“Your eyes provide your most precious sense. That’s why I care so deeply about your particular concerns. You should not be treated like a number! I give each person as much time as necessary to answer all your questions."
(Jeffrey D. Gold, MD)

Since the FDA approved the use of the Excimer Laser for Laser Vision Correction, in 1995, millions of people in the US and even more around the world have been freed from the need for glasses and contact lenses. The technology that led up to the approval included radial keratotomy (RK), which has been all but abandoned, and photorefracture keratotomy (PRK) which is still used in selected patients who are not candidates for LASIK. The approval was originally for nearsightedness only, but as the technology has advanced, vision correction can now be performed for people with astigmatism and farsightedness as well.

In PRK (and Epi-LASIK) the surface (epithelial) cells are removed and discarded and the laser treatment is applied to the second layer of the cornea to change its shape and thereby its focal point. At the end of the procedure a bandage contact lens is placed, which remains for 3 to 5 days while the epithelium regrows. This procedure is generally not as comfortable as LASIK and takes longer to heal than LASIK, however both procedures give equally good vision. 

Epi-LASIK

Liberty Vision continually strives to provide its patients the benefits of the latest advances in laser vision correction. We are very pleased to announce that we are among the first practices in our area to perform Epi-LASIK.

Epi-LASIK with the Epi-K device from Moria is an advanced "surface ablation procedure" - the laser correction is done on the surface of the cornea, rather than at a deeper layer, as in LASIK. Using a very sophisticated device called an epikeratome, Dr. Gold partially separates the epithelium, the outermost skin-like layer of the cornea. This separation is done without cutting and without a blade: blade-less. The epithelial sheet is removed and discarded. Then the laser part of the treatment is performed. The cornea is  then protected by a contact lens for about three days, while the epithelium regenerates .

Performing the laser correction on the surface of the cornea preserves its structural integrity and allows treatment of individuals who may not be good candidates for LASIK. Many patients, for example, who cannot have LASIK because their corneas are too thin, can now have laser vision correction with the same great long-term results as LASIK. Previously the only refractive surgical option for such patients was PRK (Photo Refractive Keratectomy), a procedure involving more pain and longer visual recovery time than Epi-LASIK.

Epi-LASIK is also an excellent alternative for individuals who, for a variety of reasons, may not wish to have LASIK or who are not good LASIK candidates because of participation in dangerous sports such as martial arts in which blunt trauma to the eyes is a real possibility.
The safety and efficacy of Epi-LASIK have been demonstrated in extensive clinical trials. Surgeons participating in the trials reported that their patients:

•   Achieved excellent visual results.
•   Recovered their vision faster than typical patients treated with other surface ablation procedures -             but not as rapidly as LASIK patients.
•   Experienced less pain than other surface ablation patients - but slightly more than LASIK patients.
•   Had no significant complications.
•   Could return to work soon.

There is also evidence in the scientific literature suggesting that surface ablation procedures may actually produce better visual results than LASIK. Further study is necessary to verify this observation.

Contact us to schedule a personal consultation with Dr. Gold to determine if Epi-LASIK is right for you.

The goal of Epi-LASIK is to reduce or eliminate the patient's need for glasses or contact lenses. However, the procedure does not always create 20/20 or even 20/40 vision. Liberty Vision and the manufacturers of the medical devices used in Epi-LASIK do not guarantee the results of any specific Epi-LASIK procedure and expressly do not represent that the procedure will provide the patient with perfect vision or will completely eliminate the need for glasses or contact lenses. As with any medical procedure, there are risks and complications associated with Epi-LASIK. Every patient should weigh the chance of experiencing complications against the potential benefits the procedure can provide. Dr. Gold spends a great deal of time during your consultation discussing your options and which procedure might be best for you.

LASIK

In LASIK a protective flap is created in the front of the eye (cornea) with a microkeratome. The flap is then folded back to expose the inner layers of the cornea. Laser treatment is then performed using the Excimer Laser on the inner layers to change the focal point of incoming light rays. The central cornea is flattened to correct nearsightedness, steepened for farsightedness and rounded for astigmatism. The flap is then repositioned and it adheres without the need for stitches.

Following LASIK you will leave the clinic wearing sunglasses, and go home to sleep for 4 to 5 hours during which time the flap will adhere in the correct position. You can expect very cloudy vision until after that nap. For most patients the excitement begins the next morning when they discover that they are fully capable of driving themselves to the one day post-op visit!

Following Epi-LASIK you will leave the clinic with insructions about ice packs as a major part of preventing pain. You will be able to use your eyes during the first three days with the caveat that if you experience irritation you instill some eye drops, and lie down for 20 minutes with ice packs on the  closed eyes.  Obviously you will be able to open your eyes and see to walk around the house, eat, and get dressed and perform usual activities.   If you follow your written instructions to the letter, the likelihood of pain is very remote. Your vision will improve over the first few days and then start to get really better after your bandage contact lenses are removed on the third day. The typical Epi-LASIK patient returns to work on the fourth day.

WHAT TO EXPECT

Both procedures are brief and offer minimal discomfort. We recommend that patients take Valium before the procedure to achieve mild sedation. The Valium also helps patients sleep after the procedure.

The eye is numbed with anesthetic drops. The eyelids are held open with a special eyelid retainer, so the patient does not have to worry about blinking. Movement of the eye is usually not a problem because the patient is motivated to look at the fixation light in the laser and Dr. Gold uses state-of-the-art "tracking" technology. Antibiotic, anti-inflammatory, and lubricating drops are used following the procedures. In LASIK patients the most typical reaction the first morning after surgery is: "I can't believe I can see the clock without glasses!" In Epi-LASIK the blur lasts a short time longer.

IT'S BEEN SAID: "THE EYES ARE THE WINDOWS TO THE SOUL"

WE DO WINDOWS!