Month: June 2019

June 24, 2019June 24, 2019

Lasik Surgery in HIV Positive Patients – Safety and Success

Grant Justin, MD, San Antonio, shared the result of a study at a recent ASCRS Meeting 2019 refractive surgery complications and risk Factor for HIV positive patients in the military. The objective of the study were to assess the frequency of refractive surgery performed on HIV positive active duty service member, retirees, and their dependents, and risk factors for postoperative complications in these patients.

The FDA recommends against refractive surgery in HIV positive patients or other individuals with immunodeficiencies, and the American Academy of Ophthalmology (AAO) says controlled autoimmune diseases are a relative contraindication for refractive surgery of 285 refractive surgeons found that about half of them consider HIV positive patients acceptable candidates for surgery, Dr. Justin said.

Surgery Updates

The new study analyzed refractive surgery frequency and outcomes in patients that were part of the Natural History Study a cohort of HIV positive active duty service members and retirees from the Department of Defense started in the early 1980s.

The study looked at patients from this cohort who had LASIK, PRK, and other corneal refractive procedures after being diagnosed as HIV positive. The result showed that none of the patients who received LASIK had any complications, but several patients who had received PRK and RK had complications involving corneal ulcers and Keratitis.

The study found it is critical to review a patient’s CD4 cell counts, viral loads, and whether they are on Highly Active Antiretroviral Therapy (HAART), Dr. Justin said. Patients who have poor compliance with their HAART medications may have poor compliance with postop drops, he said. He recommends surgeons consider doing unilateral surgery in these patients because of the risk of infection.

June 24, 2019June 24, 2019

Non Invasive Treatment For Patients Unsatisfied with their Vision Following Cataract or Lasik Surgery

Rajesh Rajpal, MD, Mc- Lean, Virginia discussed how corneal collagen cross linking could be implemented as a refractive procedure post-cataract surgery in addition to being a treatment for keratoconus.

Cross linking involves using oxygen, riboflavin, and UV light to stabilize the cornea. But the PiXL device (Avedro), which is not yet available in the United States, allows physicians to customize the crosslinking treatment by incorporating corneal topography measurements and an eye tracker. The end result is the ability to reshape the cornea by creating a customizable area of UV light application, Dr. Rajpal said.

Only epithelium-off crosslinking procedures are approved in the United States, but a Phase 3 clinical trial of epithelium-on crosslinking for keratoconus is currently being conducted. This modified crosslinking procedure uses a combination of a different formulation of riboflavin, supplemental oxygen, and an accelerated protocol to make the procedure non-invasive and could easily be transformed into a standalone refractive treatment, according to Dr. Rajpal.

Eye tracking allows the device to Selectively activate the riboflavin by only shining the UV light on specific areas of the cornea. The device could treat myopia by crosslinking only the central portion of the cornea and for treating hyperopia by cross linking a donut-shaped portion of the peripheral cornea.

The corneal epithelium is a barrier to all three components of the crosslinking reaction: It reduces absorption of riboflavin into the stroma, blocks the UV light, and blocks the oxygen from getting to the site of action. But the PIXL system uses “boost goggles” to bring more oxygen to the corneal surface, which benefits the crosslinking reaction and allows the procedure to have a greater effect while the epithelium is on, Dr. Rajpal said.

The primary patient population for this procedure would be emmetropic presbyopes wanting good near vision after cataract surgery, but the population could expand to include slightly myopic or hyperopic presbyopes who want good distance and near vision. A Phase 2 clinical trial for the PiXL procedure is slated to begin this year.

June 24, 2019July 17, 2019

All u need to know about Lasik

Now you can finally say goodbye to hazy and blurred vision and end your dependence on spectacles or contact lenses!

Introducing High Technology Treatments from Ojas

LASIK (Laser-in Situ keratomileusis) is the latest breakthrough in vision Technology that has transformed the lifestyle of spectacle and contact Lens users all over the world.

LASIK eliminates a life-time of dependence on glasses and contact lenses in just a matter of seconds. The thousands of operations we have successfully handled over the last 20 years, has given us an acute Understanding of the fear and apprehension people have with even the most advanced and safest of procedures like LASIK.

This book is an attempt to offer you insights into how LASIK works and what its effects are. Also, we shed light on the latest improvements in LASIK technology that has given the world an even better and true-to-the eye advanced procedure in the form of Custom LASIK.

What is Lasik?

Laser Vision correction in the blink of an eye

LASIK stands for Laser In-Situ keratomileusis, which means "to shape the cornea within its layers using a laser." LASIK is a skilled procedure that combines the state-of-the art computer technology with advanced laser precision.

How is it different from the older PRK procedure with the EXCIMER laser?

While the earlier Excimer laser procedure (PRK) treated the surface of the cornea, LASIK treats the inner tissue of the cornea and restructures by graining down myopia (minus power), hyperopia (plus power) & astigmatism(cylinder power).

Who can undergo LASIK?

