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LASIK

LASIK Eye Surgery in Henderson, NV

The eye is an amazing optical device. Like a camera, the eye focuses light into a clear image, which is then changed into electrical signals and sent to the brain for interpretation. Abnormalities in the size and shape of the eye lead to poor vision, which requires glasses or contact lenses for improved clarity.

Scientists and engineers have been working for years, trying to perfect the options for restoring vision without glasses or contact lenses. Currently, the two major categories of vision enhancement include LASIK/PRK and ICL lens implant procedures. LASIK and PRK work externally by reshaping the cornea, ICL implants are placed inside the eye to help focus light rays without glasses or contact lenses. Each procedure has specific benefits and minor risks. Our job is to help educate you on your options and guide your decision making so that you end up with the best possible vision with the safest and highest technology procedure.

Dr. DeBry will work with each patient to make sure they get the best technology for their vision-correction surgery.

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Are You an Ideal Candidate for LASIK?

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A generally healthy eye and cornea

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No uncontrolled dry eye symptoms

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Adequate corneal thickness – measured at your pre-op with a safe and simple test (pachymetry)

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Eyelid and facial structures that allow the laser to get near the eye

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Dissatisfaction with glasses and/or contact lenses

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A desire to have improved vision with a willingness to accept some risk to achieve this goal

ABOUT YOUR SURGEON

Peter W. DeBry, M.D.

Success in vision-correction surgery requires high-quality standards and attention to fine details. Dr. Peter W. DeBry brings these qualities to Las Vegas with his extensive training in eye surgery and lens implantation. Dr. DeBry completed medical school at the University of Utah in 1996. At that time he was honored with induction into the prestigious Alpha Omega Alpha medical honor society, reserved for the top physicians in each graduating class. Next, he spent three years of residency focused on medical and surgical eye care in Madison, Wisconsin, where he was chosen to help coordinate resident training as the chief resident. After this, he was one of only four doctors nationally selected to attend one of the country’s top fellowships in eye surgery techniques and spent the next year at the Bascom Palmer Eye Institute in Miami, Florida. After working with top doctors learning the most up-to-date surgical techniques, he moved to Kansas City, Missouri where he taught these techniques to new eye surgeons as Associate Clinic Professor at the University of Missouri. Finally, he relocated in 2003 to help provide cataract, and vision correction surgery for the residents of Las Vegas.

Dr. DeBry is one of the most experienced eye surgeons in Las Vegas. From performing a corneal transplant in a 90-year-old to a vision-saving glaucoma surgery in a baby, he does more complex surgeries than any other eye surgeon. Dr. DeBry was invited to be among the first few groups of eye surgeons in the United States trained in the surgical techniques for Verisyse and Staar Visian ICL Lens implantation. He has been doing these procedures since 2005, longer than any other full-time surgeon in Las Vegas. He has presented research at local and national meetings and has published articles in national ophthalmology journals.

LASIK

Our LASIK Technology

At NV Eye Surgery, our LASIK surgeons use the most advanced LASIK technology available to deliver truly customized vision correction treatments tailored to your unique eyes. We use two advanced laser systems that work together to reshape your corneas with personalized precision.

The Alcon Wavelight EX500 Laser sculpts the corneas through a fast, computer-controlled laser, which is accurate to a tiny fraction of a millimeter. Its rapid pulses ensure maximum safety and effectiveness as it makes precise changes to the surface of your cornea.

Our LASIK surgeons also use the Ziemer LDV Z4 Femto Laser, which creates a detailed topographic map of your cornea. This helps guide the laser in customizing subtle adjustments according to your eyes’ natural contours. Using both of these advanced lasers that provide mapping and precision enables an ultra-customized reshaping for spectacular vision outcomes tailored to you.

Contoura™ Vision Topography Guided All Laser LASIK

Our Contoura Vision platform takes LASIK personalization further than ever before. Unlike standard LASIK, which relies on simple wavefront mapping technology to guide treatments, Contoura is customized specifically and precisely to your unique eye topography.

