LASIK in Miami

Dr. Gelber has been involved in the area of refractive surgery since 1982 when he began doing radial keratotomy. He moved on from that procedure in 1996 when the Excimer Laser became available for PRK (photorefractive keratectomy). This technique has evolved into the current LASIK. This lifestyle changing procedure is brief and painless; there is never an OUCH but usually a WOW and vision improvement is prompt.

Dr. Gelber currently performs his laser refractive surgery at the Bascom Palmer Eye Institute. The procedure involves re-shaping the surface of the cornea with the laser. The newly created shape can neutralize nearsightedness, farsightedness and astigmatism. While the laser exposure usually lasts no more than 60 seconds, the total time for the procedure is about 20 minutes. At the outset the cornea is prepared for the laser exposure. This is accomplished in either of two ways; the INTRALASE is a femtosecond laser, which creates a thin flap on the anterior surface of the cornea. There is no traditional cutting with a blade.

For those individuals who have been denied LASIK because their cornea is too thin, we offer PHOTOREFRACTIVE KERATECTOMY (PRK) which does not utilize a cornea incision at all. This may also be appealing to those interested in the very ultimate in safety.  See “Advanced Surface Treatment” below.

If you have had prior radial keratotomy and are unhappy with your vision, there may be an opportunity to improve your condition with LASIK.  We can determine the nature of your visual changes by analyzing the surface topography and give you all the information you need to come to a decision which will be practical and safe.

There are numerous factors to consider when deciding if you are a good candidate for LASIK. Is the power of your eye within the range of the technology, is your pupil the right size, what type of astigmatism do you have, is your cornea thick enough for a safe procedure; these are among the issues that must be addressed. Miami Eye Center offers a free screening examination. If you decide to proceed with the initial comprehensive examination, this fee is applied to the surgical fee.

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ADVANCED SURFACE TREATMENT with PHOTOREFRACTIVE KERATECTOMY

In March 1996, I treated my first patient for nearsightedness with an excimer laser; the technique was known as PRK (photorefractive keratectomy).  The surface of the cornea was removed and the laser was applied.  The results were good but the healing was slow and the degree of discomfort was not acceptable.  Then along came LASIK where the corneal surface was left intact (to eliminate pain) and a thin flap of cornea was created prior to the application of the excimer laser.  Over time there have been several generations of excimer lasers and the flap is now created with an Intralase (laser) rather than a blade.  There is virtually no pain with rapid healing.  Some of us in the ophthalmic community were not entirely satisfied as there were a small number of patients developing problems with the flap.  So we have gone “back to the future” by eliminating the flap as was done with PRK, however, several significant modifications have been made. New drugs such as Neurontin which is a non-narcotic pain-killer and non-steroidal anti-inflammatory eye drops such as Nevanac or Xibrom have almost totally eliminated postoperative pain.  What we have accomplished is a procedure with the same accuracy as LASIK but without the potential for flap complications.  This is the safest technique of laser vision correction now available. 

In a recent comparative study involving 700 eyes, the total complication rate for LASIK was 6% compared to 2.9% for PRK.  No flap means the ultimate safety.  Why then are patients choosing LASIK?  The return of good vision is 24 hours with LASIK and about 4 to 5 days with PRK.  Many think that this is a small price to pay for ultimate safety.  In addition, since the flap is no longer cut, those people who have been denied LASIK in the past because their corneas are too thin may now become candidates.  Also, those with dry eyes will have a better experience with this technique as the nerves to the surface of the cornea are not severed thus preserving the tear function.  Some individuals will prefer LASIK for its benefits of rapid recovery and others will select ADVANCED SURFACE TREATMENT for its higher degree of safety. 

Call today to make an appointment so that together we can discuss your options.

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