Q. Repeat PRK or Photorefractive Keratotomy possible? Hi, welcome this is Dr. Khanna. I’m going to speak to you about a very interesting topic which came up this morning. Somebody who ten years ago had PRK which is photorefractive keratectomy. If you remember, PRK came before Lasik about 20 to 25 years ago. I remember doing my first one in 1997 or so. At that time, we did not have all the advanced lasers that we do now, nor did we have advanced medicines and drops like today, so a lot of the experiences patients had with PRK was very bad. In fact, that’s why we don’t do PRK today and we’ve gone on to Super Lasik, Epi Lasik or Laser Scraper modifications. Today, it’s a much more comfortable journey.
The topic we are coming to is, if you had PRK 10, 15, or 20 years ago and you need a touch up, what’s the best option? The best option would depend on your age. Let’s say you’re in your 40s, the touch up is likely to be less than one or two diopters. In those cases, we would to have to check your cornea with the latest methods of pachymetry and topography mapping to see if, by any chance, Lasik is possible. Ninety percent of the time, PRK might have been done because Lasik was not an option, but there might be 10% of cases that were done because Lasik was unavailable, or the surgeon was not very confident with Lasik at the time.
It’s important to come for a full exam so we can analyze what’s best for you. There are some people who will have corneal weakening or excess refractive numbers, in those cases you would want to see if implantable collamer lens (ICL) might be an option. Let’s say you’re about 55, then before we do a laser touch up, we would first have to discuss other options like presbyopic implants.
Yes, I missed the one age range for 40 to 55, right? That’s interesting because in that group there can be multiple options available and we’ll have to discuss your lifestyle, look at the numbers, and then come up with a better solution. There is no fixed answer for that age group.
As a summary, if you’re less than 40, laser touch up with PRK or rarely with Lasik, might be an option. If you’re above 55, presbyopia implants might be the first option. In 40 to 55, one of these previous two options might work depending on your lifestyle.
If you have any more questions about PRK, Lasik, touch ups or enhancements, feel free to write to us. Thank you and have a wonderful day.
Did you feel that earthquake? Yes, we were rocked by an earthquake with the epicenter being near Channel Islands. We were very lucky, we didn’t have any injuries, and nothing broke down. But, two patients came today with some interesting observations and stories and I wanted to relate them to you.
One patient recently had Lasik with us. He said when the earthquake struck he was one of the special invitees who has the alarm on his phone which goes off a few seconds before an earthquake strikes. He was able to pack his bag and rush out of the building before the earthquake struck. The second patient who came said yesterday he realized why we should have Lasik eye surgery.
He had just taken off his glasses and was rubbing his eyes or something like that when the earthquake struck. When everybody started rushing out, he ran out as well; however, he couldn’t see well because he wasn’t wearing his glasses causing him to hit his head on the door as a result.
He came in today saying, now I need Lasik eye surgery. This is just one of the examples I’ve come across in my twenty-six years helping people see better. One of the small things in life which can change when you have better vision during some big things like a natural calamity like in a storm, Hurricane Katrina, et cetera. Or, an earthquake like yesterday.
When vision becomes one of the most important things in regards to our safety, it’s at that time that we realize how important it is for our emergency responders like firefighters to have good vision when they run into smoke, rubble, and fire to save people.
I’m sure you have other interesting stories where either you’ve already experienced the benefits of having Lasik eye surgery, or you wish you had Lasik eye surgery. We would love to hear from you, so send us your stories.
Lasik Earthquake Safety lesson is over
Thank you. This is Dr. Khanna signing off.
CALL NOW to speak with your personal, friendly Patient Concierge !!
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Due to the success Dr. Rajesh Khanna has experienced over his decades of surgical expertise, performing several thousands of procedures, he is now in a position in his career where he can give back to those who previously otherwise would not have been able to benefit from the unparalleled talent and skill of the best laser eye surgeon in the USA. Because Dr. Khanna cares, he offers limited Flash Sales giving the opportunity to take advantage of his premium services at Special Discounts. Because the special sales are only offered a few times per year and spaces at our surgery centers are limited to due high demand….. CALL NOW!! AND SPEAK TO YOUR OWN PERSONAL & FRIENDLY PATIENT CONCIERGE!! They can answer all of your questions and reserve your spot at one of our state-of-the-art surgery center locations. (Remember to Mention your DISCOUNT CODE to qualify for the Los Angeles Lasik Sale Offer.)
Today our topic of discussion will be Symfony or Tecnis Multifocal lens for Presbyopia Treatment.
Hi. I am Doctor Khanna, here with some models of intraocular lens implants when we do cataract surgery or we want to get rid of glasses and you are not a candidate for Lasik surgery. For example, if you are 56 years old and you want to be able to see far, middle and near, then you are up for presbyopic implants. There are different types of presbyopic implants. Today, we are going to talk about the differences between ‘Tecnis’ and ‘symfony’, which are both from Johnson and Johnson.
