScan (wavefront analyzer) which provides a new level of measurement. The WaveScan digital information is transferred to the VISX Star S4 laser after your WavePrint™ is generated.

SAFETY: 

VISX's ActiveTrak™  is the only system that allows the physician to track your eye movement in all three dimensions during the treatment, for greater control, accuracy and safety. This is the only FDA approved three-dimensional eye tracker which continuously monitors and adjusts the laser to account for eye movements. The laser automatically shuts off if it detects significant eye movement ensuring a safe treatment. If needed, the surgeon can pause the procedure at any time providing full control of the process.

ACCURACY: 

Seven variable sized beams give the physician greater flexibility and allow for a faster, smoother treatment with precise corneal shaping. Variable Spot Scanning™  technology adds a blend zone that increases the ablation zone by 51%, increasing the overall diameter of the ablation to 8 millimeters. This offers the physician greater flexibility in developing a more personalized laser vision procedure when pupil size may be a consideration. VISX laser systems produce the smoothest surface on the cornea after the procedure. Smoother ablations promote faster healing and result in better vision. 

COMFORT: 

Unlike other systems, with ActiveTrak™ , the physician does not have to dilate your pupils. A disadvantage of some eye trackers is the requirement for the eye to be dilated. The procedure cannot take place until the eyes have dilated, increasing the overall treatment time considerably. The drops used to dilate the pupil can cause blurry vision and discomfort for hours after the surgery. Because of its faster treatment time, the VISX system translates into a more comfortable experience and even quicker recovery time.

 

Schedule a Consultation

The first step toward laser vision correction is to arrange a complimentary consultation at our office. The entire process takes approximately 1 ½ hours. At that time you will meet the eye surgeon who will perform your procedure. He will perform a comprehensive eye exam including dilation of your pupils. Not everyone is a candidate for laser vision correction. The physicians at The Fort Lauderdale Eye Institute perform a careful screening examination to determine if you are a candidate. The risks, benefits, and expectations will all be discussed at that time.

Call (888) 336-3534 or (954) 741-5500 ext. 117


Fort Lauderdale Eye Institute 
7800 West Oakland Park Blvd. 
Bldg. C, Suite 206 
Sunrise, FL 33351

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