Hydrus ® Microstent is a new type of MIGS
What is it? The Hydrus ® Microstent
It is a device which is implantable, flexible, a metal nitinol (Nickel Titanium) tube with windows (open-back stent) pre-loaded onto a hand-held delivery system which is used to implant the stent. The Hydrus ® Microstent is meant to decrease eye pressure (intraocular pressure, or IOP) in grown-up individuals with moderate to modest primary open angle glaucoma (POAG) by functioning as a support structure in one part of the natural drainage path of the eye (Schlemm’s canal). POAG is a kind of glaucoma where there is associated eye disease causing increased eye pressure and also where the eye pressure normally increases gradually. This progressive increase in eye pressure can be related to damages to the optic nerve which will impair vision significantly.
How does it work?
The Hydrus ® Microstent is implanted right into the eye of glaucoma patients to help fluid in the front part of the eye anterior chamber, or AC flow much more easily through Schlemm’s canal.
When is it used?
The Hydrus ® Microstent is intended to be used during cataract surgery. This is important for the reduction of intraocular pressure (IOP) in adult patients with mild to moderate POAG.
What will it accomplish?
In a medical research of 369 individuals, 77.2% who obtained the Hydrus ® Microstent attained a 20% or higher reduction in their IOP (intraocular pressure) compared to 57.8% (108/187) of the individuals having cataract surgery alone.
When should it not be used?
The Hydrus ® Microstent should not be used in patients who have any of the following problems:
LASIK, which is acronym that stands for laser in-situ keratomileusis, is a popular surgery used to correct vision in people who are nearsighted, farsighted, or have astigmatism. LASIK or Lasik, commonly referred to as laser eye surgery or laser vision correction, is a type of refractive surgery for the correction of myopia (nearsightedness), hyperopia (farsightedness), and astigmatism (blurred vision).
LASIK works on the principle that by reshaping the cornea, the clear front part of the eye, light traveling through the cornea is properly focused onto the retina, which is located in the back of the eye.
LASIK Surgery meaning
During LASIK eye surgery, the instrument used is called a microkeratome or femtosecond laser which creates a thin flap in the cornea. The corneal flap is then painlessly peeled back and the underlying corneal tissue which emerges is reshaped using another laser. The LASIK procedure may be done on one or both eyes during the same session, one after the other. The excimer laser is used to reshape the corneal tissue underneath the peeled back corneal flap. A liitle part of the flap (the part which has not been peeled back) acts as a hinge and connection preventing it from being completely separated from the cornea. Glasses or contact lenses are designed to compensate for the eye's imperfections. Surgical procedures aimed at improving the focusing power of the eye is called LASIK surgery which may remove or minimize the uses of glasses (spectacles) or contact lenses. 9
LASIK Eye Surgery candidate
Criteria for a Good LASIK Candidate. 1. Your Eyes Must Be Healthy. 2. Your Cornea Must Have Sufficient Thickness. 3. Your Pupils Must Not Be Overly Large. 4. Your Prescription Must Be Within Certain Limits. 5. You Must Be Over A Certain Age. 6. You Must Have Stable Vision For At Least A Year. 7. You Must Be In Good Health. 8. If You Are Pregnant, You Should Delay Surgery 9. You should have realistic expectations
LASIK Eye surgery age
Age: Most providers won't perform LASIK on those under 18 because eyes tend to keep changing into early adulthood. However, laser eye surgery has been performed on children for correction of severe vision problems. These are outliers to most cases. Usually LASIK candidates fall between the ages of 20 and 40. In 2006, the
LASIK Surgery risks
British National Health Service's National Institute for Health and Clinical Excellence (NICE) considered evidence of the effectiveness and the potential risks of the laser surgery stating "current evidence suggests that photorefractive (laser) surgery for the correction of refractive errors is safe and efficacious for use in appropriately selected patients.” Clinicians undertaking LASIK surgery should ensure that patients understand both the benefits as well as the pitfalls and potential risks of the procedure. Risks include below expected improvement in unaided vision, development of some new visual disturbances, chances of corneal infection and complications associated with the flap. These risks should be weighed against those of wearing spectacles or contact lenses." The