AEI Procedures

Surgical Procedures

77k Image RADIAL KERATOTOMY (RK) has been the most commonly performed refractive procedure performed for the correction of nearsightedness (myopia). Using a high powered microscope the surgeon makes a series of radial microscopic incisions, typically 4 or 8, on the surface of the outer focusing lens of the eye (cornea) to reduce its curvature. RK is appropriate for patients with low to moderate myopia and has a 15 year track record with hundreds of articles published about results and complications. Some of our surgeons have been performing RK for 15 years.

66k Image ASTIGMATIC KERATOTOMY (AK) is similar to RK and is used to correct astigmatism. An astigmatic eye generally has a cornea shaped like a football or teaspoon, and relaxing incisions are performed in an attempt to make the cornea more round. AK is often combined with RK and has a similar long track record.

Two - 33k Images PHOTOREFRACTIVE KERATECTOMY (PRK) involves sculpting the surface of the cornea to a new curvature with a special cold laser (excimer) by vaporizing the surface layer through a series of precise laser pulses under computer control. PRK in the United States has recently been approved by the FDA for the correction of low to moderate myopia (up to -7 diopters). PRK for the correction of far-sightedness is currently under investigation in the United States and AEI surgeons have participated in this preliminary study. The refractive surgeons at AEI have performed PRK on hundreds of eyes over the past 5 years.

Two - 44k Images AUTOMATED LAMELLAR KERATOPLASTY (ALK) AND LASIK involves separating the surface layer of the cornea with a special instrument (microkeratome). This layer is temporarily folded back and a thin disc of corneal tissue is removed with a second pass of the microkeratome. ALK is primarily indicated for the correction of higher amounts of myopia and although satisfactory results can at times be obtained, a high percentage of eyes need additional procedures and an irregular corneal surface causing some distortion of vision is not uncommon. Many refractive surgeons feel that the procedure will be significantly improved when the tissue removal is performed with the excimer laser as in PRK. This combination of ALK and PRK is called LASIK and is currently legally being performed in the United States only under a special FDA investigation at selected centers.

LASER THERMAL KERATOPLASTY (LTK) is being studied for the correction of small amounts of farsightedness. A special laser (holmium) is used to slightly tighten the fibers in the cornea in an attempt to steepen its curvature. It is still an investigational procedure in the United States.

CLEAR LENS EXTRACTION (CLE) involves the removal of the internal lens of the eye, as in a cataract operation. A lens implant of a stronger power, as calculated by special measurements and formulas, is then placed inside the eye. AEI surgeons have utilized this procedure for selected farsighted patients over the age of 40 under a special investigational protocol.

88k Image PHAKIC INTRAOCULAR LENS (PIOL) involves placement of a lens implant inside the eye for the correction of either nearsightedness or farsightedness. This lens becomes in effect an internal contact lens inside the eye rather than on the surface of the eye. At the present time this lens is being studied outside the United States.

PTOSIS is a condition of drooping eyelids. It may result in blockage of vision and can be repaired by tightening the muscles that lift the lids. Using only a local anesthetic, a small opening is made near the center of the eyelid. The levator muscle is folded over until the desired elevation of the lid has been achieved. Bagginess can be eliminated at the same time. This procedure is commonly performed in the office. In many cases it is covered by medical insurance.

BLEPHAROPLASTY is the repair of bagginess of the upper or lower lids. Excess skin and fat are removed. It is usually an office procedure under local anesthetic.

CO2 LASER SKIN RESURFACING is used to decrease wrinkles, reduce scars and acne pits, and tighten loose skin on the face. A laser beam is applied to remove old skin allowing fresher, tighter tissue to develop. It is an office procedure and can be done under local anesthesia.

ENRTOPION AND ECTROPION OF THE EYELIDS are lid malpositions. The edge of the upper or lower lid may turn in or out causing much discomfort, redness and infection. They are repaired in the office or as an outpatient, by tightening the loose muscles and other tissues. These procedures are performed under local anesthesia. Grafts may also be used to repair sever deformities.

ORBITAL FRACTURES are caused by injuries to the bones that surround the eyes. They can result in double vision or a sinking-in of the eye. We can repair them in an out patient setting.

CANCER OF THE EYELIDS is usually a local condition. Basel Cell Carcinoma is the most commonly found type. It can be completely removed in the office using a local anesthetic. Less commonly, other types of cancers are found and we are experienced in treating those as well.

LASER CONJUNCTIO-DACRYO-CYSTO-RHINOSTOMY (CDCR) WITH ENDOSCOPY is a relatively new way to treat tearing problems. Tear ducts are passage ways that drain away excess tears. If they are blocked tears usually overflow onto the face. With a miniature telescope we can actually look into the tiny tear duct and see the blockage on our specially designed, enlarging D.O.F.I. screen. The obstruction can then be lasered away until the passage is clear. On the other hand, if the tear duct has been totally destroyed by injury, such as a dog bite or auto accident, or disease of any sort, we can build a new one using an Excimer 305nm laser or a Holmium: YAG laser. Tubes can be installed to maintain the opening. This is an out patient procedure.

TEAR DUCT PLUGS are installed to help retain moisture on the surface of eyes that are too dry. Temporary plugs that dissolve are used to help determine whether permanent, removable ones are indicated.

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Refractive surgery procedures include the following:

Cosmetic and Reconstructive procedures include the following repairs:

Tear Duct procedures include the following: