Important info about a topic that Dr. Goldstein discussed in-office with you.
LASIK is the most exciting recent addition to the refractive surgery tools of the modern eye surgeon. Dr. Goldstein uses the VISX Star S4 excimer laser to perform individualized LASIK with CustomVue technology. The most current advance in LASIK is the use of the femto laser to perform bladeless LASIK surgery.
Bladeless LASIK uses laser technology to create the flap on the cornea, similar to the flap that is formed by the keratome in standard LASIK surgery. The keratome makes a physical incision with a blade, cutting a very thin layer off of the front of the cornea.
Alternatively, “All-Laser LASIK”, which uses a special femto-laser, can be chosen by a patient. The flap is created completely by a precise laser, which treats to a more exact location, shape and depth. This may allow patients who were previously not candidates for surgery to have LASIK surgery!
After the treatment is completed, regardless of the method of flap creation, the flap is replaced. The flap seals itself into position very quickly, in much the same way that a contact lens stays in place on the eye. Most surgeons smooth the flap into position to ensure that it does not have folds or wrinkles.
The patient is sent home with instructions to keep their eyes closed, or to nap for a couple of hours. Most patients report a small amount of stinging and tearing immediately after surgery. Almost all patients vision by the first day after surgery is close to 20/20, and the patients are pain free. An antibiotic eye drop is used to prevent infection. Steroid drops are needed to prevent scarring and haze. Dry eyes are also common after LASIK, and artificial tears are used for a few weeks after surgery.
Please contact us today to determine whether you are a suitable candidate for LASIK.
When a patient develops significant cataracts, surgery is the solution to the problem. LASER cataract surgery considerably improves the chances of a successful procedure and reduces overall downtime afterward.
In general, patients do not require surgery until their vision interferes with their normal daily activities. For instance, if a patient has glare that is making it difficult to drive in sunlight or at night (due to headlights), surgery may allow them the freedom to drive safely. Anytime that cataracts stop patients from enjoying their activities of daily living (ADL’s), surgery may be considered as a solution to the problem.
Cataract surgery is simply lens replacement surgery. The cloudy natural lens of the eye is removed, and replaced with a clear artificial lens implant. There are many options for lens implants. Many patients will choose advanced technology implants such as the Crystalens® implant to decrease their need for reading glasses. Dr. Goldstein will provide complete information regarding lens implant options to his patients when they have their pre-op discussion with him.
The newest technology for cataract surgery uses LASER light to perform several steps of the surgery. The incision can be performed with the femtosecond laser so that a scalpel may not be needed. Astigmatism can be corrected with the laser, and the cataract may be softened using laser as well. An additional step, the capsulorhexis, may also be performed with the laser, allowing a more precise opening in the capsule that surrounds the cataract.
The femtosecond laser, when used for cataract surgery, allows a more precise surgical technique. By decreasing the ‘manual’ or ‘done-by-hand’ steps in this surgery, the results may be improved. This will probably be most important in correcting astigmatism, and also in allowing the best placement of lens implants. In patients who select the Crystalens®, Trulign Toric, PanOptix Multifocal, or the Tecnis lens implants, the accuracy may be better. This will allow the best chance of reducing or eliminating the need for glasses after surgery.
In Presbyopia, the natural aging of the eye leads to a loss of ability to focus on near objects. Other “refractive errors” such as Nearsightedness, Farsightedness, and Astigmatism also limit the ability of a patient to see without glasses. Now, with the help of the most modern surgical techniques, all of these problems can be solved! Refractive Lens Exchange, or ReLex, may be used to replace the natural lens of the eye with one that can reduce or eliminate the need for glasses!
Dr. William Goldstein employs only the most modern techniques for ReLex surgery. He has been using a ‘needle-free, pain-free, stitch-free and patch-free’ method since 1996. The use of ‘topical anesthetic’ means drops and gels are used to apply the numbing medication. No needles are used, making surgery safer while maintaining a ‘pain-free’ situation. Dr. Goldstein also uses a self-sealing incision which is less than 1/8th inch long, so no stitches are needed. And since the topical anesthetic does not affect the movement of the eye or eyelids, no patches are needed either!
During ReLex surgery, the natural lens of the eye is removed. A membrane is left behind to act as a ‘pocket’ for an artificial lens implant. Each lens implant is carefully selected by Dr. Goldstein in an effort to reduce or eliminate the need for glasses. To maximize the patients’ freedom from glasses, Dr. Goldstein prefers to use the Crystalens® or the Tecnis multifocal lens implants for full focus.
Once surgery is completed, the patient spends a short time in the post op area, and is discharged home. By the next day, patients have generally recovered most of their vision! Antibiotic and steroid drops are used to minimize the risk of infection and swelling for a period of time after surgery.