Not everyone is eligible to undergo a LASIK procedure. A potential candidate, must be at least 18 years of age, in good health, and be free from eye diseases such as cataract or glaucoma. A Consultation with an ophthalmologist or optometrist and an in-depth eye examination is a must to find out your eligibility to undergo the LASIK procedure.

Why Choose OJAS for LASIK?

OJAS is an acknowledged leader in the application of Advanced Solutions for vision rejuvenation. Ojas combines trained and highly skilled doctors, sophisticated technology and world class procedures to offer you the very best in eye care and improved eyesight.

LASIK – Safe & Uncomplicated, But a Highly skilled & Specialized Treatment

Pre – Procedure Assessment

Before deciding to undergo laser vision correction, the doctor/optometrist will undertake the following step-by-step procedure:
Educate the patient about laser vision correction and other alternative procedures.
Study the patients eye history and previous test results (if any)
Perform the following elaborate pre-procedure diagnostic tests to determine the current state of the eye:
Lensometry
Auto refraction
Topography
Wave front Analysis & Aberrometry
Visual Acuity Testing
Pachymetry
Tonometry
Slit-Lamp Exam
Pupillometry
Retinal exam
Prepare a surgical plan based on the above diagnostic tests.

The Lasik Procedure – Simple, Safe & Short

The treatment is simple and takes only about 10 minutes to perform. The following steps ensure care & safety during the procedure:

Eyelids and lashes are cleaned
We instill Antibiotic anesthetic drops in the eye.
The patient lies back comfortably on a reclining operating table.
A protective corneal flap is created and gently lifted, revealing the inner corneal tissue. Since the corneal flap preserves the surface layer (epithelium) of the cornea, discomfort following LASIK procedure is minimal.
The computer within the laser machine is loaded with all the information of the pre-procedure tests.
The system calculates the required corneal treatment and directs the laser. Computer controlled pulses of cool laser light are applied to the inner layers of cornea. As the laser pulses, it makes a ticking sound. The inner corneal layer is reshaped with the laser to mimic your contact lens or prescription glasses.
The surgeon gently places the flap back and aligns it to its original position.
The flap heals naturally and securely.

LASIK

It cures Myopia and Hyperopia in a twinkling

Post Procedure Care

Most patients can resume work within a day after undergoing the Lasik procedure. There is minor irritation & the sensation of a foreign body after the procedure and the eye may water for some time. In case of pain, a pain killer tablet is advised.

Guiding patients in their Healing Phase

Our Patient Care cell provides post procedure care to help in the recovery process. Patients are advised to take some common and simple eye care measures like

Avoid driving, smoking & a head bath for 1-2 days.
Wear sunglasses for the first few days in sunlight.
Read and watch TV in moderation during the first few.
Avoid using eye makeup and rubbing the eye for 1 week.
Avoid heavy exercise and swimming for one week.
Avoid rough sports that could result in eye injury for one month following Lasik.

June 8, 2019July 17, 2019

Say good – bye to dependence on glasses and contact lenses

So what can CustomLASIK do for me?

Clinical studies have shown that CustomLASIK can improve not only you can see but also how well you can see. In the past, vision was measured using a standard vision chart. If you could see the letters, the doctor would proclaim your vision as a number, such as 20/20, 20/100, etc. But now, with CustomLASIK, doctors are also able to focus on the quality of your vision. Many patients who have had undergone custom LASIK procedure, report clear vision than ever before. It’s as if someone had taken an ink pad ans freshly stamped each letter on the vision chart in bold black letters. Because Custom LASIK corrects the unique imperfections in each individual’s vision, it is likely that the patient will have improved night vision.

What does CustomLASIK cost?

The cost of CustomLASIK is generally higher than the cost of conventional LASIK. CustomLASIK is performed using some of the most advanced technology in the vision industry. The procedure combines the technology of the wavefront analyzer with the precision of a computerized laser and the skill of the eye surgeon.

How will I know what procedure I need to have?

Your surgeon is the best person to tell you which procedure is the best suited for you. Everyone’s eyes are different and your eyes may best be treated with CustomLASIK. Schedule a consultation with-your eye doctor & together, you can determine which procedure is right for you.

What is CustomLASIK?

CustomLASIK is a procedure that involves the use of a wavefront analyzer which enables your surgeon to customize the Conventional LASIK procedure to your individual eye. This customized procedure can result in patients seeing clearer and sharper than ever before.

What is the difference between CustomLASIK Conventional LASIK?

CustomLASIK uses an equipment called the wavefront analyzer (aberrometer) to accurately measure the way light travels thru the eye. The resulting map of the eye is then programmed into the laser, and the laser treats the eye based on the personalized 3D map. CustomLASIK helps to treat “higher order” aberrations, which are tiny imperfections in the optical system of eye. They have a significant impact on quality of vision. In fact, higher order aberrations have been linked to visual glare and halos. Higher order aberrations were previously untreatable with contact lenses, glasses or conventional LASIK.

Is the actual LASIK part, performed the same way? Or is it a completely different procedure?

