LENS IMPLANT Technology for Macular Degeneration
New lens implants can help people with cataracts who also have macular degeneration. Two lens implant designs, both by Isaac Lipschitz, MD of Israel, are of help to a growing number of people worldwide. Click on the pdf for pictures and more information (Read More)

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Treatment of Age Related Macular Degeneration with Stem Cells
The Jules Stein Eye Institute at the University of California, Los Angeles (UCLA) has received institutional review board (IRB) approval to be a site for both the SMD and AMD trials using retinal pigment epithelial (RPE) cells derived from human embryonic stem cells (hESCs) (Read More)

Keratoconus is a condition in which the cornea becomes weak, progressively thinner, and irregular in shape. Instead of a normal, relatively round shape resulting in clear vision, the cornea in keratoconus can become cone shaped. Glasses and contacts help vision at first. In the past, the treatment then was corneal tranaplant. Now we are able to strengthen the cornea and make its shape more regular by the insertion of microscopic braces within the body of the cornea. Only eye drop anesthesia and mild sedation are required for this procedure. More recently, an FDA investigational technique called crosslinking has been used to strengthen the cornea by making an actual change in the corneal molecular structure. Crosslinking employs riboflavin (vitamin B2) eye drops and low dose ultraviolet light to accomplish the goal. All these techniques are used at the Mercy Center for Corrective Eye Surgery. For more information on the website, download the pdf brochure called "Keratoconus Treatment Options". (Read More)

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Presbyopia Treatment by Monocular
Peripheral PresbyLASIK
Robert Leonard Epstein, MD, MSEE; Mark Andrew Gurgos, COA

ABSTRACT
PURPOSE: To investigate monocular peripheral presby-
LASIK on the non-dominant eye with distance-directed
monofocal refractive surgery on the dominant eye in
treating presbyopia.
METHODS: One hundred three patients underwent
treatment with a VISX S4 system and follow-up from
1.1 to 3.9 years (mean 27.4 months). Average patient
age was 53.3 years. Preoperative refraction ranged
from
9.75 to 2.75 diopters (D). Non-dominant eyes
underwent peripheral presbyLASIK—an aspheric, pupil–
size dependent LASIK to induce central corneal relative
fl attening and peripheral corneal relative steepening.
Dominant eyes underwent monofocal refraction-based
LASIK (75.8%), wavefront-guided LASIK, limbal relaxing
incisions, or no treatment to optimize distance vision.
RESULTS: At fi nal follow-up, 91.3% (94/103) of all patients,
89% (25/28) of hyperopes, and 92% (69/75) of
myopes reported complete spectacle independence and
7.8% (8/103) used spectacles for less than 1 hour per
week. Distance unaided visual acuity was at least 20/20
in 67.9% (19/28) of hyperopes and 70.7% (53/75) of
myopes, at least 20/20 at 80 cm in 85.7% (24/28) of
hyperopes and 84% (63/75) of myopes, and at least
20/20 at 40 cm in 71.4% (20/28) of hyperopes and
65.3% (49/75) of myopes. PresbyLASIK increased overall
higher order aberrations similarly to refraction-based
LASIK for myopes but to a greater extent in hyperopic
cases. PresbyLASIK WaveScan spherical equivalent refraction
was stable in myopes but migrated an average
0.31 D in hyperopes over the follow-up period.
CONCLUSIONS: Monocular peripheral presbyLASIK is
a valuable option for presbyopic patients considering
refractive surgery. [J Refract Surg. 2009;25:516-523.]
doi:10.3928/1081597X-20090512-05 (Read More)

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Multifocal LASIK is the primary procedure we use for freedom from glasses for people age 48 and over. Multifocal LASIK is an advance over monovsion. The purpose of monovision is to provide visual clarity at long distance and at a single distance up close. The effect of monovsion is useful but expires with age. Multifocal LASIK provides a broader range of focus. As with monovision, the dominant eye is set for distance. But with multifocal LASIK, the non-dominant eye is made bifocal by a process called presbyLASIK. For people who do not have cataracts it is a reasonable, less invasive, and less expensive alternative to multifocal lens implants for the purpose of getting rid of bifocals. Published data show that over 90% of multifocal lasik patients at an average age of 53 years old became completely free of the need for any glasses The effect is adjustable and reversable if needed. . Results have been long lasting and we have been performing the procedure since 2003. People who already had cataract surgery and now want to be free of glasses may consider multifocal LASIK. To learn more, download the brochure below. (Read More)

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A new treatment called crosslinking or CXL to stop progressive vision loss from keratoconus is now under FDA clinical protocol at the Mercy Center for Corrective Eye Surgery. Mercy is the first and only crosslinking FDA clinical protocol center in Illinois or Wisconsin. The treatment, consisting of application of riboflavin eye drops and a weak dose of ultraviolet light similar to outside in the shade on a summer day, to the affected cornea. The treatment was developed in Switzerland in 1998 and is in practice widely outside the U.S. (Read More)

Seeing After 45
Robert L. Epstein, MD FACS (Read More)

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