Toronto Laser Eye Surgery - Yonge Eglinton Laser Eye & Cosmetic Centre

Corneal Cross Linking

Posted under: Keratoconus — Toronto Laser @ 11:07 am

Vision in keratoconus is typically blurry, even with glasses. This is due to the stretching of the cornea. Since the Cornea is the major focusing lens of the eye, the image formed by the cornea is then blurred. This tends to progress until people are in their 30’s. Why does it stop progressing? As we age, the cornea becomes stiffer and less likely to bulge and become irregular. Corneal cross linking acts to stiffen and bond the fibers in the cornea. It does this by using ultraviolet light. The light activates molecules called “free-radicals” that act to weld adjacent fibers in cornea, much like a braided rope. This same process is used in many of our modern polymers that are used to make many household plastics and in bonding of materials to our teeth that the dentists have used for many years. This welding of the fibers together has little effect on the clarity of the cornea, yet has been proven in many European studies to slow down and even halt the progression of Keratoconus. It is a simple procedure where vitamin B12 is applied to the cornea, followed by exposure of the cornea to Ultraviolet light for a short time. The whole process takes about 1 hour. This can be extremely beneficial in patients with keratoconus. For the first time, we now have an effective treatment to prevent keratoconus from getting worse. This treatment, when teamed together with Intacs corneal rings, and laser shaping of the cornea can often lead to a dramatic improvement in vision without the need for a corneal transplant.

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Intacs SK, another first for Yonge Eglinton Laser

Posted under: Keratoconus — Toronto Laser @ 2:58 am

We are the first center in Ontario, and one of only a few in Canada to be offering Intacs corneal ring segments for treatment of Keratoconus. These rings help to make the cornea more regular in people that have this problem. Yesterday, we implanted the “SK” variety of Intacs. These are a modification of the usual Intacs and are good for the higher degrees of keratoconus. We are the first center in Canada and the US to do this procedure with the SK implants, and are very excited to be there and watch our patients improve and benefit from the Intacs, where formerly, a corneal transplant may have been the only option.

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Yonge Eglinton Laser in MacLean’ Magazine!

Posted under: Laser Eye Correction — Toronto Laser @ 7:53 am

From Maclean’s, Canada’s Newsmagazine, June 11, 07, pages 49 and 50.
“Eye surgery without a blade

Ophthalmologist David Rootman watches
through a microscope as tiny laser beams
pulse over each of Rico Ho’s eyes, forming a
microscopic layer of bubbles within the cor-
nea. A monitor in the surgery suite shows
the same magnified image Rootman sees: a
circle filling with bubbles from top to bottom
creating a “flap” (a sliver of the cornea about
100 microns thick) that is then folded back
to apply a custom-designed corrective laser
treatment. “It’s going beautifully,” says Root-
man, still looking through the microscope
as he passes a cellulose sponge over Ho’s eye-
ball, smoothing the flap back into place where
it immediately begins reattaching to the cor-
nea. As he steps through the waiting area to
the recovery room, Ho is clearly excited. “It’s
already better,” he says.
A year after his condition (a mix of myopia,
or nearsightedness, and astigmatism, a cur-
neal irregularity that distorts images) worsened
to the point that he had to ditch his contact
lenses for uncomfortably thick glasses, Ho,
27, decided to try laser eye surgery. in research-
ing his options, he quickly decided he wanted
it done with IntraLase. Commercially avail-
able for about four years, the computer-oper-
ated lntraLase is often described as the “blade-
less” option in LASIK (the form of laser eye
surgery that involves creating a corneal flap).
IntraLase carves the flap with bubbles instead
of a hand-held oscillating metal blade, known
as the microkeratome, that has been used
since LASIK first became available in Canada
in the mid ‘90s,
Rootman introduced the IntraLase tech-
nology to the Yonge Eglinton Laser Eye Centre,
in July 2005. After using it only one day, he
never wanted to go back to the microkera-
tome. IntraLase is superior, says Rootman,
for two reasons: precision and safety. He
believes it allows better control over the thick-
ness, shape and smoothness of the corneal
flap, and is much less likely to result in any
kind of surgical complication, such as a
“buttonhole” (in which a piece of tissue from
the flap remains on the cornea). “With the
microkeratome, the staff hold their breath
for the 10 seconds it takes for the blade to go
across the cornea and come back,” he says.
“So does the surgeon.”
While many eye centres across Canada are
adopting the technology, there is some debate
in the ophthalmology community about its
benefits. LASIKMD, which has 17 Canadian
locations and performs about 40 per cent of
laser eye surgeries in the country annually,
does not offer IntraLase, “To date there is no
scientific evidence that proves it is a better
way to create a flap,” says spokesman Michel
Lanctot. “Yet people are paying between $300
and $500 more an eye just for that special
technology.” Naysayers also point out that
the procedure takes slightly longer with
IntraLase, which has to do with the Suction
pressure required to harden the cornea prior
to making an incision.
It isn’t that Rootman thinks the microkera-
tome is unsafe; he used it for almost seven
years and had good results “99.99 per cent
of the time.” But Rootman thinks IntraLase
can do much more than get people out of
glasses; he sees it as the future of ophthalmol-
ogy: “I think in five years, all corneal surgery
will be done with the laser, we won’t be using
knives at all.” Already, he has performed 10
corneal transplants using IntraLase, operat-
ing on patients from his practice at the Toronto
Western Hospital in his private clinic, as part
of a study. “Those patients are only a couple
of months out now,” says Rootman, “but I’m
convinced that it’s going to be way better for
patients compared to the standard.”
And that’s not the only way in which laser
eye surgery traditionally thought of as “cos-
metic” because it eliminates the need for
glasses, is increasingly becoming an adjunct
to medically necessary procedures. For ex-
ample, in order to work properly, the new
Lasers are taking over corneal procedures
multi-focal lens many cataract patients are
now having implanted requires the removal
of any residual refractive error. “The com-
bination of intraocular and laser refractive
surgery has become the state-of-the-art care
for many cataract patients,” “

