Getting rid of the need for reading glasses: the Kamra Inlay

Presbyopia creates the need for reading glasses over the age of 45, it’s like struggling against the tide, ultimately everyone will need reading glasses. Most people find this unwanted onset of blurred near sight a big aggravation and the need to take reading glasses everywhere even more so. It’s an indicator of ageing and the desire to avoid it is great.

In the past the solution to remove the need for reading glasses has long been less than ideal. Laser eye surgery by itself can only correct for one distance range and therefore for individuals over the age of 45 the choice has been to either correct both eyes for distance vision and wear reading glasses, or a procedure known as monovision, where one of the eyes is fixed for distance vision and the other eye for near vision.
The downside to monovision is the fact that using one of your eyes for distance vision and the other for near vision won't permit fine depth perception, or stereopsis. Our eyes have developed especially to grant us fine depth perception and the loss of this is a large sacrifice.

Monovision also allows us to read because it makes one eye shortsighted and this refraction means a closer point of focus. The unfortunate issue with this is the prerequisite for reading glasses gets stronger as you grow older, and generally within a decade monovision will not be good enough to allow fine reading and will require future augmentation. This fact often leads to the widely thought misconception that laser eye surgery only lasts a decade. The truth of the matter is that the distance correction should really last for the rest of your lifetime; it is just ability to read which will degrade as time advances.

The Kamra inlay is a novel innovative technique that overcomes a lot of the disadvantages of typical endeavours to gain independence from reading eyeglasses along the lines of monovision. It is tiny, at a diameter of only 3.8mm, black donut containing a central 1.6 mm aperture which is a mere 5 microns thick. That is actually thinner than a single cell on the surface of the cornea. It is utilised along with a Blade-free or femtosecond laser eye surgery procedure and is placed in the bed of the created flap at the conclusion of the case in just the non-dominant eye.

The basic principle is that a narrowed aperture to look through boosts the range of focus, allowing a full spectrum of vision from distance, intermediate, and all the way to the littlest line of print for near. It’s a very similar idea to the one observed in photography where a lessened aperture improves the depth of focus in a photo which means subjects seen simultaneously in the distance and in the foreground are viewed with sharp relief.

The beauty of the technique is numerous:

1. One can continue to keep the two eyes seeing well for extended distance and thereby keep hold of the imperative appreciation of depth perception that's unfortunately lost with monovision operations.
2. As opposed to the isolated near 'sweet spot' observed in monovision procedures, someone with the Kamra inlay has the whole range of vision from distance all the way to near with everything in the middle in sharp focus too.
3. The improved focal depth that is attained is acceptable to cover you over your entire life no matter what the power of spectacles that could have been required at that age and thus you may well retain independence from spectacles for the duration of your life without needing to have anything else done.
4. It delivers great reassurance to people having the treatment that it is able to be completely reversed.
5. Even patients with a conventional monofocal lens after a cataract extraction procedure would have the opportunity to read with a Kamra inlay in without all the issues encountered with multi-focal intraocular lenses such as observing halos around bright lights.
6. Individuals who have already had LASIK operations before can still have the Kamra inlay implanted as a secondary procedure when they start to need reading glasses.
7. Folks who already have good long range vision and only require reading glasses are the most suitable candidates for the Kamra inlay, as contrary to the monovision procedure in the past, now they don't need to give up the quality of their distance vision to reach their aim of eradicating the readers.

The enormous desire from the forty somethings and beyond to obtain independence from reading glasses will allow the remarkable step forward the Kamra inlay represents to make a substantial impact in the area of vision correction; the Kamra – the tiny revolution!

Dr. James Genge is a qualified and respected eye surgeon from the Northern Beaches in Sydney Australia. To learn more about the Kamra inlay, check out his website at Laser Eye Surgery Sydney.

What To Do During The Blade-Free LASIK Recovery Process

Blade-free Laser Eye Surgery has reformed vision correction technology with its accuracy and reliability, rapid recovery and safety. However, it's always vital to maintain awareness that the procedure is still a surgical procedure and conscientious restorative healing is valuable.