FDA reports “the safety and effectiveness of refractive procedures has not been determined in patients with some diseases. LASIK is a technically complex procedure requiring precision surgery. Problems, though not common, may also occur when the doctor peels back the corneal layer to create the flap, which can permanently affect vision. That is why it is important to choose a surgeon who is very experienced at performing these surgeries. LASIK may also, rarely, cause a loss of "best" vision. By best vision, we mean the highest degree of vision that you achieved with the help of contacts or eyeglasses. Some patients may also experience a kind of temporary discomfort in the first 1-2 days after LASIK eye surgery and may disappear after that. Other side effects, although rare, may include: • Glare • seeing halos around images • Difficulty driving at night • Fluctuating vision • Dry eyes
LASIK Surgery cost in USA
The actual price you pay for LASIK surgery, however, depends on many factors, and therefore the average price is only an indicator. The factors affecting the price may include the experience and reputation of the surgeon performing the surgery and also the type of technology or laser used for your procedure. Also the same surgeon may have variable pricing depending on the specific technology used. For example, a surgeon may charge more for all-laser LASIK or custom LASIK that is based upon wave-front technology. This technology for example provides the most precise vision correction possible, currently.
the average price for LASIK in 2017 was $2,088 per eye.
COST OF LASIK, PER EYE (2017)
At Khanna Vision Institute our happy, welcoming, and helpful staff strive to give our patients the best experience possible.
iDesign Wavescan is the Latest In Lasik Technology. It has over 1200 micro scans that scan the eye creating a custom treatment exclusively for you. Even corrects astigmatism! iDesign Lasik is the superior of all the previous scans for more information on idesign lasik visit: https://khannainstitute.com/idesign-wavescan-lasik
Dr. Khanna has been in the practice for over 25 years. He has completed procedures for many celebrities as well as for the average Joe. Doctor Khanna takes pride in his skills as a talented eye surgeon and is always striving to perform at his best. He has been recognized as one of the top 10 best eye surgeons in 2017 and continues to strive for greatness.
Dr. Khanna takes safety very seriously. To him your safety and vision means more than money. His personal goal is to help you achieve maximum eye health and maximum vision capabilities. He does this through his 25+ years of experience and, considering safety is a major factor for him, he creates an eye plan specifically for you.
Good Morning, Dr Khanna here, with some very interesting questions on Lasik eye surgery, looking at it from a different angle. Some things I hadn’t thought people think and that’s how we learn more.
The first question is, “where to buy Lasik goggles” initially I got confused, like what do they mean by Lasik goggles? Then I understood. When we do Lasik surgery, we provide you postoperative kits, special glasses to wear, both during night, which are clear and wrapped around your face, so that you don’t accidentally touch or rub your eyes, and then during day time, so that no dust, sun or wind goes in and irritates your eye. I understand that some people are not able to get the same from their own Lasik providers and they’re looking to get good quality ones. So if you do online search, you can find like MHI Care, (INAUDIBLE – 1:08), solar glasses, cheapertender.com, funny name but it’s true, it is very cheap. But these have some good quality, both sun glasses, driving glasses, antiglare glasses which are very affordable.
“Can Lasik cause flutters?” No, Lasik does not cause flutters and Lasik does not treat flutters.
Which leads us to the next question, “can Lasik cause dry eyes?” Yes, Lasik can cause dry eyes, but usually it’s not permanent. When we did some studies, going back 20years ago, we used an instrument called the Osteometer, which checks the corneal sensation. We found that most of the corneal sensation returned back to normal between 3-6 months, and by 6 months people will adapt. That’s why when we are preempting dry eyes, that means we don’t want people to get dry eyes from Lasik, we start artificial tears, even insert punctual occluders in the corners of the lids to preserve the natural tears to prevent dryness from occurring. It is also very important to make sure that people don’t have severe dry eyes and that would become a contraindication. Like people with (INAUDIBLE – 2:27) syndrome who cannot produce any tears at all.
