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National LASIK Expert Clarifies Ever Evolving and
Complex Field of Laser Surgery

Vadim Filatov, M.D., Helps Eliminate Consumer Confusion

GREENWICH, Conn. —Since its inception in 1996, LASIK has been the procedure of choice to correct farsightedness, nearsightedness, and astigmatism and until a few years ago, a generally standardized procedure offering relatively few options. Today, while a more evolved field of refractive surgery offers increased benefits, there is an increased difficulty for patients and doctors alike to comprehend this complex field. In a continuing effort to educate consumers, Vadim Filatov, M.D., clarifies the latest advancements in laser vision correction and what these new benefits mean to each individual.

“The ‘original’ LASIK could only be performed with two lasers and worked solely to correct nearsightedness,” says Dr. Filatov. “Over the past six years, there have been significant advancements in refractive surgery, making it safer and more effective. Advanced LASIK brings a proliferation of laser and microkeratome technology and a more customized approach to the treatment of patients. The scope of the procedure has changed allowing laser surgery to be performed on a wider range of refractive errors including hyperopia and astigmatism. An increase in the effectiveness of the procedure offers the welcomed reduction in the rate of complications and side effects.”

According to Dr. Filatov, a variety of instruments are now utilized in a myriad of procedures specifically tailored to the individual needs of each patient. The major task for potential candidates is to make certain that their needs are met with an individual treatment plan that’s suited to provide them with the best possible outcome.

Dr. Filatov continues to be one of the first refractive surgeons to evaluate and implement the most advanced techniques in refractive surgery. Trained at Yale, Harvard, and Johns Hopkins Medical School, he founded the Filatov Eye Institute in 2001 as a center for research and education. Through the Institute, Dr. Filatov devotes resources to teaching, informative seminars, a full-time LASIK fellowship program to heighten the standard of laser vision correction training across the country, and various community related activities. Each patient of the Filatov Eye Institute is given guidance and instruction prior to surgery concerning their customized treatment plan as well as several alternatives available for their unique situation.

Laser vision correction is often equated with LASIK, although the practice of refractive surgery is not limited to LASIK, Dr. Filatov notes. In fact, several procedures exist today that should be considered for each prospective patient. These include the original laser vision correction procedure called PRK as well as a newly modified PRK technique known as LASEK.

“The practice of LASIK has changed,” says Dr. Filatov. “In the past, the initial step in LASIK, the creation of the flap was performed with a device known as a microkeratome which used a steel blade to cut the flap. Now, the flap can be created without cutting the cornea with a metal blade. Instead, it is created with the aid of a new laser, thereby making LASIK an all-laser procedure. It is safer and can be performed in a more sterile fashion than the original and even advanced LASIK procedures.”

Dr. Filatov first performed the procedure a year and a half ago in Mexico and, therefore, is one of the first doctors in the United States to have gained the experience with all-laser LASIK. Filatov Eye Institute is the first practice in Connecticut and New England and only second in the New York metropolitan area to offer this advanced technology to the community.

Dr. Filatov outlines key points about the other laser vision correction options below. All laser vision correction procedures treat myopia (nearsightedness) and hyperopia (farsightedness) with or without astigmatism. Presbyopia correction may also be performed by each of the discussed procedures by leaving one eye slightly nearsighted for near vision—a technique known as monovision.

LASIK
  • FDA approved to treat farsightedness, nearsightedness, and astigmatism
  • LASIK consists of two steps:
    First, the surgeon uses an instrument called a microkeratome to make a flap in the cornea, a front part of the eye. Then, the flap is folded back and a cool laser beam changes the curvature of the tissues underneath by resculpting the underlying stroma. Once the flap is repositioned it seals back and begins to heal immediately.
  • Visual recovery is extremely rapid. Most patients see their vision improve immediately and are able to drive the next day without glasses or contact lenses.
PRK
  • FDA approved to treat myopia and hyperopia.
  • PRK uses a laser to sculpt the superficial stromal layer of the cornea after the removal of the most superficial corneal tissue, the epithelium. This contrasts with LASIK, which sculpts the deeper surface under the protective flap.
  • After the procedure, soft contact lenses are placed over the eye to help epithelial cells grow back in a more expedient and comfortable fashion. It usually takes 2-3 days for epithelium to regrow. During that period, the patient may experience mild to marked discomfort. Visual recovery is also delayed by 3-5 days as compared with LASIK.

LASEK

  • LASEK is a modified form of PRK. It is not yet FDA approved.
  • Unlike in PRK, the surgeon peels back epithelium in a sheet instead of removing it. The laser portion of the procedure is identical to PRK. After the laser treatment, epithelium is stretched over the corneal bed. As in PRK, soft contact lenses are placed over the eye.
  • Visual recovery after LASEK is similar to PRK.
  • In addition to classic LASEK, Dr. Filatov uses a hybrid of PRK and LASEK, removing a small island of central epithelium and peeling back the peripheral epithelium to gain access to corneal tissue. This technique may expedite healing and visual recovery.

The Filatov Eye Institute (FEI) is dedicated to the education of colleagues and patients alike on the latest advancements in the field of refractive surgery and on customization of these techniques to each individual based on their specific refractive error as well as their occupational and recreational needs. In addition, FEI provides educational programs for prospective patients, physicians and optometrists to ensure the highest standard of care for all patients. With proper education and guidance, patients can now customize treatment plans to suit their individual needs.

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