Lasik in 2002, Epithelial Ingrowth, Neovascularization, now seeing 20/20 with GVR Scleral Lens

This patient underwent LASIK surgery on both eyes in 2002. A 2nd LASIK surgery was done on her left eye several months after the first procedure. In 2005, this patient's vision in her left eye deteriorated to the point where eyeglasses and contact lenses were not able to help her obtain functional vision. When this patient first visited our practice we diagnosed corneal ectasia in both of her corneas. This condition is a relatively uncommon event seen in post-LASIK corneas years after the surgery was performed. It is characterized by a very distorted, irregular corneal surface. In addition, in the superior portion of her left cornea I noticed a gray arcuate haze above which were blood vessels extending onto the cornea from outside the cornea. These 2 conditions can be seen in the lower photo. The gray haze is a condition called epithelial ingrowth. This is due to the cells on the corneal surface getting underneath the LASIK flap. This is not a normal situation and must be monitored to make sure that these cells do not multiply, otherwise the LASIK flap must be lifted and the underlying epithelial cells cleaned out. The blood vessel growth visible in the superior cornea is known as "neo-vascularization." This too must be monitored to make sure that an unstable situation does not come about. In 2008, we fit both eyes with GVR Scleral lenses which have allowed this patient to see clearly (20/20) and comfortably with all day lens wear. Over the last 7 years, the epithelial ingrowth and the neo-vascularization of her left cornea have remained stable. This patient's eyes will not need to undergo any additional invasive procedures and I expect that she will be able to wear her lenses comfortably for many more years to come, however, yearly monitoring of her corneas are necessary.

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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