LASIK Eye Surgery

Lakeside Vision Center is very proud to offer the highest quality Laser Vision Correction procedures for patients in Orange County. Dr. Duzman customizes each procedure specifically for your eye. Dr. Duzman will discuss with you your goals and expectations and expertly guide you through the process to choose the appropriate procedure for you. We are proud to provide the safest surgical care and best visual results for our patient.

“LASIK” stands for Laser Assisted In-Situ Keratomileusis. It is a procedure to gently restore the shape of your cornea to a shape consistent with sharp crisp vision. When expertly done, it is a safe and effective procedure. Over 32 million LASIK procedures have been performed throughout the world. It is the most commonly performed refractive surgery in the world and has enjoyed great success. Although LASIK may not promise perfect vision, it can significantly reduce the dependence on glasses or contact lenses, therefore enabling a more active lifestyle for patients.

The LASIK Procedure

LASIK is designed to gently restore the shape of the cornea, so that incoming light rays can focus on a precise point on the retina creating a clear image for the brain to process. It has been performed in the US since the early 90s. Dr. Marguerite McDonald at LSU eye center in New Orleans performed one of the first procedures. Dr. Duzman trained at LSU under the guidance of  Dr. McDonald, and was exposed to Laser vision correction from the very onset of his ophthalmic career. Dr. Duzman has many happy patients who have undergone the LASIK procedure.

What happens the day of the procedure?

On the day of your procedure, you will arrive at the laser center and be greeted by the staff. You will be given some eye drops to numb your eye. You will undergo several sets of measurements of both eyes to assess the exact shape of your cornea. This information will be used in the treatment phase of the LASIK procedure. The procedure will only take several minutes. We will use two separate lasers in the process. The first, to create a corneal flap, and the second to gently resurface the cornea.

STEP 1 Flap Creation

During this step, we will use the IntraLase Femtosecond Laser to create a flap in the front portion of the cornea. This precise laser is focused at particular depth predetermined by Dr. Duzman to create the corneal flap. The laser creates small air bubbles that coalesce to form the flap.

You will be positioned under the laser lying down. The eye will be numbed again with eye drops and a comfortable ring will be placed on your eye. You will be asked to look at a flashing light on the laser. The ring is then precisely positioned by Dr. Duzman and is centered on the eye. You may notice your vision dimming slightly during this step. This is very normal and temporary. Your vision will return to normal after the ring is released. The laser will then be lowered into position and the process will start. The flap creation takes place in ~15 seconds.  The ring will carefully be removed from the surface of the eye. The process will then be repeated in the second eye. After the process is over, your vision may be blurred. Again, this is normal and is expected at this time. You should experience no discomfort during flap creation.

What are the Benefits of Intralase?

After several years of study, ophthalmologists have found that most LASIK complications arose from a poorly created corneal flap. Early flaps were made with imprecise instruments that were difficult to apply to the eye called micro-keratomes. The advent of the Intralase has makes this step safer, easier and much more precise.  The Intralase offers computerized control of flap architecture that the microkeratome could offer.  The flap thickness and diameter can be individualized and controlled to within an accuracy of +/- 10 microns.  The architecture of the flap is better and more consistent leading to fewer aberrations and a stronger flap.  Computerized control of centration, a smoother corneal bed, as well as control of side wall architecture are also benefits of the Intalase. Intralase also offers less risk of flap related complications and very remote risk for free flaps, and button holes.  In addition, if the procedure is interrupted for any reason it is easy to re-engage the laser safely continuing the procedure.  This was not possible with the microkeratome.  All of these attributes of the Intralase allow for a safer, more predictable and more comfortable procedure. It has therefore been adopted as the procedure of choice for Dr. Duzman.

STEP 2 Corneal Reshaping

After step one is complete, you will be asked to move to another laser. The nurse will assist you if needed. In this step, we use the Wave Light Allegreto Excimer laser. This is a cold laser that will gently and precisely reshape the corneal surface. The Allegreto uses the latest in Excimer laser technology. Specifically, it uses a smooth pattern of laser delivery whereby the laser spots overlap. This is important to create a very smooth surface, which vastly enhances the visual results. Also, the laser has an infrared tracking system that tracks the position of your eye during the procedure. This tracking system constantly adjusts the position of the laser to correspond with the position of your eye again ensuring superior results.

While you position under the Allegreto laser, your eye will receive additional eye drops. Dr. Duzman will then manually lift the flap created in step one by the IntraLase laser. Dr. Duzman will then align the Allegrato laser and engage the treatment. The laser will go through a predetermined protocol that has been specifically tailored to your eye from the pre-operative measurements. Depending on the amount of correction needed, this step takes approximately one minute.