This is how the lenses look like. This is a clear lens and this is ‘Tecnis’ and ‘symfony’. ‘Symfony’ has less rings than ‘Tecnis’ and it is considered an EDOF (extended depth of field) lens. Whereas, ‘Tecnis’ has certain ridges, which splits the incoming light into distant and near. You can see distant and near and the bimodal curve, lets you see middle. ‘Symfony’ acts like a pin hole camera where you can see middle, distance and somewhat near.
How are you going to choose between the two? If you have long hands, then choose ‘Symfony’ but if you want to real closely then choose ‘Tecnis’. If you have had previous surgery like radial keratotomy then ‘symfony’ might be a better choice. In terms of side effects, ‘Tecnis’ has glare initially which faded away and ‘Symfony’ you can see a spider web. The best option is to discuss these various choices with your surgeon and to make sure that the surgeon is comfortable with the choices.
If you have more questions about Symfony or Tecnis Multifocal lens for Presbyopia Treatment call (310) 482 1240. You can always read my book on amazon ‘The Miracle of PI in Eye’.
Have a wonderful day.
Hi. Welcome. This is doctor Khanna. I want to talk to you about fear of eye surgery. This lesson is divided into three parts. Today’s lesson is on why we are so afraid of eye surgery. In the forth coming lesson, we will discuss how to overcome the fear. Why are we so afraid of eye surgery, we have to delve back into evolution, our upbringing and find some answers there. People are always afraid of the dark. Remember when you were a kid; you thought that there might be a monster in the closet or under the bed. People are afraid to go to the graveyard but today it is so much better. There are streetlights everywhere and we have a phone with flashlight on it.
Imagine Sherlock Holmes going out in the night when there is fog and mist around. There is an inherent fear in us coming from the times we lived in the forest. In the night, predators would come out and that fear has continued. Another thing you might have heard of is insomnia, when people are unable to sleep. It is very interesting why some people find it difficult to fall asleep and the simple answer might surprise you. The answer could be that they are afraid that they may not be able to get up if they go to sleep. They are afraid to lose their consciousness and go into a semi-conscious state. It is inculcated in every culture. Each civilization that is present on earth celebrate the festival of light in the dark days. That is their hope to overcome the darkness.
Another fear the people have is for the white coat. It is funny that people can check their blood pressure at home and it is okay and then they come to the hospital and see the white coat and the blood pressure shoots up. These are all evolutionary mechanisms that are built in for safety to preserve us and they all stack against us. There is one more called the menace reflex; when something comes near the eyes or when we sneeze, they instantly close. That is encoded in our DNA.
Corneas and eyes are every important. In fact, some evolutionary biologists feel that this reflex may have pre-dated the existence of eyes. Small microorganism who do not have eyes have had light shun on them and they immediately move away. All those things combined in the subconscious and conscious mind are all playing to develop fear about eye surgery. Do not feel fearful.
In the next lesson, we are going to come up with methods that are time tested and true to see, how we can overcome the fears regarding eye surgery. Thank you
Interviewer: Hi guys, today we are hanging out with the laser man and we are going to ask you a few question. How are you doctor?
Doctor Khanna: Fine, thank you and welcome to this show.
Interviewer: Okay, the first thing I would like to know. Since you have been talking about laser surgery, how long does it last?
Doctor: There are two answers to that if I understand correctly. First, what I understand is how long will the procedure take. The procedure takes a minute or two per eye. The second part if I understand correctly is; will it last me a lifetime or not. In the modern technology of ‘eye design laser surgery’, it is a lifetime outcome. 20 to 25 years ago, with the other conventional lasers, it never lasted long. All infrared group was incorrect and it did not last. Without confusing you, if you are in your 20’s to 40’s and you are a good candidate for ‘Lasik’, which is a computer, controlled active laser eye design technology. The imperfections will be wiped off for life. So it is a lifetime investment.
Interviewer: Wonderful. Now that we have asked about this part, I would like to ask you what the side effects or after effects, we can have from this surgery?
Doctor: That is a very good question. We need to know about that so that we can plan ahead and in our practice we avoid those side effects. The most common being dry eye. Because we know that, we are fashion a flapping Lasik eye surgery. Whenever you do a flap whether it is by laser or by automatic microkeratomes, you end up cutting the cornea nerves. The cornea nerve supplies the eye with sensation, which helps in the production of tears. Around 3-6 months after Lasik, while the cornea nerves are recovering there can be dry eyes. We start patients on artificial tears ointment and even put in (inaudible 02:12) to preserve the natural tears. Another side effect, which used to be more common but it is less common but still occurs is ‘glaring halos’ in the post-operative period. Treating the dry eye does decrease that incidence but is somebody is inconvenienced we do prescribe yellow tinted glassed that people wear for driving bikes which cuts of the glare.
