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LASIK Laser Eye Surgery Frequently Asked Questions
Provided by Dr. William Gonzalez


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Cataract Surgery


About Cataracts

A cataract is a cloudy area in the lens in the front of the eye, which is normally clear. There is no pain associated with the condition but there are other symptoms, including:
  • Blurred/hazy vision
  • Spots in front of the eye(s)
  • Sensitivity to glare
  • A feeling of "film" over the eye(s)

Risk factors for developing cataracts include being over 55 years old, eye injury or disease, a family history of cataracts, smoking or use of certain medications.

For people who are significantly affected by cataracts, lens replacement surgery may be recommended. During cataract replacement, the most common surgical procedure in the country, the lens is removed and replaced with an artificial one called an intraocular lens or IOL.

Cataract Surgery

We perform a minimally invasive, no-stitch cataract surgery called phacoemulsification ("phaco") surgery. First, the eye is numbed with anesthetic eyedrops. Then a tiny incision is made in the eye to make room for a small ultrasonic probe. This probe breaks up, or emulsifies, the cloudy lens into tiny pieces.

After the cloudy lens has been removed, a new artificial lens is implanted in the eye. With the recent advance of foldable IOLs (intraocular lenses), artificial lenses can be implanted through the same small incision from the phaco procedure. The doctors at Capital Eye have been pioneers in the development of techniques and equipment that have resulted in the increased safety and comfort of the procedure. We are always evaluating new technology and adopting techniques that will improve our outcomes and benefit our patients.


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Lasik Surgery


Many people who are tired of wearing glasses or contact lenses seek the help of refractive surgeons. Refractive surgery improves vision by correcting refractive errors such as nearsightedness (myopia), farsightedness (hyperopia) and astigmatism. A high percentage of patients enjoy 20/20 vision or better after their procedure.

Common refractive procedures include LASIK, PRK, LASEK, refractive lensectomy (clear lens replacement or CLR), INTACS, CK, AK and ICL.

LASIK stands for laser-assisted in-situ keratomileusis. During the procedure, a thin flap is created on the cornea using a microkeratome or a femtosecond laser. This flap is then lifted, and an excimer laser reshapes corneal tissue to alter the way light enters the eye. The flap is then replaced. The entire procedure takes only 15-30 minutes per eye. Recovery time is also short, and improvement in vision can be seen within a day. Vision often continues to improve and stabilize for a few weeks.


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Glaucoma


Glaucoma is a leading cause of blindness in the U.S. It occurs when the pressure inside the eye rises, damaging the optic nerve and causing vision loss. The condition often develops over many years without causing pain or other noticeable symptoms-so you may not experience vision loss until the disease has progressed.

Symptoms that you could be developing glaucoma include blurred vision, loss of peripheral vision, halo effects around lights, and painful or reddened eyes. People at high risk include those who are over the age of 40, diabetic, near-sighted, African-American, or who have a family history of glaucoma.

To detect glaucoma, your physician will test your visual acuity and visual field as well as the pressure in your eye. Regular eye exams help to monitor the changes in your eyesight and to determine whether you may develop glaucoma.

Once diagnosed, glaucoma can be controlled. Treatments to lower pressure in the eye include non-surgical methods such as prescription eye drops and medications, laser therapy, and surgery.
Glaucoma Surgery

Some cases of glaucoma can be treated with medications. For others, laser or traditional surgery is required to lower eye pressure. Common surgeries include:
  • Laser Peripheral Iridotomy (LPI)-For patients with narrow-angle glaucoma. A small hole is made in the iris to increase the angle between the iris and cornea and encourage fluid drainage.
  • Argon Laser Trabeculoplasty (ALT) and Selective Laser Trabeculoplasty (SLT)-For patients with primary open angle glaucoma (POAG). The trabecular passages are opened to increase fluid drainage. ALT is effective in about 75% of patients, and SLT may be repeated.
  • Nd:YAG Laser Cyclophotocoagulation (YAG CP)-For patients with severe glaucoma damage who have not been helped with other surgeries. The ciliary body that produces intraocular fluid is destroyed.
  • Filtering Microsurgery (Trabeculectomy)-For patients who have not been helped with laser surgery or medications. A new drainage passage is created by cutting a small hole in the sclera (the white part of the eye) and creating a collection pouch between the sclera and conjunctiva (the outer covering of the eye).
  • Tube Shunt Surgery-May be recommended for patients with neovascular glaucoma, failed trabeculectomy, or susceptibility to developing scar tissue. A thin, flexible tube (a shunt) with a silicone pouch is inserted in the eye to facilitate drainage.



