SightLine Laser Eye Center & Ophthalmic Associates

Serving Doctors and Their Patients

Surgical Eye Care 


 

Cataract Surgery
Cataracts usually develop as part of the aging process, however, other causes include: family history, medical problems such as diabetes, injury to the eye, medications such as steroids or previous eye surgery. How rapidly a cataract develops varies among individuals, and even varies between the two eyes.

The amount and pattern of the cloudiness within the lens can vary.  If the cloudiness is not near the center of the lens, you may not be aware that a cataract is present.  However, many people experience common symptoms which include: painless blurring of vision, glare or light sensitivity, frequent eyeglass prescription changes, double vision in one eye, needing brighter light to read, poor night vision, or fading or yellowing of colors.
Cataract surgery should be considered when cataracts interfere with a person’s ability to live their desired lifestyle or perform daily tasks. After the cataract is removed, an intraocular lens is required to replace the focusing power of the natural lens.

Cataract surgery is a painless outpatient procedure which is covered by Medicare and most private insurances.  Your eye doctor can detect the presence and extent of a cataract through your regular eye exam and refer you for a surgery consult.
 

Premium Intraocular Lenses
Your eye doctor and surgeon will discuss your activities and interests with you to help to determine which lens is right for you.  Medicare beneficiaries may choose to receive a premium lens.  You will be responsible for payment of that portion of the charge for the lens and associated services that exceed the charge for a conventional lens.  Our billing department is available to help with any inquiries.
 
The Toric IOL offers patients with astigmatism the best opportunity for bilateral spectacle-independent distance vision. 
 
Presbyopia-Correcting IOLs offer cataract patients the opportunity to potentially see clearly at various distances.  While standard (monofocal) IOLs usually provide excellent distance vision, presbyopic lenses provide focusing ability at distance, near and even intermediate ranges.  SightLine offers all three presbyopic lenses (Crystalens, ReSTOR and Tecnis Multifocal).  Each of the lenses provides different combinations of focusing range.  
 

CLICK IMAGE FOR MORE INFO
CLICK IMAGE FOR MORE INFO
CLICK IMAGE FOR MORE INFO
CLICK IMAGE FOR MORE INFO

 

 
Visian ICL (Implantable Collamer Lens)

For patients who are extremely near or far-sighted or are otherwise unable to have LASIK (and who don't have cataracts), intraocular lens implants (ICLs) are an option which is available.

ICLs are a tiny lens which can correct myopia, hyperopia and astigmatism.  The lens is placed inside the eye in a manner similar to that used for cataract patients; however unlike with cataract surgery, this procedure does not require removal of the natural lens of the eye.  Therefore, the normal focusing  ability of the eye is retained. Because the lens implant is within the eye, it is not associated with many of the problems associated with current contact lenses such as dry eye and conjunctivitis.  This outpatient procedure is painless and the visual recovery is generally rapid.

CLICK IMAGE FOR MORE INFO

 

Keratoconus Treatment
Keratoconus is a common disease that results in progressive bulging of the cornea, the clear front portion of the eye. The normal outward pressure within the eye causes the cornea to progressively bulge into a cone-like shape.  Keratoconus can cause high levels of astigmatism which can interfere with the ability to see clearly. Often keratoconus patients first require glasses, then contact lenses, and, if the condition progresses to a severe level, a corneal transplant may be required.  There are different treatment options depending on the severity of the condition.  Your eye doctor can detect the presence of keratoconus and  will refer you to our office to help determine your treatment options.

 
Corneal Cross-Linking (CXL)
A normal cornea has cross-links between its collagen fibers that keep it strong and able to retain its normal shape. In keratoconus, the cornea is weak with too few cross-links. The CXL procedure uses riboflavin eye drops and a special light to add cross-links to the cornea.  These new cross-links help strengthen the cornea, making it more stable, which stops the thinning process and further loss of vision. Many research studies have shown that CXL may prevent further vision loss in over 95% of patients and slightly improves vision in 60-81% of patients treated.
Human studies of corneal cross linking began in 2003 in Dresden, Germany.  Since then, tens of thousands of patients have had the treatment around the world.  Corneal cross linking was done in studies in the United States for many years prior to the April 2016 FDA approval. Sightline treated about 230 patients in the initial studies prior to using the new FDA approved Avedro products starting in October of 2016.  Due to this recent FDA approval, not all insurances are covering the procedure.  Financing options are available.


 

Endothelial Keratoplasty (EK)

The cornea is composed of three layers.  The inner endothelium layer is composed of thousands of small pump cells.  These cells are responsible for pumping fluid out of the cornea so it can remain clear to provide good vision.  If these cells become dysfunctional, damaged, or destroyed, the cornea absorbs fluid and becomes swollen and cloudy, causing blurred vision.  These inner endothelial cells can be lost due to aging, diseases (such as Fuchs’ Corneal Dystrophy), trauma, or previous eye surgery.  If a critical number of endothelial cells are lost, a corneal transplant operation may be indicated. 

For the past 100 years, full-thickness corneal transplant, penetrating keratoplasty (PK), was the solution.  While this procedure has had over a 90% success rate, the recovery period is long and often requires periodic suture removals.   It is very common to be left with large amounts of corneal distortion, requiring the use of thick glasses or hard contact lenses to achieve acceptable vision.

In many patients, the middle and the outer layers of the cornea are just swollen, but remain healthy.  Eye researchers and surgeons have long recognized that for many patients needing a corneal transplant, only the diseased or missing endothelial cells need to be replaced. In more recent years, a new technique called EK has evolved, which accomplishes the goal of replacing only the endothelial cell layer.  This new technique is a significant improvement over the standard full thickness operation. 

There are several significant advantages to the EK operation.   Since only the inner layer of the cornea is replaced, over 90% of the patient’s own cornea remains behind giving the cornea greater strength and a reduced incidence of rejection.  The operation is also faster and the wound is smaller.  The smaller wound results in virtually no corneal distortion. The maximum return in vision takes only about 1 to 3 months following EK as compared to 6-12 months with full-thickness transplant (PK).

Surgery is usually performed as an outpatient at a hospital or surgery center, under local anesthesia. If you also have a cataract, then cataract surgery can be performed at the same time as EK surgery.  Routine post-op care includes visits at 1 day and 3, 6, 12 and 24 months after the surgery.  Several eye drops are used before and after the procedure.


EK is not for everyone.  Some patients with corneal scarring or other conditions are not suitable candidates for EK.  Your eye doctor can detect the presence of corneal dysfunction and where appropriate, will refer you to Dr. Phillips or Dr. Valli for surgery consultation.