Finally, there can be under correction or over correction with eye design technology but the incidence is very little. To make sure it does not occur we have nomograms we apply and this should measure the refraction between one to three months to make sure we hit a point and brought the patient down to zero. Those are the common side effects. In some patients, especially the younger ones there can be some inflammation in the post-op period. We do start steroid drops but do not worry these are not bulk up your muscles, they are very low dose. They do help to prevent and treat the inflammation. Infection is always a treat, we do not see it commonly but we start topical antibiotics drops a day before and we continue for 5-7 days after surgery.
Those are the common side effects that we see and we work hard to prevent any of them from occurring.
Interviewer: Very nice. We have gotten to understand two things today. The first was about the laser, how long it takes and how long does it last. The second thing you were talking about was the side effects. Now that you have mentioned this few things, we just want to know if it is different for each customer or for each person?
Doctor: Yes. Not everybody is a candidate for laser eye surgery. There are certain criteria that they must fit in before we can qualify them. Age being the first, if you are less than 18 years old, you are very mature and have developed cataracts or gone beyond 50 years of age, Lasik may not be the best choice for you. In that age group between 18 and 50, we have to see if your cornea has good uniformed thickness and shape. Shape and thickness of the cornea is important and any systemic disease has to be considered. Finally, your refraction has to be stable, which is usually the case between 18 to 50 years of age. We do like to make sure, so that we do not hit a moving target. If all those qualify and your prescription had to be under 10 diopters and depending on the corneal thickness, we have to see how much tissue can be ablated so that the safety zone is empty.
To summarize, we look at age, refraction, third the stability of refraction, fourth the corneal shape and fifth the corneal thickness.
Interviewer: So it depends on every individual.
Doctor: Every individual is unique as is their eye and all of them must pass these criteria. If there is any red flag on any of that, then we cannot do Lasik for that person. We would have to switch to another kind of therapy like EPILASIK, SUPERLASIK, ICL or presbiopic implant in the eye.
Interviewer: To ensure that the eyes are going to be well kept, well maintained and well done. How do you confirm that the patient would deserve this Lasik or another Lasik that you just spoke about?
Doctor: That is another beautiful question that you have asked me. What we like to do is; we want to know what the patient wants out of the procedure. We know all the procedure we have and what they can give to the patient. Each patient is different, 18-4 it is easier because they want good distance and the eye will change its shape using the muscles to see near. If they qualify, Lasik will be the first choice but if the prescription were high for example -15, we would offer them ICL. If a patient is about 4 or definitely above 55, then ‘SUPERLASIK’ or presbyopic implant in eye is a better choice. The difference being Lasik static vision and presbyopic gives dynamic vision. What I mean by that is; there are three zones of vision.
Distance: when you are driving a car and you want to see far
Middle: which was never important 20 years ago but is definitely important now. For seeing I phones, laptops and dashboard of the car.
Close: for reading and to see small bottles
Lasik can give you one of these three. That is why they say under 50 Lasik works well, because when you see one zone distance, the muscles are strong enough to show you the other two zones by changing the shape of the lens. When you are above 50, the lens is not able to change shape. If you do Lasik, you are able to set their vision for distance, middle or near. Whereas, ‘presbyopic’ gives you all three; distance, middle and near. That is a better choice for people above 50 and Lasik is a better choice for people below 50.
Interviewer: Fantastic. Thank you so much doctor. I am personally convinced about what you have said. I would definitely come up with more questions some other time. It is great to hang out with you. I am looking forward to seeing you again and coming up with questions that the customers or people will ask me
Doctor: Thank you so much. Have a wonderful day
If you live in Camarillo LASIK eye surgery could change your life. As you drive down on the busy 101 freeway towards Thousand Oaks the marine layer may prevent may hamper your vision by clouding your glasses. iDesign lasik eye surgery may be the solution you are seeking. As of march 2018 idesign Lasik is only available at Khanna Vision Institute.
When you are shopping at the outlet malls, good vision is required to see all those price tags. Unless you want to ignore the prices and just let someone else pay the bills. For the common folks procedure is important consideration.
We offer financing options and lay away solutions to patients seeking to improve their vision. We sacrifice profits to make better eyesight more available. What we don’t cut costs on is quality and customer service. That is our pride.
We provide options other than lasik like superlasik. At least seventy percent of people who come to our office for a Lasik consult are deemed not to be candidates. We do attract many people including movie actors.
There are many factors which may require another procedure – these include age, power of your glasses, your lifestyle and sports habits. When a thorough detailed eye screening is performed with OCT and Topography more people are weeded out. The combination of shape and thickness is the most important factor for safety of lasik. If these are normal NEVER have lasik performed on your eyes. Have a second opinion with us.
