LASIK

LASIK is short for “laser-assisted in-situ keratomileusis” and is the most common type of laser vision correction.  It involves creating a hinged, partial thickness corneal flap, using a microkeratome blade or a laser, and then gently lifting the flap to expose the underlying corneal tissue.  An excimer laser is then used to reshape the underlying corneal tissue.  The flap is laid back down to act as a natural bandage and the eye is allowed to heal on its own.  LASIK is used to correct near-sightedness, far-sightedness, and astigmatism. 

Custom LASIK

Custom LASIK uses advanced wavefront-guided technology to measure the unique optical characteristics of one’s eye, and uses these specific measurements to help guide the laser correction during the LASIK procedure.  This technology is designed to reduce high-order optical aberrations within one’s eye and improve the visual quality after surgery.  Custom treatment can be done in combination with any form of laser vision correction. 

iLASIK or intraLASIK (all-laser LASIK)

iLASIK refers to a specific type of LASIK that utilizes two separate lasers.  A special femptosecond laser, instead of a microkeratome blade, is used to create the hinged, partial thickness corneal flap at the beginning of the procedure.  A second laser, the excimer laser, is used to sculpt the underlying corneal tissue.  The laser flap can be precisely adjusted to accommodate for special cases where the corneal curvature or thickness may not be suitable for using a standard microkeratome. 

Epi-LASIK (no-cut, no-flap LASIK)

Dr. Ahee and Dr. Barlow are the only surgeons in Southern Utah certified to perform Epi-LASIK.  Epi-LASIK, or “no-cut, no-flap” LASIK, refers to a specific type of laser vision correction surgery. Most of the complications that occur during LASIK surgery involve cutting into the cornea and making a corneal flap with either a blade or laser. With the development of Epi-LASIK, no cutting is needed.  The outer surface layer of the cornea (the epithelium) can be gently lifted and removed with a special device called an epithelial separator, and the underlying tissue can then be sculpted with the excimer laser to correct vision.  This eliminates flap complications.  The epithelium grows back and heals on its own over a few days.  This can be an excellent alternative to patients who have thin corneas and other contraindications for LASIK.

Photorefractive Keratectomy (PRK)

Photorefractive Keratectomy, or PRK, is a specific type of laser vision correction.  It is also referred to surface ablation.  In other words, it does not involve creating a corneal flap.  Instead, only the thin surface layer of the cornea, the epithelium, is removed to expose the underlying tissue.  The epithelium is usually removed by loosening its adhesions with a dilute alcohol solution, then gently brushing it away.  The underlying corneal tissue can then be sculpted with the excimer laser.  The epithelium grows back and heals on its own over a few days.  This can be an excellent alternative to patients who have thin corneas and other contraindications for LASIK.

Conductive Keratoplasty (CK)

Conductive Keratoplasty, or CK, utilizes a special radio-frequency probe to reshape and steepen the corneal curvature.  This is designed to help improve near vision and reduce dependency on reading glasses in patients suffering from presbyopia.  It can also be used to help reduce astigmatism.

Implantable Collamer Lens (ICL)

The ICL is a new intraocular lens that can be implanted into the eye without removing the natural lens. This lens is an excellent choice for younger patients (ideally between ages 21-45) who are not presbyopic (i.e. do not need reading glasses) and need or desire an alternative to laser vision correction surgery. The ICL is implanted through a microscopic incision that requires no stitches and does not alter the natural shape or health of the cornea. It can remain inside the eye indefinitely. If the patient is unhappy with their vision, or if the vision changes significantly, the lens can be removed. 

Refractive Lens Exchange (RLE) refers to the technique by which a patient’s natural lens is removed prior to the development of cataracts, and replaced with an implant lens. This procedure can be done to correct presbyopia— the need for reading glasses (see Crystalens and Restor lens) or in cases where the patient is not a good candidate for laser vision correction surgery. The technique is essentially the same as cataract surgery.

