New York Ophthalmologists

Do You Recommend ICL or PRK For Thin Corneas?

I am 28, have a prescription of -3.0 (right) and -2.0 (left) and a central corneal thickness of 470 in both eyes which I understand too thin for Lasik. I have been to two separate eye clinics and one advises PRK and one ICL. The surgeon recommending ICL says they believe my corneas are too thin even for PRK and that ICL would be much safer. ICL does sound like the more pleasant option but is twice the price! Any advice?

i will explain the math and then the real answer will be obvious to everyone

it is unsafe to do anything if your initial corneal thickness is below 450, because then you may have KC

assuming your thickness is 455, to fix -3 about 35 microns of cornea would need to be lasered off

if you chose hi-def, then you would need about 55 microns removed, so you would be left with 400

the minimum safe thickness is 250, or else you would increase the chance of getting KC

a LASIK flap can be as thick as 150 microns, so you can see that 400-150 = 250 which is the safe limit

therefore, you cannot get LASIK

PRK is an outdated procedure that i did myself but stopped doing in 1999

LASEK is the Advanced Surface Ablation that has replaced PRK

based on this math, it is obvious that LASEK is the choice for you, provided my assumptions are correct

an ICL involves cutting into your eye and putting a piece of plastic in it behind the iris

very few surgeons would recommend an ICL for your low Rx, given the risk/benefit ratio

i think that clearly, an ASA is the safest option for you in this case

Emil Chynn, MD

New York Ophthalmologist

Tear Pump Failure After Upper Eyelid Blepharoplasty, What Should I do?

I have a problem with watering eyes following upper eyelid blepharoplasty ( now 6 months after ), especially when outside with breezes of wind. I am sure it's not connected to blocked tear ducts etc as it affects both eyes and started directly after the surgery. I have looked on the internet but all the cases I have found seem to be connected with lower lids ? When I mentioned the watering eyes to the surgeon he dismissed it as not being connected to the surgery ?

Tearing is a common problem after blepharoplasty surgery. In most cases of upper eyelid surgery it is due to the eyelids not closing completely which can cause or worsen a dry eye problem. Although this doesn't always make sense to patients, a dry eye can actually cause the eye to create excessive tear production. It is not common for upper eyelid surgery to cause to tear duct issues.

I recommend that you see an Ophthalmologist or an Oculoplastic Surgeon to evaluate and treat your problem.

David Schlessinger, MD

New York Oculoplastic Surgeon

Is PRK Recovery Longer for Those with Nystagmus?

I've been approved for PRK surgery, my doctor sent me to the eye center for additional testing to make sure the laser could track my eyes because of the movement. My question is, will my recovery time be longer because of the constant movement of my eyes? It's imperative that I be able to drive and be able to work on the computer the week after the surgery.

I've done Lasek on a bunch of patients with nystagmus successfully you should avoid LASIK or IntraLase as cutting a flap is risky since your eye is never still. The VISX laser tracks at 60 Hz ie 60 times per second. No nystagmus is more rapid than that my concern is it sounds like your doctor is an open access doctor who is renting the laser so needs someone else to answer this question who knows the laser more intimately your case is very challenging id go to a surgeon who owns his own laseris doing 1,000 cases each year and has treated patients before w nystagmus lasek is the advanced form of PRK btw hope this helps

Emil Chynn, MD

New York Ophthalmologist