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Procedures and Surgeries



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CATARACT SURGERY

Cataract surgery is a minimally invasive procedure performed on an outpatient basis at Naples Premier Surgery Center. The eye is anesthetized with topical and/or local anesthesia along with IV sedation. A small incision is made, into which an ultrasound probe is inserted to break up or emulsify the cataract into tiny pieces which are then suctioned out of the eye. Once the cataract has been removed, a new artificial intraocular lens is inserted to help improve vision. A stitch is usually not even needed!

Each surgical patient is meticulously tested prior to cataract surgery to determine which intraocular lens is best for them. Dr. Tran and Dr. Vu employs the newest technology in intraocular lenses, including the Acrysof® Toric lens for astigmatism, the Restor® multifocal lens, the Tecnis multifocal lens, the Crystalens® accommodative lens, and Trulign Toric accommodative lens. Each of these lenses offers different advantages for post-surgical vision. The most effective lens depends on each patient’s individual preferences and goals for their vision.

RESTOR made by Alcon

 

 

 

Tecnis Multifocal by AMO

 

 

 

CRYSTALENS made by Bausch and Lomb

 

 

 

Toric Intraocular Lens

Toric IOLs are specifically designed for patients with astigmatism. In the past, patients with astigmatism would need eyeglasses or contact lenses even after cataract surgery. Toric IOLs such as the Acrysof® Toric, and the Trulign Toric correct cataracts and astigmatism with just one lens, providing a convenient and affordable solution to your vision needs.

Multifocal Intraocular Lens

In the past, intraocular lenses were monofocal, meaning they were only able to correct distance vision, often leaving patients with the need for reading glasses. Multifocal IOLs such as the Tecnis multifocal or Restor® offer patients freedom from glasses after cataract surgery by improving vision at all distances. Up to 80% of patients do not need to rely on glasses with the Restor® multifocal IOL.

For more information please visit acrysofrestor.com

Accommodative Intraocular Lens

Accommodative IOLs such as the Crystalens® offer a full range of restored vision for cataract patients. The Crystalens® mimics the natural lens’ accommodative capabilities, allowing the patient to see clearly across a wide range of distances.

For more information please visit crystalens.com

Laser Cataract Surgery

Laser-based cataract surgery is when a femtosecond laser is used to break the eye’s natural lens into fragments for easier removal through an incision. A laser may also be used to make incisions into the eye during the cataract procedure.

A Better Vue Eye Physicians is one of very few ophthalmology practices in the country to have access to this technology and your surgeon will determine whether or not laser cataract surgery should be included in your treatment plan.

ADVANCED LASER CATARACT SURGERY AND ORA

Naples Premier Surgery Center now offers the LENSAR Laser System as part of your advanced cataract procedure because it is safe, effective and uses the same proven laser technology that’s been used in LASIK procedures for over a decade.

What is LENSAR and how does it improve my cataract procedure?

Your eye works a lot like a camera, using a lens to focus on an image. If your camera lens became cloudy, you'd have a hard time viewing the world around you. Just like a camera, the lenses in your eyes can become cloudy as you age, making it harder for you to see. This natural condition, known as a cataract, affects more than half of Americans by age 80.

The LENSAR Laser System allows your surgeon to offer you a better,more precise cataract removal procedure that is customized to your eye. With the LENSAR Laser System, your surgeon can remove your cataract in a more advanced way. Using the LENSAR Laser System ensures that your customized cataract procedure is performed with laser precision. This is because of Augmented Reality, a unique imaging system that provides your surgeon with a reconstructed 3-D view of your eye, in order to help plan and treat your cataract.

Want to Learn More? Click Here

ORA- Optiwave Refractive Analysis

It used to be that your surgeon needed to wait weeks after performing surgery to determine your vision results. Thanks to ORA, this is no longer the case. Now, during the procedure, your surgeon can take measurements of your eye, make any necessary adjustments and refine your visual outcome. ORA measurements are taken after the clouded cataract is removed, when the surgeon has a clear view, allowing your surgeon to tailor your procedure to your individual eye. No matter what premium cataract procedure you and your surgeon decide upon, you can feel confident that by adding the ORA System, you’ll receive the best possible results.

