Hi. This is Dr. Khanna, and today we are going to talk about iDesign LASIK eye surgery and why it’s one of the best LASIK vision corrections available today.
We have come a long way from the early ‘90s, when lasers were first invented to correct or reshape the human cornea. The precision and accuracy and safety has increased in the culmination of iDesign. It’s better than SMILE. It’s better than conventional, Wavefront Optimized, and even Wavefront LASIK, because it can not only correct astigmatism and other aberrations, it can do it very precisely. Let me just focus then on a little iDesign picture to show you what all it measures, and then it can treat that. If you look at this picture, it identifies the outer iris boundary. It identifies the inner iris boundary.
It identifies the hills and valleys, and also, the center of the cornea, the fixation, reflects, and the pupil, center of the pupil. These become very important when you’re dealing with esotropia or exotropia or angle alpha and kappa. Without getting you confused, all the three things I mentioned, the center of the pupil, center of the cornea, and the side reflects should be well opposed or as close to each other. The fun begins when they are separated, and that’s where we get into angle alpha and kappa. It becomes very important that the computer which is generating the treatment profile takes those into consideration and the algorithm is based on previous studies and seen where the outcomes would be the best.
iDesign Lasik does that. We don’t have that facility in conventional and other forms. Now we’re going to turn to some more interesting pictures here. If you look on this, I’ll move onto this side. These are 3-D images of the higher order aberrations, all aberrations, and the refractive map, and the point spread function of the higher. If you want to focus on in here, you’ll see it looks fairly uniform, though even from here to here versus from here to here, you see the shape is different. If you’re using SMILE or conventional, they’ll not be able to match, correct the shape, because for -5, it’ll be just making it like a sphere. Whereas in iDesign Lasik, the treatment is matched to the exact shape.
This gets even more interesting when we look at the higher order aberrations. What are the higher order aberrations? They’re called coma, etc., trefoil patterns. The lower order is what we are used to. The sphere, cylinder. But in the higher order of aberrations, if you look, how do they generate this? If you want to do SMILE or conventional, how is going to be possible to match the shape to correct this? What it means is, here on the hill and here, it needs more spots and here it needs less spots. The same thing we can see in the point spread function, that the cornea is not uniform when you compare superiorly and inferiorly, and even temporally and nasally.
If you were to put a mirror here, this spot and this spot wouldn’t match. That means the treatment profile is unique for each eye, and that can only be achieved by a really fast computer processor and special cameras which can pick up and then transmit all that information to a laser which can use that by variable spot scanning to reshape the cornea to give us the most precise vision possible.
I hope this is helpful. If you have any questions, feel free to comment or reach us at 805-230-2126. Have a wonderful day.
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.
Hi. How are you? This is doctor Khanna, laser man here once again, bringing you up to speed with the latest in eye technology. Today, we are going to talk about a very exciting and new topic; laser cataract surgery. There are a lot of myths about laser cataract surgery and we are going to bust them all. We are going to talk about 7 myths of laser cataract surgery, which has been found not to be true and we are going to go over it one-by-one.
Laser cataract surgery is safer the manual cataract surgery. Even doctors believe that but reports came out of a study that showed that it was not the case. Laser surgery is at best as good as manual cataract surgery but not safer. That is one myth, which has been busted not by me but by published and reviewed journal studies of Europe.
Laser cataract surgery is going to be free and covered by insurance. That is not true. Medical insurance has determined that if someone wants to upgrade to laser cataract surgery, they will have to pay extra.
Laser can perform all the steps of cataract surgery. I think that is one of the biggest myths out there, thinking that it is going to be a robotic surgery and robots are going to come and do everything. That is not true. Lasers do certain steps pf the procedure, mainly opening in the lens and sometimes cutting the lens. They cannot do all the steps. In fact, some steps are done better by hand.
Cataract wounds made by lasers are better than those made by diamond knives. The reverse is true, diamond knives can make better and more precise wounds than the current generation of lasers used in cataract surgery. It is very logical why this happens, because the laser will need to see where they have to act. They are seen by using ‘ocular coherence topography’. The wounds have to made at the junction between the clear part and the hazy part which is the cornea and sclera. It is sometimes not discreet for the machines and that is why human eyes can detect them better and make better wounds.
If we do laser cataract surgery, we would not have to wear glasses after the procedure. That is not true. Only ‘presbyopic implants in eye’, can free you from the bondage of contact lens and glasses after cataract surgery and not laser.