A cataract is a clouding of the natural lens inside the eye. It occurs with aging, and is most common in elderly patients, although it can occur at any age. The most common symptoms include blurred vision, excessive glare or halos around lights, and dimming of vision. Cataract surgery involves removing the cloudy lens and replacing it with a clear implant lens. Our cataract surgeons are leading experts in their field and use the most advanced technologies and techniques to give you the safest and best results.

Recently, there have been great advances in artificial lens technology. The Acrysof IQ Intraocular Lens (IOL) is an example. All currently available artificial lenses filter ultraviolet (UV) light, which is harmful to the retina in the eye. The Acrysof IQ IOL filters both UV light and high-energy blue light. Clinical studies have shown that high-energy blue light causes oxidative damage to the retina and may be a risk factor for developing macular degeneration. The Acysof IQ lens incorporates a patented chromophore that blocks harmful blue light and UV light in much the same way as our natural lens does prior to developing cataracts. The FDA clinical studies showed no adverse side effects on color vision or quality of vision. The Acrysof IQ IOL inserts through a micro-incision that requires no stitches, and it is designed to conform to the natural shape of the lens capsule. This helps it stay stable and centered in the eye. But what makes the Acrysof IQ IOL unique is its ability to filter blue light. The Acrysof IQ (Blue-Blocker) IOL enhances the benefits of advanced cataract surgery by filtering out harmful blue light and, thus providing a replacement lens that protects the retina more like your natural lens.  Additionally, this lens is designed with wavefront-guieded, aspheric optics that help improve contrast sensitivity and overall visual quality.

Restor Lens Implant

The Acrysof Restor lens is a pseudo-accomodative intraocular lens implant that utilizes apodized, diffractive technology to allow patients to see clearly at both distance and near without glasses. This lens can be implanted inside of the eye during cataract surgery or refractive lens exchange surgery. This lens also incorporates advanced “blue-blocker” technology for improved retina protection, and “wavefront-guided, aspheric” technology that improves contrast sensitivity and overall visual quality.

The Crystalens is a unique intraocular lens implant that is designed to accommodate like your natural lens, allowing you to focus between distance and near objects without bifocals or reading glasses. It can be implanted inside the eye during cataract surgery or refractive lens exchange surgery.   With the Crystalens, all of the incoming light is focused at one point that can be adjusted from distance to near using the eye’s natural focusing mechanism.

The Acysof Toric lens implant is a specially designed intraocular lens implant that is used to reduce or eliminate astigmatism during cataract surgery.  Astigmatism refers to corneal curvature that is elongated or flatter in one axis, and shortened or steeper in the opposite axis.  This causes distortion and blurring of images.  With presice measurements and marking of the eye prior to cataract surgery, this lens can be implanted and carefully positioned inside the eye to correct pre-existing astigmatism and improve visual outcomes.  Many patients who choose this technology for their cataract surgery find they don’t need to wear distance glasses after surgery.  This lens also incorporates advanced “blue-blocker” technology for improved retina protection, and “wavefront-guided, aspheric” technology that improves contrast sensitivity and overall visual quality.

Limbal Relaxing Incisions (LRIs)

Limbal Relaxing Incisions, or LRIs, are partial thickness corneal incisions strategically placed to reduce or eliminate pre-existing astigmatism during cataract surgery or refractive lens exchange surgery. Astigmatism refers to corneal curvature that is elongated or flatter in one axis, and shortened or steeper in the opposite axis.  This causes distortion and blurring of images.  With presice measurements and marking of the eye prior to surgery, an incision is fashioned at limbus (the junction between the corneal and sclera) in the axis of steepest curvature, thereby “relaxing” that axis and leaving the corneal in a more round shape.  This helps the patients to see more clearly after surgery and can reduce or eliminate the need for distance glasses. The procedure is virtually painless and can be easily incorporated into the state-of-the-art techniques our surgeons use for cataract surgery and refractive lens exchange surgery.

