Dr Patrick Versace of the Vision Eye Institute, Bondi Junction is experienced in diagnosing the full range of vision problems, including those brought about the natural process of ageing, such as Presbyopia.

What is Presbyopia?

When we are young, the lens of our eye is extremely flexible allowing us to focus on objects that are near. As we mature and head into our forties, our lens loses this flexibility and hence our ability to focus on things close to us.

Presbyopia is the leading cause of people needing reading glasses or bifocals, and becomes progressively worse with age, until recently, has required either contact lenses or glasses to correct the problem.

Symptoms of Presbyopia

• Needing brighter lights to read
• “Tired eyes” after reading for a short time
• Needing to hold books and menus further away
• Difficulty performing certain tasks, such as reading fine print, threading a needle or removing a splinter

The Treatment

• Monovision/Laser Blended Vision
• Refractive Lens Exchange
• Reading Glasses
• Contact Lenses

For more information about the options available to treat Presbyopia, contact Dr Patrick Versace at the vision eye institute, Bondi Junction.

Dr Patrick Versace is a leading expert in the treatment of presbyopia using  Presbylasik.

THE BREAKTHROUGH

THE MOST EXCITING ADVANCE IN A GENERATION

It’s not often you can announce a development that is truly game changing. But that’s what has happened with LaserLensSMA. The same technology that ophthalmologists have used to perform over 3 million LASIK vision correction procedures worldwide can now be used during cataract and lens replacement surgery. And leading the way – again – is Vision Eye Institute, first with LaserLensSMA in Australia (and the Southern Hemisphere).

WHAT IS LASERLENSSMA?

This revolutionary breakthrough brings high levels of predictability and control into the surgeon’s hands. In simple terms, LaserLensSMA allows laser technology (known as femtosecond laser) to perform significant parts of cataract and refractive lens exchange surgery. SMA stands for ‘safer, more accurate’ – because of the high level of precision that this new technology introduces to the procedure.

MICRON LEVEL PRECISION

The benefit of LaserLensSMA is that the first three steps of the procedure – the Corneal Incision, Capsulorhexis and partial Lens Fragmentation – are performed using an image-guided femtosecond laser, rather than manually. This means that some of the most critical steps now have a higher level of predictability and control, enhancing the surgeons ability to predictably perform cataract and lens replacement surgery.

For more information about this revolution in cataract vision correction and treatment, please contact Dr Partick Versace or the Vision Eye Institute on 1300 065 766 or ask a question.

LASER LENS REPLACEMENT
LaserLensSMA can be used for Lens Replacement, sometimes called Lens Exchange or a Lensectomy. This procedure is for those who have a very high prescription of short-sightedness or long-sightedness – beyond what can be treated by LASIK vision correction, and often for people 45+. The natural lens of the eye is replaced with a new lens. And now with Laser Lens SMA, it can be done with unmatched reproducibility.

THE FUTURE
Will all cataract and lens replacement surgery eventually be performed via Laser Lens SMA? Leading surgeons around the world who have used this technology believe so. They readily admit that, even though they’ve been performing manual surgery for many years, LaserLensSMA technology delivers unmatched predictability, providing them with unparalleled levels of confidence.

IS IT RIGHT FOR YOU?
LaserLensSMA isn’t going to be for everyone – not in the near future, anyway. Right now, it’s only located at the Vision Eye Institute clinic in Chatswood. It’s only slightly more expensive than traditional surgery.

To find out more,Ask a question online for Dr Versace or ask your GP, Optometrist or call Vision Eye Institute on 1 300 253 242.

The cost of under going Laser surgery will vary depending on the procedure that you require. During your initial consultation with Dr Patrick Versace, He will discuss the options and costs with you.

As a guide for the costs involved in laser correction surgery, fees range from $3,000 per eye to $3,400 per eye. Please consult your Vision Laser clinic for full details.