After cataract surgery, drops will not be needed. Again, that does not hold the light of day. You will need drops. Drop less surgeries is a different concept. After the laser cataract surgery, you might need more drops.
Laser cataract surgery might be less painful and faster by cataract surgery done by hand. I feel sorry but, we have to bust that one too. When we do laser cataract surgery, we have to apply something that would hold your eye while the laser moves around making the openings and cutting the lens up. That is held by negative suction pressure, which is painful and we have to give you medication for that. For that, we have to add another step, we have to do the part of the surgery done with laser first and then in the operative room, we have to do the rest of the surgery by hand. It increases the time that you would be in the operating theater.
I hope you have seen the truth about laser cataracts surgery. It is a good procedure but it is not recommended for all based on knowledge and published studies that we have. Thank you for listening to me. Have a wonderful day. Keep sending your questions here.
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
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.
Deals like these do not last for long . Only 45 days.
One of the best Lasik surgeons in Los Angeles
Great advanced cutting edge laser technology.
Meticulous care with amazing number of follow ups.
Hit the number now – (805) 230 2126
and Yes you get the all time favorite – Free screening
Newer LASIK is here. The laser used for lasik is shinier faster and more accurate. These factors make it more safer. We always focus on safety. The more safer the procedure the less fear we will have- consciously and subconsciously.
Do you think all LASIK are the same?
Just like all cars are not the same, even though each one usually takes us to our destination. LASIK quality may vary depending on the surgeons experience, LASER used.
It has become much safer since the early days of LASIK in the nineties.
The tracker can follow all micro movements of the eyes.
Experienced surgeons know the limitations of LASIK
Current 4th generation LASERS are more precise. Utilizing knowledge of maths and physics the shape of cornea is maintained similar to that before surgery. This reduces aberrations, which was another cause for visual dissatisfaction. Early lasers were whole beam lasers like carpet-bombing, Newer ones are flying spot or variable spot, yielding precise placement only where needed
The diagnostic Wavefront devices can map visual errors more accurately and even show the surgeon what the patient is seeing.
The flap designing instruments are more refined and tested. They are more friendly to the eyes.
Sterilization techniques have improved.
Blend zones (a way of applying the computer controlled laser) and larger zones have decreased the incidence of glare and haloes.
More than 5 million procedures have been performed. The cumulative data has yielded learning points which would have taken a surgeon a lifetime to accumulate. Dedicated LASIK surgeons have access to this data, and can use the wisdom of their peers. As the computer chips have advanced they have increased the speed and response rate of the lasers. The surgeon has power to override all these gizmos. Hence an attentive surgeon with quick reflexes is still the most important.
If not candidate for LASIK, Advanced surface ablation or epilasik an option.
Blended vision for better distance and near reading.
Newly discovered drops reduce pain and increase tear production. Modern materials help preserves tears and keep the eyes moist
As important as the car is the driver. Age restrictions. Numbers of successful surgeries done are important.
Are lasers maintained by authorized companies? The assistants are certified and only Licensed operators used.
If by any chance you were not able to comprehend the stuff above it does not matter- rest assured we understand. We apply the same knowledge when we touch your precious eyes – so place your trust in us.
Many patients are unaware they might have keratoconus and they see their eye doctor because of increasing spectacle blur or progressive changes in their prescription. In many instances even a good refraction yields poor vision. Keratoconus should be diagnosed by a cornea specialist who may see typical findings when examining the patient at the slit-lamp.
In early forms of the disease there may be no obvious finding on slit-lamp evaluation and the diagnosis is made by computerized video keratography only. Keratoconus can start at puberty and progresses to the mid thirties at which time progression slows and often stops. Because it affects the young primarily, Keratoconus is a serious eye disease.
Keratoconus treatment here in Los Angeles depends on your symptoms. When your symptoms are mild, your vision can be corrected with eyeglasses. Later you may need to wear special hard contact lenses to help keep vision in proper focus. However, a permanent treatment to Keratoconus does exist.
New research suggests the weakening of the corneal tissue that leads to keratoconus may be due to an imbalance of enzymes within the cornea. This imbalance makes the cornea more susceptible to oxidative damage from compounds called free radicals, causing it to weaken and bulge forward.
A number of surgical options are available to the keratoconus patient. Since keratoconus can vary widely from patient to patient, the proper recommendation of any of these procedures depends on the individual nature of your problem.