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News Story: CustomVue/IntraLase LASIK now accepted by the US Air Force!!

Posted under: Laser Eye Correction — Toronto Laser @ 4:56 pm

I thought our patients might be interested in this story, since the Lasers used in the Air Force are the same as the ones used at our Yonge Eglinton Centre- DSR.
5/24/2007 - WASHINGTON (AFPN) – Air Force officials have changed the policy to allow people applying for aviation and aviation-related jobs to have had LASIK surgery. The change became effective May 21. The change also removes the altitude and high-performance aircraft restrictions for people who have had LASIK.

The decision to make these changes was based on studies that showed there was little to no effect on LASIK-treated eyes when subjected to the wind blast experienced during aircraft ejection or exposure to high altitude.

Due to stresses placed on the eyes during flight combined with the active lifestyle of military members, the recommended refractive surgeries are Wave Front Guided Photorefractive Keratectomy, or WFG-PRK, and Wave Front Guided Laser In-Situ Keratomileusis, know as WFG-LASIK, using the femtosecond laser. The eyes are more trauma resistant after surgery using one of these methods compared to other forms of refractive surgeries.

With all refractive surgeries, there is no guarantee of “perfect” sight after undergoing the procedures. Individuals must still meet the standards prescribed in AFI 48-123, Medical Examination and Standards, for entrance into the Air Force and aviation and special-duty positions.

Additional information and guidance can be found at the AF Knowledge Exchange by accessing the restricted “Dot Mil” site: https://kx.afms.mil/USAF-RS%20or%20public%20access or public access:
http://airforcemedicine.afms.mil/USAF-RS

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Multifocal IOL’s

Posted under: Cataracts — Toronto Laser @ 2:57 pm

I have a lot of patients asking me about intra-ocular lenses these days. Intra-ocular lenses are commonly called IOL’s. They put the eye into focus after cataract surgery. In the old days (30 years ago), cataract surgery was a major upset for people. They required a prolonged hospital stay and often had to lie still for many days. Then, after the banadages were removed, they would have to be fit with contact lenses or very thick glasses. The glasses were unsightly and caused all sorts of unwelcome distortions. The thick prescription glasses were needed because the cataract removal put the eye way out of focus. The cataract develops in the lens of the eye. The lens accounts for about 1/3 of the focusing power of the eye. Therefore, when it is removed, the eye is very much out of focus. Now, we replace the lens with a small plastic lens that stays in the eye permanently. The new lenses are very safe, in fact, a cataract operation is rarely done these days without one. One problem though, the lenses don’t completely correct distance vision and people need reading glasses.

