5 REASONS TO CHOOSE LAS VEGAS EYE INSTITUTE FOR LASIK

LASER Vision correction is an amazing procedure and there are many excellent places to get it done. However, we know that when it comes to your eyes that it’s not only normal, but expected, to be nervous about getting this procedure done. We want to put you at ease and let you know what we would look for in a refractive surgery practice.

An experienced and well-trained surgeon. Notice that we didn’t just say experienced. We find that many practices talk about how many “cases” they have done. However, what you really care about is how many they have done right. At Las Vegas Eye Institute Dr. Swanic has been doing LASIK procedures for 10 years since he began his Cornea and Refractive surgery fellowship at UCLA. He is certified to use both the Visx and Wavelight platforms but this does not mean he just did a weekend course (that is actually all it takes to become certified.) He did a year of fellowship training with Rex Hamilton M.D. at UCLA where he not only learned the best techniques to perform the procedure but more importantly the best way to evaluate people BEFORE performing the procedure. At a tertiary care facility like UCLA, that sees patients from all over the world, he was able to see the very rare complications of refractive surgery and learn how to avoid them.
 
Up to date preoperative testing equipment. People sometimes feel our screening for LASIK can be a bit exhaustive, but of course, when something is as important as your eyesight you don’t want shortcuts. All patients at Las Vegas Eye Institute undergo an extensive evaluation of the shape and curvature of their cornea (the structure where LASIK is performed). We no longer use conventional corneal topography as we find it can give variable results that can be hard for even the most experienced surgeon to properly evaluate.
 
We utilize the Cassini system that uses up to 700 multicolored LEDs to detect even the most subtle abnormalities in the way light reflects off of your cornea. We then carefully evaluate the structure of the cornea with our Zeiss Cirrus 6000 OCT that measures the eye at a rate of 100,000 scans a second. It is able to measure the thickness of your cornea at thousands of points in just a fraction of a second. We further evaluate the epithelial thickness of the cornea with this same device to make sure the epithelium (surface layer) is not masking any underlying significant shape changes. Lastly, we utilize the iDesign system to measure your refractive error, the size of your pupils, the centration of your pupils, the topography of the cornea (a second time in addition to the Cassini), and lastly your whole eye’s wavefront which is a detailed map of the way light is bent in your eye.
 
The latest in LASIK technology. LASIK technology has advanced significantly since the excimer LASER was FDA approved in 1995. We are celebrating 25 years of LASIK in the United States this year! This is great because it shows that the procedure is stable and safe, but it highlights that you want to make sure your surgeon has the latest tools to get you the best vision possible. We are proud to offer the latest in Wavefront-guided ablations utilizing the Johnson & Johnson Visx iDesign platform. This device measures your prescription to 1/100th of a diopter. It also utilizes over 1250 data points to provide our excimer laser with a sophisticated wavefront-guided plan to treat the most subtle abnormalities of your eye.

Prior to performing this wavefront-guided ablation we utilize the exquisitely precise Zeiss Visumax femtosecond laser to create your LASIK flap. The Visumax laser utilizes low energy pulses fired at 500,000 times per second to create a flap of any size and depth that Dr. Swanic chooses. If you have a thin cornea and we need a flap as thin as 80 microns (a human hair is 75 microns thick) we can deliver this result with remarkable precision.

The advantage our patients notice though is its comfort. The Visumax is low suction which means that your vision will not blackout at any point during your procedure and you are very unlikely to be left with unsightly red spots. Dr. Swanic loves this feature as he has gone through many different flap creation platforms in his career and none have been this comfortable or this gentle on the eye.

Evaluation by your surgeon BEFORE and AFTER your treatment. Dr. Swanic takes great pride in his outcomes and that means that even with the best technologies he wants to double-check all of his preoperative and postoperative data personally. He will be seeing you for your LASIK consultation, he will perform your procedure, and he will see you after your procedure. You will likely find this very different than most practices. You may pay slightly more for this luxury but we think it’s valuable to have access to a surgeon with extensive knowledge and experience in refractive surgery.
 
A surgeon who has had the procedure performed on his own eyes. It’s not great when you walk into your refractive surgery evaluation and see your doctor wearing glasses. You will notice that Dr. Swanic doesn’t wear glasses and that is because he had Laser Vision Correction performed on his eyes 10 years ago and still enjoys 20/20 vision. This means that he knows what its like to have this done not only because he has performed it countless times but because he has gone through it himself. He believes strongly in refractive surgery and loves giving his patients the gift of clear vision that he enjoys every day.

WHAT DOES MY LASIK COST INCLUDE AT LAS VEGAS EYE INSTITUTE?

