Category Archives: LASIK Eye Surgery

What is the Best Eye Surgery for Astigmatism?

One of the most important aspects of a successful eye surgery is to make sure the patient is ideally matched with the procedure that is best for their specific vision problem.

Astigmatism is one of the most common vision problems that must be considered in any vision correction procedure.

What is astigmatism and how is it diagnosed?


Astigmatism is a very common problem, with almost everyone experiencing it to at least some small degree. In the past, eye doctors diagnosed astigmatism by refraction, which is when the patient is asked a series of questions (such as, “Which is better, 1 or 2?”) and the optometrist obtains a reading off of an instrument called a phoropter. A phoropter uses diopters as the unit of measurement, which provides readings in .25 increments. Using this older method, many patients are presumed to have no astigmatism at all. Thanks to advancements in technologies in recent years, we now use an instrument called an aberrometer, which is used to treat patients for Custom Wavefront-Guided LASIK. This instrument measures prescriptions in increments of .01 diopters. Aberrometry is ideal for objective and very precise measurements of astigmatism. Measured with this level of accuracy, it’s extremely rare to find a patient with 0.00 diopters of astigmatism. So,

1. Almost everyone has at least a little astigmatism

2. Astigmatism can be measured subjectively with a phoropter or objectively via aberrometry

3. LASIK corrects astigmatism

Which Surgeries are Most Common for Patients with Astigmatism?

When it comes to correcting astigmatism, the first line of defense, surgically speaking, is LASIK. This is because LASIK is effective for a wide variety of patients and offers the quickest recovery time. It is considered the “gold standard” for the surgical correction of astigmatism, so it’s the first option for those who are deemed LASIK candidates.

If LASIK is not an option, the primary backup plan is PRK surgery. While PRK works just as well as LASIK surgery at correcting wide ranges of astigmatism, PRK is typically Plan B simply because it includes the longer recovery time. If we find the cornea is not strong enough to make the flap necessary for LASIK, then we will likely offer PRK instead.

You can read more about LASIK surgery here and PRK surgery here.

What about Patients Who are not Candidates for LASIK or PRK Eye Surgery?

Phakic intraocular lenses are often used to correct nearsightedness in patients under 40 years old, as these patients still have the ability to adjust their focus (which is called accommodation). During this procedure, a lens is implanted inside the eye. In phakic IOL surgery, a lens is added, but the natural lens remains intact, which permits these younger patients to continue to be able to accommodate in order to see up close.

In the United States, phakic intraocular lenses currently are only approved and available to correct nearsightedness and are not available for the correction of astigmatism. Intraocular lenses used in cataract surgery, however, can correct astigmatism.

What about Intraocular Lenses Like the Ones Used in Cataract Surgery?

There are two types of patients who can have intraocular lens implants:

– Patients who have not yet developed cataracts and are candidates for a procedure known as Llear lens Exchange.

– Patients who have a cloudy crystalline lens in the eye and are thus candidates for cataract surgery where the natural lens is replaced with a synthetic one.

In cataract surgery, which is usually performed on patients 60 and older, the natural lens of the eye is replaced with an intraocular lens (IOL). IOLs for cataract patients that can correct astigmatism are called toric IOLs. Toric IOLs can also be used as part of an elective procedure called Clear Lens Extraction (CLE) or Refractive Lens Exchange (RLE), which is when the cataract surgery is performed in order to become eyeglass-free rather than to treat a cloudy natural lens. In CLE and RLE, the natural lens of the eye is removed and replaced with a synthetic lens.

Even though goals of CLE, RLE and cataract surgery are the same, i.e. the best vision possible, CLE and RLE are considered elective procedures, while cataract surgery falls into the medically necessary category.

