Lasik in 2003, Ectasia, Intacs, Ferrera Rings, Eye Pain, Now Seeing Clearly with GVR Scleral Lens

This patient visited us from Mexico after suffering debilitating vision loss from LASIK and additional ocular surgeries. In 2003 this woman had LASIK surgery in both eyes. In 2005 she underwent a 2nd LASIK procedure in her right eye. Several years later she developed post-LASIK ectasia in her left eye. In 2007, Intacs surgery was attempted in her left eye but the surgery was not successful so a penetrating keratoplasty (corneal transplant) was done instead. In 2012 this patient's right eye developed post-LASIK ectasia. After visiting several world famous eye institutions, this patient visited us for the first time in 2013. At that time we fit both eyes with GVR Scleral lenses which provided her with clear (20/20), comfortable and stable vision for the first time in many years. While her vision remained clear and stable for 18 months, in November, 2014, she visited a corneal specialist in Mexico who told her that the ectasia in her right eye had progressed and that she needed Intacs surgery in order for her to avoid corneal transplant surgery. Instead of placing Intacs plastic rings into her right cornea, this doctor inserted Ferrara rings into the center of her right cornea. Ferrara rings are plastic semicircular inserts that do not have FDA approval for use in the United States. The Ferrara rings surgery created additional distortions to her right eye and left her with constant pain in this eye. Last week we refit this patient's right eye with a GVR Scleral lens. She is now seeing clearly and comfortably once again in both eyes. In addition, the pain in her right eye is no longer there. It has been my experience that most patients who have suffered from post-LASIK ectasia do not do well after undergoing either Intacs or Ferrara ring surgery. In the lower left photo shown here is an image of this patient's right cornea. A special dye was used to highlight the lower Ferrara ring and the LASIK flap border. The lower "horse-shoe" image is the inferior Ferrara ring. It is located very close to the corneal surface which is one reason why she is experiencing eye pain. The lower center photo shows the Ferrara rings circling around the pupillary border. At night, when this patient's pupil is most dilated, she notes distortions around lights. The lower right photo shows the GCR Scleral lens over her left corneal transplant. As long as she wears her scleral lenses, this patient will have clear, stable vision. She will never need to undergo a corneal transplant in her right eye.

The Wavefront Scleral Lens

The corneal irregularities created by refractive surgeries, such as LASIK and RK, are responsible for ghosting, halos, starbursting, and loss of contrast sensitivity. These "higher order aberrations" may exist on both the anterior and posterior. With aberrometry, the defects of the entire optical system can now be corrected by a scleral lens.

The Wavefront Scleral Lens

Autologous Serum for Dry Eyes

Dry eye conditions are among the most challenging conditions faced by refractive surgery patients. With autologous serum, blood is spun down to plasma, forming an eye drop that helps rehabilitate the cornea.

Learn More about Autologous Serum

Dr. Boshnick on CBS This Morning


See Dr. Boshnick and Dr. Morris Waxler (former FDA chief research scientist on refractive surgery) talk about bad LASIK

Optimum Infinite Gas Permeable Material

I am happy to announce that our Global Vision Rehabilitation Center will be designing and fitting all of our “high need” patients with the Optimum Infinite gas permeable contact lens material. The Optimum Infinite material is the most oxygen permeable material ever to be approved by the FDA. In addition, this newly FDA approved material includes a UV lens blocker. Now for the first time, with certain patients, wearing a scleral lens made with the Infinite material under extended wear conditions can be considered.

SMAP 3D Scleral Lens Design

NEW: Powerpoint presentation on SMAP 3D

Last year we introduced an exciting piece of technology that has allowed us to custom design a scleral lens much more accurately. It is the SMAP 3D, which is a computer attached to a dedicated camera that allows us to obtain a 3 dimensional image of the entire front surface of the eye, including the cornea and the surrounding white portion of the eye (the sclera). Up until now there has not been any technology that would allow us to measure the ocular curvatures outside the cornea. The SMAP allows us to do this. Read More

Have Twitter?

Follow @Boshnick or check https://twitter.com/boshnick

Have Instagram?

Dr. Boshnick on Instagram

Check out EyeFreedom.com

EyeFreedom.com

The NEW YORK TIMES on LASIK

Blurred Vision, Burning Eyes: This Is a Lasik Success?

EyePrint Pro

EyePrintPro technology creates a scleral lens based on a mold of the cornea. The molding is accurate to 1 or 2 microns and fits perfectly because it exactly mirrors the irregularities of the individual corneal surface. The technology is well suited for post-Lasik, Keratoconus, RK, eye injury, and corneal transplant patients. Read More in this PDF about EyePrintPro Scleral Lens Technology

Watch Video at YouTube