Don’t worry – ICL( Implantable Collamer lens) , PIE (Presbyopia Implant in Eye), Intacs options deliver equally good results.
The first step is a short drive to our office. Come and meet us and see which vision correction procedure may be the best for you.
So drive up from Camarillo and give us a chance to help you. Living in Camarillo Lasik will enhance your life. Golf scores might finally improve.
Date: March 19 2018
Call (805) 230 2126 NOW for $1499 Tax Day Lasik Special Price Revealed for Los Angeles.
Have you been wondering what to do with the Tax refund you are about to get. Invest it in your sight. Now there is. good reason to use it wisely. Khanna Vision Institute is offering special pricing during months of March and April. If you avail of this Lasik deal with your refund it may be almost free for you.
If you had saved money in FLEX or HSA plans now might be the best time to make use of those dollars. Combine the $1499 lasik special with your tax refund and add to it your HSA amount. This would make an awesome gift to yourself. Or your significant other. Or your loved ones.
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This is an updated article about what to expect on day of Lasik Eye Surgery. Many people are anxious about the procedure and this informative piece is directed to them. One of our secrets is work on this anxiety even before the day of procedure. How do we do this? We go over all consents and explain the procedure in detail a few days before. Our considerate staff even helps them finance the procedure ahead of time. For the special extra nervous or claustrophobic folks we even lay them under the laser and do a demo.
LASIK surgery is very beneficial and in most cases a painless procedure. The procedure itself is only about 4 to 5 minutes for both eyes. At Khanna Institute we strive to make it as comfortable as possible for each of our patients.
We make all patients feel welcome at our office. There is always someone at the front desk to greet and help the patient. This eases anxiety. We offer Xanax in low dose to further lower apprehension. Last minute questions are answered by our knowledgable techs. Once everything is ready for surgery the patient is taken back and prepared for their LASIK surgery. This includes getting a bonnet to cover their hair and Cleaning the eye with Betadinde solution swab. It is the strongest antiseptic. It kills bugs hiding in the lashes of the eye.
When in surgery suite the patient is lasik flat under the idesign laser system. The patients family or friends can watch all of the laser eye surgery through the window. Advanced automated idesign lasik surgery is performed. Throughout the procedure there is patients fav music in the background. Doctor and surgical and laser techs explain each step so nothing comes as a surprise.
After the LASIK surgery the surgeon checks each eye to make sure the patient is fine. Then the post up instructions are given. The eyes are shielded and dark sunglasses given. Postoperative instructions are given. The patient then is free to go, but will come back the next day for a follow up. Patients are always satisfied with their noticeable improved vision as soon as the next day.
We hope what-to-expect-on-day-of-lasik-eye-surgery helps you to overcome anxiety of your Los Angeles lasik procedure. If you have suggestions for this or future posts please do not hesitate to contact us.
Prnyama works to help relieve anxiety in general. We have found that is especially useful before nerve racking surgical procedures. For those of our readers who are unfamiliar with what is prnayama or pranayama let us go over basic concepts of Yoga.
Yoga is ancient Indian art of improving our mental physical and spiritual health. It was neglected for thousands of years till America discovered its virtues. University based experiments were able to document the benefits of Yoga to reduce Blood pressure and stress based disease.
Yoga relies on pranayama or deep breathing exercises. There are two reasons for it. In line with western medicine the inhaled oxygen is increased with deep breathing. As you may already know oxygen is necessary for our cells to live. Another reason for relying on deep breathing is a spiritual one. IF the creator needs to send us messages the breath is the best route. Everything we eat or come in contact with gets altered before reaching the cells. Breath is delivered pure to all cells including those of the brain.
Armed with knowledge, we at Khanna Vision institute tried this time tested technique on a young adult seeking Lasik eye surgery
This young gentelman had had Road Traffic Accident with brain injury. He did not want to take any additional drugs but was claustrophobic. Rajesh Khanna, MD used deep breathing technique of Prnayama, and his melodious voice to relax him. Before taking him into the Lasik suite Dr.Khanna taught him how to deep breathe and visualize his breath. Dr. K told him to see incoming breath as cool purple color and outgoing breath as green.
Our young patient was pretty enthusiastic with this idea. he also loved the personalized touch. Once inside the laser suite he started with pranayama. After his eye was cleaned and draped he continued with the process. A word of caution: He was instructed to pause when under the laser. We do not want breath to condense on the optics of the advanced laser.
Thus LASIK was performed successfully. The smile tells it all.
If you are contemplating an eye procedure but are anxious, come and see us. If for some reason you cannot have your eye surgeon contact us to learn this art. In the meantime start practicing this cost free method to improve your physical and mental health.