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LASIK and Refractive Surgery

Dr. Joel Geffin is The Eye Care Group’s refractive surgery specialist. He has been performing refractive surgery since his fellowship in the early 1990’s. Dr. Geffin offers his patients extremely personal attention. Unlike some practices, Dr. Geffin will personally examine each and every patient who comes to The Eye Care Group for a refractive surgery evaluation. He will spend as much time with you before and after your surgery as you feel is needed. Dr. Geffin realizes that having refractive surgery is a very important and personal decision and he wants to be certain that you make the right choice.

When patients visit corporate and discount laser centers they are typically attracted by a low price ad. Corporate laser centers are “sales driven” and once there, patients are often presented with any array of options as if they were buying a car. The options packages often include different quality lasers, doctors of varying experience and even the length and type of post operative care. The sales people at these corporate laser centers are often commissioned and will always try to “up sell” the patient to the more lucrative packages. Usually patients end up paying as much or more at these corporate laser centers as they do for Premium LASIK at The Eye Care Group.

Dr Joel GeffinAt The Eye Care Group our philosophy is simple – we are driven by quality patient care. We believe that everyone who has laser vision correction should have the best possible procedure available. Dr. Geffin, our experienced surgeon, provides personalized care before and after your procedure and is always available for any of his patient’s concerns. For all of his patients he only uses what is widely believed to be the world’s finest excimer laser, the Allegretto Wave®, by ALCON® WaveLight®. For Dr. Geffin and his dedicated staff, Premium LASIK and Personal Attention is the only way we know.

Dr. Geffin is a Board Certified ophthalmologist and fellowship trained in both corneal surgery and refractive surgery. This makes Dr. Geffin one of a few select eye surgeons who has received full fellowship training in surgery of the cornea, the external window of the eye, and refractive surgery, which corrects the eye’s ability to focus. Dr. Geffin’s special surgical skills include not only LASIK and PRK but also corneal transplants and cataract surgery.


LASIK procedure

During LASIK the surgeon first creates a thin corneal flap using a device called a microkeratome. The cornea flap is lifted up, and the laser beam is applied to the exposed interior surface of the cornea to reshape the tissue. The flap is then replaced over the treated area. This corneal flap serves as a natural bandage, which eliminates the discomfort associated with other types of refractive surgery, and expedites the healing process. Because of the extraordinary bonding properties of the corneal tissue, stitches are not needed to keep the flap in place after LASIK surgery.

Advanced Surface Ablation

Advanced Surface Ablation also referred to as Photorefractive Keratectomy or PRK, represents an important alternative option for many patients interested in LASIK refractive surgery. Historically, when the excimer laser was first approved by the FDA in the mid-1990’s American refractive surgeons were predominantly performing PRK. By the year 2000 because of rapid visual recovery and the ability to perform surgery on both eyes at the same sitting the predominant procedure in the United States had become LASIK. In the last few years however, Advanced Surface Ablation has made a big come back due to its outstanding visual outcomes and unsurpassed safety profile.

With Advanced Surface Ablation instead of creating a corneal flap, the surface epithelial cells are gently removed and the exposed corneal surface is then treated with the Wavelight® Allegretto Wave® laser and covered with a bandage contact lens. The surface cells quickly regenerate creating a pristine refractive surface. LASEK (not to be confused with LASIK) and Epi-LASIK are also forms of Advanced Surface Ablation. Generally, patients who choose Advanced Surface Ablation will have each eye done on a separate day.

Advanced Surface Ablation is an excellent choice not only for patients who are extremely safety conscious but also for individuals who are moderately to severely nearsightedness and have corneas too thin for LASIK. Advanced Surface Ablation is also an exciting option for farsighted people whose only alternative previously was glasses or contact lenses. Because Advanced Surface Ablation does not rely on the healing of a corneal flap it may also be a good choice for individuals who participate in contact sports or have aspirations for flight operations in the military.

Wavelight® Allegretto Wave® Laser
Laser vision correction procedures differ in a number of ways, but conventional treatments use the same formula to treat every person with the same optical prescription.

The Wavelight® Allegretto Wave®, however, was conceived from the start to perform custom treatments and incorporates wavefront technology principles into each procedure while adjusting each treatment to the patient’s individual cornea.
The Wavelight® Allegretto Wave® is one of the fastest laser systems available in the U.S. today, and allows the surgeon to finely sculpt the patient’s new vision with precise accuracy. This laser also features an ultra-fast eye-tracking system to follow eye movement during the procedure.

xThis high-speed tracker is a key component of the system’s unique PerfectPulseTM Technology, developed to accurately control the energy level and exact placement of every laser pulse. Understanding that all eyes are not the same, the Wavelight® Allegretto Wave® takes into consideration each patient’s individual corneal steepness and automatically compensates for laser energy that can be lost in the periphery of the cornea due to the eye’s natural shape. By doing so, the Wavelight® Allegretto Wave® specifically addresses spherical aberrations that can potentially cause glare and may distort night vision.

More about the Wavelight® Allegretto Wave®:
In FDA trials, 93% of all patients saw as well or better without glasses after treatment than they did with glasses prior to treatment. More than 50% achieved 20/16 vision or better.

Fewer than 5% needed an enhancement later
The Allegretto Wave® was granted clearance for the widest approval range ever
initially granted to a new laser system Wavelight® Allegretto Wave® is capable of producing some of the largest available optical zones. The optical zone refers to the portion of the cornea that has been corrected by the laser. A larger optical zone is especially important for night vision, and for patients with very large pupils. In the past, night vision problems had been one of the biggest drawbacks to conventional laser correction surgery. Wavefront-optimized technology built into Wavelight® Allegretto Wave® addresses this limitation.

Better Night Vision and Glare Control
At night and in dark conditions, the pupil becomes larger to permit the maximum amount of light to enter the eye. Laser eye correction needs to take this fact into account. If the optical zone is smaller than the size of the pupil at its largest, there is a good chance that the patient will experience poor night vision or problems with glare and halos around bright objects such as oncoming headlights. Wavelight® Allegretto Wave® is able to produce a larger optical zone, virtually eliminating glare and night vision problems associated with older generation lasers.

Wavefront Optimized
One of the most innovative features of the Wavelight® Allegretto Wave® is the way it uses wavefront-optimized technology to automatically compensate for the curvature of the cornea. In earlier laser correction systems, the “optical zone,” or area of correction, was centered on the front of the cornea; the result was a flattened circular area that ended with an abrupt edge, causing unwanted side effects like poor night vision, glare, and halos. 

Wavelight® Allegretto Wave® changes all that. The Wavelight® Allegretto Wave® sends extra pulses to the peripheral cornea area in order to compensate for the angle of the laser beam. In this manner, the aspherical shape of the cornea is preserved to a degree that older lasers simply could not achieve. This compensation, combined with the incredibly small, 1mm size of the laser, produces a smooth, effective optical zone that results in what can only be described as high performance vision.

Imagine a glass ball. If you took a flashlight and aimed it directly at the top of the ball, the light would form a circular shape on the surface of the ball. If you now aimed the flashlight towards the side of the ball, the light would form an elliptical shape and not seem as bright anymore. This is because the same amount of light is suddenly distributed over a larger area and some of the light is reflected away due to the angled surface of the glass ball.