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Retinal Diseases


The retina is a thin sheet of nerve tissue in the back of the eye where light rays are focused and transmitted to the brain. The vitreous is a gel-like substance that fills the eye and is connected to the retina, optic nerve and many blood vessels. Problems with the retina and vitreous -- including retinal tear and detachment, macular degeneration, diabetic retinopathy, infection and trauma -- can lead to vision loss and blindness. Early detection and treatment are critical in correcting problems before vision is lost or preventing further deterioration from occurring.

Diabetic Retinopathy

Diabetic retinopathy is a complication of diabetes that weakens the blood vessels that supply nourishment to the retina (the light-sensitive lining in the back of the eye where vision is focused). These weak vessels can leak, swell or develop thin branches, causing a loss of vision. In its advanced stages, the disease can cause blurred or cloudy vision, floaters and blind spots-and, eventually, blindness. This damage is irreversible.

Fortunately, diabetic retinopathy is preventable. People with diabetes are most susceptible to developing it, but your risk is reduced if you follow your prescribed diet and medications, exercise regularly, control your blood pressure, and avoid alcohol and cigarettes. Regular eye exams are an integral part of making sure your eyes are healthy.

Although damage caused by diabetic retinopathy cannot be corrected, patients diagnosed with the condition can be treated to slow its progression and prevent further vision loss. Treatment modalities include laser and surgical procedures.

Macular Degeneration

The macula is a part of the retina in the back of the eye that ensures that our central vision is clear and sharp. Macular degeneration causes a progressive loss of vision. It is the number-one cause of blindness in the U.S.

There are two kinds of macular degeneration: "wet" and "dry." The "wet" form can be treated in its early stages. Regular eye exams are highly recommended to detect macular degeneration early and prevent permanent vision loss.

Symptoms often associated with macular degeneration include:
  • A gradual loss of ability to see objects clearly
  • A gradual loss of color vision
  • Distorted vision
  • A dark or empty area appearing in the center of vision

Retinal Tear and Retinal Detachment

The vitreous is a clear liquid that fills our eyes and gives them shape. When we are young, the vitreous has a thick, gelatinous consistency and is firmly attached to the retina. As we age, the vitreous thins and separates from the retina. Although this usually results in nothing more than a few harmless floaters, tension from the detached vitreous can sometimes tear the retina.

If liquid seeps through the tear and collects behind the retina or between its nerve layers, the retinal tear can become a retinal detachment. Retinal detachment can cause significant, permanent vision loss and requires immediate medical treatment.

There are three kinds of retinal detachment. The most common form, described above, occurs when fluid leaks into the retina; people who are nearsighted or who have had an injury or eye surgery are most susceptible. Less frequently, friction between the retina and vitreous or scar tissue pulls the retina loose, something that occurs most often in patients with diabetes. Third, disease-related swelling or bleeding under the retina can push it away from the eye wall.

Signs of retinal tear or detachment include flashes of light, a group or web of floaters, wavy or watery vision, a sense that there is a veil or curtain obstructing vision, or a sudden drop in vision quality. If you experience any of these symptoms, call your doctor immediately. Early treatment is essential to preserve your vision.


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William L. Gonzalez, M.D.
Capital Eye Physicians & Surgeons LLC

Office Address:

4000 Mitchellville Rd.
Suite B-128
Bowie, MD 20716
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