Incisions on the Cornea to Correct Astigmatism

Sometimes, astigmatism can be treated during or after cataract surgery (or after an elective IOL procedure) by creating small incisions on the cornea. Corneal incisions for astigmatism can be called Limbal Relaxing Incisions (LRIs), Astigmatic Keratotomy (AK) or Arcuate Keratotomy (also AK). While a corneal incision procedure like LRIs and AK can be performed as a standalone elective procedure, it is most commonly performed in conjunction with either cataract surgery or a clear lens exchange. LRIs and AK can be performed as an adjustment after intraocular lens surgery when astigmatism is measured post-operatively, or it can be performed as part of the IOL procedure when the pre-operative astigmatism level indicates the need.

The difference between AK and LRI is simply the location of the cornea that is treated; LRIs are performed on a more peripheral part of the cornea. The two procedures provide similar results.

Astigmatism correction: What is next for you?

Woolfson Eye Institute (headquartered in Atlanta, GA, with nine locations around the Southeast) offers a wide variety of options for patients who require correction of astigmatism.

Our primary goal is to match each patient with the procedure that is right for them, whether that is LASIK, PRK, IOLs, or some other vision correction procedure.
No one should tell you exactly what surgery makes the most sense without providing a thorough eye examination. We encourage you to contact one of our offices today in order to schedule your complimentary consultation to see which procedure is right for you.

You don’t have to live with blurred vision due to astigmatism. Give us a call today and see why thousands of patients (including over 300 eye doctors) have chosen Dr. Woolfson for their eye surgery. Trust the Doctor the Doctors Trust! Contact us today!

LASIK Over 40: What are Your Options?

So you’ve reached your 40s. They say life begins at 40, right? While that may be true in many respects, by the time your eyes reach 40, they’ve certainly completed plenty of “hard living.”

With so much LASIK marketing and advertising on television, radio, and online, many people over the age of 40 (and even into their 50s) are starting to ask themselves, “Is LASIK right for me?”

It’s a great question. At Woolfson Eye Institute, we take pride in our ability to provide “Your Best Vision at any Age.” Does that include LASIK for those over the age of 40?

The answer: Sometimes.

LASIK over 40: The challenge

box2The average LASIK patient at Woolfson Eye Institute is 38 years of age. At this age, the most common complaint patients have is that their distance vision has become increasingly blurry (known as nearsightedness).

The challenge for patients over the age of 40 who wear contacts or glasses is correcting nearsightedness with LASIK (which is common), while at the same time getting them to understand a condition known as presbyopia, which literally translates to “old eyes.”

If you are approaching 40 years of age, presbyopia is in your near future; and if you’re over 40, it’s likely already happening.

So, not only are you already struggling with your distance vision, but you’re also likely beginning to struggle with tasks like reading and seeing well up close, which you’ve never had a problem with (hey, it stinks getting old!).

Many patients are alarmed to learn about presbyopia, but the reality is that, as people age, their eyes break down over time. This is similar to an autofocus camera that just wears down after too much use.

If you choose to have traditional LASIK to correct your nearsightedness, you will likely still need reading glasses to see up close, due to presbyopia, which is not corrected with LASIK (however, Monovision LASIK may be an option for you).

While many patients aren’t thrilled to hear this, the good news is that LASIK can help correct your nearsightedness (seeing far away), and as a result, help you live a higher quality of life.


The “over 40” LASIK evaluation

At Woolfson Eye Institute, it’s a requirement for patients to come see us for a LASIK evaluation before surgery is performed. It doesn’t matter if you’re 18 or 80; it’s necessary to ensure you are a good fit for LASIK.

We take a scientific approach to analyzing your vision from all angles to determine whether or not you are a LASIK candidate. We also provide a LASIK self-evaluation quiz right here on our website, which you can fill out by visiting this page.


Is it time for your “over 40” vision correction consult?

eye-squareYou probably think of Woolfson Eye Institute as a LASIK center and you probably think of an evaluation as being only for LASIK. In fact, a Woolfson Eye Institute refractive surgery consult is an opportunity for you to meet with a doctor who specializes in recommending the best treatment for you, whether that is LASIK, PRK, cataract surgery, or something else.

The bottom line— we don’t try to sell you an eye procedure you don’t need! This is your vision we’re talking about here and it cannot be left to chance. We match each and every patient to the procedure that is best for them.