On the day: Laser vision correction is, in general, completely painless after the operation. It is normal however that on the day of the procedure the eye seems sensitive to light and stings slightly for about three to four hours. I support anti-inflammatory analgesics and rest for this. Keep the eye dry and avoid rubbing it.. At the conclusion of the operation the eyes are shielded with clear plastic shields, and these should be kept on for the 1st day and while asleep for 3 nights. Eye drops (antibiotic, lubricant and anti-inflammatory) are commenced on the day of the operation 4 times daily.

The Following Day: Virtually all people find this a fantastic day following laser eye surgery, their vision is in most cases 6/6 (20/20, perfect distance vision) and there is a massive amount of excitement about the fresh, new world that has opened up. Remarks such as “I can see all the leaves on the trees” are standard. The eye will be comfortable. Continuing with the drops is imperative and the principal rules are no eye rubbing and avoiding water and sweat in the eye for about 2 weeks. Contact sports will need to be put on pause for 2 weeks. Most people can go back to work the very next day and there is no restriction on flying. The medicated drops are used for a week.

The Following Month: Eyesight has now stabilized, although there is regularly a light level of dryness that manifests as periodically blurry vision. Even though the eye is comfortable the lubricating eyedrops have to be continued for 3 months to correct this. Generally speaking, the eye at that point returns to normal.

Blade free Laser Vision Correction’s easy, comfortable recovery period and remarkable accuracy make it the most suitable solution for the contemporary life. The point that it is much more safe in comparison to contact lenses when it comes to risk of infection make it the very first preference for people who want to be independent from spectacles or contact lenses.

Visit Dr. Genge's website at Laser Eye Surgery Sydney to learn more about all kinds of eye procedures and eye health issues, including cataract surgery and laser eye surgery.

Phakic IOLs, An Alternative For Those Not Suitable For LASIK Surgery

LASIK is a secure and precise way of achieving freedom from eyeglasses or contacts. There tend to be however a small portion of subjects who regrettably are unsuitable for laser eye surgery. In general, those individuals are either too myopic (shortsighted) and fall outside the solution possible with LASIK, have overly thin corneas, or have atypically shaped corneas (keratoconus). Patients' eyesight can sometimes be made worse yet if medicated with LASIK in these circumstances, but conscientious pre-operative assessment detects them.

In circumstances where the affected individual has too high a amount of myopia (shortsightedness) but still have a regularly shaped cornea, the most appropriate treatment is the implantation of a Phakic Intra-ocular Lens or Cachet lens. This approach only takes 10 minutes long, is pain free and the patient can see well the day after. It offers the ability to repair even the most serious myopia absolutely. There has also been more than 10 years follow-up on this lens to analyze safety and efficacy, that displays excellent long-term stability and safety. The lens can not correct for astigmatism, accordingly some patients undergo a ‘bioptics’ procedure in which fine-tuning of the eyesight is achieved with a very small laser touch-up.



If the corneal shape is unnatural or the patient has sizeable astigmatism, the most suitable choice of procedure is an ICL (Intra-ocular Contact Lens) implantation. An ICL can help remedy astigmatism and also either myopia (shortsighted) or hyperopia (longsighted). A modern study researched quality of vision in high myopia (> -8 diopters) and found it was better in patients who had an ICL implantation compared to Laser vision correction. With the Intra-ocular Contact Lens, over 95% of patients are able to see at the vision standard necessary for driving or even better, and simple, quick enhancement procedures can be performed for many patients who do not initially meet this standard. There tends to be around a 1.7% chance of forming a cataract which in those scenarios is a quick correction regardless by undertaking a cataract extraction / Intra-ocular Lens Implantation. This cataract / lens implantation is generally the only viable alternative to an ICL regardless.

This thrilling cutting edge technology of Phakic IOL Implantation is a thrilling improvement, offering independence from eyeglasses and contact lenses in individuals who might by no means be able to achieve this otherwise, in a safe, quick and pain-free procedure with recovery of vision after only 1 day.