YAG Laser Capsulotomy

During cataract surgery, the intraocular lens, which has become cloudy, is permanently removed and replaced with an implant lens. Once removed, the cataract can never come back. However, the thin membrane that holds the implant lens in place can eventually become hazy and cause blurry vision. If this occurs, our surgeons can perform a YAG laser capsulotomy to restore your clear vision. The procedure is painless and takes only a few minutes to perform in the office. It involves using a laser to create a small opening in the thin membrane while leaving the implant lens untouched. 

Selective Laser Trabeculoplasty (SLT)

Selective Laser Trabeculoplasty (SLT) is a revolutionary new laser treatment for glaucoma. The Dixie Ophthalmic Specialists at Zion Eye Institute is the first and only office in Southern Utah to have an in-house SLT laser for glaucoma. Unlike previous laser treatments for glaucoma, such as argon laser trabeculoplasty (ALT), the SLT laser does not cause scaring or damage to the drainage structures inside the eye. Clinical studies have shown SLT to be extremely safe, comfortable, and effective for lowering eye pressure associated with glaucoma. Many patients are able to decrease or eliminate the need for glaucoma eye drops after having SLT. The procedure only takes a few minutes to perform in the office and one laser treatment can remain effective for 3-5 years. Because there is no scaring, the treatment can be repeated as necessary.

Ahmed Valve

An Ahmed Valve, or glaucoma drainage valve, is a device that is used to help lower intraocular pressure when maximum medical therapy with eye drops and laser treatment is not enough.  The valve is made of silicone, and consists of a micro-tube connected to a small end-plate or reservoir.  The tube is surgically inserted into the front part of the eye allowing the aqueous fluid from inside the eye to slowly drain through the tube and into the reservoir which is placed on the outside of the eye under the conjunctiva.  The fluid is then naturally absorbed by the surrounding tissue.  The slow drainage of fluid is not harmful to the eye and decreases the internal pressure.  The valve is not visible to the naked eye after surgery.

Trabeculectomy with Mini-Shunt

Trabeculectomy surgery with Mini-Shunt is used to help lower intraocular pressure when maximum medical therapy with eye drops and laser treatment is not enough.  The surgery involves creating a tiny scleral flap superior to the cornea and inserting a microscopic, stainless steel, mini-shunt into the front part of the eye under the scleral flap.  This allows the aqueous fluid from inside the eye to slowly drain through the shunt and form a small bleb, or fluid filled conjunctival cyst.  The bleb is concealed by the upper eyelid.  The slow drainage of fluid is not harmful to the eye and decreases the internal pressure.

Vitrectomy

Vitrectomy surgery involves removing the vitreous gel inside the eye and replacing it with special fluid.  The vitreous gel is located in the back part of the eye where the retina is located.  This highly delicate surgery is necessary to repair retinal problems such as macular puckers, macular holes, vitreal hemorrhages, and some retinal detachments.  Removing the vitreous is not harmful to the eye.

Scleral Buckling

A sclera buckle is a surgical procedure used to repair retinal detachments.  The retina is a thin layer of neural tissue that lines the inside of the eye like wallpaper.  If it detaches from the wall it does not function properly and vision is lost in the area of the detachment.  Scleral buckling surgery involves placing a silicone band around the outside of the eye that pushes the wall of the eye slightly inward, thereby creating counter-force inside the eye that pushes the detached retina back against the inner wall, allowing it to re-attach.  The encircling band remains on the eye but is not visible after the surgery.

Intra-Vitreal Injections For Wet Macular Degeneration

The most recent advances in treatment of wet macular degeneration is the use of anti-angiogenic medications (such as Avastin or Lucnetis) that are injected directly into the back part of the eye where they can reduce or eliminate abnormal bleeding in the retina caused by macular degeneration.  Our fellowship trained retina specialists use the most advanced technologies and techniques to diagnose and treat macular degeneration.  The injections are done by our specialists and take only a few minutes time.  They are virtually painless and can be repeated as needed.