Using advanced mapping, this technology can capture thousands of data points across your corneas to fully understand every subtle curve that makes your eyes one-of-a-kind. Your LASIK surgeon can then use this detailed blueprint of your eyes to guide the laser in reshaping your corneas in a way that smooths out imperfections and improves your vision tailored specifically to you.

LASIK at NV Eye Surgery in Las Vegas, Nevada, with Contour Vision, is customized and fine-tuned to the natural structure of your eyes only. The benefit is the best possible visual outcomes with incredible sharpness, vivid color, and ultra-clear night vision.

How Does Contoura Vision Work?

Contoura Vision is a type of LASIK surgery that creates a detailed map of your cornea, the clear outer layer of your eye. During LASIK with Contoura Vision, your LASIK surgeon uses the Contoura Vision system to create a detailed map of your eye and then inputs that information into the laser to reshape the cornea according to your unique map.

This precisely smooths out any uneven areas on the cornea, removing any irregularities and improving your eyes’ ability to focus. Contoura Vision works exceptionally well if you have both nearsightedness and astigmatism, which is when the cornea has an irregular curve. The highly personalized Contoura Vision system leads to excellent visual results.


Better than Glasses and Contacts!

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Basic Information About the Eye and Vision

The eye works like a camera to focus light and create a clear image. There are two main eye structures that share the job of providing good focus, the cornea, and the lens. The cornea is the window of the eye, much like your car windshield. It is made of living tissue (cells and collagen) that is perfectly clear and shaped with a curved surface. As the light rays enter this curved surface the rays are bent (or refracted), directing the rays closer together and towards the lens. The next structure that light rays encounter is the lens. The lens of the eye is shaped like an M&M candy and is also composed of perfectly clear cells and collagen. The lens also bends the light rays, refracting them towards the posterior surface in the eye, the retina.

The eye is amazing! Your body has it’s own auto-focusing camera system with 3-D technology. Clear vision without glasses requires the eye to be a perfect shape and size with each component of the eye doing its job in the focusing process. Looking around the world at the people you see every day it is easy to realize that we all aren’t born with a perfect shape and size. If your eye is bigger or smaller than average, or if each component of the eye (cornea and lens) doesn’t focus perfectly, your vision will be out of focus. Blurry vision due to focusing problems is called Refractive Error. There are three main categories of refractive error: myopia, hyperopia, and astigmatism.

Myopia, or nearsightedness, is a condition of the eye where the focusing power of the eye does not match the size and shape of the eyeball. People who are myopic generally have an eye that is bigger than average or a cornea that has a higher curvature than average. This results in blurred vision for distant objects. One benefit to being myopic is the ability to see things up close without your glasses or contact lenses.

Hyperopia is caused by an eye that is smaller than average or a cornea that is flatter than it should be. In many people, the auto-focusing ability of the eye is able to help keep an image in focus when the eye is young and healthy. Because of this many hyperopic people don’t need to wear glasses when they are children and young adults. Eventually the auto-focus mechanism ages and blurry vision results, leading to the need for glasses. A hyperopic person can’t see well in the distance or up close without glasses or contact lenses.

Astigmatism is a focusing problem of the eye related to the shape of the cornea. A normal cornea is perfectly round like a basketball. With astigmatism, the eye develops with a slightly oval shape like a football. Astigmatism is corrected with glasses or contact lenses. Almost everyone has a small amount of astigmatism. Astigmatism can be treated with LASIK and PRK. The ICL surgery at this time is limited in the ability to correct significant amounts of astigmatism.

There are three main methods of surgically treating refractive error. Since the cornea and lens are the two eye structures that focus the light, they are the main structures commonly treated to improve vision. Laser technology can be used to reshape the cornea (LASIK and PRK), and surgical procedures can be done to replace the existing lens (Refractive lens exchange) or simply insert a new lens (EVO Visian ICL).

