Surgeries and Treatments

Vascular Treatments

• Created in Surgeries and Treatments

Laser treatments are used for a variety of vascular occlusions. For central vein occlusion, the purpose of the treatment is to prevent further growth of new blood vessels in the front of the eye. For branch vein occlusions and macular edema (swelling), the treatment is used to close leaky blood vessels and prevent others from breaking open.

Vascular occlusion laser treatments are the same as some of the treatments used for diabetic retinopathy.
Focal Laser Treatment is an in-office procedure used to treat macular edema, or swelling in the anterior part of the eye. Patients undergo a dilated eye examination and a flouroscein angiograph prior to the treatment in order to identify the location of leaky blood vessels that cause the swelling. During the procedure, a laser is used to seal off the leaky blood vessels and prevent further leakage. As the existing blood dissipates, the swelling is reduced. The sooner the problem is diagnosed and the earlier treatment is applied, the higher the likelihood of a successful outcome.

Grid Laser Treatment is also an outpatient procedure that is used to seal off a wider array of leaky blood vessels over a diffuse area. Because there are more leaks, there is also more swelling in the eye. The laser treatment is similar to focal laser treatment except that more leaks are sealed in the eye. Again, the object of this treatment is to reduce swelling in the eye.

Pan Retinal Photocoagulation (PRP) When swelling in parts of the eye becomes severe, it can cause ischemic tissue (oxygen-deprived tissue) to send signals to the body requesting the production of new blood vessels. These new vessels tend to be abnormal and often break open and bleed, making the situation worse. With PRP, tissue is selectively destroyed using a laser in order to force the new blood vessels to shut down. When successful, this technique reduces the eye's demand for oxygen and stops the signal for more new blood vessels. PRP is a same day, outpatient procedure. Patients must have a clinical examination as well as a flouroscein angiograph prior to the treatment. There are no sutures and no patching or eye drops are required afterwards. Full recovery time is roughly 90 days.

Vascular Treatments

•Created in Surgeries and Treatments
Laser treatments are used for a variety of vascular occlusions. For central vein occlusion, the purpose of the treatment is to prevent further growth of new blood vessels in the front of the eye. For branch vein occlusions and macular edema (swelling), the treatment is used to close leaky blood vessels and prevent others from breaking open.

Vascular occlusion laser treatments are the same as some of the treatments used for diabetic retinopathy.
Focal Laser Treatment is an in-office procedure used to treat macular edema, or swelling in the anterior part of the eye. Patients undergo a dilated eye examination and a flouroscein angiograph prior to the treatment in order to identify the location of leaky blood vessels that cause the swelling. During the procedure, a laser is used to seal off the leaky blood vessels and prevent further leakage. As the existing blood dissipates, the swelling is reduced. The sooner the problem is diagnosed and the earlier treatment is applied, the higher the likelihood of a successful outcome.

Grid Laser Treatment is also an outpatient procedure that is used to seal off a wider array of leaky blood vessels over a diffuse area. Because there are more leaks, there is also more swelling in the eye. The laser treatment is similar to focal laser treatment except that more leaks are sealed in the eye. Again, the object of this treatment is to reduce swelling in the eye.

Pan Retinal Photocoagulation (PRP) When swelling in parts of the eye becomes severe, it can cause ischemic tissue (oxygen-deprived tissue) to send signals to the body requesting the production of new blood vessels. These new vessels tend to be abnormal and often break open and bleed, making the situation worse. With PRP, tissue is selectively destroyed using a laser in order to force the new blood vessels to shut down. When successful, this technique reduces the eye's demand for oxygen and stops the signal for more new blood vessels. PRP is a same day, outpatient procedure. Patients must have a clinical examination as well as a flouroscein angiograph prior to the treatment. There are no sutures and no patching or eye drops are required afterwards. Full recovery time is roughly 90 days.