James Genge is a trusted ophthalmic surgeon from Sydney. Feel free to ask him any questions relating to Laser Eye Surgery or other eye health issues on his website at Laser Eye Surgery Sydney.

Why Choose Femtosecond Laser LASIK Over Blade LASIK?

Blade free Laser Vision Correction is all about the apex of technology for LASIK eye surgery. Blade-free allows laser eye surgery to grasp the highest degrees of accuracy and reliability, ease, comfort and safety for subjects. In Blade free Laser Eye Surgery, the corneal flap is created by means of a Femtosecond Laser as opposed to a Microkeratome (an oscillating blade) that is used in regular Lasik surgery.

The reasons Blade Free (Femtosecond Laser) LASIK is more advanced than Blade (Microkeratome) LASIK are numerous:

1. Blade-free LASIK creates a perfect flap every time; this is not the case when using a Microkeratome. A blade can sometimes produce a ‘button hole’ flap that fails to permit treatment to continue and includes a hazard of scarring the cornea. Working with a Femtosecond Laser all but eliminates this risk. A flawless flap equals greater vision.

2. The slimmer flaps made with a Femtosecond Laser are less dangerous in the long run in comparison to blade flaps as the cornea post op has greater firmness as it's wider. This lessens the risk of a consequence called Ectasia, where the cornea can bulge forward with a period of time, sometimes requiring a transplant of the cornea to correct.

3. Blade free (Femtosecond Laser) Laser Vision Correction routinely outperforms blade (Microkeratome) lasers in scientific studies reviewing visual quality. The flap profile and level of smoothness is superior, offering vision as good as or better than their eyeglasses.
A flap created by using a blade is thinner on the outside and thicker around the middle, this unevenness may blur vision. A Femtosecond laser (blade free) created flap is a steady thickness spanning its total diameter, reducing the possibility of micro-wrinkles, the ideal flap profile giving the best achievable vision in Laser Vision Correction.

4. Blade free (Femtosecond Laser) Laser Vision Correction allows the position of the flap to be crafted perfectly, an accomplishment unattainable with a Microkeratome. The ophthalmologist offers a digital image of the flap position superimposed over the affected individual’s cornea and prior to creating it he or she can manipulate and optimize the flap placement so it is centred flawlessly every time. This gives superior vision and safeness.

5. A Femtosecond flap is created with a top to bottom straight side cut, which is again a feat not doable with a blade or Microkeratome flap. This substantially minimizes the risk of a side-effect called epithelial ingrowth, where the cells on the surface of the cornea become seeded underneath the flap. It also enables a superior flap profile as the flap slides back downwards similar to a miniature manhole cover.

Laser Eye Surgery has progressed in an exhilarating new direction together with the introduction of blade-free femtosecond laser flaps; it is finally delivering on its promise of the safest and most exacting operation feasible.

Dr James Genge (M.B., B.S., B.Med.Sci. (Hons)., F.R.A.N.Z.C.O.) is an internationally trained and highly regarded eye doctor and laser eye specialist in the Sydney area. If you would like to know more, take a look at his website at Laser Eye Surgery Sydney.

How Femtosecond LASIK Is The Safest And Most Precise Way To Perform Laser Vision Correction

Laser eye surgery has been a consistently innovating field over the past 23 years. The very apex of technology available is Femtosecond Laser Eye Surgery that will provide unparalleled safety and dependability in Laser Eye Surgery. I feel Laser vision correction delivers our patients with the best quality achievable outcome with a fast and pain free solution.

The earliest approach used in Laser eye surgery was PRK or photo-refractive keratectomy, where the front surface film of cells is "scraped" off the cornea and the lasik treatment is carried out on the layer underneath. It is an appropriate treatment method for modest shortsighted or myopic corrections. However, there is significant discomfort following the operation for several days and the final stabilisation of eyesight takes six to eight weeks.