Another way we help people pre-avoid dry eyes, is that cyclosporine drops like Restasis or Zydra in indicated (INAUDIBLE – 2:41)
Our next question is, “can Lasik cure blindness?” I think that is a very general question. If the blindness legally is resulting from nearsightedness or astigmatism, yes, it can cure that. But if the blindness is from retinal detachment, (INAUDIBLE – 3:02) generation, optic nerve atrophy, then Lasik cannot help.
“Can Lasik correct double vision?” This is very important, because just yesterday, we got referred to a 24 year old young man but his neurologist, to find out the cause of his double vision. Now double vision is known as diplopia. We had to separate diplopia from monocular diplopia, where in each eye, when the other eye is closed you see double, to binocular diplopia you see double only when both eyes are open. When it is binocular diplopia, then more nerve related issues or muscle related issues are the cause. Because both eyes have to work in sync, so if the muscle is weak on one eye, one eye will move and the other eye will not and then you can have double vision. But this boy has a very clear history, that even when the left eye was closed, the right eye saw double. And the other way, when his right eye was closed, his left eye could see double too. Such things point more towards astigmatism, and that was my first impression, and we checked it his numbers, found astigmatism, put it in the trial frame and he said yes the diplopia disappeared. So that will be cured by Lasik.
“Can Lasik be done twice?” Yes, Lasik can be done twice. And when we do it the second time, we don’t even have to lift the flap. If we do Lasik today, and patient need to be enhanced to fine-tune in six months, we can just lift the old flap. But if the flap was done 10 – 15 years ago, with older instruments, it might not be wise to lift it up, and then the option becomes doing a surface treatment.
Thank you so much, keep your questions coming and watch out for answers.
So, you have gone ahead and had Lasik Eye Surgery. You may be wondering what to expect next. Are there any side effects or precautions you need to look out for or be careful of? We are here to answer all of your questions.
After having Lasik Eye Surgery it is common to have some temporary side effects. One side effect is that you might experience some tearing from either one or both of your eyes, and it might switch between the eyes. Your eyes may feel irritated and/or you might feel like there is something in your eye. There might be the occasional appearance of small red spots on the whites of your eyes. You also may experience sensitivity to light and your vision may be a bit hazy on the day of your treatment. These are all common side effects and should not alarm you. If you are experiencing any other side effect or are concerned about any part of your recovery contact your surgeon immediately.
Now that your Lasik Eye Surgery is over, there are some precautions we would like to go over with you. As with any surgery, or procedure, there are some steps you need to take to avoid injury or infection. First up, you are going to want to avoid showering or washing your hair until at least the next day. If you do decide to shower the next day you must be careful not to get any water, shampoo, or soap in your eyes for at least a week after surgery. Not that you would normally want any products in your eyes anyway! This just means you have to be extra careful. You will also want to avoid going swimming or using a sauna for at least three weeks after surgery. If you are thinking about getting your hair colored or permed, you must wait at least 10 days after your surgery. You should also avoid wearing any eye makeup for at least a week, and make sure it is clean so you can avoid any bacterial contamination or infection. You have to try not to rub your eyes for at least a month and you must sleep with your eye goggles for at least a week. You can exercise again two days after surgery but make sure to wear eye protection for up to a month after your Lasik Eye Surgery. Keep away from dirty or dusty surroundings for at least a week, and lastly make sure to wear sunglasses when you are outside in the bright sun.
By following these precautions, you will help to ensure a fast and safe recovery from your Lasik Eye Surgery.
If you have any questions or would like to set up a consultation call today 310 482 1240
Hi, Dr Khanna here and today we’re going to do a lot of comparisons, because there are different questions asked.
“Which Lasik Laser is best?” So there are multiple kind of lasers, the top three are: the VISX from Johnson-Johnson, Aligrator from Alcon, and shuwen (? 0:21), but out of the three, only the first two are FTA approved.
“Which Lasik clinic is the best?” Now that’s a very tough question, but they have to look at three elements. They should have: the best lasers, surgeons who are the best and experienced, and they being able to give you the best personalized care. So you have to look at these factors in whichever city you are, and select the best.