Vascular Treatments

•Created in Surgeries and Treatments

Laser treatments are used for a variety of vascular occlusions. For central vein occlusion, the purpose of the treatment is to prevent further growth of new blood vessels in the front of the eye. For branch vein occlusions and macular edema (swelling), the treatment is used to close leaky blood vessels and prevent others from breaking open.

Vascular occlusion laser treatments are the same as some of the treatments used for diabetic retinopathy.
Focal Laser Treatment is an in-office procedure used to treat macular edema, or swelling in the anterior part of the eye. Patients undergo a dilated eye examination and a flouroscein angiograph prior to the treatment in order to identify the location of leaky blood vessels that cause the swelling. During the procedure, a laser is used to seal off the leaky blood vessels and prevent further leakage. As the existing blood dissipates, the swelling is reduced. The sooner the problem is diagnosed and the earlier treatment is applied, the higher the likelihood of a successful outcome.

Grid Laser Treatment is also an outpatient procedure that is used to seal off a wider array of leaky blood vessels over a diffuse area. Because there are more leaks, there is also more swelling in the eye. The laser treatment is similar to focal laser treatment except that more leaks are sealed in the eye. Again, the object of this treatment is to reduce swelling in the eye.

Pan Retinal Photocoagulation (PRP) When swelling in parts of the eye becomes severe, it can cause ischemic tissue (oxygen-deprived tissue) to send signals to the body requesting the production of new blood vessels. These new vessels tend to be abnormal and often break open and bleed, making the situation worse. With PRP, tissue is selectively destroyed using a laser in order to force the new blood vessels to shut down. When successful, this technique reduces the eye's demand for oxygen and stops the signal for more new blood vessels. PRP is a same day, outpatient procedure. Patients must have a clinical examination as well as a flouroscein angiograph prior to the treatment. There are no sutures and no patching or eye drops are required afterwards. Full recovery time is roughly 90 days.

Laser Vision Correction

•Created in Surgeries and Treatments

LASIK (Laser-In-Situ Keratomileusis)
For more than three decades, laser vision correction has been the dominant method for refractive surgery. Today, LASIK is most frequently used as an outpatient procedure for the correction of low, moderate and high prescriptions.

Prior to LASIK surgery, your eye doctor will create a computer-generated map of the surface of your eye. This information is calibrated into the laser used for the surgery. After anesthetizing the eye with eye drops, the surgeon then uses a microsurgical instrument to create a corneal flap. An excimer laser directs a cool beam of light onto the surface under the flap in order to precisely and gently reshape the eye. The flap is put back in place, completing the brief surgery (usually five minutes or less per eye). Patients are usually back to their normal activity level within 24 hours.

Good candidates for LASIK are at least 18 years of age, in generally good health, with no eye diseases (such as cataracts or glaucoma) or certain health problems (such as uncontrolled diabetes or autoimmune disease). Candidates must also have a stable glasses prescription for at least one year. Because of hormonal shifts, pregnant or nursing women are not eligible for at least two menstrual cycles after nursing has been discontinued.

PRK (Photorefractive Keratectomy)
PRK is another commonly used form of laser correction surgery. No scalpels are used nor are any incisions made in this procedure. PRK is often used when the patient does not have enough corneal thickness for LASIK.

Once again, your eye doctor prepares a detailed map of your eyes' surface which is calibrated to the excimer laser. After anesthetizing the eye with eye drops, the surgeon gently removes the eye's protective first layer of cells (epithelium) with the excimer laser and carefully reshapes the area with computer-controlled pulses of cool laser light. Deeper cell layers remain virtually untouched and the epithelial layer regenerates itself in days.

Post-operatively, PRK patients are placed on antibiotic drops and anti-inflammatory agents to reduce swelling and promote comfort. Patients are also fitted with a bandage contact lens for the first two or three days until the epithelium is healed. To complete the healing process, PRK patients use steroid anti-inflammatory drops for about two months after the procedure

Glaucoma Treatments and Surgery

• Created in Surgeries and Treatments

Two laser treatments and one surgery may be recommended at different stages in the treatment of glaucoma: Laser Peripheral Iridotomy (LPI), Argonne Laser Trabeculoplasty (ALT) and glaucoma surgery.