Monovision is an option to help people in their 40’s and older to avoid wearing reading glasses. As the eye ages, it loses its ability to focus on items within 18-24 inches. This aging change is called presbyopia. One method to treat presbyopia, monovision, is to use your dominant eye for distance activities (driving, TV) and the other eye for close activities (reading, computer). This is commonly done with contact lenses for people in the mid-40’s and older. If you are in your 40’s and are considering LASIK, PRK, or an ICL implant, monovision may be beneficial for you. If you have not tried monovision, before having a permanent surgery we recommend working with your optometrist in a monovision contact lens trial to make sure you can adjust to it. Benefits of monovision include less need for reading glasses. Some people have difficulty tolerating the different focus between the two eyes and reduced depth perception.

Dr. DeBry often works closely with your optometrist planning your refractive surgery. Your optometrist may help make some of the initial measurements on your eye to achieve an accurate power selection. The optometrist may also see you for some of the post-operative visits. You have the choice to decide which doctors will participate in your pre- and post-operative care. If your optometrist provides some of these services they will be paid accordingly based on the services they provide. We may elect to have you pay separate payments to our clinic and the optometrist. Please see the co-management consent form located later in this book for more information.

What is All-Laser LASIK?

As described previously, LASIK treatments require a thin flap to be made on the cornea. In the past, this flap was created with a very sharp blade called a microkeratome. In a small percentage of people, the microkeratome-created unique problems as the flap were cut with imperfections or centering issues. To lower the risk of irregular flaps a laser was developed for flap creation. This Femtosecond laser cuts tissue with an accuracy of 0.01 mm and makes perfectly circular flaps with a very consistent thickness. The use of all-laser LASIK has made LASIK a safer procedure. It has also added a little more cost to the procedure because now 2 lasers are used instead of one. An interesting side note, the femtosecond laser fires a laser pulse 0.000000000000001 seconds in duration. This rapid burst of energy causes a microscopic explosion in the tissue, breaking bonds.

What is custom LASIK (wavefront-guided LASIK)?

Normal LASIK uses the refraction numbers based on your glasses to create a treatment plan. Studies have shown that vision can be improved and some negative visual symptoms decreased if the laser is programmed to treat higher order aberrations along with the refraction numbers. To achieve this, additional measurements are made on the eyes to measure the individual “fingerprint” of your eye. These measurements are then put into the LASIK excimer computer to provide a custom treatment designed just for you. This may give better results depending on your corneal structure and refraction.

What Happens on the Day of Surgery?

Having eye surgery is a bit like a trip to the dentist. It is a little uncomfortable, takes about 15 minutes to have it done, and has great benefits. It can be scary as some people don’t like things coming up close to their eyes. To help relax you we will provide a prescription for relaxing medication, a sleeping pill commonly used to relax anxious nerves. If you are small in stature and not an anxious person taking ½ of a pill is usually fine. If you have a lot of anxiety or are a bigger person you can take a whole pill or in some cases even more.

During the procedure, you will lie down on a comfortable bed with a firm headrest. Get comfortable, as it is very important to hold still once the procedure starts. The eyelids are cleansed and sticky tape is put around the eyelashes to keep them out. A small wire is used to gently hold open the eyelids. During the treatment, there are several steps…

1

The Femtosecond laser will cut the flap. A suction ring is placed on the eye during this step. It takes only 15 seconds but is a bit uncomfortable due to the pressure from the suction ring. Your vision will fade to black during this time.

2

Next, the flap will be lifted and the corneal tissue prepared for the excimer laser. During this step, your vision will be blurry.

3

The excimer laser treatment is next. This takes between 15 and 45 seconds depending on the degree of correction being treated. There will be a red or green light during this time and it is important that you focus on the colored light to keep the laser treatment centered on the cornea.

4

After the laser, the flap will be irrigated. You will feel some cold water around the eye. Then the flap will be placed back into position and allowed to seal for a few minutes. The wire holding the lids will be removed and the treatment repeated on the other eye.

After the procedure, we encourage you to go home and take a nap. You will be sleepy from the relaxing medication and it is helpful to keep your eyes closed for a few hours to start the healing process. The vision will be a little blurry for the first 24 hours but will improve even more over the next several days as the cornea starts to heal.

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