Come see us for your evaluation and we’ll determine which vision correction procedure is right for you. With locations all around the greater Atlanta area (Atlanta/Sandy Springs, CAirport Location, Cumming, Lawrenceville, and Stockbridge), as well as locations in Tennessee (Chattanooga, and Knoxville) and Asheville, North Carolina, you’ll be able to find a Woolfson Eye Institute clinic near you.

Woolfson and Stulting First in Georgia to Offer Topography-Guided Custom LASIK

By Tom Spetalnick, OD

Woolfson Eye Institute is proud to introduce Contoura Vision, Alcon’s topography-guided custom ablation technology. Contoura, in the FDA clinical trials, delivered visual acuity exceeding 20/20 to the majority of patients, uncorrected visual acuity that is equal to or better than preoperative corrected acuity, as well as a reduction in visual symptoms like difficulty driving at night.

On March 22, over 500 surgeons seeking Contoura certification witnessed Doyle Stulting, MD, PhD and TV personality Patricia Stark broadcast a live satellite seminar from Atlanta that went out to 34 locations across the nation. Their telecast will serve as Alcon’s training video for future Contoura surgeons.

The strategy of topo-guided Contoura may sound similar to that of wavefront-guided custom ablation, which Woolfson began offering in 2003, but there are important distinctions. In wavefront-guided ablation the entire optical pathway is measured, and the treatment on the cornea is based on the summation of the total wavefront properties of an eye. In Contoura, the laser pattern for the correction of high-order aberrations is derived from the corneal topography. According to Dr. Stulting, “Topography is more reproducible than wavefront measurements, not pupil size-dependent, measures more points than wavefront, avoids treating intraocular aberrations, and more accurately measures peripheral corneal irregularities, where most visual symptoms arise.”

Dr. Stulting and Patricia Stark co-moderating Alcon's national Contoura surgeon training

Dr. Stulting and Patricia Stark co-moderating Alcon’s national Contoura surgeon training

The Topography-Guided Custom Ablation Treatment (T- CAT) study was one of many research projects that Doyle Stulting, MD, PhD brought to Woolfson Eye Institute when he joined the practice in 2010. As the Medical Monitor for the T-CAT study, Dr. Stulting supervised participating U.S. centers and surgeons, including Jonathan Woolfson, MD. Stulting and Alcon obtained FDA approval for T-CAT for myopic patients (up to -9.00 SEQ) based on refractive results that exceeded any previously delivered in FDA LASIK trials.

Drs. Stulting and Woolfson, the first in the state of Georgia to offer Contoura Vision as a LASIK option, are providing the new treatment in the Sandy Springs office. “We’ve never rushed to be the first to offer new technology, but our involvement with Contoura in the clinical trials gave us total confidence to make it available to our patients,” said Woolfson. The practice now has four modes of laser vision correction: conventional, wavefront-guided, wavefront-optimized, and now topography-guided in the form of Contoura Vision. Patients referred for LASIK will continue to be screened to determine which technology is indicated for their LASIK treatment.

Doyle Stulting, MD, PhD, Selected to Present Prestigious Binkhorst Lecture at ASCRS-ASOA Annual Meeting

FAIRFAX, VA – February 12, 2016 – Physician-scientist, Doyle Stulting, MD, PhD, will be awarded the Binkhorst Medal, and he will present the esteemed Binkhorst Lecture during the Opening General Session of the American Society of Cataract and Refractive Surgery (ASCRS) and American Society of Ophthalmic Administrators (ASOA) Annual Symposium and Congress in New Orleans May 7, 2016. Dr. Stulting’s lecture will be titled “Predicting and Treating Corneal Ectasia.”

Since 1975, the Binkhorst Medal has been awarded to the world’s most prominent ophthalmologists whose careers have made significant contributions to the science and practice of ophthalmology. During his distinguished career, Dr. Stulting’s work has established him as a foremost leader in the field of ophthalmology and a primary force in the surgical management of complex cataracts, corneal disease and intraocular lens complications.

