RK Followed by Lasik, Followed by Deteriorating Vision

The patient seen in this photo with me, visited our office for the first time from Guatemala 10 years ago. In the 1980's this patient underwent 2 separate Radial Keratotomy procedures in both eyes. Over the following years his vision began to deteriorate to the point where he was not able to obtain functional vision with eyeglasses or any type of contact lens. Because of this, in 2001 and 2002 he underwent 2 separate LASIK procedures in his right eye and 1 LASIK procedure in his left eye in 2001. Needless to say, over the following years his vision and ocular comfort continued to deteriorate. Several corneal surgeons suggested that he undergo corneal transplant surgery in his right eye since the right eye was significantly more compromised that his left eye. In 2006 we fit this patient's right eye with a GVR Scleral lens which provided this eye with clear, undistorted 20/20 vision. Prior to visiting us, the best corrected vision that he was able to achieve with his right eye was less than 20/200. Because this patient's left eye was significantly less distorted he was able to achieve acceptable vision with a disposable soft lens. This patient visited our office today for his yearly eye health and scleral lens examination. Both of his corneas are stable, clear and healthy. In the ocular photo to the right can be seen several small blood vessels growing onto the corneal surface along the RK incisions (which still remain open). This is not a healthy situation as the cornea is the only tissue in our body without any blood vessels. However, this condition has remained stable for the last 10 years but still needs to be monitored on a yearly basis. The photo to the right shows the GVR Scleral lens over this patient's right cornea. Look carefully and you can see the straight, gray, scarred RK incisions radiating inward from the periphery of the cornea. The LASIK flap incision going around the corneal periphery is difficult to see in this photo. This patient will never need to undergo corneal transplant surgery. 

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

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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

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