Refractive Surgery

Refractive Surgery today refers to a number of procedures that can help reduce or possibly eliminate your need to wear glasses. Depending on you current prescription, age, corneal shape and corneal thickness, one of the following procedures may be better for you. At your consulation with Dr. Keamy, your individual needs and eyes will be examined to help you choose the right procedure for you.

Laser in-situ keratomileusis (LASIK)

Laser in-situ keratomileusis (LASIK) is the most popular of all the refractive surgery procedures today. A device called a microkeratome creates a flap in the cornea. Once the flap is lifted, an excimer laser reshapes the cornea. Dr. Keamy uses the VISX S4 laser with an eye tracker. Afterwards the flap is placed back into position. The LASIK technique has a relatively quick recovery with functional vision within only a few days. It is relatively painless. Most patients are quite happy with their results however the surgery is not without risk nor are the results guaranteed. Sometimes an enhancement or second surgery must be done to achieve optimal results. The procedure is approved for low to high myopia, low to moderate hyperopia, and astigmatism.

LASIK is performed on an outpatient basis in Dr. Keamy's office and takes only a few minutes. You will remain awake during the procedure and the only anesthetic you will need is eye drops. Afterwards you will use both steroid and antibiotic drops for one week. Anticipate being in our office about one hour on the day of the procedure. Most patients experience improved vision the same day and are able to return to work the very next day.
.
LASIK is not recommended for all patients who come for a consultation. Sometimes a surface laser correction PRK is a better option or possibly no surgery at all. When you meet with Dr. Keamy for your consultation, after a thorough examination and discussion, she will be able to tell you if you are suitable to proceed. Before your consultation, please keep your contact lenses out for 10-14 days prior to consultation.

For further information on LASIK, contact us .

Top of Page

Custom LASIK & PRK

When a light is projected onto your retina, a wavefront, which measures your eyes visual system, is created. The measurements obtained from the wavefront are converted into a waveprint, a representation of your optical system. This system creates a new level of diagnostic information – a unique visual profile – as personal as a fingerprint of your vision.

With these wavefront details and measurements, Dr. Keamy is able to individualize your laser vision correction procedure. Using the results of the wavefront procedure, the laser can reshape your cornea to neutralize the refractive errors with either LASIK or PRK. Since each eye is unique, the wavefront technology can provide you with a more precise and detailed analysis of your vision allowing her to customize your laser vision correction procedure. Dr. Keamy uses the CustomVue TM system with the VISX S4 laser.

For further information on Custom LASIK & PRK, contact us .

Photorefractive Keratectomy (PRK)

Photorefractive keratectomy (PRK) uses an excimer laser to reshape the cornea. Unlike LASIK, there is no flap. The epithelium, the first layer of the cornea, is removed with either the laser or a blade and then the second layer of the cornea the stroma is reshaped by the laser. As in LASIK, Dr. Keamy uses the VISX S4 laser with an eye tracker.

PRK may be used to treat low to moderate myopia (nearsightedness), low hyperopia (farsightedness), or mild astigmatism. Since the superficial layer of the cornea the epithelium is removed, it takes up to 10 days for the cornea to heal. This generally means that patients who undergo PRK will require up to two weeks recovery to achieve functional vision to several months to achieve their best vision.

The outcomes of PRK and LASIK are quite comparable at the 6 month post-operative visit. Many people choose PRK because they are not a candidate for LASIK. Other people choose PRK since there is no risk of flap complications. PRK is an elective procedure which, like any procedure, has risks and benefits. Additionally an enhancement procedure may sometimes be required. Overall, PRK is an excellent procedure for low to moderate degrees of myopia and astigmatism.

For more information on Photorefractive Keratectomy (PRK), click here.

Phakic IOL

For Phakic IOL, a special lens called intraocular (IOL) contact lens is placed either in front of or behind the iris so that it works with the eye's natural lens to bend the light rays more appropriately. In younger patients this procedure preserves the ability to focus up close. Risks associated with Phakic IOL are cataracts or possibly glaucoma, but the most refined form of this procedure looks promising. It is being actively investigated and has been gaining acceptance worldwide. Phakic IOL is a recently FDA approved alternative for patients who do not meet the criteria for LASIK or PRK or any of the other refractive procedures.

For more information on Phakic IOL, click here.

Top of Page

Clear Lens Extraction

For people over 55, who are very farsighted or severely nearsighted, an alternative approach is replacement of their natural lens with an artificial lens of a more appropriate power. This is essentially the same operation as cataract surgery. We can select an implant to either correct distance or reading vision. In patients who are beginning to develop a cataract or who are approaching the cataract age group, this approach is logical. The lens is removed before a true cataract develops so no cataract surgery will be unnecessary in the future.

For more information on Clear Lens Extraction, click here.

Conductive Keratoplasty (CK)

Conductive Keratoplasty (CK) is the first non-laser procedure for baby boomers who have had clear distance vision all their life, but now struggle to see up close.

CK is a safe, minimally invasive alternative to laser procedures. It is ideal for people over 45 once presbyopia has begun. It is also a good procedure for low levels of hyperopia. Conductive Keratoplasty (CK) can help restore your vision, allowing you to see read you could 10 years ago.

CK is an exciting new advancement in vision correction because it uses radiofrequency (RF) energy instead of a laser to reshape your cornea. CK can change how the eye focuses light by reshaping the surface of your eye (cornea). When the shape is changed, light can be refocused on the correct part of your eye (retina). To produce this reshaping, CK uses the controlled release of RF energy to heat and shrink corneal tissue. This steepens the cornea and allows light to properly focus on the retina again.

For further information on Conductive Keratoplasty (CK), contact us .

Before Your Consultation

Patients who wear soft contact lenses or rigid gas-permeable contact lenses should discontinue their contact lens wear at least 10 to 14 days prior to the evaluation. One or more careful refractions (determinations of eyeglass correction needed) will be completed. If you have your prior eye glass prescriptions it is helpful to bring it in. Contact lens wearing patients who are believed to have an unstable refraction will be asked to discontinue contact lens wear and return for a repeat refraction in one to three weeks. When back-to-back refractions are stable (equivalent), the procedure may be scheduled. Corneal topography, a detailed surface map of the cornea, will also be completed to rule out keratoconus and irregular astigmatism of the cornea. An instrument called a pachymeter will help determine your corneal thickness. A thourough eye exam will be completed including a dilated exam. Only healthy eyes are eligible for surgery.

Top of Page