That is where the multifocal lenses come in. These lenses give patients more normal vision, as they have a focus for up close (reading) and for distance as well. When combined with astigmatism surgery, people can be freed of glasses for 80% of all their activities. For long periods of reading, a small correction may be needed. The only downside of the multifocal lenses is that people will notice rings around lights at night due to the way the lenses are shaped. Most people get used to this, and the benefit of being able to function without glasses makes them more than happy.

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Yonge Eglinton Laser in the news

Posted under: Laser Eye Correction — Toronto Laser @ 2:47 pm

Watch out for the MacLean’s magazine issue at the end of May, I think May 31st, 2007 issue. They were in to speak to us about our centre and about IntraLase and Customvue. The US Navy has done a very big study on the same technology we use here at YELC and have found it to be superior to other modes of Laser vision correction with the microkeratome (the blade) and other excimer lasers. That is one reason why we have the Visx Star S4 and IntraLase, as we want to use only the best and proven technology to acheive the greatest results for our patients.

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ICL’s

Posted under: Vision correction — Toronto Laser @ 2:41 pm

What is an ICL? These are exciting devices to help correct very severe degrees of near-sightedness, farsightedness and astigmatism. They are a thin piece of soft plastic, much like a contact lens. But, unlike a contact lens, it can be inserted actually into the eye, and remains there. It has the lens correction built into it and never needs to be removed or cleaned. I have patients who are blind without glasses or contacts and now can see near 20/20 (normal) Imagine not being able to see anything clearly past the tip of your nose, and then leaving after a 20 minute operation and being able to see across the street. It is really quite amazing. The ICL is also for people with thin corneas that may not be eligible for laser vision correction.

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LASIK, why is it so expensive?

Posted under: Laser Eye Correction — Toronto Laser @ 5:35 pm

At our centre, we have decided to concentrate on IntraLase for preparing the flap, and VisX CustomVue for the corneal shaping. Why? because there are now several good studies that show that this is the winning combination to give people the best results, closest to target, in the safest way possible. So we don’t want to offer anything else, even though decent results can be obtained with other methods. To us, decent is not good enough. IntraLase/CustomVue is giving us outstanding results, which is what it is all about. So we think we are offering tremendous value to our patients. High likelihood of no glasses, with the lowest chance of having a flap problem. In comparison, I once had to take my dog to the vet for an operation, and the bill was $2000. When I looked it over, it was totally reasonable. The doctor has a business to run, and has expenses we don’t even imagine. So too in the Laser vision correction area, there are expensive devices, insurance, staffing etc, that actually makes $2500 per eye sound like a very good value for a life changing experience.

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Custom vs. Standard Laser Vision Correction

Posted under: Laser Eye Correction — Toronto Laser @ 10:34 am

We offer CustomVue, wavefront guided treatment to almost all our patients. The standard treatments, while good, represent older, less precise ways of reshaping the cornea. Without CustomVue, we cannot utilize the iris registration program, which allows us to precisely align the laser treatment and uniquely identify our patients by the laser. This alignment ensures a great result and takes into acount the shifting of the pupil when the pupil gets smaller. I can tell you, the smoothness of the surface after the laser is applied, is truly remarkable. While our older laser was good, the VisX Star S4 with iris registration is a quantum leap forward, so much so that we recommend it in most instances.

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Do you still use the microkeratome for LASIK?

Posted under: Laser Eye Correction — Toronto Laser @ 10:28 am

No, not at all. After the first day of using the IntraLase, I decided not to offer the treatment to patients. I felt the microkeratome, while a good device, has had its time in the sun, and it was appropriate to move on to better methods of creating the flap. And now there is lots of information and data out there to support the better outcomes that are available combining IntraLase with CustomVue (VisX) laser treatment. When I had my PRK and my wife had her LASIK (9 years ago), the IntraLase and CustomVue were not available, but if they were, we would have had it done that method.

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April 11, 2008

Corneal Cross Linking

July 10, 2007

Intacs SK, another first for Yonge Eglinton Laser

June 16, 2007

Yonge Eglinton Laser in MacLean’ Magazine!

May 28, 2007

News Story: CustomVue/IntraLase LASIK now accepted by the US Air Force!!

May 27, 2007

Multifocal IOL’s

Yonge Eglinton Laser in the news

ICL’s

May 8, 2007

LASIK, why is it so expensive?

May 5, 2007

Custom vs. Standard Laser Vision Correction

Do you still use the microkeratome for LASIK?