“Which is better Lasik or PRK?” Both are good surgeries, the surgeon had to decide which is safer for you. So in general, PRK or variations like Lasek and epi-Lasik are safer for you because they don’t cut into corneal. But they can also have their own side effects like haze. Lasik is more popular, because it’s faster healing because you can get back to work sooner, and you don’t want to be struggling to get your vision improved. So Lasik is faster, but PRK is safer.
“Which is better Lasik or Lasek?” Lasek is that form of PRK, where we remove the top layer by chemical instead of by hand, and I think Lasek is safe, in fact we can even do Lasek with in patients with (INAUDIBLE – 1:50), whereas that’s an absolute contraindication in Lasik. For 75% of the people, Lasek would be a better option.
“Which is better Lasik or ICL?” Lasik is less intrusive, it’s more on the surface, but ICL is indicated when there is a mismatch in the amount of corrections to be delivered in the amount of corneal available for safety. So in general I’d say if you have 520micro corneal and then the fraction is minus 12, ICL, but if you have a 460micro corneal and minus 6, ICL. But like for other scenarios like 520 corneal with minus 3 diopter refraction, Lasik would be a better choice, because it is less invasive, less side effects and you don’t penetrate inside the eye.
“Which is better, smile versus Lasik?” I think we did a whole video on this, but just to summarize what’s available in the US, Lasik, like I design Lasik and treat astigmatism, hyperopia, and myopia, whereas smile can only treat myopia and Lasik heals much faster than smile.
“Why does Lasik cause dryness?” Because it cuts the nerves, but that is not supposed to be permanent.
“Are we awake during Lasik?” Yes, it’s important to remain awake. We do you and anxiolytic or Sedative to keep the edge off, nut you need to be looking at the laser light, and the laser light has to focus on you so that the position of the delivery of laser is maintained.
And here is another question which is a big mis-normal , “Why do Lasik Doctor wear glasses?” Few doctors do wear, because it’s everybody’s individual, but there was a recent general study in (INAUDIBLE – 4:05) surgery, and 70% of refractive surgeons have had Lasik eye surgery, so because you see one or two people who wearing and then that gets spread, that’s not true. So most of the refractive surgeons have had Lasik.
“Which is cheaper, Lasik or Lasek?” I think pricing is dependent on how the business is run, because the cost to do both surgeries, Lasik, Lasek, or epi-Lasik, super-Lasik is similar. But there might be more follow ups required with Lasek and epi-Lasik, and in epi-Lasik, another special instrument is used. So some practices have the same price, so that price does not affect the best choice, and other practices grade it. They have different packages, but just to summarize, the pricing should be relatively same.
“Are Lasik prices negotiable?” That again becomes a business question, and I’m sure all Lasik centers usually have some discounts running, and you should specifically ask. There are a lot of centers like us, and where we learnt from, our mentors… we give special discounts to the armed forces, and to cops and firefighters, teachers, so you should always try to get some discounts and ask based on your profession. And if discounts are not available, the next thing is to try to get interest free payment plans.
And I think that comes to the end, apart from one more interesting question, “Can I pay for Lasik eye surgery with bit coins?” And I think that is also getting more popular ad that your answer might be yes right now.
Thank you for listening, have a wonderful day, use your money for investment, not for burning and throwing it away.
Best Laser Lasik Eye Surgery is being offered at Khanna Vison Institute located at Westlake Village and Beverly Hills. Idesign Lasik surgery is one of the best things to happen in the advance of lasik eye surgery. Why are we calling it Best Laser Lasik Eye Surgery? Lets look at the facts.Continue reading
Hi, Dr Khanna here, and today’s questions are related to our workforce, because people are interested to know ‘when can they go back to work?’
So the first question, “When can I return to work?” So it depends on the kind of work you do. So most people can go bat to work the next day, I know some people in the financial industry who go back to work the same day in the night because they save it on the laptop. But it’s best to keep the eyes closed on the first day, so the earliest you should return to work the next day. But for Nurses and Doctors who are exposed to bugs in the hospitals, it’s better to wait 48 -72 hours, so the epithelium is fully healed, so bugs don’t find a way to enter into your Lasik flaps. At the same time, same thing applies to people who may be in the in the agricultural industry working with animals like (INAUDIBLE – 1:00) or taking care of horses, so in those instances, it’s better to wait 2-3 days before going to work .