The laser correction fee includes:

• Surgeon’s fees
• Optometrist’s fees
• Post operative medications
• 4 post-operative visits at 1 week, 1 month, 3 months and 6 months
• Enhancements (if required) for at least the first 24 months (see clinic for details)

The cost of laser eye surgery cannot be claimed from Medicare or from most Private Health Funds. However, you may be eligible for a Medical Expenses rebate on your tax return. Please check with your tax accountant for full details.

Please note: The initial assessment is not part of the surgery fee, please contact your clinic for details.

Payment Plans

At Vision Laser, we understand that the decision to have laser eye surgery is a big one. The financial cost of the procedure needs careful consideration and needs to be balanced with the real benefits that can be obtained with laser eye surgery. Many Australians who believe that laser eye surgery is outside of their budget are missing out on the wonderful benefits that freedom from glasses or contact lenses provides.

We offer a range of realistic and affordable financing options to help you experience the freedom of clear vision:

• Interest-free payment plans
• Extended payment plans

Both of these plans are provided by GE CareCredit, which is a credit facility offered by GE Finance Australasia Pty Ltd, trading as GE Money.

12 month interest-free payment plan available*

Click the calculator below to estimate your monthly payments
CareCredit Repayment Estimate Calculator

Call 1800 601 747 or email your clinic for further details about this offer or the extended payment plan.

*Available to approved applicants only. Fees and charges apply. Minimum amount financed $500.

Net medical expenses tax offset

The Australian Tax Office (ATO) allows Australian taxpayers to claim a tax offset on the out-of-pocket expenses they incur on certain medical expenses.

On the ATO website, Net medical expenses are defined as the medical expenses you have paid less any refunds you received, or could get, from Medicare or a private health insurer.

You can claim a tax offset of 20% – 20 cents in the dollar – of your net medical expenses over $1,500. There is no upper limit on the amount you can claim.

Most procedures performed at the Vision Eye Institute fall under the definition of Claimable Medical Expenses.  According to the ATO, “You can claim expenses relating to an illness or operation paid to legally qualifieddoctors, nurses or chemists and public or private hospitals”.

Laser eye surgery is specifically listed as a procedure that qualifies for the tax offset.

You can read more about the Net Medical Expenses Tax Offset on the ATO website.

The 2010 Commonwealth Budget provided for an increase in the threshold from $1,500 to $2,000, effective from July 1, 2010.

This information is provided as general assistance only and does not take into account your personal financial or medical circumstances, nor does it guarantee that surgical procedures performed at Vision Laser with qualify for the tax offset.  Before making a decision about your eligibility to claim the tax offset, please consult your accountant or other tax professional

Have been recently diagnosed as having a cataract or maybe a long term suffer of clouded vision as a result of cataract?, there is no need to worry. Cataracts are not unusual in adults. They frequently occur as part of the eye’s natural ageing process. However, with cataracts it is possible to turn back the clock. The latest advances in micro-surgery have proven to be remarkably successful, giving improved visual results and dramatically shortened recovery times. When deteriorating vision from a cataract begins to interfere with your work or lifestyle it is time to give the situation serious consideration.

What are Cataracts?

The lens of the human eye works rather like the lens of a camera. Toward the front of the eye, the lens focuses light onto the retina at the back of the eye. Light passes through it to produce a sharp image on the retina. When the lens of the eye becomes cloudy or opaque, light is unable to pass through and your vision is blurred. This condition is known as a cataract. There are many misconceptions about cataracts. For instance, a cataract is not a film or growth visible on the outside of the eye. It is not caused from the over-use of the eyes, and using the eye does not make it worse.

Cataracts usually develop over a period of a few months. They are caused by the deterioration of the normal protein structure within the lens of the eye as a person ages. This makes the lens cloudy. Most people with cataracts are healthy and have no other eye disease. However, cataract formation can also follow eye injuries, glaucoma, general medical conditions such as diabetes, the taking of certain drugs, or radiation damage. Cataracts can occur as early as age 40 but occur mainly in people over the age of 60 years. They are the leading cause of vision loss among older adults, and they may affect up to 60% of adults over the age of 65 years. Occasionally they may occur as a congenital defect in infants or children.