After the laser disengages, Dr. Duzman will gently replace the flap into position and irrigate the eye. You will then receive some antibiotic drops and your eye will be shielded with a clear shield to protect the eye. You will then be escorted to the waiting room and be discharged to go home.

During the whole procedure, Dr. Duzman will be talking to you and telling you what the step will be. You will not feel any discomfort during the process. If you do feel something or something is bothering you, please let Dr. Duzman know and Dr. Duzman and his staff will immediately address the situation.

LASIK Risks

The technology used in the LASIK procedure by Dr. Duzman is the result of decades of research and is very safe. The LASIK procedure has been approved by the US military for fighter pilots and by NASA for its astronaut core. These individuals require the sharpest vision and often sustain heavy physical demands. LASIK has been very stable in these individuals.

Despite the long safety record of LASIK, the procedure is an elective procedure with other alternatives including eyeglasses, contact lenses, photorefractive keratectomy, and other refractive procedures. As with any surgical procedure, there are risks associated with the treatment. The risks will be completely discussed with you during your consultation with Dr. Duzman.
As with any surgery, the chance of infection is present. Dr. Duzman takes definitive steps to prevent infection using the latest, strongest, and most specific antibiotics. It is a very rare occurrence and usually can be successfully managed when identified.

Probably, the most mentioned LASIK risk to date has been the possibility of glare and halos. Glare and Halos are usually the result of optical imperfections that are inherent in the eye. The incidence of post-operative glare and halos has been significantly reduced by the design of the Allegreto Wave light system. The Allegreto system is a wavefront guided system that treats the imperfection/abberations unique to every eye. Before wavefront LASIK was introduced, surgeons would correct only the lower order aberrations of the eye (nearsightedness, farsightedness and astigmatism). In most cases, the visual improvement vastly outweighed these minor imperfections. With advances in laser technology and laser delivery, we have been able to treat more complex aberrations resulting in far superior quality of vision. Significant glare and halos are longer common with Custom LASIK. Now our patients can enjoy both visual acuity and visual quality improvements after the LASIK procedure.

The other issue that has received a significant amount of attention is dry eyes after surgery. Dry eyes are a common condition in much of the population especially in Orange County. There are many reasons for dry eye from environmental to inflammatory to hormonal. Although it is true that dry eye disease can be aggravated by LASIK, there are many treatments available now that allow many dry eye patients to be good candidates for Laser Vision correction procedures. There are also other procedures available (see PRK) to reduce the incidence of dry eyes after Laser Vision Correction. During your consultation with Dr. Duzman, he will carefully assess your level of dry eye and discuss with you treatment options and alternatives. In most cases, it is very easy to treat dry eyes pre-operatively and optimize the eyes for the procedure.

In the past, flap related complications have also been of some concern. This was much more widely seen when the flap was performed with a micro-keratome (blade). With the femtosecond intralase system, Dr. Duzman has much better control of the depth and geometry of the flap. In clinical trials, it has been shown that Intralase flaps are 2.5 times stronger than flaps made by a Keratome. The geometry of the flap created by the Intralase is such it has the fit much like a manhole cover. This stabilizes the flap and reduces the chance of it moving in the post-operative period. The Intralase also creates a very smooth bed thereby reducing the aberrations that the Excimer laser has to face. The advent of the Intralase and its careful guidance by Dr. Duzman has significantly improved our results and patient satisfaction.

There are several other risks that are very rare and will be discussed with you during your consultation with Dr. Duzman. If you have any questions, we encourage you to ask during your consultation. An individual evaluation of your eyes by a board certified ophthalmologist is paramount in the decision of what procedure is right for you and assessment of your eyes will better allow Dr. Duzman to better outline the expected result from Laser Vision Correction. Please contact our friendly staff to schedule your complementary free consultation with Dr. Duzman.

 Choosing Your LASIK surgeon

If you are seeking LASIK in Orange County we hope you have the chance to meet our doctors and hear the stories from many patients in the area that have benefited from this procedure. These are the questions that Dr. Duzman believes are essential to ask when you have your LASIK Consultation

How did you become LASIK trained?

Dr. Duzman was trained in Laser Vision Correction during the early portions of his residency in the early 90’s. He trained with Dr. Marguerite McDonald and Dr. Herbert Kaufman at Louisiana State University Eye Center where the first Laser Vision Correction procedures were performed. Dr. Duzman has maintained interest in the subject and continues his education through specialized advance courses accredited by the American Academy of Ophthalmology and the American Association of cataract and Refractive Surgeons.

Will I be seeing you (the surgeon) at each visit?

