Refractive Procedures

Implantable Collamer Lens(ICL™) (Now FDA approved)

The Visian ICL™ is a recently FDA approved, technologically innovative approach patented by STAAR™ to correct moderate to severe myopia (near-sightedness) and hyperopia (far-sightedness) in patients who are not candidates for LASIK. The ICL™ is a permanent implant and corrects vision using the same optical principles as contact lenses. Once the surgeon has chosen the proper lens power according to the patient's individual needs, the ICL™ is folded and inserted behind the patient's iris (colored part of the eye) and in front of the patient's natural lens using the same lens injection technology used in millions of cataract-IOL procedures. Dr. Tyson has recently been certified to perform this revolutionary technique which will significantly expand the range of corrective options he will be able to offer his patients. The ICL will offer patients who are not candidates for LASIK their first opportunity to have a glasses free lifestyle.

A Guide to the STAAR Visian ICL Procedure:

Implanting the Visian is actually a two-part process. Step one requires the use of a YAG Laser to make two small openings in the outside of the iris at 90 degrees apart. The openings guard against possible elevation of intraocular pressure immediately following the implantation of the new lens.

Step two is the insertion of the new collamer lens. The Visian ICL has a foldable design that makes it easy to insert the lens through a small (3 mm) incision in the cornea, the outer surface of the eye. The incision is self-sealing so no stitches are required.

As the lens is advanced from the cartridge into the eye, it slowly unfolds and is moved into place in front of the iris (the colored part of the eye).

Patients receive topical or local anesthesia to minimize any discomfort during the procedure. The procedure is done in the office on an outpatient basis. Please be sure to have someone drive you to the office and home after the procedure is completed. Eye drops or oral medication may be prescribed and a follow-up visit is required 2 to 4 hours after the procedure (the same day), as well as a 1 day visit.

How effective is the Visian ICL for improving vision?

A U.S. FDA clinical trial of 294 patients showed excellent results three years after implantation with the Visian ICL:

95% of patients achieved 20/40 eyesight or better without glasses or contact lenses, allowing them to drive a car without the need for corrective eyewear

59 % of patients had 20/20 or better

92% reported they were very satisfied or extremely satisfied with the improvement to their eyesight.

If you would like to know more about this exciting alternative to LASIK please click here http://www.visianinfo.com

Lens replacement surgery

The Crystalens

The ReSTOR lens

The ReZoom lens

Three deluxe, advanced technology lenses to choose from.

For the vast majority of patients wishing to minimize or eliminate their dependence on glasses or contact lenses, LASIK or Custom Wavefront LASIK will be the procedures of choice. If you are not a candidate for LASIK because you have certain LASIK contraindications, often PRK, LASEK or ICL are recommended by Dr. Tyson. All of these Laser Eye Surgery procedures are performed by reshaping the cornea by using an Excimer Laser. These procedures are safe, effective and predictable in correcting nearsightedness, farsightedness and astigmatism. However, for patients in their 40's, corneal laser eye surgery may not be able to completely help them overcome their goal of eliminating glasses or contact lenses for arms length or near reading vision as this is the time when people begin to experience presbyopia. In the early phases of presbyopia, Dr. Tyson may be able to offer you some intermediate and near vision correction through the use of monovision LASIK. With the continual progression of presbyopia, it becomes more and more difficult for patients to maintain their focusing ability for intermediate and near vision due to the gradual loss of accommodation. Presbyopia begins because of the natural loss of elasticity of the crystalline lens inside your eye. Thus, presbyopia is a problem of the lens, not the cornea, and therefore it is the lens that must be treated if someone truly suffers from presbyopia.

For some patients then, rather than having a corneal laser eye surgery procedure such as LASIK, Custom LASIK, PRK, LASIK, LASEK, ICL or monovision LASIK, a different type of refractive surgery can be used to better help them achieve their goals of being less dependent on glasses or contact lenses for not only distance vision, but intermediate arms length and close near vision. This type of refractive surgery is called Lens Replacement Surgery which includes ReSTOR ®, ReZoom™ and Crystalens ™ deluxe lenses.

ReSTOR ®, ReZoom™ and Crystalens™ Lens Replacement Surgery is performed in a similar manner to cataract surgery. It is performed in an outpatient surgery center. With ReSTOR ®, ReZoom™ and Crystalens Lens Replacement Surgery, Dr. Tyson will numb the eye with eye drops much like with LASIK. He will then make a very tiny incision at the outer edge of the cornea through which a microscopic instrument can be inserted. Using ultrasound from the tip of the microscopic instrument, your surgeon will actually be able to gently break the crystaline lens into pieces small enough to be washed away and drawn through the probe and removed from the eye. Once your natural crystalline lens has been removed, it can now be replaced by a new permanent lens implant. The new lens is readily inserted and placed in position through the same tiny incision at the outer edge of the cornea through which the natural lens was removed.

In order to help you achieve your goal of being able to see at far, intermediate arms length and up close for reading vision, Dr. Tyson will select from advanced intraocular lens technology available today which includes ReSTOR®, ReZoom™ and Crystalens ™ deluxe lenses. Each of these advanced technology lenses uses a slightly different optical design to help you achieve your goal of clear vision at all distances. Dr. Tyson will discuss his recommendation based on many factors in your consultation.

LASEK(Laser Epithelial Keratomileusis)

LASEK (laser epithelial keratomileusis) is a relatively new procedure that is technically a variation of PRK. Also called epithelial LASIK or E-LASIK, LASEK is used mostly for people with corneas that are too thin or too flat for LASIK. It was developed to reduce the chance of complications that occur when the flap created during LASIK is not the ideal thickness or diameter. In LASEK, the epithelium, or outer layer of the cornea, is cut not with the microkeratome cutting tool used in LASIK, but with a finer blade called a trephine. Then the surgeon covers the eye with an alcohol solution (perhaps one part alcohol and four parts sterile water) for around 30 seconds. The solution loosens the edges of the epithelium.

After sponging the alcohol solution from the eye, the surgeon uses a tiny hoe to lift the edge of the epithelial flap and gently fold it back out of the way. Then he or she uses an excimer laser, as in LASIK or PRK, to sculpt the corneal tissue underneath. Afterward, the epithelial flap is placed back on the eye with a kind of spatula.

In many ways, what you can expect from LASEK is similar to what you can expect from LASIK, but there are some differences. According to doctors who perform LASEK, the flap edge heals in about a day, though patients usually wear a bandage contact lens for around four days. You may feel eye irritation during the first day or two afterward. Also, the time it takes to recover good vision is often longer up to four to seven days. Of course, it varies from one person to the next.

Photorefractive keratectomy( PRK)

PRK uses the excimer laser to sculpt an area 5 to 9 millimeters in diameter on the surface of the eye. This process removes only 5-10% of the thickness of the cornea for mild to moderate myopia and up to 30% for extreme myopia - about the thickness of 1 to 3 human hairs. The major benefit of this procedure is that the integrity and the strength of the corneal dome is retained. The disadvantage of PRK is that 1)healing takes longer than in LASIK. It may take several days for the surface to heal and vision to sharpen.  2)PRK is more uncomfortable for the patient 3) generally, PRK patients must be on postoperative drops for several weeks to months.  It is for these reasons that we reserve PRK for very special situations, such as patients with recurrent erosion syndrome

Paragon CRT® (Corneal Refractive Therapy)