Van’s Eyecare

LASIK is an acronym for laser-assisted in situ keratomileusis, and is commonly referred to simply as laser eye surgery. Lasik is one type of refractive surgery for correcting myopia, hyperopia, and astigmatism.

In Lasik surgery an eye surgeon uses a special laser for the precise and controlled removal of corneal tissue. The procedure reshapes the cornea and permanently changes its focusing power, typically eliminating the need for eyeglasses or contacts.

LASIK Eye Surgery Co-Management combines the best of your Loveland Optometrist and the Ophthalmologist. As a professional partner with the ophthalmologist who performs the surgery, Dr. Van has been trained in all aspects of the procedure. He will ensure that you are well prepared for the surgery and that you understand your surgical options. Additionally he will provide you with all the necessary pre-op exams and preparations, plus any required post-op care for up to 12 months following the surgery.

Cataract surgery is the removal of the natural lens of the eye (also called “crystalline lens”) that has developed an opacification, which is referred to as a cataract. Metabolic changes of the crystalline lens fibers over time lead to the development of the cataract and loss of transparency, causing impairment or loss of vision. Many patients’ first symptoms are strong glare from lights and small light sources at night, along with reduced acuity at low light levels. During cataract surgery, a patient’s cloudy natural lens is removed and replaced with a synthetic lens to restore the lens’s transparency.

Two main types of surgical procedures are in common use throughout the world. The first procedure is phacoemulsification (phaco) and the second involves two different types of extracapsular cataract extraction (ECCE). Phacoemulsification is the most commonly performed cataract procedure in the developed world. However, the high cost of a phacoemulsification machine and of the associated disposable equipment means that ECCE and MSICS (manual small incision cataract surger) remain the most commonly performed procedure in developing countries.
Types of surgery

  • Phacoemulsification (Phaco) is the most common technique used developed countries. It involves the use of a machine with an ultrasonic handpiece equipped with a titanium or steel tip.
  • Manual small incision cataract surgery (MSICS): This technique is an evolution of ECCE (see below) where the entire lens is expressed out of the eye through a self-sealing scleral tunnel wound.
  • Extracapsular cataract extraction (ECCE): Extracapsular cataract extraction involves the removal of almost the entire natural lens while the elastic lens capsule (posterior capsule) is left intact to allow implantation of an intraocular lens.
  • Intracapsular cataract extraction (ICCE) involves the removal of the lens and the surrounding lens capsule in one piece. The procedure has a relatively high rate of complications due to the large incision required and pressure placed on the vitreous body.
  • Cryoextraction is a form of ICCE that freezes the lens with a cryogenic substance such as liquid nitrogen. In this technique, the cataract is extracted through use of a cryoextractor — a cryoprobe whose refrigerated tip adheres to and freezes tissue of the lens, permitting its removal. Although it is now used primarily for the removal of subluxated lenses, it was the favored form of cataract extraction from the late 1960s to the early 1980s

While cataract surgery is one of the safest procedures available with a high rate of success, rare complications can arise. Your ophthalmologist will discuss the specific potential complications of the procedures that are unique to your eye prior to having you sign a consent form. The most common difficulties arising after surgery are persistent inflammation, changes in eye pressure, infection, or swelling of the retina at the back of the eye (cystoid macular edema), and retinal detachment.

If the delicate bag the lens sits in is injured, then the artificial lens may need to be placed in a different location. In some cases, the intraocular lens moves or does not function properly and may need to be repositioned, exchanged, or removed. All of these complications are rare but can lead to significant visual loss; thus, close follow-up is required after surgery. If you have pre-existing macular degeneration or floaters, these will not be made better by cataract surgery.

In some cases, within months to years after surgery, the thin lens capsule may become cloudy, causing blurred vision after cataract surgery. You may have the sensation that the cataract is returning because your vision is becoming blurry again. This process is termed posterior capsular opacification, or a “secondary cataract.”

To restore vision, a laser is used in the office to painlessly create a hole in the cloudy bag. This procedure takes only a few minutes in the office, and vision usually improves rapidly.