Laser Peripheral Iridotomy (LPI)
This preventative technique is used to preempt the occurrence of a glaucoma attack. During an eye examination, an eye doctor may notice that the angle in the eye appears to be too narrow. A narrow angle tends not to drain properly and can lead to a build up of fluid and pressure, a precursor to glaucoma. In LPI, a laser is used to place a tiny opening in the iris in order to improve drainage. The treatment requires no sutures and is handled on a same day, outpatient basis. The patient is required to use anti-inflammatory eye drops for approximately one week following the treatment. LPI has a very high success rate.

Argon Laser Trabeculoplasty (ALT)
ALT is used for patients who have already been diagnosed with glaucoma and for whom eye pressure remains too high even after trying treatments with various eye drops. During the treatment, a laser is applied to heat up certain portions of the tissue. This process stretches the pores and opens up the outflow channels for fluid, which decreases eye pressure.

ALT is a same day, outpatient procedure that causes minimal discomfort. A topical anesthetic is administered in the eye prior to the treatment. Then a clear lens is placed on the eye to help focus light. The patient experiences approximately 30 to 40 flashes of light while the laser is applied. The treatment takes about ten minutes per eye and patients usually go home after another hour. Anti-inflammatory eye drops are administered for approximately one week following the treatment. Any reduction in IOP is seen within the first four weeks following the procedure. The success rate for ALT is approximately 75%.

Glaucoma Surgery
When all other treatments fail, glaucoma surgery (filtration) may be called for. The purpose of the surgery is to create a new outflow channel that works in tandem with the existing channels. The resulting increased drainage reduces the pressure in the eye and prevents any further eye deterioration. It is important to understand that glaucoma surgery cannot improve or reverse the damage already done by the disease. Its use is as a preventative measure to limit further damage or worsening of the disease. The surgery has about an 80% success rate.

Glaucoma surgery is handled on an outpatient basis; no overnight hospital stay is needed. The procedure takes less than one hour. A local anesthetic is administered. The surgery does require some sutures, which may need to be removed during recovery. Patients use antibiotic and anti-inflammatory eye drops for several weeks following the procedure. Blurry vision may occur after the surgery but is typically temporary. This surgery is successful for about 2 out of every 3 people who undergo it.
Cataract Surgery
• Created in Surgeries and Treatments
When cataracts reach the stage where they are seriously decreasing an individual's vision, cataract surgery is called for. In this common procedure, the doctor removes the natural lens in the patient's eye, which is replaced by a permanent lens implant. The implant is made specifically to fit the patient's prescription and eye length for each eye.

Cataract surgery is performed on an outpatient basis and requires no stitches; patients go home the same day. About one week prior to the surgery, the patient undergoes pre-operative testing, including a blood test and electrocardiogram. After the surgery, the patient must wear an eye patch for the first 24 hours. Eye drops to prevent eye infection are required for the complete 2-4 week recover period. Cataract surgery is performed on only one eye at a time.

In rare cases, the skin of the cataract, which is left in the eye, can cause cloudiness of vision after the surgery. If this occurs, the cloudiness can be removed using a laser treatment.

Corneal Transplants

• Created in Surgeries and Treatments

Corneal transplants are commonly used for treating two types of corneal problems. The first is kerotaconus, a disease that causes progressive thinning of the cornea. The second is excessive scarring caused by chemical burns, blunt trauma or other severe lacerations to the cornea.

During the surgery, the central corneal area, known as a corneal button, is removed and replaced with tissue from another person's eye. The replacement corneal tissue is then sutured in place. While vision will not be perfect after recovery, the patient will regain a certain amount of central vision. For keratoconus patients, a lens is fitted after the surgery to help soften the curvature of the eye and improve vision.

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