What are the Symptoms of Cataracts

Depending on the size and location of the cloudy areas in a lens, you may not even be aware a cataract is developing. As the cataract progresses, you may be aware of one or all of the following symptoms:

• Decreased vision at night and in other situations with poor lighting
• Increased sensitivity to glare or bright sunlight
• Difficulty with night driving – often due to headlights appearing too bright
• Impaired depth perception
• Colour distortion (some people describe this phenomenon as colours appearing washed out)
• Hazy or cloudy vision
• Frequent changes to the prescription in your glasses
• Better near vision for a while
• Double vision – often occurs even with one eye closed

As the cataract develops you will find stronger glasses no longer improve your sight. This can lead to an imbalance between the two eyes, which may cause headaches.

What are some of the common Causes of Cataract

There are four different types of cataracts, each with different causes:

• Age-related cataract – this is by far the most common type of cataract
• Congenital cataract – some babies are born with cataracts or develop them in childhood
• Secondary cataract – cataracts are more likely to develop in people who have other health problems such as diabetes, or secondary to the use of some medications
• Traumatic cataract – a cataract from an eye injury may occur years later

What is the Diagnosis

A regular eye examination is all that is needed to detect a cataract. The ophthalmologist (eye doctor) will check your vision and prescription. He or she will then put drops in your eyes to enlarge your pupils. This allows the doctor to see inside your eyes. A bright light is used to look inside, checking your lenses for cloudiness and checking for other problems inside of your eyes.

If the doctor determines you have a cataract, special tests will be undertaken to measure your eye for the intraocular lens (IOL) which will be inserted. These tests measure the curvature of your eye (keratometry) and the length of your eye (A-Scan). Your information is then used to calculate the correct strength IOL to give you the best visual result.

What are some of the Treatment options

A change in your glasses may be treatment enough for early cataracts. However, surgery is often the only effective treatment for more advanced cataracts. There is no evidence that a change in diet or medications will stop or slow cataract formation.

What is Laser Cataract Surgery?

Cataract Laser surgeons are buzzing about femtosecond laser cataract surgery, a new technology aimed at helping surgeons achieve better results with toric and multifocal IOLs.

Traditional cataract surgery is already pretty successful, but the lasers deliver a benefit that’s difficult to achieve with traditional techniques. They can create a perfectly round, perfectly centered opening in the front of the bag that holds the cataractous lens. That’s especially important for some specialty IOLs.

When the capsulorhexis (the name for the opening in the anterior portion of the capsular bag) is too small, it can interfere with the performance of multifocal lenses like the Bausch & Lomb Crystalens and the Alcon Restor. When it’s too large, it can cause any intraocular lens to tilt and push forward, particularly troublesome for toric and multifocal lenses. The lasers, which work external to the eye, with no need for sterile condition, also can make stepped clear corneal incisions, paracentesis incisions and relaxing incisions, and can at least partially emulsify the crystalline lens.

Phacoemulsification and aspiration are still necessary, but the lasers supposedly make it possible to remove the cataractous lens much more gently, helping to preserve the other structures inside the eye. The laser treatments will probably be applied outside of the OR, then the patient will be wheeled into the OR for the completion of the procedure, says a spokesperson for OptiMedica, one of 3 companies making lasers.

Currently only 1 company, LenSx of Aliso Viejo, Calif., holds FDA approval to market a femtosecond laser; the LensX laser is approved for capsulorhexis and incisions, but not yet for emulsification of the lens. An American surgeon, Steven Slade, MD, performed the first femtosecond cataract surgeries at the Slade-Baker Vision Center in Houston last month, says company spokeswoman Trudy Larkin. She says LenSx lasers will be for sale in October; she declined to disclose pricing, but she says the lasers will be available on a for-purchase or a fee-per-case basis. In addition to LenSx and OptiMedica, 1 other company, LensAR of Winter Park, Fla., also displayed a femtosecond cataract laser at the American Society of Cataract and Refractive Surgeons in Boston last week.