“Dr. Stulting’s research efforts have been vital to advancing the study and practice of ophthalmic surgery. It is exactly this kind of tireless dedication to the advancement of the field that exemplifies recipients of the Binkhorst Medal,” says ASCRS President Robert J. Cionni, MD.

Dr. Stulting has been performing refractive surgery for more than 20 years and is known for his clinical expertise in pediatric corneal transplantation, having published the largest clinical series in the literature on this topic. Most recently, he was principal investigator for a physician-sponsored clinical trial of riboflavin-UVA corneal collagen cross-linking–the first of its kind in the United States.

meet-dr-stulting

“In 1998, Theo Seiler called our attention to the possibility of destabilizing the cornea with laser in situ keratomileusis (LASIK), resulting in corneal ectasia, with decreasing visual acuity, thinning, and steepening of the corneal curvature,” says Dr. Stulting. “Analysis of patients who developed ectasia and others who have had successful LASIK has allowed us to identify risk factors for this undesirable outcome.”
Corneal collagen crosslinking (CXL) was introduced to the print literature over a decade ago and is the standard for care for the treatment of ectatic corneal disease around the world. Stiffening the cornea with CXL can stop the progression of not only corneal ectasia after LASIK but also the progression of naturally occurring ectatic diseases such as keratoconus and pellucid marginal degeneration.

Focusing on improving the cornea’s resistance to deformation has led to exploring newer technologies that might be applied to the noninvasive measurement of corneal stiffness rather than using the traditional measurements of visual function, corneal curvature and corneal thickness. Improvements in CXL methodologies have and will continue to reduce the risks of CXL.

“Coupled with noninvasive techniques for measuring corneal biomechanics and more advanced screening methods, newer technologies for stiffening the cornea have the potential to eliminate visual loss from ectatic corneal disease,” Dr. Stulting adds, “and eliminate the need for as many as 50 percent of the corneal transplants performed in the United States.”

stulting-microscope

Dr. Stulting received his MD and PhD degrees from Duke University, in Durham, N.C, graduating summa cum laude. He served his internal medicine internship and residency at Washington University’s Barnes Hospital and his ophthalmology residency at the University of Miami, Bascom Palmer Eye Institute. Dr. Stulting completed a fellowship in cornea and external disease at Emory University, where he practiced, taught, and performed research as a member of the faculty from 1982 to 2010. In 2010, he founded the Stulting Research Center at Woolfson Eye Institute, where he conducts a variety of clinical trials in cataract, refractive surgery, cornea and external disease.

Dr. Stulting has served as a member of the FDA Ophthalmic Devices Panel and completed a term as Chair of the Panel in 1998. He is Past President of the American Society of Cataract and Refractive Surgery, has served on the Board of Directors of the Eye Bank Association of America, is a member of the Board of Directors of the Georgia Eye Bank, and is Co-Medical Director of the Georgia Eye Bank. He recently completed a 10-year term as Editor-In-Chief of the journal Cornea and is on the editorial board of other journals.

Registration is open for the ASCRS-ASOA Annual Symposium and Congress, which will be held in New Orleans May 6-10. This is the only event in the United States dedicated to the needs of the anterior segment specialist. More than 14,000 medical doctors, nurses and technicians, practice administrators, industry leaders and exhibitors attend the meeting.

The American Society of Cataract and Refractive Surgery is an international educational society with more than 9,000 members. Its mission is to advance the art and science of ophthalmic surgery and the knowledge and skills of ophthalmic surgeons by providing clinical and practice management education and by working with patients, government and the medical community to promote the delivery and advancement of high-quality eye care. ASCRS.org

The mission of the American Society of Ophthalmic Administrators is to advance the skills and professionalism of ophthalmic practice management. Founded in 1986 by administrators for administrators, ASOA is the premier organization for the business side of the ophthalmic practice. Serving administrators, managers, physicians and office staff, ASOA offers avenues for personal and professional growth and provides support, tools and resources for the daily challenges of managing a practice. ASOA celebrates its 30th anniversary in 2016. ASOA.org

LASIK Results: Outcomes, Side Effects, and Complications

lasik patient after surgery

Have you ever thought about the success rates of LASIK? After all, if you are undergoing any kind of surgical procedure (especially on your eyes), it’s good to know the facts.