When selecting a LASIK provider, it is important to understand what your LASIK cost includes. Some providers advertise for a low initial cost, only to charge more for “add-ons” which result in a much higher cost of LASIK than the price that was initially quoted. At Las Vegas Eye Institute we do not have a multiple tiered pricing programs like you may find at other LASIK providers. This means that whether you opt for PRK or LASIK or need some mild dry eye treatment after your procedure, you will not incur any additional costs for any necessary post-operative treatments. At Las Vegas Eye Institute, we strive to provide a premium LASIK experience which includes transparency in pricing. We do not want people to find out after the fact that any additional services they may need to get the optimal visual results are not included in the price they paid. At Las Vegas Eye Institute, our standard LASIK price for all patients includes:

Wavefront Guided Excimer LASER treatment utilizing the Visx iDesign 2.0 Topography integrated treatment algorithm (also known as Custom LASIK)
Femtosecond LASER flap creation with the Zeiss Visumax 500 kHz platform
Enhancements of all procedures (Wavefront Guided if appropriate) for the first 2 years if needed (generally enhancements are not needed due to high accuracy of the iDesign 2.0 platform)
PRK Procedures with advanced alcohol assisted epithelium removal and MMC placement
Punctal plug placement if indicated (permanent or 3 month or 6 month dissolvable) to alleviate temporary eye dryness
At Las Vegas Eye Institute, Custom LASIK is included with each LASIK procedure at no additional cost.  With Custom LASIK, specific data points unique to your eyes are taken into consideration when planning your LASIK procedure.  Small abnormalities in your eyes are measured with the advanced technological device called the iDesign 2.0. The iDesign 2.0 was FDA approved in 2018 and can capture over 1,200 data points to design your LASIK treatment while older technology can only capture about 250.  With this device, treatments are customized to patients individual eyes and provide better visual results than that offered by older technology.

You will notice that at Las Vegas Eye Institue, Dr. Swanic does not offer LASIK procedures that are performed with a blade (known as a microkeratome).  Although the microkeratome is an excellent device that Dr. Swanic previously utilized, he feels that with recent advances in technology, the new Visumax femtosecond platform which is a bladeless, all-laser platform, provides for a significant improvement in the safety of LASIK.  The Visumax platform, in particular, is also remarkable in that the flap thickness can be programmed to any depth that Dr. Swanic customizes for your case and it is accurate to a 3-micron standard deviation. This means that most flaps should be within 3 microns of target and nearly all flaps should be within 10 microns of target.  To give you a frame of reference one strand of human hair is 75 microns in thickness. The accuracy of modern all-laser LASIK is truly marvelous.

Some patients may experience a temporary period of eye dryness that can make vision initially slightly less clear than targeted or provide mild discomfort in the weeks following the LASIK procedure.  The good news is that at Las Vegas Eye Institute, we treat your case according to your individual needs and provide punctal occlusion at no additional cost if we find that it may be helpful after the procedure.  Prior to Dr. Swanic starting his own ophthalmology practice in 2013, he worked at other ophthalmology practices where patients are told to pay for punctal occlusion at the time they sign up for their LASIK procedure as an add-on to the initial LASIK cost.  We do not do this at Las Vegas Eye Institute because this is not necessary for many patients and it is not easy to predict prior to the LASIK procedure who will need this service. Regardless, patients of Las Vegas Eye Institute can rest assured that punctal occlusion, if necessary, is an included portion of your procedure. Some patients may benefit from very short-acting plugs that dissolve in 3 months or 6 months.  These are simple to place and you will not feel them at all. Dr. Swanic also utilizes permanent plugs that are made of silicone, but we don’t use them often for our LASIK patients. The reason is that the dryness of LASIK is temporary and is usually fully resolved by 6 months. Also, permanent plugs can be felt by a small percentage of patients after placement for about the first week, so we would prefer to only use them for patients that really need them.  

Our treatments all include 2 years of LASIK enhancements if needed.  Fortunately, with the new Visx iDesign 2.0 platform our current enhancement rate is well under 5%.  Again we feel asking patients to pay for some form of “assurance” enhancement package doesn’t make sense because the vast majority of patients will never need it.  Ultimately, when choosing the right doctor to perform your LASIK surgery, finding the right surgeon is more important than price. Dr. Swanic completed his ophthalmology residency at Tufts, his refractive surgery fellowship at UCLA and is dedicated to providing the highest and most technologically advanced level of care to all his patients.

AM I A CANDIDATE FOR LASIK OR REFRACTIVE SURGERY?

This is a common reason for consultations at Las Vegas Eye Institute.  Here we attempt to discuss some of the key elements of a thorough examination for refractive surgery.  Some of the things that we evaluate at our office you may already know, such as your glasses or contact lens prescription.  However, you may not be aware of conditions like irregular corneal shape or subtle eye dryness. An evaluation at Las Vegas Eye Institute is the best way to find out about your LASIK candidacy.