Wavefront-guided laser eye surgery is one of the latest developments in surgical vision correction. It simply means that the laser procedure that re-shapes the cornea takes into account small optical imperfections that are present in the human eye. The benefit of wavefront-guided treatment, compared to traditional laser treatment, is that a better quality of vision can be achieved.

The optical principle behind this type of correction is called wavefront technology, which is a technology that was originally developed in the field of astronomy in order to reduce the optical aberrations (imperfections) in telescopes.

The wavefont-guided correction systems used at The Eye Institute have three main parts:

1. Wavefront aberrometer – the instrument for measuring the optical imperfections of the eye before surgery.
2. Active eye-tracker – the laser’s eye-tracker that tracks the eye’s position at an extremely high rate in order to ensure that even the small involuntary movements of the eyeball are compensated for during surgery. Without this capability, wavefront-guided treatment would not be possible.
3. Wavefront correction – the actual laser treatment given to the cornea during surgery, which takes into account the small optical imperfections.

Wavefront-guided laser correction is considered to be the most advanced method of laser vision correction. The systems we use have received clinical approval from the highly respected Food and Drug Administration in the USA. The Vision Eye Institute clinics were the first in Australia to utilise this revolutionary technology.

Wavefront-guided laser treatment is possible for most people, but not everyone — it depends on the prescription. At Vision Eye Institute it does not cost more than traditional laser treatment. After your laser assessment consultation has been completed the doctor will be able to advise you if your eyes can benefit from wavefront-guided laser treatment.

]]> http://www.drpatrickversace.com.au/wavefront-guided-laser-correction/feed/ 0 http://www.drpatrickversace.com.au/introduction-to-eye-laser-surgery/ http://www.drpatrickversace.com.au/introduction-to-eye-laser-surgery/#comments Wed, 09 Mar 2011 00:10:14 +0000 Laser eye surgery http://www.drpatrickversace.com.au/?p=387 Laser Eye Surgery – An introduction

Laser vision correction, or laser eye surgery, is a surgical treatment for people who want to reduce their dependence on glasses or contact lenses. If you are dissatisfied wearing glasses or contact lenses, then laser vision correction could be for you.

The revolutionary procedure known as LASIK has become one of the most popular and successful in the world today.

And now it is even better, thanks to the introduction of the IntraLase method, the 100% blade-free procedure that is especially suited to people who have previously been afraid to have anything done to their eyes!

Read on to learn more about the remakable advances in technology, and about what is involved in having laser vision correction.

The IOP is critical to the typical working of your eye. In case the force is too decreased, the eye itself deflates, and folds over form in the rear of the eye (retina), leading to a blurring of the eyesight. In the event that the force is too high the optic nerve fibres become compressed and sooner or later die. The passing away of these cells results in irreversible visual damage.

A circular pump inside of the eye, referred to as the ciliary body, generates the clear liquid which is called aqueous. The aqueous moves inside the eye and returns to the blood stream through a lattice work called the Trabecular Meshwork. This is situated in a ring advancing right around the junction of the iris and cornea (called “the angle”). The meshwork provides some resistance to the flow of aqueous, so the pressure in the eye is maintained. If the resistance to flow increases in the meshwork, the IOP builds up. Aqueous fluid also drains out of the eye through the ciliary body and sclera (uveo-scleral outflow).

The IOP is measured as millimetres of mercury (mm Hg). The normal eye usually has a reading between 12 and 21 mm Hg.

The most common cause of raised IOP is a malfunction in the Trabecular Meshwork – it simply does not drain the aqueous as efficiently as it should. The IOP rises slowly, but may not cause damage to the actual eye structure for many years. What can happen, though, is that the increased IOP begins to interfere with the delicate nerve cells at the back of the eye; these cells convert light energy into nervous impulses, and transmit them to the part of the brain which is responsible for sight.

PRK is the first type of laser Eye surgery to have been developed. It started in 1987, but became less frequently used by the mid-1990′s as LASIK vision correction evolved. Later, a modified PRK technique, called LASEK, was developed, and this was further refined into the ASLA technique in use today.