In this article, we are going to discuss LASIK outcomes, which can be divided into three major categories:

  1. Side effects
  2. Complications
  3. Refractive outcomes

What are the side effects of LASIK surgery?

When we talk about side effects, we’re talking about things that are not long-lasting. Side effects are not expected to affect the ultimate surgical result.

Haziness and blurred vision

Immediately following LASIK, patients commonly notice some haziness and blurred vision for several hours, or possibly even a few days. This temporary LASIK side effect should not create lots of anxiety.

Glare

Glare symptoms can manifest as starbursts, halos, or just a general haziness. Patients who are bothered by glare following LASIK usually express concerns about their quality of vision based on symptoms experienced while driving at night. Glare is something that can last a few days, weeks, or even months.

It’s important to note that not every patient has glare as a side effect, but when they do, it’s usually comparable to what they’ve experienced with contact lenses. An encouraging detail is that a wavefront-guided procedure (also known as Custom LASIK) actually decreases the chance of developing long-term glare symptoms. According to FDA trials, after a custom LASIK procedure, patients are more likely to report improvement rather than worsening of their night vision.

Dry eye

Dryness is another common side effect. Dryness after LASIK has to do with the temporary damage that’s been done to the nerve endings in the cornea, which can take several weeks, months, or even longer to recover.

Most patients don’t have much difficulty with dryness. Typically, patients who experience dryness are given lubricant eye drops. In fact, every patient is given lubricant drops as part of their LASIK kit that goes with their surgery, but patients who have dryness symptoms that last longer than a few weeks or months will sometimes be put on a prescription eye drop.

What are some of the complications of LASIK surgery?

Complications are more serious than side effects, and may even affect a patient’s long-term result. Complications sometimes require added medication or other treatment—sometimes even further surgical intervention.

Flap striae (wrinkles in the LASIK flap)

Wrinkles in the LASIK flap are called flap striae. Striae can be microscopic and have no impact on the vision, or they can be larger and seriously affect the vision, as can happen when the LASIK flap shifts from eye rubbing or eye squeezing.

The severe wrinkles that come from a slippage of the LASIK flap often are accompanied by interesting or exciting stories. One case involved a patient who got in a bar fight the night after LASIK. Another patient ran into a tree when they were four-wheeling in the woods.

Surprisingly, these patients can end up with very good vision and eye health, but slipped flaps should be treated sooner rather than later to minimize the chances of the vision being compromised by the event.

Epithelial ingrowth

Another complication after LASIK is called epithelial ingrowth. Ingrowth is when the outer layer of cells that cover the cornea manage to find their way under the LASIK flap. It’s actually very rare to have ingrowth after an initial LASIK procedure, but more common after a flap has been lifted in order to offer a re-treatment (something we call a LASIK enhancement).

When we lift the LASIK flap, the edge of the flap isn’t as smooth as a brand new LASIK flap. This is where the cells sneak in, filling in the gap that they’re supposed to fill in. However, sometimes the cells will be a little bit more aggressive than they need to and get under the flap. That’s fixable by lifting the flap if it’s a significant amount, or just monitoring to make sure it fizzles out, which is something that it can do on its own.

To treat ingrowth, the surgeon will lift the LASIK flap and wipe away the cells, then lay the flap back down. Most ingrowth cases endure a single treatment to resolve the problem, but there are instances in which the ingrowth may recur and require repeat treatment.

Inflammation under the LASIK flap—diffuse lamellar keratitis (DLK)

Inflammation under the LASIK flap is called diffuse lamellar keratitis. This occurs when white blood cells sneak under the flap. We put all patients on anti-inflammatory drops that decrease the level of irritation and inflammation after LASIK.