Now, doctors can perform multiple types of corneal transplants, including deep anterior lamellar keratoplasty (DALK). DALK has emerged as the preferred transplant approach for keratoconus in most countries, although penetrating keratoplasty (PK) remains more popular in the United States.
One of the perceived advantages of DALK is that there is no risk of endothelial rejection, which should result in a higher likelihood of long-term allograft survival.
Dr. Khanna and the Keratoconus experts at Khanna Vision Institute are leading edge Los Angeles experts in the latest treatment options for Keratoconus. Dr. Khanna offers both DALK, Intacs for Keratoconus, and Cornea Cross Linking Riboflavin. Together, these leading treatments can help stop the progression of Keratoconus. Contact Dr. Khanna to get the latest technologies available for Keratoconus.
Rajesh Khanna is a Board Certified Lasik Eye Surgeon in Los Angeles who fixes most vision problems. He performs Lasik, Super Lasik, Advanced fixing of the cornea, lens implants, and cataract surgery. He uses the most updated and FDA approved machines for all of his surgeries and assures his patients that they are in safe hands. He focuses on fixing eyesight perfectly for each individual patient and hopes to maximize patient satisfaction. Many of his patients include rock stars, movie stars, doctors, and other professionals.
Lasik is a laser eye surgery that reshapes the cornea to fix most eyesight problems. A flap is cut open in the cornea and a laser is beamed inside the eye. Once the eye has been reshaped, the flap is put back in place and the eye begins to heal immediately. Most patients are able to see within a day or two after walking out of surgery and only need eye drops for a few weeks to help the healing process.
Dr. Khanna has completed two residencies in Ophthalmology, fellowship in various eye surgeries, and training at State University in New York. Additional to his practice, he trains student ophthalmology surgeons at UCLA and is on the faculty at St. Johns Hospital where he performs cataract procedures. Dr. Khanna has been practicing advanced eye surgeries for over 25 years and is very experienced in what he does.
Lasik Eye Surgeon Los Angeles – Rajesh Khanna is an award-winning ophthalmologist who has been recognized by doctors, magazines, and numerous organizations. He was identified as the top doctor in L.A. in 2011, voted best Lasik surgeon by the readers of the L.A Daily News and the Ventura County Star, listed as one of America’s top ophthalmologists by Consumer Research Council of America, featured on the cover of Beverly Hills Times, and featured on the Best of L.A. SoCal T.V and numerous radio stations across the country. Additionally, he was featured in a 2011 article in Newsweek where he was listed as one of the top 15 leaders in laser eye surgery. He is trusted by many Hollywood celebrities and doctors.
If you think that you may be a candidate for Lasik or another eye surgery, contact Rajesh Khanna’s office at 1 (310) 736 4806 to set up an appointment. Lasik or PI patients will receive a free consultation to see if they are able to get this surgery.
Have you wondered exactly what is Lasik? If you’ve been prescribed glasses or contact lenses, chances are that your optometrist has listed Lasik as an option. Lasik is a type of laser eye surgery that can correct most vision issues: nearsightedness, farsightedness, astigmatisms, and difficulty reading for people over 40. It corrects the shape of the cornea to help sharpen images without the help of glasses or contacts. This surgery has been performed for over thirty years and is safe, pain-free, and has a very short recovery time.
Ideal candidates for this procedure are at least 18 years old, have a stable prescription that hasn’t changed more than 1.0 in a year, and has a vision prescription between -14.0 and +6.0. However, only a consultation with an ophthalmologist can determine whether or not a patient is eligible for Lasik.
The procedure itself is very simple and doesn’t take more than eight to twelve minutes total. Patients use eye drops to numb each eye and the surgeon creates a ring of blue dye around the cornea as a reference point. Then, the surgeon uses a microkeratome, a precise vacuum-like instrument, to cut a small flap of corneal tissue and shines a laser to reshape the cornea to fix the condition of the patient. The surgeon puts back the flap in its original position and the tissue begins to heal immediately. To help the healing process, patients are given daily eye drops for the following weeks. When asked what is Lasik recovery like, ophthalmologists say patients regain vision within just a day or two of walking out of the operation room.
Lasik eye surgery is very low risk, however, a few patients do get dry eyes. This can generally be fixed through hydrating eye drops or in severe cases patients can get an implant that slows the draining of tears. Each of these procedures are painless, comfortable, and can last up to a few years depending on the implant the patient is eligible for.