ALK Disaster

The 4 images below are of the same eye that underwent a procedure known as "Automated Lamellar Keratoplasty" or simply "ALK". To the best of my knowledge, ALK is not done any longer due to the many complications associated with it. This procedure used a microkeratome (a small slicing machine) to alter the shape of the cornea. This eye was very farsighted (hyperopia) before undergoing ALK. In an effort to eliminate the hyperopia, a condition known as corneal ectasia corneal ectasia was created. What resulted was a very steep distorted dry cornea that left this patient with 20/400 vision in this eye which could not be corrected with eyeglasses or contact lenses. In the first photo look carefully at the pupil around 4:00. Note the corneal haze. This is a result of this surgery. The 2nd photo shows a more magnified view of the corneal haze. The third photo was taken through a biomicroscope using a special dye and filter to highlight the area of the cornea that was surgically altered. Note the round outlined shape in the center of the photo. This area of the cornea is 6 mm in diameter and is extremely distorted and steep. The dark areas in the center are areas of the cornea devoid of moisture. The last image was taken with a technology known as "optical coherence tomography" or simply "OCT". In this image the thick curved grey structure is the cornea. The 2 lines above the cornea represent the front and back surfaces of a scleral lens. The curved pointed outline in the center of the cornea is where the cornea was surgically altered. There is no surgical procedure that will undo the damage done to this eye by this surgery. The only technology that will allow an eye like this to function visually again is a well designed and fit scleral lens. This patient now has 20/20 undistorted vision with this eye with the scleral lens.

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

Have Instagram?

Dr. Boshnick on Instagram

Check out


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