The immune system naturally fights infection, but when the response is excessive and white blood cells appear under the LASIK flap in too high of numbers, they can affect the long-term result. When we see this, we want to intervene very quickly, which typically consists of increasing the dosage of anti-inflammatory drops.

The small percentage of patients who develop diffuse lamellar keratitis or DLK usually respond well to increasing the anti-inflammatory drops for several days or even a couple of weeks. Occasionally we’ll lift the LASIK flap to rinse away the offending cells. Rarely, we’ll put patients on oral corticosteroids (like prednisone) to help minimize the amount of recurrence.

LASIK infections—serious, but rare

The most serious complication that we worry about is infection. Infection after LASIK is very uncommon, happening to about one in 5,000 LASIK patients across the country. In our practice, the number is actually much lower than that. We’ve had three LASIK infections out of 80,000 procedures (roughly 1 in 27,000 procedures), so we are doing something right.

We believe that our low infection rate is a product of careful in-office instillation of antibiotic drops and the care we take in instructing patients on their own care.

Complications during surgery

Another category of complications are those that can occur during surgery. Intraoperative complications occur when some step of the LASIK procedure does not go as expected. In about one out of 2,000 LASIK cases the flap, which is created with either a laser or an instrument called a micro-keratomereason, isn’t as smooth as it needs to be. In that case, the surgeon will make the decision to stop the procedure. It’s important for a LASIK surgeon to be willing and able to make the decision to discontinue surgery in the rare event that the flap-making step does not go perfectly.

While it’s not fun to have your LASIK surgery interrupted, it is the correct way to handle a case like that. Patients who experience this are typically able to come back and proceed with vision correction surgery several months later.

What are the average outcomes of LASIK surgery?

Since we are discussing LASIK side effects and complications, we also want to talk about the positives, which are the results we are able to achieve for our patients. The general results of LASIK are excellent. In fact, it’s one of the most successful elective procedures based on patient satisfaction ever.

At our practice, approximately 90% of patients achieve 20/20 vision or better. Roughly 5% of our patients do come back for LASIK enhancement. This is not because we have 5% of our patients having horrible results-far from it. The patients who come back for enhancements are frequently seeing very close to 20/20.

Patients who end up with 20/20 vision or better are usually ecstatic. Patients who end up with a vision that’s 20/25 are usually happy.

Even though patients who are 20/30 or worse may have already seen a huge difference in their vision, they sometimes want to seek a fine-tuning. In fact, when we have a patient who is not yet happy with his or her vision, we’re often able to offer a retreatment.

Timing retreatment is an important decision. It is important to ensure that your vision has stabilized, typically for 6 months, prior to offering an enhancement. When an enhancement is indicated, our goal is to do everything we can to make sure the next procedure is the patient’s last procedure.

Struggling with your vision? Here’s your next step.

At Woolfson Eye Institute, we are committed to matching you with the procedure that is right for you, whether that is LASIK, PRK or something else entirely.

If you aren’t happy with your vision, and are considering LASIK or any other form of eye surgery, please find our location nearest you, and give us a call today!

See more at: https://www.woolfsoneye.com

What Credentials Should I Look for When Selecting a LASIK Surgeon?

atlanta lasik surgeon credentials and experience
A bad eye procedure outcome can negatively affect your life in a serious way.

If you’re thinking about getting LASIK to correct your eyes, there are several factors to look for when selecting a LASIK surgeon.

What you should know about your LASIK surgeon

1. Certification.

Medical doctors are legally permitted to offer surgical procedures outside their own specialties. Make sure the LASIK surgeon you are considering is a licensed ophthalmologist.

Eye surgeons should be trained in ophthalmology, so be certain that your potential LASIK surgeon is an ophthalmologist licensed in your state. State licensing boards can validate a surgeon’s credentials.

Similarly, not every ophthalmologist is board certified. You should confirm that your LASIK surgeon is a board certified ophthalmologist.

Dr. Jonathan Woolfson, the founder and medical director at Woolfson Eye Institute, is a board certified ophthalmologist with memberships in the American Academy of Ophthalmology, the American Society of Cataract and Refractive Surgery, the International Society of Refractive Surgery, and the American Medical Association.

