Lasers are frequently used in a variety of eye surgeries. No longer does laser eye surgery simply mean LASIK or PRK. Today, Dr. Aizuss uses lasers for cataract surgery, for treatment of intraocular pressure in glaucoma, and for correcting refractive errors as in LASIK or PRK. Lasers are also used for other procedures, such as the removal of floaters, to cause regression of blood vessels growing abnormally or leaking in diabetic retinopathy, and to seal leaking blood vessels in macular degeneration.
What Is Laser Eye Surgery?
Dr. Aizuss uses lasers in both his Encino and West Hills practices. While everyone associates laser surgery with LASIK vision correction surgery, lasers have a far bigger role. Any time a laser is used, for instance to seal a leaking blood vessel in diabetic retinopathy or lower pressure in glaucoma, this qualifies as laser surgery.
Benefits Of Laser Eye Surgery
Lasers have different functions in the different eye diseases and conditions described above. In most cases, using the laser enables better accuracy, easier healing, and less risk for complications than would manual methods. For instance, in cataract surgery, using the laser to open the capsule involves far less potential for tearing the capsule than when using forceps. Also, when breaking up the cataract, the laser allows use of lower ultrasonic energy and therefore less danger of damaging the endothelial cells that line the back surface of the cornea.
For other uses, such as sealing leaking blood vessels or eliminating floaters, lasers really present options for treatment that cannot be done manually.
Laser Eye Surgery Treatments Used For Cataracts
Dr. Aizuss uses the VICTUS femtosecond laser for all of his laser cataract surgeries. Cataract surgery removes the cataract-clouded lens in the eye and replaces it with an artificial intraocular lens.
Dr. Aizuss uses the VICTUS femtosecond laser for these steps in his cataract surgeries.
- For the capsulotomy — An incision needs to be made in the capsule of the eye that holds the lens clouded by cataracts. Dr. Aizuss wants to gain access, but not to remove the capsule, as it will be used to hold the artificial intraocular lens. A needle or forceps was used in traditional cataract surgery to create a nearly circular tear in the anterior capsule, but Dr. Aizuss now uses the VICTUS laser for this step. He believes it makes a more accurate capsulotomy that can be reproduced time after time. This accuracy may allow the IOL to be centered more accurately and ensures a precise size of the capsulotomy.
- Lens and cataract fragmentation — In cataract surgery, once the cataract-clouded lens is accessed it needs to be broken up and removed. In traditional cataract surgery, this is done with an ultrasonic device that breaks up the clouded lens with ultrasonic energy. This can create heat in the incision and impact the final outcome negatively. The ultrasonic energy in some advanced cases may have a deleterious effect on some cells that line the back surface of the cornea. Dr. Aizuss uses the VICTUS laser for this step. The laser softens the cataract as it breaks it up. This breaks the cataract into smaller, softer pieces that are easier to then vacuum away. This dramatically lowers the amount of ultrasonic energy that needs to be used inside the eye.
- Astigmatism correction — In most cases of a patient having astigmatism, a condition where the cornea is shaped more like a football than a baseball or has two different curves on the surface, the condition can now be corrected with new toric IOLs. But for some patients, their astigmatism is less than the minimum amount that can be corrected by toric lenses or in rare situations the proper toric lens may not be on the market. In these cases, Dr. Aizuss uses the VICTUS laser to make astigmatic corneal relaxing incisions that help to reduce astigmatism. These help the cornea to become more round and more like a baseball than a football. Prior to the development of the new toric IOLs, this was the only way to correct for astigmatism during cataract surgery. But manually making these incisions can lack precision. By using a laser, Dr. Aizuss can precisely plan and make these incisions if they are needed, dramatically increasing the chances that the patient will not need to wear eyeglass correction for his or her astigmatism after their cataract surgery.
Laser Eye Surgery Treatments Used To Treat Glaucoma
Glaucoma is an eye disease where the intraocular pressure inside the eye builds to the point where it eventually damages the optic nerve, permanently impairing the patient’s vision. Dr. Aizuss uses laser eye surgery in three areas for treating glaucoma.
- Trabeculoplasty — In primary open-angle glaucoma, Dr. Aizuss uses a laser to open blocked portions of the trabecular meshwork, which is the area that allows fluid to drain from the eye. In glaucoma, this meshwork is either blocked or is significantly hampering drainage.
- Iridotomy — In narrow-angle glaucoma, the angle between the iris and the cornea in the eye is too small. This causes the iris to block fluid drainage, increasing inner eye pressure. In laser iridotomy, Dr. Aizuss makes a small hole in the iris, allowing it to fall back from the fluid channel, helping the fluid drain.
- Cyclophotocoagulation — Dr. Aizuss uses a laser in this glaucoma treatment to hamper the ciliary body’s ability to make fluid. This lowers eye pressure. This is a procedure that is not frequently used.
Laser Eye Surgery Treatments Used For Vision Correction
When a person is nearsighted, farsighted, or has astigmatism, the shape of the cornea is not perfect in relation to the length of the eye. Because the cornea bends light that enters the eye onto the retina at the back of the eye, if the shape is wrong this results in errors in the refraction of the light. These are known as refractive errors: myopia (nearsightedness), hyperopia (farsightedness), presbyopia (loss of near vision with age), and astigmatism.
Dr. Aizuss uses an excimer laser to reshape the cornea so that light rays are focused more precisely on the retina, producing clear, sharp vision. You know this procedure by its acronym — LASIK (laser-assisted in situ keratomileusis).
Photorefractive keratectomy (PRK) is another laser procedure for vision correction. PRK differs from LASIK only in that it removes the thin outer layer of the cornea, the epithelium and no LASIK flap is created. Rather the laser is applied directly to the surface of the eye. In LASIK, the epithelium is left in place and a partial thickness flap created with a laser. The laser correction is then applied underneath the LASIK flap.
What Other Vision Impairments Can Laser Eye Surgery Treat?
- Diabetic retinopathy — Lasers are used in the treatment of diabetic retinopathy. Lasers are used to treat leaking blood vessels in the eye, sealing the area of leakage. They are also used to eliminate abnormal blood vessels that form in the eye and to cause regression of growth and decreased stimulus to growth of abnormal vessels.
- Floaters — Floaters are those clear strings, cobwebs, or grey specks floating around in front of your vision. They are actually shadows cast by clumps of debris in the vitreous gel in the middle of the eye which form shadows on the retina in the back of the eye. Lasers can now be used to vaporize or break up the clumps, removing or decreasing the floaters.
- Macular degeneration — In age-related macular degeneration, blood vessels in the eyes begin leaking blood into the interior of the eye. This impacts the central area of vision. Laser eye surgery can be used to seal these leaking blood vessels. Leaking blood vessels are involved with the “wet form” of macular degeneration, which is far more dangerous for the person’s vision. There are more effective methods of treating macular degeneration than use of the laser such as injection of VEGF agents or vascular endothelial growth factor inhibitors.
Risks Of Laser Eye Surgery
The risk of laser eye surgery is very minimal. Lasers are extremely safe medical devices. The risks of surgery differ depending on the type of surgery. Dr. Aizuss is happy to discuss all the risks and benefits of any surgery with each individual patient or their family.
Schedule a Consultation
If you are interested in learning more about laser eye surgery, contact us at (818) 907-1038 (Encino) or (818) 346 8118 (West Hills) to schedule an appointment today! Dr. David Aizuss from Ophthalmology Associates of the Valley proudly serves patients in Encino, West Hills, Calabasas, Agoura Hills, Tarzana, Woodland Hills, Sherman Oaks, and Reseda, CA with laser eye surgery.