Argon Laser Treatment

There are many different lasers used in ophthalmology.  The argon laser is a special, green-wavelength laser that is often used for retinal therapy.  The laser induces heat energy in the retina and can be precisely focused and adjusted from simply stimulating the retina to reduce swelling, to creating small scars in the retina to cauterize blood vessels or prevent a retinal tear from extending and/or leading to a retinal detachment.  The laser procedure is painless and performed in our state-of-the-art laser facility in our surgery center.

Pterygium

A pterygium is a small growth on the white part of the eye that extends onto the cornea and grows in a triangular shape towards the pupil.  They typically occur on the nasal side of the eye.  These lesions are benign and grow very slowly.  If they cause chronic irritation and redness, or interfere with your vision, then they can be surgically removed.  The surgery involves removing the abnormal conjunctiva and placing a tissue graft over the area where the pterygium was removed. 

Ptosis (Droopy Eyelids)

Ptosis is a condition in which the eyelid is drooping or closing involuntarily.  Ptosis repair can be done for cosmetic purposes, or if the lids droop enough to interfere with vision, the surgery may be covered by medical insurance.  The surgical repair depends on the cause of the ptosis, such as scarring, degeneration, or neural conditions.  Our fellowship-trained specialists will determine the cause and discuss your options with you. 

Dermatochalasis (Blepharoplasty)

Dermatochalsis is a condition in which the skin above the upper eyelid is sagging and interfering with function of the upper eyelid.  It is very common and usually occurs with aging.  The surgical procedure to repair this condition is called Blepharoplasty, and can be done for cosmetic purposes, or if the skin is sagging enough to interfere with vision, it may be covered by medical insurance.   Our fellowship-trained specialists will do a few simple tests to determine if your medical insurance will cover the surgery. 

Ectropion/Entropion

Ectropion refers to the lower eyelid turning outward abnormally, and Entropion refers to the lower eyelid turning inward abnormally.  These abnormal eyelid positions can be caused by several different conditions and usually lead to abnormal tearing, redness and discomfort.  The surgical repair depends on the cause.  Our fellowship-trained specialists will determine the cause and discuss your options with you. 

Conjunctival Chalasis

Conjunctival Chalasis is a condition in which the conjunctiva loses its normal elasticity and no longer adheres well to the underlying sclera.  This leads to redundancy of the conjunctiva which bunches up along the lower lid margin.  Common symptoms include chronic redness, irritation, and tearing that does not respond to medical therapy, such as eye drops.  The abnormal areas of conjunctiva can be surgically removed and replaced with graft tissue to relieve symptoms. 

Strabismus (Crossed Eyes)

Strabismus is a term that describes misalignment of the eyes.  Although this is most common in young children, it can also happen to adults for a variety of reasons, including trauma, neurological and vascular conditions.  In adults, the most common symptom is newly developed double vision.  This can be managed with prismatic eyeglasses or surgically repaired by repositioning the extraocular muscles that control eye movements. 

Dacryo-Cysto-Rhinostomy (DCR)

Dacryo-Cysto-Rhinostomy, or DCR, is a surgical procedure that creates an artificial passage from the nasolacrimal sac into the nasopharynx.  The normal passage of tears goes from the ocular surface through the canaliculi into the nasolacrimal sac, then down the nasolacrimal duct, and out into the nasopharynx.   If any part of this pathway is blocked, it causes chronic, excessive watering of the eye.  The most common blockage occurs in the nasolacrimal duct and DCR surgery is done to relieve this. 

Orbital Reconstruction

The eye and its surrounding structures are very delicate and can sustain significant damage from trauma, especially blunt trauma and lacerations.  Our highly experienced, fellowship-trained specialists have the knowledge and skill to properly repair the damage and preserve as much vision as possible.  If the eyeball cannot be saved, they can replace it with a cosmetically suitable prosthesis.

Chalazion

A chalazion is lesion or bump that occurs on the eyelid.  It is caused by a blockage of the glands within the eyelid.  The blockage causes the glands to swell and this leads to redness, inflammation, and pain.  These lesions often resolve on their own with conservative treatment such as warm compresses or medicated ointment, but sometimes they need to be surgically incised and drained.  Our specialist can examine the lesion and determine the best treatment.