...Special
Techniques
MONOVISION
 During
childhood, our eyes have the ability to focus on objects as close as
our nose and to objects very far away. A young person without any refractive
error can see the objects at 25 cm distance to infinity clearly. The
lens in our eyes acts as a focusing lens in a camera. When the objects
are near, the lens thickens and focuses the light rays on the retina
to obtain a clear image.
As each year passes, that ability to "focus" decreases. But
typically, by the time we reach our forties, we need an aid, such as
reading glasses or bifocals, to focus on objects near to us. This condition
is called presbyopia.
 When
a nearsighted (Myopic) people reach the age of forty, they too experience
presbyopia. Because the nearsighted eye has a natural focal point "at
near", many nearsighted presbyopes can remove their glasses or
contact lenses and read or do close work comfortably. Many myopes choose
to wear bifocals to eliminate the need for removing and replacing their
glasses. If you plan to have refractive surgery to eliminate or reduce
your myopia, like everyone else, you will still experience presbyopia
sometime in your forties.
 Monovision
addresses the problem of presbyopia that most people start to encounter
at the age of 40-45 when they begin to need reading glasses or bifocals
for close vision. With monovision, the dominant eye (the eye you would
use to focus a camera) is focused for distance vision, and the non-dominant
eye is focused for near to intermediate vision. This can be done with
contact lenses, refractive surgery (Lasik) or intraocular lenses.
 With
both eyes open, near, intermediate and far objects can be seen well
without the aid of glasses.
Monovision certainly isn't appropriate for everyone. However, when paired
with the right person, it can be a great fit. Monovision is a blend
of near and distance vision, and is ideal for people with an active
lifestyle. However, there is a caveat to consider: since it is a compromise,
most people's vision isn't perfectly crisp up close or far away. Instead,
it offers the best of both worlds.
 Most
people who opt for monovision go through a brief period of adaptation
as the brain "learns" to see with the eye best suited for
the task. If you're considering refractive surgery as a permanent form
of monovision, it might be best to consider a "test drive"
with contact lenses before making a decision.
About 75% of people like monovision. We test our patients with contact
lenses before laser treatment to see whether they will be able to adapt
to monovision.
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PHAKIC
IOL (INTRAOCULAR LENS)
Phakic IOL procedures are being used on severely nearsighted and farsighted
patients who may not be candidates for the more common laser procedures
such as PRK , LASEK, and LASIK. Phakic IOL is the procedure of choice
for high myopia and high hyperopia.
The word "Phakic" refers to those who have not undergone cataract
surgery and still have their eye's natural internal lens. IOL stands
for "intra-ocular lens." In the Phakic IOL procedure, an intra-ocular
lens is placed inside the eye. The patient's natural lens is not removed,
as it would be in cataract surgery. Unlike in clear lens extraction,
the crystalline lens of the eye is not removed so patients undergoing
this procedure can retain any pre-existing focusing ability. There are
three lens designs. The NuVita lens is placed in front of the iris.
The Artisan, or iris claw lens is attached on the front of the iris.
The Implantable Contact Lens, or ICL, is placed between the iris and
crystalline lens.
Advantages include no effect on corneal thickness, removability and
very clear vision.
Eligible
Candidates
- Individuals
who have extreme myopia (over -15.00 diopters)
- Individuals
who have extreme hyperopia (over +6.00 diopters)
- Individuals
who are under the age of 40 years of age.
- Individuals
without any health issues affecting their eyes
What
to expect on the day of surgery
You
will arrive at the surgery center about an hour prior to your procedure.
Once you have been checked in, you may be offered a sedative to help
you relax. You will then be prepared for surgery. The area around your
eyes will be cleaned and a sterile drape will be applied around your
eye. Powerful eye drops or a local anesthetic will be used to numb your
eyes. When your eye is completely numb, an eyelid holder will be placed
between your eyelids to keep you from blinking during the procedure.
Next, a small incision will be made and the intra-ocular lens will be
inserted. The Phakic IOL procedure is very quick, typically taking less
than 20 minutes. There also is a short recovery time. The results of
the surgery are almost immediate, however your vision will probably
be a little blurry from the anesthesia, so someone will need to drive
you home. You should relax for the rest of the day. You may experience
some discomfort, but this is usually alleviated with an over-the-counter
pain reliever. Most patients resume normal activities within a day or
two.
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