2. Experience.

Experience should also be very high in the list of things you’ll want to know about your LASIK surgeon. How many procedures has he or she performed?

One of the best guidelines regarding expertise in any field comes from Malcolm Gladwell’s book, Outliers, which includes the “10,000-hour rule.”

10,000 hours has become the accepted standard to be an expert in most fields. Not a lot of ophthalmologists have spent 10,000 hours performing LASIK. We’re proud to have a doctor who has done 80,000 LASIK cases — translating to well over 10,000 hours of LASIK-related care.

3. Trust.

Being able to trust the doctor and see this person’s reputation in the community is important. Numbers are important, and 80,000 is a large one, but it’s also meaningful to consider who some of the patients are. Do eye doctors and professional athletes choose the doctor for surgery? What do these patients have to say about his or her experience?

More than 300 eye doctors have chosen Dr. Woolfson to perform their own LASIK. Also, many professional athletes, celebrities, business leaders, and people like you have chosen Dr. Woolfson for their LASIK surgery in the Atlanta area and the Southeast.

4. Outcome analysis.

Many providers of LASIK may get good results, but not every surgeon monitors and analyzes their results. A practice with good quality control should have a sophisticated outcomes analysis program. At Woolfson Eye Institute, we are committed to outcome analysis in order to continue to constantly improve what we’re doing.

Choose Dr. Jonathan Woolfson as your Atlanta-area LASIK surgeon

Dr. Woolfson has the credentials, the experience, and the trust of eye doctors.

Check out what our patients say about us.

When you’re ready, fill out our free, online self-evaluation to find out if you’re a good candidate for LASIK surgery or another vision correction surgery.

Surgery to Replace Reading Glasses: Does it Exist?


Around the age of 40, people begin to experience blurred vision when reading or looking at a computer screen. No longer can you adjust focus and see things close up. This only gets worse as you get older, until you are 60 and have no ability to focus. But is it possible to fix near vision and replace reading glasses with surgery or other options?

You probably know about LASIK surgery and its ability to correct eyesight. But what you may not realize is that most patients who move forward with this treatment are nearsighted, meaning they have poor vision far away and can see reasonably well up close.

When we, at our Southeastern laser correction centers, tell people 40 or over that even if they have LASIK surgery, they will still require reading glasses when looking at a computer screen or anything closer, he or she is often surprised and disappointed.

But guess what? There actually are ways to address near vision, with or without LASIK.

Monovision contact lenses

Monovision contact lenses are one option for correcting near vision, or presbyopia. When people wear these lenses, one contact lens gives them far vision, and the other lens gives them near vision.

Monovision LASIK

Most corrections that can be done with contact lenses can also be done with LASIK. This is true for monovision.

When patients come to us at Woolfson Eye Institute, and they have not had monovision lenses, we typically connect them with a trusted eye doctor in the community who can, at least temporarily, fit them with monovision contact lenses.

This way patients can make sure they are satisfied with one eye seeing near and one eye seeing far. They can go out in the real world and drive or hike or whatever they normally do to see if this type of vision works for them.

We take this step to better serve our patients because monovision is not for everyone. People who are avid tennis players or golfers most likely won’t be candidates for monovision. Neither will anyone who wants their depth perception to be as good as possible.

But don’t worry. Other options exist for people who don’t want monovision.

Do eye exercises or surgery to repair adjustable focus work?

reading glasses eye chart from Atlanta's Woolfson Eye Institute
In a perfect world, we would be able to show our patients some eye exercises, and they would be able to get their near vision back. But, unfortunately, this isn’t possible.

Research has shown that eye exercises cannot alter the eye’s basic anatomy or eliminate near vision problems. Nobody escapes presbyopia.

Surgery to repair the focusing system that breaks down has not been adequately successful to achieve FDA approval. There have been several unsuccessful attempts to use implants or other surgical procedures to restore adjustable focus for people over 40.

So, what does work?