But here’s a question women ask more often. “When can I wear makeup, because I don’t want to go to work without makeup?” So within 48 – 72 hours again, you can start wearing makeup. We just want the flap to heal completely, so nothing is able to penetrate inside.
“How young can I be to have Lasik?” The FTA approved range is from 18 onwards, but off FTA, we can do it even younger, and there has to be certain indications for that. For most common indication for doing Lasik, and I’ve done laser vision correction on as young as 13, is when one eye is amblyopic or lazy, and then you are worried because of contact lenses intolerance, the eye should not become totally lazy. So you to stimulate that nerve pathway, so in those instances you can do. Another time you can do, is when kids are going to college and they’re more (INAUDIBLE – 2:17) some kids cannot handle contact lenses by themselves, or more prone to infections since Lasik eye surgery is safer than contact lenses. If the refraction has stabilized, usually in girls, it stabilizes by 15years, whereas in boys, 17 – 18, but if you have done serial exams and found that refraction is stable, then it can be done.
“How does Lasik work?” Lasik works by reshaping the front part of the corneal, so that the incoming light gets focused on the retina on a single point. So that means astigmatism, nearsightedness and farsightedness can all be treated.
“How long does Lasik take to heal?” So there are three steps in the healing of Lasik eye surgery. The first one is like immediately I finish doing the eye surgery, within 1-2 minutes, negative suction created by the endothelium makes the flap attach to the bed. Just like a (INAUDIBLE – 3:27) it sticks back, so this is the first stage of healing.
The second stage is within 48-72 hours when the epithelium which has been cut grows back over the cart and spreads to all the sides. This is the second stage, and this is what we want to wait for before sending you work or apply makeup etc.
But the third stage is the long term. Over the next few months fibrosis occurs. So the flap is stuck down even more tightly.
So initially, two minutes, then 48-72 hours and finally many months.
Hope all these questions and answers are continuing to help educate you about Lasik eye surgery. Have a good day.
See a testimonial from a Lasik patient who has 20/20 after Lasik surgery with Dr. Khanna from the Khanna Institute of Lasik and Refractive Surgery: http://youtu.be/p8Zzm8b2II4
Lasik eye surgery proves to give a person a permanent corrected vision and this is why more people want to try this recent advancement. It is also known as the painless and safest procedure. However, there are some limitations as to what you can do right after having the treatment.
· Staring at Bright Lights
The patients of Lasik eye surgery will be given dark sunglasses just to dim the light he or she can see. This is because you should have a gentle view of the surroundings and this is also to prevent you from scratching your eyes.
One is not allowed to drive since the patient still needs to depend on other people after a few days or weeks or as long as the healing process is happening. Not being permitted to drive also prevents your eyes from having tiny debris such as dust.
· Applying Cosmetics
Cosmetics may infect the eyes so it must thoroughly be avoided. Otherwise, the healing process will not be completed successfully. Cosmetics include false eyelashes. The only allowed cosmetic is the eye drops since it helps in keeping your eyes moisturized.
Though exercising has no direct effect to the eyes of a patient having Lasik eye surgery treatment, physicians still prohibit doing routines as a precautionary measure. It is recommended that physical fitness must only be done after a month of having the treatment. The patient must rest most of the time and must not take long in front of the television and computers.
· Drinking Alcohol
Alcohol can halt the effects of any type of medication taken by a person so it must be avoided as well after having Lasik eye surgery.
· Taking a Bath in a Shower
It is advisable that no water shall enter the eyes for the first few days after the treatment so taking a bath with a shower must be avoided. However, one can wear goggles as an eye protection.
All types of surgery surely have do’s and dont’s and knowing the things above Things to Avoid After Lasik Eye Surgery can help you make your treatment successful.
By Rajesh Khanna, MD
Lasik Vision Expert and Host of Hangout with Laserman