Laser Vision Correction is a general term used to describe various surgical methods to reshape the cornea to treat myopia, hyperopia and astigmatism.
Dr. Gualtieri is always involved in every step: initial consultation, pre-surgical testing, the surgery, and post-surgical care.
Call our office today for a LASIK evaluation at 619-688-2648
Laser Vision Correction is an elective procedure and is an alternative to wearing glasses or contact lenses.
There are various types of Laser Vision Correction procedures. Each has its particular benefits depending on the patient's eye health and vision goals.
PRK "Photo-refractive keratectomy"
PRK was the first US laser refractive procedure approved in October 1997 by the FDA to be safe and effective for treating myopia. Approval for treatments for astigmatism and hyperopia followed. PRK procedure uses a “cool” excimer laser light beam to reshape the surface of the cornea in such a way that light rays are refocused properly on the retina thus allowing clear vision. The amount and pattern of treatment depends on the degree of myopia, hyperopia, and or astigmatism.
Prior to any PRK procedure, a careful screening of prospective patients is done. Patients with unreal expectations or certain health conditions of the body or eye are excluded, due to complications and poor results such as diabetes, pregnancy, poor wound healing, connective tissue diseases, glaucoma, and ocular herpes. The acceptable candidate has “healthy eyes” with the exception of needing glasses or contacts to see.
During the pre-treatment work up period, special tests and measurements are performed to collect data used in planning the treatment. These include refraction (glasses power or strength), keratometry (corneal roundness or curvature) and topography (computer corneal surface map).
Once accurate reproducible data is collected, it is compared to information about the patient’s glasses strength from at least one year ago. If measurements are very similar or “stable” then PRK can be safely and confidently done.
The actual PRK procedure takes only a few minutes. It begins when Dr. Gualtieri numbs the eye with eye drops and inserts an eyelid speculum to prevent blinking. The surface epithelial cells are removed with a soft brush to expose the corneal stroma. The laser energy is then applied to the center of the corneal stroma from 30-60 seconds and a new corneal surface shape is made. A clear bandage contact lens is placed on the eye to allow the remaining peripheral epitheliam cells to mulltiply and grow over the treated area. The recovery time for good vision is just a few days. There is minimal discomfort, managed by pain-reducing eye drops. A few office visits are required to check the healing of the surface. Other drops are used for a few weeks to prevent infection and clouding of the cornea.
An alternative to PRK is LASEK (with an "E") discussed below.
LASIK "Laser in-situ keratomileusis"
LASIK combines two well-known and accepted procedures PRK & ALK (automated lamellar keratectomy) to reshape the cornea so that light rays refocus properly on the retina allowing clear vision. LASIK has been FDA approved to correct myopia, hyperopia and astigmatism. The basics of PRK were discussed in the PRK section. The ALK procedure was developed many years ago, and involved using a mechanical device, a “microkeratome” that creates a very precise superficial cut across the cornea producing a thin “cap” of tissue. Modifications of each of these 2 procedures resulted in today’s Modern LASIK procedure.
Prior to any LASIK procedure, a careful screening of prospective patients is done. Patients with unreal expectations or certain health conditions of the body or eye are excluded due to possible complications and poor results. Examples of unfavorable medical conditions are diabetes, pregnancy, poor wound healing, connective tissue diseases, glaucoma, and ocular herpes. The acceptable candidate has “healthy eyes” with the exception of needing glasses or contacts to see.
During the pre-treatment work up period, special tests and measurements are performed to collect data used in planning the treatment. These include refraction (glasses power or strength), keratometry (corneal roundness or curvature) and topography (computer corneal surface map). If a Custom treatment is desired (CustomVue®), an extra Wavescan measurement is made of the eye’s optical system.
Once accurate and reproducible data is collected, it is compared to information about the patient’s glasses strength from at least one year ago. If measurements are very similar or “stable” then LASIK can be safely and confidently done.
The actual LASIK procedure takes only a few minutes to perform and begins (1) when Dr. Gualtieri numbs the eye with drops then places and eyelid opening speculum to prevent blinking. (2) He then applies the microkeratome to the eye with suction. (3) The device slides across the corneal part way to produce a precision cut and the corneal tissue “flap.”. The microkeratome is removed and the flap is pulled back (4)to expose the underlying stromal tissue. The “cool” excimer laser beam energy is applied (5) to the center of the exposed corneal stromal tissue, thus reshaping the cornea.
The flap is replaced (6-8) and a clear bandage contact lens may or may not be applied. Good vision returns within a few hours. There is minimal discomfort, managed by drops. Other drops are used for a week to prevent infection and clouding of the cornea. A few office visits are required to check healing. Dr. Gualtieri has had excellent results with the many patients who have chosen LASIK!
LASEK "Laser assisted epithelial keratectomy"
LASEK is a modification of PRK (photorefractive keratectomy). PRK was the first US laser refractive procedure approved in October 1997 by the FDA to be safe and effective for treating myopia. Later approval for treatments for astigmatism and hyperopia followed. The LASEK procedure uses a “cool” excimer laser light beam to reshape the surface of the cornea in such a way that light rays are refocused properly on the retina thus allowing clear vision. The amount and pattern of treatment depends on the degree of myopia, hyperopia, and or astigmatism.
