Lasik Over RK Articles

Two RKs, Then Four Lasiks, then Ectasia, Neovascularization, and Epithelial Ingrowth.

The eyes seen here underwent 2 separate Radial Keratotomy surgeries in the 1980's. Beginning in 2000 and for several years after, each eye underwent 4 separate LASIK surgeries. Both eyes developed ectasia following these surgeries. In addition, over a period of years, both corneas became neo-vascularized (blood vessel growth onto the cornea) and developed epithelial ingrowth. Epithelial ingrowth is a condition where the cells from the outermost corneal layer (the epithelium) begins to grow under the LASIK flap where it does not belong creating a cloudy cornea. Look carefully at the first photo and you can see at 11:00 and 12:00 a cloudy inflamed appearance within the open RK incisions. These are epithelial cells that have gotten into the central cornea through the open RK incisions. In the 2nd photo, notice the grey haze opposite the pupil. This is epithelial ingrowth. Epithelial cells have gotten under the LASIK flap and are growing in an area where they do not belong. Note the blood vessels growing onto the cornea from 9:00 and 10:00. Again, blood vessels do not belong on the cornea. At the present time this patient has an appointment with a corneal specialist to determine if a corneal transplant in the left eye is the most appropriate course of action.

Epithelial Ingrowth After RK and Lasik Surgery

The top photo was taken in 2010. Note the blood vessels growing along the RK incision. In addition, if you look carefully you will notice a few milky-white deposits near the blood vessels close to the pupil. This was the first sign of epithelial cells ( the outer cellular layer of the cornea) getting underneath the LASIK flap. The lower photo was taken in 2013. Note how the milky white area has grown dramatically. The R-K surgery was done in 1988 and the LASIK surgery was done in 1999. At the present time this patient is having a consultation at a major university eye center for a corneal transplant.

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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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

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