What is your Refractive Error?
This is the most important question for helping to determine if you are a candidate for LASIK.  The good news is that with modern LASER Vision correction technologies most patients presenting for refractive screening will be candidates for refractive surgery.  At Las Vegas Eye institute the Visx iDesign 2.0 system is FDA approved for correction of myopia (nearsightedness), astigmatism, and hyperopia (farsightedness.)

The above video is a great primer on astigmatism and how it is treated.
Our Visx iDesign Laser is FDA approved for treatments up to 12D of nearsightedness; however, due to restraints on how much tissue we can safely remove, most surgeons will limit LASIK to corrections of -8.00 to -9.00 diopters.  Our laser is approved to also correct up to 5 diopters of astigmatism when using its iDesign Wavefront guidance and as long as we feel that you are an appropriate candidate we can attempt to correct that full amount. Lastly, for people that are farsighted the Wavefront Guidance program allows corrections up to +4.00 diopters, but we generally try to limit our corrections to patients with +3.00 diopters or less.  The reason for this is that Dr. Swanic has found with most LASER platforms, even including our advanced iDesign 2.0 system, it is difficult to successfully correct over +3.00 diopters and have it remain stable long term. We have had patients get excellent correction of +4.00 or even +5.00 diopters of farsightedness, but unfortunately we have seen it regress back to about +3.00 diopters over the first few years after original treatment.

The above video helps explain the condition of Hyperopia or Farsightedness.
Have you ever been told that you have any eye diseases?
One of the things that LASIK consults focus on is the detection of eye diseases that you may not even be aware that you have.  The one that we focus most heavily on is Keratoconus. Our testing is focused on making sure that you don’t have keratoconus or a predisposition to developing keratoconus (this is referred to as forme fruste keratoconus.)  People with Forme Fruste Keratoconus should not undergo LASIK eye surgery because it can lead to a condition called corneal ectasia.
The above video gives more information on the disease Keratoconus.

Subtle abnormalities of the eye can be detected by one of our advanced diagnostic devices.  We actually use 2 different corneal topographic devices at Las Vegas Eye Institute for this purpose. The first is the infrared topography built into the iDesign 2.0 platform.  Although you can’t see them, hundreds of infrared lights are reflected off of your cornea and create a precise map of your eye. This map is later used during your LASIK treatment to improve its accuracy but we also use this data to evaluate the shape of your eye for any subtle disease.  Next, we use the Cassini topographer to which uses 679 multicolored LEDs to create a GPS like map of your corneal shape. This gives us incredible corneal detail to detect even the subtlest of disease.
Starting in November of 2019 we are excited to be adding epithelial thickness mapping with the Zeiss Cirrus 6000 OCT. Optical Coherence Tomography (OCT) is amazing Laser technology that scans your eye at 100,000 times per second to create a detailed map of your cornea.  We have been using OCT technology for years at Las Vegas Eye Institute for corneal analysis prior to LASIK but we are proud to add detailed analysis of the corneal epithelium (the 50 micron surface layer of the eye). Studies have shown that subtle findings of early Keratoconus can be masked by our epithelium but with this technology we now have the capability to spot them wear other devices would have missed them.  We are proud to be on the cutting edge at Las Vegas Eye Institute, all of this technology comes at a cost, but we are confident that you will agree that your vision is priceless.
Have you been told that you have dry eye?  Do you have trouble wearing contact lenses?

Contacts can be rough on the eyes, especially in the dry Las Vegas heat.  The good news is that even if your contacts bother your eyes this often does not mean that you have dry eye that would prevent you from undergoing LASIK or PRK.  Dr. Swanic used to have extreme difficulty wearing contacts. In fact, he only wore glasses for the two years leading up to his PRK procedure because his eyes would turn very red after just two hours of contact lens wear.  Fortunately, his eyes were carefully evaluated for signs of dryness (none were found) and the decision was made to proceed with PRK.  

People with severe dry eye should not undergo LASIK as this is likely to make their dryness worse, maybe not permanently, but possibly for several months to a year.  At Las Vegas Eye Institute all LASIK patients are evaluated for dryness preoperatively. If signs of dryness are found we will attempt to address them preoperatively. If we cannot get them under control adequate control then we will regretfully recommend avoiding Laser vision correction.  For patients over the age of 40 they may still be a good candidate for Refractive Lens Exchange which is discussed elsewhere on our website.
I have more questions. How can I learn more?

We have lots of great information on our website covering LASIK, Cataract Surgery, and other treatment options on our website, but truly the best way to get your Laser vision correction questions answered is to come in for a complimentary LASIK screening exam.
 
By: Matthew Swanic M.D.
Cornea and Refractive Fellowship Trained Surgeon
Las Vegas Eye Institute

Contact Details:
Las Vegas Eye Institute
9555 S Eastern Ave #260, Las Vegas, NV 89123
Phone: (702) 816-2525
Website: https://lasvegaseyeinstitute.com/
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