Prior to any LASEK procedure, a careful screening of prospective patients is done. Patients with unreal expectations or certain health conditions of the body or eye are excluded due to possible complications and poor results. Examples of unfavorable medical conditions are diabetes, pregnancy, poor wound healing, connective tissue diseases, glaucoma, and ocular herpes. The acceptable candidate has “healthy eyes” with the exception of needing glasses or contacts to see.
During the pre-treatment work up period, special tests and measurements are performed to collect data used in planning the treatment. These include refraction (glasses power or strength), keratometry (corneal roundness or curvature) and topography (computer corneal surface map). If a Custom treatment is desired (CustomVue®), an extra Wavescan measurement is made of the eye’s optical system.
Once accurate and reproducible data is collected, it is compared to information about the patient’s glasses strength from at least one year ago. If measurements are very similar or “stable” then LASEK can be safely and confidently done.
The actual LASEK procedure takes only a few minutes. It begins when Dr. Gualtieri numbs the eye with eye drops and inserts an eyelid speculum to prevent blinking. Then he applies a special alcohol solution to the corneal surface to loosen the surface epithelial cells. The cells are slid aside in a solid sheet to expose the corneal stroma. The laser energy is then applied to the center of the corneal stroma from 30-60 seconds and a new corneal surface shape is made. The sheet of cells is moved back into position to cover the treated area. A clear bandage contact lens is placed on the eye while the surface epithelial cells reattach to the treated area. The recovery time for good vision is just a few days. There is minimal discomfort, managed by pain-reducing eye drops. A few office visits are required to check the healing of the surface. Other drops are used for a few weeks to prevent infection and clouding of the cornea.
LASEK is the preferred choice for patients that have thin corneal or other conditions that may make the LASIK procedure unsafe.
CUSTOM LASER VISION CORRECTION BY VISX CUSTOMVUE®
Not every eye is the same. Eyes truley are unique structures and have subtle differences much like fingerprints. Each persons eye processes the same visual information differently. Sometime these differences are "negative" that is they can actually cause vision that is distorted or limited. If these subtle differences are not addressed, the final outcome of a laser vision correction procedure may not be satisfying to the patient. The CustomVue® program can find these subtle differences and correct them during the laser treatment. The discovery process is done by a unique and sophisticate device called the WaveScan® optical analyser. To learn more about CustomeVue® and WaveScan® technology CLICK HERE
i DESIGN by Johnson & Johnson
The new iDESIGN
Refractive Studio provides Dr. Gualtieri with the ability to deliver
one-of-a-kind custom laser vision correction for each patient to have
excellent visual outcomes following their LASIK procedure.
LASIK vision correction surgery is performed in 2 steps. The step 1 requires the production of a thin layer of corneal tissue called a “flap” prior to step 2, which is application of the reshaping laser beam. The “flap” is replaced over the newly reshaped corneal surface. The “flap” size, shape, and thickness are determined by the microkeratome settings and performance. Visual results depend on correct “flap” production.
Traditionally, the flap has been made using a mechanical device called a “microkeratome.” The standard microkeratome uses a very sharp, sterile blade to slide across the cornea to produce the flap. This system works very well. However, sometimes mechanical devices stick, jam, or freeze-up during the “flap” making step resulting in less than perfect results.
IntraLase is a whole new way of making the LASIK flap without using a mechanical microkeratome. The IntraLase system uses a special laser beam to make the same flap, but no blade is involved.
The advantages with IntraLase are that it is safer and more precise. There are no mechanical parts to break or jam. There is no blade that will chip or dull. The actual thickness of the flap can be selected and it is uniform, avoiding thin areas within the flap. This means better results for you!
Dr. Gualtieri is certified on the IntraLase system. In his opinion, the IntraLase step is well worth the small extra cost !
Laser Vision Correction is a general term used to describe various surgical methods to reshape the cornea to treat myopia, hyperopia and astigmatism. 
Prior to any PRK procedure, a careful screening of prospective patients is done. Patients with unreal expectations or certain health conditions of the body or eye are excluded, due to complications and poor results such as diabetes, pregnancy, poor wound healing, connective tissue diseases, glaucoma, and ocular herpes. The acceptable candidate has “healthy eyes” with the exception of needing glasses or contacts to see.
The actual PRK procedure takes only a few minutes. It begins when Dr. Gualtieri numbs the eye with eye drops and inserts an eyelid speculum to prevent blinking. The surface epithelial cells are removed with a soft brush to expose the corneal stroma. The laser energy is then applied to the center of the corneal stroma from 30-60 seconds and a new corneal surface shape is made. A clear bandage contact lens is placed on the eye to allow the remaining peripheral epitheliam cells to mulltiply and grow over the treated area. The recovery time for good vision is just a few days. There is minimal discomfort, managed by pain-reducing eye drops. A few office visits are required to check the healing of the surface. Other drops are used for a few weeks to prevent infection and clouding of the cornea. 
During the pre-treatment work up period, special tests and measurements are performed to collect data used in planning the treatment. These include refraction (glasses power or strength), keratometry (corneal roundness or curvature) and topography (computer corneal surface map). If a Custom treatment is desired (CustomVue®), an extra Wavescan measurement is made of the eye’s optical system.
LASIK vision correction surgery is performed in 2 steps. The step 1 requires the production of a thin layer of corneal tissue called a “flap” prior to step 2, which is application of the reshaping laser beam. The “flap” is replaced over the newly reshaped corneal surface. The “flap” size, shape, and thickness are determined by the microkeratome settings and performance. Visual results depend on correct “flap” production.
