Cornea-Based Refractive Surgery: Laser Vision Correction

LASIK, or laser vision correction, dramatically improves the eye’s ability to focus through the controlled use of an excimer laser. The procedure gently and precisely reshapes the patient’s cornea to its optimal shape. We use the VISX S4-IR^TM excimer laser, the most advanced laser technology platform available to refractive surgeons.

The First Laser: IntraLase®

To reach the cornea and reshape it, surgeons must first create a corneal flap. Many surgeons still use a microkeratome, which is actually a metal razor blade, to create this flap. The truth is that the incorrect use of microkeratomes is the source of the majority of complications with LASIK.

We are one of a select group of surgical centers in the country to create the corneal flap with an additional laser instead of a metal blade. It’s called the IntraLase® femotosecond laser and it offers Dr. Goldberg and the patient unprecedented control, accuracy, and precision. When you hear the phrase “all-laser LASIK”, that means that one laser creates the corneal flap and another laser reshapes the cornea.

With IntraLase®, Dr. Goldberg actually creates the corneal flap from below the surface of the cornea. The beam of laser light is focused to a precise point within the stroma (central layer of the cornea), where a string of tiny 2 to 3–micron bubbles is formed. Thousands of these microscopic bubbles are precisely positioned to define the flap’s dimensions and distinct beveled edge, as well as location of the hinge. Bubbles are then stacked along the edge of the flap up to the corneal surface to complete the flap. The process from start to finish takes approximately 45 seconds. The surgeon then lifts the flap to allow for treatment by the excimer laser. When treatment is complete, the flap is accurately repositioned, thanks to its beveled edge.

Replacing the microkeratome with IntraLase® gives LASIK patients a critical added safety factor. While hundreds of thousands of LASIK procedures have been performed without incident, the creation of the corneal flap remains the most frequent source of complications.

The Second Laser: VISX Star S4^TM

Once the corneal flap has been created, Dr. Goldberg reshapes your cornea with the VISX Star S4-IR^TM excimer laser, the most advanced technology platform available to refractive surgeons. Using the Star S4^TM allows Dr. Goldberg to protect your corneas more effectively than other laser systems.

Some locations on your cornea do not need to be shaped as much as other locations. Dr. Goldberg can constantly and precisely adjust the size of the Star S4^TM laser beam to accommodate your cornea’s unique needs. Most other lasers, including LADARVision®, don’t change size. The result is that doctors using LADARVision® remove more of your corneal tissue than is actually necessary.

Removing a minimum of corneal tissue is a critical means of protecting patients with thin corneas and large pupils, which is why the Star S4^TM is the preferred choice of many experienced refractive surgeons.

The Star S4^TM also uses 3-D tracking technology which allows Dr. Goldberg to work with undilated pupils, which are widely believed to improve accuracy because the surgeon does not have to adjust to an abnormally expanded pupil.

And now our Star S4® laser includes the most promising advancement in refractive surgery since LASIK itself: CustomVue^TM, your personal best vision.

Custom Cornea Wavefront Guided LASIK

Custom Cornea LASIK takes laser vision correction to a whole new level. The procedure consists of the most precise measurement of your individual eye imperfections available anywhere and new laser software that reshapes the cornea with much more accuracy than glasses or contacts could ever achieve.

Like your fingerprint, your vision is unique. Dr. Goldberg understands the individuality of each eye and is one of the first eye surgeons to adopt the VISX WaveScan WaveFront® System. With this system, Dr. Goldberg can treat more than simple nearsightedness, farsightedness, and astigmatism. For the first time in history, we have the potential to improve vision beyond the limits of glasses and contact lenses.

It’s called Wavefront, and the technology measures and corrects for imperfections in your eyes 25 times more precisely than standard methods. This allows Dr. Goldberg to analyze your eye’s specific irregularities so that he can completely customize your laser eye surgery for your vision! In the hands of a specially trained and highly skilled eye surgeon like Dr. Goldberg, wavefront technology means better diagnosis, better treatment, and better vision. Once touted as the means to a sort of elusive “supervision,” WaveFront is now a reality and better vision is attainable.

Atlantic Laser Vision Center is one of several certified iLASIKTM facilities in New Jersey. iLASIKTM is a combination of the most advanced technologies used in laser vision correction. iLASIKTM includes:

• Intralse femtosecond laser for all-laser, no blade LASIK
• VISX S4-IR excimer laser to correct near-sightedness (myopia), far-sightedness (hyperopia) and astigmatism.
• Custom Vue Wave Scan for wavefront analysis and customized wavefront guided laser vision correction.

This is the leading technology in laser vision correction. Dr. Daniel Goldberg and the Atlantic Laser Vision Center have pioneered their use in New Jersey. NASA, the Unites States Navy and Armed Forces have chosen this technology for their pilots. We are happy to be providing the best for our patients.

Advanced Surface Ablation PRK/Lasek/Epi LASIK

Surface Ablation Procedures

Surface treatments reduce the total depth of treatment and eliminate the potential for complications from a LASIK flap. Advantages of LASIK over surface treatment include faster recovery with less discomfort and easier enhancement if needed.

LASEK / PRK / EpiLASIK

Surface ablation procedures include PRK (PhotoRefractive Keratectomy), LASEK (Laser Assisted Sub-Epithelial Keratomileusis), and EpiLASIK. These refractive surgeries are available to patients whose corneas are too thin for LASIK surgery. Like LASIK, PRK and LASEK at our New Jersey practice reshape the cornea to improve visual acuity. Unlike LASIK, PRK, LASEK and epiLASIK use a flap that consists of only the epithelial layer of your cornea – the very topmost layer.

After surface ablation (PRK, LASEK, EpiLASIK), our New Jersey patients will find that healing takes longer than with LASIK, but they are excellent options for those patients who do not qualify for LASIK. In fact, before LASIK, PRK was the standard for refractive laser surgery, and millions of eyes have seen major improvements with PRK surgeries since the mid-80s.

PRK and LASEK at our New Jersey practice begin with Dr. Goldberg anesthetizing the patient’s eye with powerful numbing drops. He then gently detaches the epithelium, which is about 50 microns thick, by using a solution that weakens the epithelium and allows it to fold back into a flap. In LASEK, this flap will be returned into its place to heal. In PRK, this flap will be removed to allow the eye to regenerate its lost epithelial tissue.

After the epithelium flap is moved out of the way, Dr. Goldberg guides the VISX Star 4^TM laser in reshaping the cornea. When the cornea has been reshaped, the epithelium flap is returned to its original position (LASEK and EpiLASIK), or gently wiped away (PRK), and a contact lens is placed on the cornea. This special lens serves as a bandage for the patient’s cornea and aids in healing and reducing post-operative discomfort. Generally patients wear this lens for several days following a procedure.

The major difference between PRK and LASEK or EpiLASIK is that in PRK procedures, the epithelial flap is removed entirely, allowing the epithelial layer to reform naturally. Some refractive surgeons believe that LASEK or EpiLASIK results in less discomfort and lower risk of haze compared to PRK. However, advanced PRK techniques have equaled the outcomes.