The following stage in the progression of Laser Eye Surgery was LASIK, whereby a blade known as a microkeratome is used to create a partially thick flap in the cornea. By saving the front surface layer of cell, the restoration of vision is fast, usually 1-2 days, and the procedure is pain free post-operatively. The disadvantage of LASIK performed with a microkeratome blade is the potential of making an irregular flap due to the procedure like a button-hole flap. If this occurs the laser procedure can't be undertaken. The depth of the flap is also fairly erratic. There is an uncommon side-effect of LASIK surgery called ectasia where the cornea becomes unstable and bulges in front over time, extreme cases requiring a corneal transplant to rectify. Producing too profound a flap heightens the danger of ectasia.

The most advanced way of conducting Laser eye surgery is to use a laser, called a Femtosecond Laser, to produce the corneal flap as an alternative to a blade. There are many benefits to doing this. The thickness of the flap is far less in a Femtosecond laser created flap ?n contrast to that created with a blade - this substantially lessens the possibility of the infrequent ectasisa risk I described before. As the laser makes a vertical cut on the side on the flap, any time this is repositioned the flap profile rests more precisely resulting in superior quality sight. The danger of getting an abnormally sliced flap is also avoided.

The Most state-of-the-art laser system in the world for Laser eye surgeryusing a Femtosecond Laser is the Alcon Refractive Suite. It features all the strengths offered by Femtosecond laser vision correction as well as benefits that make it more advanced than other femtosecond LASIK systems. It is the world’s fastest Femtosecond Laser, providing the most effective safety profile and the most comfortable treatment for the patient. It is the fastest Excimer laser in the world also; the laser that actually does the reshaping. A speedier treatment is a more precise treatment, since there is less dehydration of the corneal bed throughout the procedure,which results in in better results. The process also has the Fastest eye tracker in the world, ensuring the solution consistently will go precisely where it is supposed to.

Don't hesitate to ask Dr. Genge any sort of questions you might have regarding laser eye surgery or any other eye health issues, by visiting his website at Laser Eye Surgery Sydney.

How You'll Benefit From LASIK

Whether it's an entire variety of new experiences, or increased confidence in yourself, Laser Eye Surgery comes with a lengthy list of benefits.


INSTANT OUTCOME

One of the many genuinely outstanding rewards of LASIK eye surgery is certainly that most LASIK patients experience considerably improved vision after only mere moments of the surgery. It is quite common for patients to demonstrate near-perfect vision at the time of their follow-up examinations the very day after LASIK eye surgery, and to right away stop using contacts or glasses.


ESCAPE FROM CORRECTIVE EYEWEAR

After successfully going through laser vision correction, one of the benefits patients are most happy about is escape from corrective contacts and eyeglasses. In the great majority of circumstances, patients enjoy visual awareness that is superior to or as good as what they previously experienced with the use of corrective contacts, and are no longer dependent on corrective contacts. For countless LASIK patients, long gone are the days of stressing over ruined eyeglasses or misplaced contacts, carting about cumbersome cleaning and storing solutions, or having to pay for costly replacements each time refractive necessities change.


FRESH ACTIVITIES

Patients who have undergone successful laser eye surgery see that travelling has become considerably more enjoyable and easy due to the fact that they do not need to fret about packing a reserve pair of eyeglasses or all the accessories essential for users of contact lenses. In addition, such activities as swimming, cycling, skydiving, and even spending a day at the beach become more fun without the anxieties and troubles connected to corrective contacts.


ENHANCED SELF-CONFIDENCE

Potentially the most life altering of the many LASIK rewards is the improved self-confidence many patients attain. After laser eye surgery, patients no longer feel like their faces are buried by spectacles. From the convenience of not having to stress about contact lenses, to improved self-confidence and a broader assortment of achievable activities, patients who go through with laser vision correction commonly come to feel as if a whole new world has been exposed to them.

Don't hesitate to ask Dr. Genge any questions you might have about LASIK or any other vision health and wellbeing matters, by visiting his site at Laser Eye Surgery Sydney.

How Safe Is LASIK Anyway?

Laser eye surgery has illustrated its safety and efficacy over a 23-year period. So far, there have been over 36,000,000 laser eye surgeries performed over the globe and no-one has ever lost one of their eyes from having the procedure performed. The risk associated with laser vision correction is safer than that caused by using contact lenses and regarding infection, LASIK represents a small one-time risk, as apposed to the constant risk of eye damage via infection found in those who use contact lenses.