At Lakeside Vision Center, we pride ourselves in the work that we do. Dr. Duzman sees every patient at every post-operative visit. Your care will be maintained at our clinic and the course of treatment be determined by Dr. Duzman. We do not utilize other health care practitioners in your care. What sets us apart from many surgeons is that we strongly feel that LASIK is a medical procedure that needs to be followed and cared for by a Medical Doctor.

What is Custom LASIK and is it right for me?

Dr. Duzman has had extensive experience with many laser delivery systems. He believes that the Wave light Allergreto system has the best technology with a fast, effective, precise and predictable laser delivery to optimize visual results.

Do you have Blade-FREE LASIK Technology? If not, why not?

Over the years, Dr. Duzman has experience with both Microkeratome systems and Laser systems to create the corneal flap. Dr. Duzman now utilizes only the Intralase all laser LASIK process because of its greater accuracy, consistency, and safety.

Does your practice provide follow up care included with the price?

Our price for LASIK is very competitive in our current market. We pride ourselves for providing comprehensive care for that price. Our price includes all of the pre-op, intra-op and post-op management of your needs. We do not place a time limit on our responsibility to handle the rare complications that may arise from the LASIK procedure . Also, in the rare occasion that we may need to enhance your results, this is included for a 1year period post operatively.

How many surgeries have you performed?

Dr. Duzman has thousands of satisfied patients who have undergone Laser Vision Correction. We have many patients who are willing to speak with you regarding their experience during the process. Dr. Duzman also has a wide experience with other more technically challenging microsurgical techniques such as cataract, glaucoma and pediatric ophthalmic surgeries.

Other methods of laser vision correction

PRK (Photo-Refractive Keratectomy)

Some patients may not be candidates for LASIK, There are several contra-indications to performing LASIK. This is why it is integral to have an eye evaluation by a Medical eye Doctor familiar with eye diseases. It is only through that expertise that your situation be individualizes for the right procedure. During your comprehensive consultation with Dr. Duzman, he will be able to assess if you are a good candidate for LASIK.

If you are not a good candidate for LASIK or you do not wish to have LASIK done, Dr. Duzman may recommend Photorefractive Keratectomy (PRK). PRK is a well established procedure that utilized the benefits of the Allegreto wave light system to reshape the cornea without creating a corneal flap.

In 1987, Dr. Marguerite McDonald, one of Dr. Duzmans’ laser vision correction mentors performed the first PRK on a seeing eye in the world. PRK was the first laser refractive procedure to be approved by the FDA in 1995. During the FDA clinical trials, Louisiana State University, Dr. Duzman’s training institution, was one of the leading clinical sites.

In PRK, no corneal flap is created. Instead, Dr. Duzman gently removes the surface epithelial layer of the cornea and the excimer laser is applied to the bed remaining. This reshapes the cornea in the exact same manner and has the same advantages of aberrational control as the LASIK procedure. The procedure is then complete. In the following several days, the epithelium heals to cover the corneal surface. Healing from PRK takes longer than is does with LASIK however, long-term results are identical.

If you are not a LASIK candidate because of dry eye, a cornea that is too thin or a prescription that is too high to treat with LASIK, PRK may be a solution that Dr. Duzman can employ to achieve your visual restorative needs. Since only the surface epithelium is removed there is more corneal tissue to work, with and a higher prescription can be managed. Also if your cornea is thin, there is more corneal tissue to work with and even patients with thin corneas can have some correction available to them with PRK. PRK is also very useful for patients with dry eyes. In LASIK, the flap creation severs some of the superficial nerves sub serving corneal sensation. These nerves do grow back but during the healing process dry eyes may be exacerbated. As Dr. Duzman evaluates your eyes, he will recommend and discuss the options that are available for you. Some patients may be candidates for both procedures and have the choice of procedure. Please contact our friendly staff to schedule your free consultation with Dr. Duzman and learn about your customized refractive corrective options.

Am I a candidate?

• Dr. Duzman will evaluate the condition of your eye. You should consider Laser Refractive Surgery if:
• You are over 21.
• Have a stable prescription for the past 6 months.
• Have nearsightedness, farsightedness or astigmatism.
• No systemic conditions that may affect healing.
• No sight-threatening eye diseases.
• The desire to reduce dependence on glasses and contact lenses.
• Have had multiple lens related irritations, ulcers and lens intolerability (The cause of these need to be carefully evaluated by Dr. Duzman).
• As each eye is different, it is vital that a board certified ophthalmologist evaluate your eyes. If you meet any of these criteria, please call us to make an appointment with Dr. Duzman to discuss your options.