LASIK

How LASIK Works

The universal refractive errors myopia, hyperopia, and astigmatism result from flaws in the shape of the cornea. In order to refract light that enters the eye properly, the cornea must be perfectly spherical. The more drastic the flaw in this spherical shape, the more severe the resulting refractive error.

The objective of LASIK is to restore the cornea to a more ideal shape so that light can once again be refracted properly. This is accomplished by removing tiny amounts of corneal tissue with a highly precise excimer laser through a flap created in the uppermost layer of the cornea. Most patients emerge from LASIK surgery with 20/20 or better vision and no further need for corrective eyewear such as glasses or contact lenses.

Candidacy for LASIK

LASIK is not well-suited to all patients; at A Better Vue Eye Physicians, we will determine your candidacy for the procedure by conducting a thorough evaluation of your eyes. Generally, suitable LASIK candidates:

• Are at least 18 years of age

• Have had stable vision for at least one year

• Do not have an eye injury, infection, or corneal scarring

• Do not have an autoimmune disorder or a history of ocular herpes

• Are not pregnant or nursing

• Do not have dry eye syndrome

• Have sufficient corneal thickness to support the creation of a flap

Patients who are not suitable candidates for LASIK surgery may be eligible to undergo ASA, a similar procedure that does not require the creation of a corneal flap.

The LASIK Procedure

The LASIK procedure is performed in our Bonita Springs laser center and requires about 15 minutes altogether to complete. Once the eye has been anesthetized, the surgeon will create a flap in the cornea; in the traditional LASIK procedure, this flap is made with a blade called a microkeratome. The flap is folded back to expose the underlying corneal tissue, which is then reshaped using the excimer laser. Once the necessary alterations have been made, the flap is replaced, and the surgery is complete.

Recovery from Surgery

Patients are able to return to their homes shortly after the LASIK procedure, and should relax for the rest of the day. Although most patients experience little to no discomfort after surgery, activities that place strain on the eyes, such as reading or operating a computer, should be avoided in the first 24 hours. Anti-inflammatory, antibiotic, or moistening eye drops may be prescribed. Most patients are able to return to work and other routine activities the day after the procedure. For the first several days, patients should wear protective eye shields at night and sunglasses during the day.

After LASIK, most patients experience an immediate improvement in their vision. Over the next several months, vision continues to improve, usually stabilizing in about six months. We will monitor your progress through post-operative appointments at our office.

Learn More about LASIK

If you would like to learn more about LASIK, please contact us today.

ASA (Alternative to LASIK)

What Is ASA (Advanced Surface Ablation)?

Advanced Surface Ablation (ASA) actually predates LASIK in its availability as a laser refractive surgery. Like LASIK, ASA refractive surgery uses an excimer laser to correct myopia (nearsightedness), hyperopia (farsightedness), and astigmatism through the reshaping of the cornea. The primary difference between the two surgeries lies in how the underlying corneal tissue is accessed. With LASIK, either a microkeratome blade or the IntraLase® laser is used to create a flap in the surface layer of the cornea, called the epithelium. With ASA, the epithelium is removed altogether. Therefore, ASA entails a longer recovery period than LASIK; however, it produces similarly outstanding results while eliminating the possibility of flap-related complications.

ASA Candidates

ASA is generally recommended to patients who wish to restore their vision through refractive surgery, but are not good candidates for LASIK. However, some patients, including many members of the military and professional athletes, choose ASA over LASIK to avoid the corneal flap.

In general, ASA candidates should:

• Have a refractive error such as hyperopia, myopia, or astigmatism

• Have a prescription that has been stable for at least one year

• Be in good overall health

• Not have any eye diseases or conditions that would make laser vision correction inadvisable

ASA Procedure

At the beginning of your ASA surgery at our Bonita Springs laser center, eye drops will be used to anesthetize your eye. Once the eye has been completely numbed, a protective eyelid holder will be used to prevent you from blinking during the procedure. The epithelium will be removed by the surgeon, and the excimer laser will be used to precisely reshape your cornea, as in LASIK. The epithelium will regrow during your healing period.