The safety of LASIK has been meticulously assessed by governmental organizations such as NASA, the Australian Army and the Military. The result of their investigations is that LASIK eye surgery performed with a femtosecond Laser creating the flap (Blade-free laser eye surgery) is now approved for astronauts, the SAS and Top Gun pilots.

Sports professionals have had laser eye surgery to optimize their performance, among them are Barry Hall and David Beckham.

The procedure despite having the best safety record of any procedure still carries with it the potential for complications however, which I will discuss below.

Enhancement:
LASIK eye surgery is carried out on living tissue. Although extremely precise, there is on average a 3-4% potential the vision correction will be decent but not absolutely optimal. In these instances, I generally wait about 3 months to ensure that the residual glasses prescription is stable and then lift up the same corneal flap created before to fine tune the result. As enhancements are small corrections they are correspondingly more accurate. One of the best things about laser eye surgery is that although mostly very stable in the long term, should anyone experience any refraction change in their sight, enhancements such as these can be performed at almost any time in the future.

Risk of infection:
The infection rate for LASIK eye surgery is very low, much less than the infection rate with contact lenses. The likelihood of scarring of the eye resulting from an infection eventuating is rarer still, likely less than 1: 20 000. In the event that this happens, I can correct it by transplanting the cornea. However, I am a corneal subspecialist and perform a good deal of corneal transplants, but I have never had to transplant a cornea for this reason.

Issues With The Corneal Flap:
The risk of getting an irregular flap, for instance a buttonhole flap, a possibility with blade laser, is by and large done away with with Femtosecond (Blade-Free) laser. Thanks to the improved safety this entails, blade-free is the sole type of LASIK eye surgery I will conduct.
Swelling under the flap can occasionally develop (diffuse lamellar keratitis) but can be treated with an increased usage of anti-inflammatory eyedrops.
Epithelium, or cells that grow on the surface of the cornea, can very seldom grow into the flap interface. Typically if this transpires these cells break down and go away, however should they do not go away, the flap is raised and the offending cells are removed.

Dry Eye Phenomenon:
Whenever the corneal nerves are cut (such as when creating a corneal flap), it will cause dry eye. It is advised to use lubricating eye drops to renew the tear film during this time period, as the nerves will come back throughout a 3 month period and everything generally goes back to normal.

Ectasia:
Very rarely, LASIK eye surgery brings with it a danger of ectasia, that is when the cornea bulges forward over a period of time because of it becoming too pliable. Extreme cases have required transplantation of the cornea to repair the issue. Fortunately the screening of patients pre-operatively has improved and become more and more precise and unsuitable persons for laser vision correction are typically determined. The new process of collagen cross-linking can prevent the further development of this uncommon issue and if performed early will allow for the patient to maintain their vision and steer clear of the need for corneal transplantation. I am one of but a handful of eye specialists in Australia who is skilled in this process and perform it in my rooms, however fortunately I have never needed to perform this on my own patients.

Halos and Glare:
Patients can in some cases see an increased amount of glare around lights at night, following the surgery. It is extremely unusual to see this last much more than about a week, as it is normally attributed to the corneal flap stabilising.

Quality of Vision:
Almost all patients subsequent to LASIK eye surgery see as clearly or more clearly when compared to their vision with glasses and contact lenses. There will always be a tiny minority who may feel their quality of vision isn't as crisp as what it was at first. Usually this issue is resolved with a laser eye surgery enhancement and will scarcely persist.

LASIK surgery has proven its effectiveness over a 23 year outstanding safety and precision track record. This is only going to develop too, as new advances such as blade-free laser vision correction assure heightened safety and precision, rendering it the clear choice in eye surgery.

Dr James Genge (M.B., B.S., B.Med.Sci. (Hons)., F.R.A.N.Z.C.O.) is an internationally trained and highly regarded eye doctor and laser eye specialist in the Sydney area.. If you would like to know more, take a look at his website at Laser Eye Surgery Sydney.