Dr. Miller is a board certified eye surgeon who performs hundreds of vision correction procedures each year. While at Northwestern University, he was involved with the physicians who led the early FDA trials on the VISX excimer laser. In 1993, the FDA approved the VISX laser for laser vision correction. His commitment to leading technologies continues today. The Laser Vision Correction Center of New Jersey employs the most advanced technology available to help ensure maximum safety and visual results for patients. The practice has been listed in Castle Connolly's "How to Find the Best Doctors in the New York Metro Area" every year since 1997, and He was selected as one of "America's Top Ophthalmologists."
We use the FDA-approved, Star S4 CustomVue excimer laser from VISX, the pioneer in excimer laser technology. The VISX laser employs wavefront technology for highly accurate and customized mapping of the cornea. It also incorporates an active tracking system ("Active Trak") to ensure synchronous tracking of your eye movements during surgery for accurate laser application. In addition, the VISX Star S4 laser has Variable Spot Scanning (VSS), which allows larger ablation zones with minimal increase in ablation depth, thereby increasing the safety of the treatment. The VISX CustomVue system produces the smoothest corneal ablations of any current system and remarkable, customized vision results for patients.
For creation of the corneal flap, we use the FemtoSecond (FS) laser, better known as IntraLase, the latest, blade-free technology available. The FS laser replaces the microkeratome (mechanical blade) previously used for flap creation. This new laser creates a precision flap in just 15 seconds and eliminates any risks imposed from the microkeratome. Less trauma to the eye and more precision accuracy affords better visual outcomes for our patients.
Candidates for laser eye surgery must have had a stable eyeglass prescription for at least a year. If you have an unstable eyeglass prescription (more than 0.50 diopter change within one year), then you are not a good candidate for vision correction. Additionally, if you have keratoconus (a steepening of the cornea) or another active eye disease, uncontrolled diabetes, or are pregnant or nursing, you will not be a good candidate.
LASIK is the most popular form of laser vision correction today, with millions of procedures performed worldwide every year. The surgery is a two-step process in which a thin, protective flap is first created with the FS laser in the outer layer of the cornea. The excimer laser then gently reshapes the underlying corneal tissue, allowing the cornea to correctly focus light on the back of the retina. Once the excimer laser has finished reshaping the corneal tissue, the outer flap is replaced in its original position, where it easily bonds with the surrounding tissue. The creation of the corneal flap in LASIK results in fast post-operative healing times and minimal discomfort following surgery.
Generally speaking, patients experience no pain during the LASIK procedure and minimal discomfort afterward. We will anesthetize the eyes prior to surgery with numbing drops. Post-operatively, patients may experience red, scratchy eyes. This feeling generally fades within 24 hours. Your eyes may feel more dry than usual for the first week to a month after the procedure; however, all patients are evaluated for dry eyes pre-operatively. Oral nutritional supplements to enhance the tear film, prescription drops called Restasis, which increase tear production and the insertion of punctal plugs to help your eyes retain moisture, are all available to you and effective in helping to decrease the amount of dry eye before or after surgery.
All-laser LASIK refers to a new technology that has replaced the microkeratome (mechanical blade) used during the first step of the LASIK procedure. Intralase has developed a new laser called the FemtoSecond or FS laser, which is capable of targeting very precise depths and locations within the outer corneal layer, resulting in a more accurate creation of the corneal flap. Less trauma (without a blade) and improved accuracy affords a quicker recovery time and better visual outcome. IntraLase is now the preferred first step in laser vision correction.
Custom LASIK is the newest advance in laser vision correction. It makes use of wavefront technology, originally developed for use by astronomers, to customize your laser vision treatment specifically to your eyes. With wavefront technology, ophthalmologists are able to measure the unique aberrations present in each person’s eyes and then create a customized, three-dimensional corneal map. This mapping allows for greater accuracy in determining your candidacy for LASIK as well as for precise application of the excimer laser during the procedure itself. With Custom LASIK, your laser vision correction will be truly customized to your unique eyes. we may use the Prevue Lens prior to the procedure to show his patients the benefits of Custom LASIK as compared with standard LASIK.
We offer our patients the option of previewing their potential new vision through the PreVue Lens from VISX. To do this, he uses your personalized wavescan measurement to reshape a plastic lens with the excimer laser. This lens, customized with your own unique vision correction, is then placed within a trial frame for you to look through. While the PreVue Lens cannot predict your end visual results, it does offer both an excellent guideline for what is possible with Custom LASIK and a good basis for doctor-patient communication.
Monovision is a treatment often considered by those patients in mid-life or older. These patients have already lost most of the eye’s natural ability to focus on objects at close range (presbyopia), but would still like to be free from glasses or contacts. Monovision offers this option. During laser vision correction for monovision, we will correct one eye for near focus and the other eye for distance. He has patients try out monovision with contact lenses first to find out if this treatment is the best option for them.
We can use Custom LASIK correction on the distance eye. This level of treatment, however, is not approved for the near vision eye, for which Dr. Miller uses standard LASIK.
As with any surgical procedure, LASIK does have certain risks, and patients should be fully aware of possible complications before deciding to have laser vision correction. The incidence of these complications, however, is low and most are medically manageable.
The most common complications following LASIK are associated with either the laser reshaping of the corneal tissue or with the flap. Over-correction, under-correction, or loss of best-corrected vision are possible complications from laser reshaping, as are night vision problems such as glare and halos. These complications occur in only a small percentage of patients, are usually medically manageable, and can be greatly minimized by the use of nomograms and Custom LASIK wavefront mapping.
Infrequent complications associated with the flap include a thin, short, displaced or wrinkled flap. To significantly reduce these risks, we recommend an ALL-Laser procedure, utilizing the latest technology with the FS (FemtoSecond) laser to create the flap. This revolutionary, new laser is now the preferred first step in laser vision correction. In addition, we educate patients as to the importance of post-operative care.
Understanding the risks associated with LASIK is an important part of a patient’s research when deciding on laser vision correction. we would be happy to discuss both the risks and benefits of LASIK eye surgery with you in further detail.