ASA Recovery

Following your laser treatment, a protective bandage contact lens will be inserted into your eye to promote regeneration of the epithelium, and you will be given post-operative anti-inflammatory and antibiotic eye drops. You will need someone to drive you home from our laser center after your ASA surgery, as your vision may be blurry for one to five days after treatment. Many patients are able to return to their normal daily activities within three of treatment, and improved vision should be noticeable within one to two weeks, though vision may fluctuate over the next six months as the cornea heals.

Contact Our ASA Surgery Team

If you would like to learn more about ASA, please contact us today.

GLAUCOMA SURGERY AND LASERS

Lasers

Selective Laser Trabeculoplasty (SLT)

SLT is a laser that treats the drain directly to help increase the outflow of fluid. It treats specific cells "selectively," leaving the trabecular meshwork intact. For this reason, SLT may be safely repeated. It is not painful, and often can be an alternative to eye drops in early open angle glaucoma.

Laser Peripheral Iridotomy (LPI)

Angle-closure glaucoma, also called closed-angle glaucoma, occurs when the iris bulges forward to narrow or block the drainage angle formed by the cornea and the iris. As a result, aqueous fluid can no longer reach the trabecular meshwork at the angle.

LPI creates a small hole in the iris, allowing it to fall away from the drainage angle and unblock the drain.

Surgeries

Trabeculectomy (Filtration Surgery)

During trabeculectomy (sometimes also called filtration surgery), a new drainage opening is created to bypass the clogged drainage channels of the trabecular meshwork. The opening is partially covered with a flap of tissue from the sclera (the white part of the eye) and the conjunctiva (the clear thin covering over the sclera). This new opening allows fluid (aqueous humor) to drain out of the eye under the conjunctiva and form a little blister, or bubble, called a bleb. The bleb is located just under the upper eyelid, where it is not visible.

Tube-Shunt Surgery for Glaucoma

Tube-shunt surgery involves placing a flexible plastic tube with an attached silicone drainage pouch in the eye to help drain fluid (aqueous humor) from the eye. This type of surgery is usually done after a failed trabeculectomy. If a person already has or is likely to form scar tissue in the eye, this type of surgery may be done initially. Tube-shunt surgery is outpatient, and is done under local anesthesia. A Baerveldt, Molteno, or Ahmed tube shunt may be used by your doctor, depending on the type of glaucoma, and the lowering of IOP needed.

Canaloplasty for Glaucoma

One recent state-of-the-art surgical advancement is canaloplasty, a new interventional treatment for glaucoma that gives many hope of saving their vision. This procedure can reduce pressure in the eye by nearly 40 percent - and many glaucoma patients no longer need medications.

Canaloplasty is a non-penetrating surgical procedure that does not require a fistula creation.

Insertion of a micro-catheter will enlarge your eye's main drainage channel and other natural outflow channels by injecting a sterile, gel-like material while passing the catheter. After the drainage channel is made larger, the micro-catheter is removed and a suture is placed within the canal system and suture tension within this system controls eye pressure.

Express Mini-shunt for Glaucoma

One of the latest advanced surgical procedures is Express Mini -Shunt implantation. The Express mini-shunt is a device that is available as an alternate or concurrent to traditional glaucoma filtering (trabeculectomy) surgery. It is advantageous to both the patient and the doctor because it allows the doctor to provide the patient with a reduction of pressure and a reduction of medications required after the procedure. The doctor can perform this procedure more simply with and without the extra tissue manipulation required with the traditional filtering procedure.

EYELID PROCEDURES

Upper and Lower Eyelid Blepharoplasty

With age, sun exposure or genetic factors, loose skin and excess fat may accumulate in your upper and lower eyelids. Blepharoplasty corrects sagging eyelids, excess folds and under-eye pouches. The surgery is performed under local anesthesia with sedation and takes one to two hours. You can resume light activity within three days, and exercise and more vigorous activities in one week.