Intraocular lenses or accommodating intraocular lenses

People with cataracts can choose to have a lens with built-in distance and near power. Bifocal Multifocal Intraocular lenses are similar to bifocal or multifocal contact lenses, both of which do a good job of delivering both near and distance vision.

But what if you don’t have a cataract? We actually don’t have to wait until a patient has a cataract. These lenses can be used as an elective procedure.

Another similar technology is accommodating intraocular lenses. These lenses provide a small degree of adjustable focus, which sometimes can provide near vision comparable to what people had when they were in their 30s or 40s.

However, these lenses are not always ideal for delivering excellent near vision, so they tend to be used less frequently than multifocals and monovision.

Corneal inlays

Recently, a procedure — comparable to LASIK — called corneal inlays has been in development. Imagine a flap or pocket being made in the cornea and a lens inserted to provide near vision. This technology is under development and not yet FDA approved, although there is some optimism that one of these corneal implants will be available soon.

One type of corneal inlay is called the KAMRA. These inlays take advantage of an optical principle called the pinhole effect. By looking through a small aperture, essentially an artificial small pupil, near and distance objects are both in better focus. Squinting improves your vision via the exact same property. This type of inlay, we hope, will be available in the next few months, and we expect to offer it at our laser correction center.

Imagine turning back the clock for your eyes to when you were 40 and didn’t have to wear reading glasses. This could be a reality very soon.

Woolfson Eye Institute can help you see better and even replace your reading glasses

At Woolfson Eye Institute, with offices in Georgia, Tennessee, and North Carolina, we want to give you the vision you deserve. That’s why we offer monovision and intraocular lenses and are seeking newer treatments for people who want to see up close again without glasses.

If you have questions or want to visit one of our centers, click here to find a location near you and to contact us about setting up an appointment.

Dr. R. Doyle Stulting Honored by International Society of Refractive Surgery (ISRS) with Prestigious 2014 José I. Barraquer Lecture and Award

R. Doyle Stulting, MD, PhDSan Francisco – R. Doyle Stulting, MD, PhD, Director of the Stulting Research Center, Woolfson Eye Institute, professor of ophthalmology emeritus at Emory University and adjunct professor of ophthalmology at the Moran Eye Institute, was honored by the International Society of Refractive Surgery (ISRS), a partner of the American Academy of Ophthalmology (AAO), with the 2014 José I. Barraquer Lecture and Award.

The award honors a physician who has made significant contributions in the field of refractive surgery during his or her career. This individual exemplifies the character and scientific dedication of José I. Barraquer, MD—one of the founding fathers of refractive surgery.

Dr. Stulting received his MD degree and PhD in microbiology and immunology from Duke University. He completed his internal medicine internship and residency at Washington University’s Barnes Hospital and his ophthalmology residency at the University of Miami, Bascom Palmer Eye Institute. Dr. Stulting completed a fellowship in cornea and external disease at Emory University, where he practiced, taught and performed research from 1982 to 2010.

In 2010, he left Emory University to establish the Stulting Research Center at Woolfson Eye Institute, where he conducts a variety of clinical trials in cataract, refractive surgery, cornea and external disease.

Dr. Stulting was given the Barraquer Award at a special award ceremony at the 2014 ISRS Annual Meeting in Chicago, Illinois (see picture attached).


About the International Society of Refractive Surgery (ISRS)

The International Society of Refractive Surgery (ISRS), a partner of the American Academy of Ophthalmology (AAO), is the leading worldwide organization for refractive surgeons, with over 2,300 members from more than 80 different countries. To learn more about the latest clinical and research developments in refractive, cornea, cataract and lens-based surgery, visit www.isrs.org.

About the American Academy of Ophthalmology (AAO)

American Academy of Ophthalmology is the world’s largest association of eye physicians and surgeons—”Eye M.D.s”—with more than 32,000 members worldwide. Eye health care is provided by the three “O’s” – opticians, optometrists, and ophthalmologists. It is the ophthalmologist, or Eye M.D., who can treat it all (eye diseases and injuries) and perform eye surgery. For more information, visit www.aao.org.

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