Unlike LASIK, no corneal flap is created during  the PRK surgical  procedure.  Instead, PRK involves removing the top layer of the cornea (the epithelium) so that the laser beam can access and re-shape the cornea below the surface.
Description of the procedure

The PRK procedure takes about 15 minutes per eye:

• The cornea is anaesthetised.
• Anaesthetic drops are applied to the eye, and an eyelid holder is put in place to keep the eye from blinking.
• The corneal epithelium layer is removed.
• The surgeon removes the top layer of the cornea (the epithelium) in order to gain access to the corneal bed below the surface.  The top layer will regenerate naturally within a few days.  Unlike LASIK, no corneal flap is created in the PRK procedure.
• The corneal bed is re-shaped by the laser.
• Pulses of laser energy are then applied to re-shape the corneal bed specifically to the prescription of the eye.  The laser uses a cool ultraviolet light beam to precisely ablate, or vapourise, a pre-determined amount of corneal tissue.
• A soft contact lens is applied.
• The eye is fitted with a “band-aid” soft contact lens for protection while the top layer of the cornea regenerates over the next few days.  (Sometimes an eyepad is used instead of a contact lens).
• Antibiotic and anti-inflammatory eye drops are applied.
• Because the recovery of the eye was relatively slow with PRK, it gave way to the LASIK technique.
• Both eyes are not usually treated on the same day.

Post-op Visual Recovery

Vision is blurry for about a week after surgery. Also, because the 2 eyes are not usually treated on the same day, it takes longer for patients to resume normal activities.
Post-op Comfort

The eyes can feel uncomfortable or painful for about 2 days.
Post-op Stabilisation of Prescription

Stabilisation may take 3 months. Significant regression can occur, particularly with high prescriptions.
Post-op Corneal Haze

Some corneal haze is present for a few months.

LASEK (Laser Epithelial Keratomileusis)

LASEK is a type of laser vision surgery for the correction of refractive errors such as short-sightedness (myopia) and astigmatism.

LASEK was developed for use in cases where LASIK was considered unsuitable because the thickness or topography of the cornea was not adequate.

Both the LASEK and LASIK procedures involve creation of a corneal flap, followed by re-shaping of the cornea.  In LASEK, only the topmost (epithelial) layer of the cornea is used for the flap. In contrast, the LASIK procedure the flap is thicker.
Description of the procedure

The LASEK procedure takes about 15 minutes per eye:

• The cornea is anaesthetised.
• Anaesthetic drops are applied to the eye, and an eyelid holder is put in place to keep the eye from blinking.
• The corneal epithelium layer is removed.
• Eyedrops are applied to the corneal surface to help separate the epithelium layer from the corneal bed. The surgeon gently moves the top layer, or epithelium flap, to one side, thereby exposing the corneal bed.
• The corneal bed is re-shaped by the laser.
• The surgeon uses the laser to re-shape the corneal tissue immediately below the topmost layer (epithelium) of the cornea.  (This contrasts with the LASIK procedure in which deeper layers of corneal tissue are penetrated.)  The laser uses a cool ultraviolet light beam to precisely ablate, or vapourise, a pre-determined amount of corneal tissue for the required prescription of the eye.
• The  corneal epithelium is placed back over the cornea.
• The surgeon re-positions the epithelium layer to cover the corneal bed that was lasered.  A “band-aid” soft contact lens is applied to protect the eye while it is healing over the next few days.  Antibiotic and anti-inflammatory drops are also applied.
• Both eyes can usually be treated on the same day.

Post-op Visual Recovery

Vision is blurry for about a week after surgery, but both eyes can be treated on the same day.
Post-op Comfort

The eyes can feel uncomfortable or painful for about 2 days.
Post-op Stabilisation of Prescription

Stabilisation takes about 2 months.
Post-op Corneal Haze

Some corneal haze is present for a few months but it does not usually affect the vision.

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