Ptosis Repair

Ptosis is the medical term for drooping of the upper eyelid, a condition that may affect one or both eyes. When the edge of the upper eyelid falls, it may block the upper field of your vision. Symptoms of ptosis include a decreased ability to keep your eyes open, eye strain and eyebrow fatigue from the increased effort needed to raise your eyelids, and fatigue. Acquired ptosis is treated surgically, with the specific operation based on the severity of the ptosis and the strength of the levator muscle. Surgery is designed to reattach the stretched muscle to its normal location.

Ectropion Repair

Ectropion is the medical term used to describe an abnormal lower eyelid that turns outward and no longer touches the eye. As a result, the conjunctiva (the mucous membrane that lines the eyelid) may become red and exposed. This condition usually involves one or both lower eyelids but rarely, may affect the upper eyelid(s). If the ectropion is due to laxity of the eyelid's supporting structures, it is best treated surgically. Depending on the cause, surgery can reposition the eyelid back to its normal position against the eye.

Entropion Repair

Entropion is a condition in which an eyelid turns inward, rubbing against the eye, making it red, irritated and sensitive to light and wind. If it is not treated, the condition can lead to excessive tearing, crusting of the eyelid, mucous discharge, and irritation of the eye. A serious inflammation could result in damage to the eye. There are a number of surgical techniques for successfully treating entropion and each surgeon will have a preferred method. The usual treatment for entropion involves tightening of the eyelid and its attachments to restore the lid to its normal position.

BOTOX/ XEOMIN/ DYSPORT AND DERMAL FILLERS

Botox/Xeomin/Dysport

BOTOX®/Xeomin/Dysport Cosmetic is a simple, effective way to reduce the appearance of facial wrinkles and achieve a revitalized appearance. Botox Cosmetic is a purified chemical made from a special neurotoxin that has been proven to relax the muscles that cause wrinkles in the face.

Dr. Tran injects Botox into the skin using a tiny needle. For most patients, treatment takes less than 20 minutes. There is little, if any, discomfort. Once the chemicals in Botox enter and affect the body, they temporarily block the nerve impulses of specifically targeted muscles; this relaxes them and makes the skin appear smoother.

If you wish to slow the appearance of aging in the face, around the eyes, and on the forehead, Botox/Xeomin/Dysport may be a good choice. Facial wrinkles can be classified into two distinct types: ‘dynamic wrinkles’ occur when facial muscles contract, while ‘static wrinkles’ remain visible even when those muscles are at rest. Treating dynamic wrinkles with Botox can effectively delay the onset of permanent static wrinkles. Botox/Xeomin/Dysport can also diminish the appearance of creases between eyebrows, do away with persistent crow’s feet, and forehead wrinkles.

The results of Botox/Xeomin/Dysport aren’t noticeable until a few days (4 – 8) have passed. Results typically last about 3-6 months. There is no downtime with Botox/Xeomin/Dysport – you can return to your daily activities immediately. The injection areas will be indistinguishable.

If you are interested in receiving BOTOX® /Xeomin/Dysport treatment or have any questions regarding its administration, side-effects, or results, feel free to contact us today!

Dermal Filler (Juvederm XC)

Juvederm XC helps replace the hyaluronic acid your skin has lost, adding volume to smooth away facial wrinkles and folds. Juvederm XC achieves its smooth consistency due to an innovative manufacturing process called Hylacross technology.

Hylacross gives Juvederm XC its unique smooth-gel properties as well as robust gel structure that holds up over time. That’s why Juvederm XC is the first smooth-consistency hyaluronic acid gel and the only hyaluronic acid filler that’s FDA approved to last up to 1 year with only 1 treatment.

Juvederm XC is formulated with lidocaine, a common anesthetic, to provide a more comfortable experience during and after treatment. It provides the smooth, natural-looking results you expect with the improved comfort you want.