The actual LASIK procedure is performed in exactly the same way in both Conventional LASIK and CustomLASIK. However, the pre-op testing for conventional LASIK and custom LASIK differ greatly. The wavefront analyzer used with CustomLASIK brings a whole new level of knowledge and accuracy for the surgeon to perform this advanced procedure.

June 7, 2019June 7, 2019

Association of Near work and Myopia in Children

Ku et al ( p. 214 ) conducted a nationwide, population-based prospective study to examine the association between near visual activities and incident myopia in Taiwanese children over 4 year of follow-up. The study involved 1958 Children from the Taiwan 2009 National Health Interview Surgery. The researchers estimated the association between incident myopia and 3 types of near visual activities: reading; electronic screen use (computer and handheld devices); and attending cram school-classes outside the regular school system. At baseline, 26.8% of children had myopia, whereas 27.7% of those without myopia at baseline developed incident myopia between 2010 and 2013. The researchers reported that of the 3 types of closes visual work, attending cram school for more than 2 hours a day increased the risk of incident myopia. They conclude that greater time spent in cram school is associated with a higher risk of incident myopia in Taiwanese children, potentially because it increases Near Visual activity and reduces outdoor time.

June 7, 2019July 17, 2019

LASIK – Answers To Frequently Asked Questions

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What is the Basic for patient selection in LASIK surgery?

The patient should:

Be above 18 years of age.

The patient’s vision and his prescription lens power must be stable over the past six months.

What diagnostic tests are required before one can undergo LASIK procedure?

Besides routine eye examination two preoperative tests – Topography & Pachymetry are performed.

Topography maps the refractive power of the cornea, identifies certain Corneal conditions like Keratoconus. Pachymetry measures the thickness of the cornea.

What is the range of power that the LASIK technique can treat successfully?

Provides the corneal Thickness is adequate, the LASIK technique can correct

Myopia from -1.00 to 15.00D
Hyperopia from +1.00 to +6.00D
Astigmatism from +1.00 to +6.00D & -1.00 to – 6.00D

Can both eyes be treated on the same day?

Yes, LASIK can be performed on both eyes on the same day.

Does the patient require to stay at the laser Centre?

No, LASIK is an In-clinic procedure and the patient can go home within Thirty minutes of its completion.

Is LASIK painful?

Lasik is not a painful procedure because the cornea is numbed with eye drop anesthesia.

However there may be mild discomfort and minimal pain during and after the Procedure, Depending upon the tolerance level of the patient.

When can a person get back to work after undergoing the LASIK procedure?

Patients can usually return to normal Work and routine after a day or two of treatment.

Does LASIK does not affect the colour, shape or size of the eye?

No, LASIK does not affect the colour, shape or size of the eye.

If you have any questions that are not dealt with in this article, do pick up the phone and ask for an appointment. We are always at hand to answer questions raised by our patients.

June 7, 2019July 17, 2019

Different Treatments For Removing Eye Glass Numbers

Introducing High Technology Treatment from Ojas

LASIK ( Laser-in Situ keratomileusis) is the latest breakthrough in vision technology that has transformed the lifestyle of spectacle and contact lens users all over the world.

LASIK eliminates a life-time of dependence on glasses and contact lenses in just a matter of seconds. The thousand of operations we have successfully handled over the 20 years, has given us an acute understanding of the fear and apprehension people have with even the most advanced and safest of procedures like LASIK.

This book is an attempt to offer you insights into how LASIK works and what its effects are. Also, we shed light on the latest improvement in LASIK technology that has given the world an even better and true-to-the-eye advanced procedure in the form of custom LASIK.

PRK – Photorefractive Keratectomy

Prior to LASIK, PRK was the most commonly performed laser vision correction surgery. This procedure also utilizes the excimer laser to reshape the curvature of the cornea and correct nearsightedness, farsightedness & astigmatism. PRK is useful in patients with thin corneas. Again, the excimer laser is used in the treatment of corneal opacity, corneal scars & superficial corneal dystrophy.

Lasek – Laser Epithelial Keratomileusis

In this procedure, diluted alcohol solution is used to soften the epithelial flap. It is then moved to one side & the excimer laser is administered to correct the vision defect. Lasek is useful in Patients with thin or flat Corneas who are poor candidates for LASIK.

EPI-LASIK

In this Procedure, the epithelial flap in first lifted with an epikeratome and after administering the laser, the flap is rolled back to normal position. Patients with thin corneas are advised this procedure.

Phakic Intra Ocular Lens ( IOL ) Implantation

In this procedure, the surgeon places an artificial lens either on the iris or behind the iris (ICL) and in front of the eye’s natural lens to correct vision defects.

This Procedure is ideal to correct high degrees of nearsightedness (Myopia) and farsightedness (Hyperopia). Toric phakic IOL is the latest development in correcting cylindrical powers along with high spherical power of the eye.

Refractive lens exchange (RLE)

In this procedure the clear lens is removed from the artificial lens is implanted in its place. This lens has-in Refractive power and is specifically implanted to meet the patient’s visual needs RLE is useful in treating high degree of nearsightedness & farsightedness.