Penn Optical Group

What is LASIK?

Dr. Tisch and Dr. Horowitz provide initial screening and consults for the in-office corrective vision proceedure called LASIK. LASIK stands for laser in-situ keratomileusis, which means to treat the cornea with a laser. LASIK surgery involves creating a thin flap of corneal tissue using an automated device called a microkeratome. This part of the LASIK procedure requires about 10 seconds. Creation of the flap provides access to the central part of the cornea. The excimer laser is used to reshape the cornea by removing, or ablating, a microscopic layer of corneal tissue. We work with a premiere New York City LASIK facility which has treated thousands of Manhattan LASIK Eye Surgery patients.

The creation of the flap provides access to the central part of the cornea. The molecules are used to reshape the cornea by removing a microscopic layer of corneal tissue.

In the case of vision loss, the tissue removed is in the center of the cornea, which results in flattening of the cornea. For most patients, flattening of the cornea will allow incoming light rays to be focused on the retina. In other cases, the tissue removed is in the periphery of the cornea, which results in a steepening of the cornea. This steepening is what allows patients to see clearly. It will also treat any defect at the same time by steepening the flatter meridian of the cornea and flattening the steeper meridian, bringing the light rays to one single point of focus on the retina.

This portion of the procedure usually takes anywhere from 10 seconds to approximately 60 seconds. Once our doctor has completed this portion of the procedure, the flap is placed back down to its original position and allowed to dry for approximately two minutes. It takes around seven minutes to treat each eye. The corneal flap seals in its original position through osmotic and ionic forces. There are no stitches required in the operations.

The longer the period of time from the procedure date, the more secure the corneal flap. The flap can be re-lifted using special instrumentation up to two years after the procedure. After the first week, it is rare that the corneal flap will dislocate under normal circumstances.

One of the many advantages to this procedure is that if there is residual vision problems after the initial procedure, the flap can be re-lifted and an additional treatment can be used to treat the residual refractive error. This procedure is called an enhancement. Enhancements are required on average approximately 5 percent of the time in our practice depending on the amount of original vision loss.

The greater the amount of refractive error preoperatively, the greater the likelihood enhancement will be necessary at some point following the procedure. Enhancements are required because it did not fully respond to the original treatment or regressed after treatment. The cornea, being living tissue, will vary in its response to the molecules from individual to individual.

A nomogram is a table our doctor uses prior to the procedures. The nomogram determines how many seconds of treatment are needed to correct an individual patient's refractive error. This is based on several factors including the amount of refractive error to be treated and the age of the patient. Our Doctor tracks all of his patients' results in a computer database so that he can continually modify his nomogram based on his results. This helps to minimize the chances that an enhancement is needed.

Call us today at 212-279-4826 to schedule your FREE LASIK Consultation.

Allegretto Wavelight Custom LASIK

Our LASIK surgeons use the newest technology in Custom LASIK Surgery, the Allegretto Wavelight laser. They perform refractive surgery procedures in New York City using this laser, a revolutionary tool in laser vision correction. Currently the fastest correction in the United States, Allegretto Wavelight is safe, accurate, and has given a majority of its patients better than 20/20 vision.

The extremely controlled and precise Allegretto Wavelight is ideal for custom operations. The Allegretto Wavelight is calibrated specifically to your needs, ensuring the proper energy level is used to achieve a rounder and more natural corneal surface during the procedure.

The Allegretto Wavelight also constantly monitors the position of the eyeball. It measures the location every four to six milliseconds, automatically adjusting its internal mirrors. A second check on the position is performed just to make sure it has not changed position. If it moves out of position or moves too quickly to be tracked, the Allegretto Wavelight will stop. It will not release a pulse until it has returned to its original position.

What are the benefits of custom LASIK with Allegretto Wavelight?

The Allegretto Wavelight received the widest approval rating given to a new refractive procedure for correcting ocular probelms. The results of using Allegretto Wavelight have been overwhelmingly positive with exceptional clinical results as shown by these findings

(1) One year following the Allegretto Wavelight, more than 93 percent of patients reported that they saw as well or better than they had before treatment, even with spectacles or contacts

(2) One year following the Allegretto Wavelight, more than 98 percent of patients achieved 20/40 vision, the visual acuity required to pass most driving tests

(3) Almost 60 percent of nearsighted patients achieved 20/16 vision one year after the Allegretto Wavelight

(4) Both nearsighted and farsighted patients treated with the Allegretto Wavelight report an improvement in their reaction to night driving glare and bright lights. Additionally, nearsighted patients report an improved light sensitivity

(5) A vast majority of patients, more than 90 percent, achieve refractive correction within 1 diopter of their desired correction

Am I eligible for LASIK with the Allegretto Wavelight?

