Dallas Non-Laser Vision Correction
VERISYSE LENS
 This is a non-laser treatment using a lens implant very much like a contact lens implanted in the eye behind the cornea to correct for moderate to high amounts of nearsightedness (myopia) and low amounts of farsightedness.
This procedure is for patients who are not laser candidates, who don’t want laser, have thin corneas, deep set eyes or have very strong prescriptions. There is no need to take out the normal crystalline lens in that this is not cataract surgery.
While phakic lenses appear to be efficacious in the correction of farsightedness surgeons are being more selective in these patients due to anatomical considerations of the farsighted eye. The Farsighted eye is smaller than a nearsighted eye and in some cases there isn't enough room for the implant. This for the time being will likely limit the number of farsighted patients who can benefit from Phakic lens implants.
The FDA has approved a limited number of lenses for vision correction. This lens is safe and effective and has been used in Europe for 30 years. Our lens of choice is the VERISYSE lens. The Artesian / Verisyse most recently received FDA approval for distance correction up to -20 diopters of nearsightedness and minimal amounts of farsightedness. Significant amounts of astigmatism are not correctable with phakic lens implantation yet can be corrected with adjunct procedures including laser.
Bifocal phakic lens implantation is under current studies. The Artesian lens is an anterior lens placed in front of the iris. Another lens, the Staar lens is a posterior lens placed behind the iris. In general there is an overall patient satisfaction of 91% with the use of these lens implants. The procedures are reversible. Recent data on the Staar lens reports after 3 years post-op 95% of the patients saw 20/40 or better uncorrected, 59% were 20/20 uncorrected or better. This select group of patients was correctable to 20/20 before the surgery.
What's new for people over 40 with reading problems?
As we get older, the lens inside the eye loses its elasticity and its ability to focus for both near and far. This condition is called Presbyopia. This creates not only a problem in reading but often times some decreased distance vision too. Presbyopia requires the use of glasses for near work and in some cases a separate prescription for distance vision. Bifocal eyeglasses or contact lenses are the treatment of choice in most cases.
The following is some technology that is now available as surgical treatment plans for Presbyopia
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Lens Implants (RL)
 Bifocal Lens Implants: Implanted Lenses that change focusThe first approval for focusing lens implants was in November 2003 to Eyeonics' Crysta Lens. Imagine an implanted lens that changes shape and focuses in the eye for clear distance and near vision. The procedure is the same procedure for the time standard for cataract surgery. The difference is in the lens implant. These lenses have the ability to flex or change shape in the eye and focus for all your viewing distances. In the case of the Crysta Lens there is a flexible haptic at each end that can move slightly front to back creating a focusing effect. For you scientists who ask how, an ultrasound biomicroscope shows that ciliary body contraction in the eye causes a forward motion of the vitreous fluid behind the lens resulting in a forward movement of the lens creating accommodative effect. The amount of accommodation (focusing) of this lens is limited to maximum of + 2.50 diopters. For some people this will be enough to give them reading vision for others it will reduce their dependence on glasses. Other lenses are the AcrySoft ReSTOR lens and the ReZoom lens. These lenses are stable lenses and don’t depend on the ciliary muscle in the eye. Refractive Lensectomy RL corrects nearsightedness or farsightedness by replacing the natural lens in the eye with an artificial lens implant. The lens implant has a calculated power to replace the lens in the eye. Basically this is the same procedure as the tried and proven cataract surgery that has been successfully performed untold times over the past fifty years. In the case of cataract surgery the surgeon takes out a lens that is cloudy and replaces it with a focusing lens implant. RL is also the procedure of choice for patients without cataract who want better vision and our not candidates for Laser Vision surgery due to thin corneas, very high prescriptions, fear of laser surgery, dry eye or deep set eyes. RL can be combined with other refractive procedures like Lasik, PRK, and CK, to enhance the final outcome. As a result of RL ones dependency on glasses can be eliminated or their dependency reduced. People who are candidates for the procedure are those who:
- Need cataract surgery and want to reduce or eliminate their dependence on eyeglasses
- Do not want or may not be a candidate for Laser vision correction
- Have very high refractive errors
- Thin corneas and not a candidate for Lasik / Laser vision surgery
Like any other surgical procedure there are risks. Complications with RL are rare. It is a safe, effective and permanent procedure. After RL you will have reasonably good to excellent distance vision but may need reading glasses for some near tasks. The advent of accommodating lens implants such as the Crystalens, ReZoom Lens and the ReStore Lens is helping to achieve near normal vision with no to minimal dependency on eyeglasses. Moderate amounts of astigmatism may require additional refractive procedures performed after RL.
