Procedures
Focal Macular Grid Treatment
People with diabetes are at risk of developing several kinds of diabetic eye diseases. One of these is macular edema, which is often asymptomatic until vision loss starts to occur. Leaking blood vessels within the retina will seep into the center of the macula, causing inflammation due to the accumulation of fluid.
Focal macular grid treatment is aimed at preventing further leakage by sealing off damaged blood vessels. The treatment consists of placing several hundred small laser burns in a grid-like pattern in the areas of retinal leakage around the macula. This can effectively prevent leakage from occurring and reduce the amount of fluid in the retina. The incredibly precise laser used targets each individual leaking blood vessel and removes any damaged tissue or scars that have formed.
Focal macular grid treatment can reduce a patient’s risk of vision loss. This in-office procedure is performed once a topical anesthetic has been applied to numb the eye. Focal macular grid treatment is generally completed in only a few minutes and usually requires just one session.
LASIK Laser Vision Correction
LASIK, also known as Laser-Assisted In Situ Keratomileusis or laser vision correction, is a refractive procedure that reshapes the cornea to correct nearsightedness, farsightedness and astigmatism.
LASIK is the most common type of refractive surgery. Using targeted excimer laser beam energy, the LASIK procedure reshapes corneal tissue to correct refractive errors so that light rays are focused more precisely on the retina to produce clear, sharp vision. Patients who choose to undergo LASIK typically achieve clear vision without the need for glasses or contact lenses, while also benefiting from minimal downtime and little to no post-operative discomfort.
Many improvements have been made over the years in LASIK procedures. Among the newest and most advanced is the Advanced CustomVue procedure, which combines wavefront guidance technology with the STAR S4 Excimer Laser system to provide patients with a highly precise and accurate method of laser vision correction.
Eyelid Lesion / Papilloma Excision
An eyelid papilloma is a rounded growth that protrudes from the upper or lower eyelid. These are very common lesions that most frequently develop in middle-aged and older patients. Papillomas are most often benign, but in rare cases may be precancerous or malignant. Many patients opt to have these lesions removed even if they pose no medical risk for cosmetic purposes or because they are a source of discomfort.
The standard of treatment for most eyelid papillomas is surgical excision. Due to the proximity to the eye, especially if the lesion is near the margin, cutting it away is safer than most alternative procedures. After a local anesthetic is applied, your doctor will use surgical tools to remove the papilloma in its entirety. The procedure typically takes less than 30 minutes. Some patients experience mild bleeding or bruising at the treatment site afterward, but these usually resolve within a few days. Even after a complete excision, there is a possibility that the papilloma will eventually return.
Laser Peripheral Iridotomy (LPI)
Laser peripheral iridotomy (LPI) is a laser procedure used to lower eye pressure in patients with angle-closure glaucoma. Angle-closure glaucoma is a condition resulting from a blockage in a fluid drainage channel of the eye. Using a laser, a small hole is made in the iris, increasing the angle between the iris and cornea to allow fluid from the eye to drain.
Laser peripheral iridotomy is an outpatient procedure. Patients are given eye drops to constrict the pupils. Once these have taken effect, an anesthetic is applied to the eye and the laser treatment can begin. The doctor precisely targets a spot in the periphery of the iris and uses laser pulses to create a tiny hole. The procedure is completed in a few minutes and most patients experience little to no discomfort.
After the laser treatment, the patient’s intraocular pressure will be monitored several times to ensure the LPI was successful. Topical corticosteroids will need to be applied to the eye for approximately one week to prevent swelling.
Punctal Plugs
Punctal plugs can relieve dry eye symptoms when drops or ointments fail. Punctal plugs are placed in the opening of the tear ducts (called “puncta”) in the eyelids to block tear drainage and keep the eyes moist. Implantation should reduce the need for artificial tear drops and increase the patient’s overall comfort.
Punctal plugs come in a few different shapes and sizes, and may be placed in the lower or upper eyelid or both eyelids. The most common plugs are umbrella-shaped and made of silicone. They may be placed partially inside the tear duct or embedded entirely within the duct (Herrick plugs). A recently introduced acrylic plug called the SmartPLUG softens at body temperature and expands to custom-fit each patient’s eye.
Implantation takes only a few seconds in a professional’s office. In some cases, before implantation, collagen is temporarily placed in the eye to predict the effectiveness of punctal plugs.
Penetrating Keratoplasty (PKP)
An improperly curved cornea may be corrected surgically for patients whose curvature is too steep or flat to be treated with other methods, or when extensive damage has occurred due to disease, infection or surgery. Corneal transplantation, also known as keratoplasty, may be performed in patients with:
- Dry eyes
- Blepharitis
- Corneal ulceration
- Corneal dystrophies
- Pterygia
- Traumatic injury
Penetrating keratoplasty (PKP) involves replacing the entire thickness of the cornea with a donor graft. The new cornea is stitched into place, and stitches are usually removed after a year. It may take this long for vision to be restored to satisfactory levels as well, requiring many patients to wear glasses or contact lenses after this procedure.
As with any type of surgical procedure, there are certain risks associated with PKP, including bleeding, infection, graft rejection and astigmatism. With the development of technological advances, PKP is performed less and less often. Dr. Lee will determine whether or not this procedure is right for you after a thorough evaluation of your eyes and any pre-existing conditions.