Though the Allegretto Wavelight allows more people to receive custom procedures than before, there are certain individuals who are not good candidates forthis procedure. You are probably NOT a good candidate for this treatment if you:

(1) Are under 21 years old. At this age, your are still growing and are susceptible to change

(2) Are pregnant or nursing. While pregnant, changes occur in your hormone system that can alter your vision. It's better to postpone the operation until after your child is born and after you are finished nursing

(3) Are taking certain medications

(4) Have high blood pressure

(5) Have very large pupils

(6) Have thin corneas

(7) Have dry eyes

(8) Have Glaucoma Keratoconus (a corneal irregularity)

(9) Suffer from eye inflammation

(10) Suffer from Herpes simplex

(11) Suffered severe eye injuries in the past

(12) Suffered corneal infections or scars

(13) Suffer from unstable refraction or refractive errors

(14) Suffer from other diseases of the eyes such as AMD, anopsia or others

Our physician encourages you to speak with him to determine if you are eligible for the Allegretto Wavelight.

Schedule a free consultation by calling our office at (212) 279-4826

Frequently Asked Questions

1. Is this procedure painful?

There is typically little pain or discomfort during the operations, though patients have reported a sensation of pressure from the lid speculum, an instrument designed to hold the eyelid open. Patients also report pressure when a suction ring is placed during the creation of the corneal flap. Following Allegretto Wavelight procedures at our office, your eyes may be red, watery, itchy, or irritated for four to eight hours. Though there are some cases of excessive tearing, and patients rarely experience any pain following the operation.

2. How long does it usually take for a patient's vision to recover after the procedure?

Even with blurry vision, the patients at our office report a marked improvement immediately after the procedure. Patients typically recover 90 to 99 percent of their vision in the 12 to 24 hours following the procedure. A patient's vision is expected to gradually improve over the next several weeks.

3. Can a person go blind from the operation?

As with any surgical procedure involving the eyes, this procedure does run the theoretical risk of blindness. This risk is extremely small, however, and would require a series of unlikely and catastrophic events to occur simultaneously. Optic nerve damage after the operation has been reported in a handful of cases in the medical literature. The risk of vision-threatening complications as a result of Allegretto Wavelight from our practice is less than 0.1 percent. The doctor will review any complications with you when you visit our office for your free consultation.

4. What problems with halos and glare do people report following the procedure?

In the immediate and postoperative period following the operations, some patients may experience halos or glare. These problems usually resolve themselves within eight weeks of the the procedure. Cases of permanent halos or glare are extremely rare but can be especially hazardous when driving at nighttime. Patients with large pupils who have high prescriptions of visual acuity problems(>6.0 diopters) are at risk for developing glare following an operation. Patients who experience glare prior to the procedure when wearing contact lenses and patients with severe visual problems are also at risk. Our specialist, uses a special device called a pupillometer to measure your pupils in conditions simulating those at night. He will help you determine the benefits and potential risks of the procedures unique to your condition.

5. When can I resume my normal activities like returning to work and driving?

Most patients can return to work and even drive the day after their operation. If you work on a computer or do significant amounts of reading, your eyes will experience dryness. During the early postoperative period, you will have to use artificial lubricating drops more frequently when doing these activities.

The only restrictions that you have following the procedure are to refrain from wearing makeup for one week postoperatively. You must also refrain from swimming or using hot tubs for the first two weeks after the operation. You will inevitably get some water in your eyes when taking a shower, but you should not let the shower hit you directly in the face for the first two weeks after the operation.

6. What about problems with drying of the eyes after the operation?

The degree and frequency of eyes drying following the operations varies from person to person. Eyes that are dry occur after the procedure because the nerves that innervate the cornea are cut during the surgery. This causes decreased stimulus to blinking and hence less tearing. For some, the dryness following the operation can last for several months, which is why our Doctor will instruct you to frequently use artificial tears after the procedure. The dryness will subside once the nerves in the cornea have grown back.

Call our office at (212) 279-4826for more information.