Orthokeratology / Contact Lenses That Correct Vision
Dr Consor is certified to fit the Paragon CRT lens
Refractive therapy also known as Orthokeratology (Ortho-K) is a non-surgical process that reshapes the cornea (the window of the eye) using a custom designed reverse geometry gas permeable (not soft) contact lens. A reverse geometry design differs from the traditional contact lens design in that the lens is flatter in the center and becomes more curved in the periphery. Customized aspheric curves that match your cornea are applied put on the back of the contact lens. The center of the lens gently applies pressure to the central cornea making it flatter.
The process is painless and by accurately controlling the corneal flattening it's possible to bring the eye in to correct focus and compensate for myopia (nearsightedness) and small amounts of astigmatism. At this point in time orthokeratology will not correct for hyperopia (farsightedness). After removal of the contact lens the cornea retains its flattened shape for most of or all the remainder of the day.
The lens is placed on the eye approximately 30 minutes before bed time and then removed in the morning. In some cases a Day Wear program is prescribed. The patient will wear lenses for part of the day and remove the lens with resulting clear vision for the remainder of the day. As each case is unique depending on the shape of the cornea, the elasticity of the cornea and the patient’s lifestyle needs. In some cases patients wear a retainer lens for one to two days and then go a few days without any correction. Once their vision subjectively changes they put lenses on to re-flatten the cornea.
In most cases results from Ortho-K are experienced after the first day or night of lens wear. Vision in the majority of cases immediately improves. Vision improvement should be noticed each day until the eye stabilizes. Some cases can take from three to six months until vision is functional and stable. Although our goal is free the patient of the need for glasses in some cases glasses may be needed for reading or part time wear. RT / Ortho-K does not work for every one. We will be happy to let you know if you are a candidate.
During the fitting process you will need to return to the office for a series of visits so that we can monitor the results. In many cases it may take more than one pair of lenses to finalize the fit. The case fee you pay will include the contact lens examination, all lens designs and additional pairs of lenses to finalize the fit. Also included are all your follow up visits for six months. Typically the lenses need to be redesigned and changed every 12-18 months to accommodate the flatter cornea and enhance the results. Fresh lenses will also provide the eye with the oxygen that it needs to maintain good ocular health. The shape of the cornea can be easily fine tuned by minor modifications in the lens design. Improvement in vision is temporary; therefore lens wear must be continued on a prescribed wearing schedule to maintain the therapeutic effect. Once you stop wearing these lenses chances are your vision will go back to wherever it would have been if you never wore the OrthoK lens. There is some long tern therapeutic benefit (permanent improvement in vision without lenses) but the results can’t be guaranteed as each person’s corneal anatomy and physiology differs.
Ortho-K for all ages
The principle of flattening the cornea is the same for adults and children. There is a greater potential therapeutic benefit for children in that the earlier a person is fit with the Ortho-K lens the greater the chance of slowing or stopping the progression of their myopia. This may result in no need for glasses or a lesser prescription (thinner lenses) that otherwise might be required by the time they reach the teenage years.
Federal Drug Administration (FDA) approved
The FDA has approved rigid gas permeable contact lenses for overnight Ortho-K wear. Prior to approval the FDA monitored clinical studies for 15 years to evaluate the risk and benefits of the overnight procedure. The procedure is FDA Approved. Daily wear traditional contact lenses are worn all day and extended wear lenses are worn 24 hours a day for consecutive days. Ortho-K overnight lenses are only worn 6-8 hours a night or as a daily wear lens in some cases. For more information on the subject please visit: www.ortho-k.net and www.paragoncrt.com
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