Surgical Procedures

LASIK Surgery – click here

LASIK surgery is a procedure that corrects abnormalities in the eye to improve your vision. LASIK can correct conditions such as nearsightedness, farsightedness and astigmatism. With LASIK surgery, many of our patients walk away with 20/20 vision and all of the conveniences that come along with better sight.

LASIK surgery is one of the safest and most comfortable procedures you can undergo. Due to this, and its high success rate, LASIK is the most common procedure used to correct vision. In refractive surgeries, the laser reshapes the surface of your eye, improving the cornea so that light is properly focused on the retina. This allows you to see without using glasses or contact lenses. Each eye is done separately, and the procedure takes around five minutes for each eye. You will be asked to look directly into the laser for the length of the procedure, but it will be entirely painless; you may only feel some mild pressure on the eye.

You can expect hazy and blurry vision immediately after receiving LASIK, but your vision will begin to improve almost immediately. LASIK in itself is a simple procedure, and it has a simple recovery to match. A femtosecond laser creates a flap, the flap is lifted, an excimer laser reshapes your cornea, and then the flap is placed back down. In most cases vision is corrected in only a couple days after surgery, and the recovery is very simple. We recommend that you rest as much as possible to allow the eye to heal quickly, but you will be able to return to your routine a day or two after having the procedure done.

Cataract Surgery – click here

The bad news? There isn’t an exercise or moisturizer on the planet that counteracts the effects of aging on the lenses of our eyes. The good news? Cataract surgery is a very common, safe and effective surgery. As the lens ages, it develops opaque spots that impair vision. Fifty percent of people between 65 and 75 have cataracts so we perform a lot of cataract surgeries. Cataract surgery is painless and performed outpatient in our surgery center. You could notice a dramatic improvement in just hours, and be back to your normal routine within a few days.

Intraocular Lens Implants – click here

Intraocular lens implants are an exciting alternative for people who are nearsighted, farsighted or have a moderate to high degree of astigmatism, but not LASIK candidates. The lenses are similar to contact lenses, only they are surgically implanted inside the eye rather than worn on the surface. Intraocular lens implants replace cloudy lenses to correct or restore vision for cataract patients. Intraocular lens implant surgery requires meticulous measurements, skilled hands and a history of working with specialty implants like toric and multifocal to standard lenses.

Refractive Lens Exchange Surgery – click here

Certain prescriptions or eye conditions like thin corneas can cross you off the LASIK list. Luckily that doesn’t mean you’re stuck with glasses or contacts forever. Much like cataract surgery, our eye surgeons replace your lens with an artificial one during refractive lens exchange (RLE). The new lens is customized specifically to you and precisely corrects near or farsighted vision and astigmatism. You can kiss your glasses and contacts goodbye.

PRK Surgery – click here

PRK is a laser correction surgery very similar to LASIK that is more beneficial for those who have very thin corneas. While traditional LASIK cuts a flap into the cornea, the PRK procedure simply removes only the outermost layer of the cornea (called the epithelium) before using the same excimer laser used in LASIK to sculpt the cornea and correct refractive error. Altering the shape of the cornea allows light entering the eye to be properly focused on the retina for clear vision. While both procedures will result in corrected vision, some prefer LASIK for the faster healing times and others prefer PRK for its extra safety as the original laser surgery for vision correction. PRK is a safer procedure for patients with thin corneas since more of the cornea is left untouched during the procedure than in LASIK. Unlike LASIK surgery, there is no risk of corneal flap complications because the cornea does not need to be cut.

Like most other refractive surgeries this procedure only takes 5 minutes per eye, and most people only feel a little pressure. You will be awake during the procedure but your eyes will be numbed with a topical anesthetic. Your surgeon will have you look into a target light while the laser uses pulses of light to reshape your cornea. As an additional benefit, patients experience less dryness in the eyes following PRK surgery. However, PRK does have a slightly longer recovery time than LASIK surgery as the outer layer of the cornea has to repair itself. After the procedure, you will have a corneal abrasion that will take 3-5 days to heal. The body is an amazing thing, and the cornea is able to repair itself without sutures or much interference from your surgeon. During the healing time you will wear a soft contact lens that acts as a bandage to minimize pain, promote healing, and protect the cornea. After the cornea has healed, your surgeon will remove this bandage lens for you. As a PRK patient, you will likely experience mild discomfort during the healing process. Expect some blurry vision initially; it is very normal for several weeks to pass before vision is clear and stable! Your vision will continue to improve and you will achieve excellent sight and minimal disruption to the cornea with PRK laser correction surgery.

Corneal Transplant – click here

If your cornea becomes cloudy, scarred or diseased, a cornea transplant could be your best option to save your sight. The cornea is a very important part of the eye, and, if left damaged, patients can suffer vision loss or blindness.

A corneal transplant is a surgical procedure that replaces all or part of your damaged cornea with donor corneal tissue. Corneal transplants can be categorized as “full thickness” or “back layer.” The goal is to replace damaged or diseased cornea tissue that is impacting the patient’s vision beyond what can be corrected with eyeglasses or contact lenses.

Corneal transplants are very common in the United States; about 40,000 are performed each year. While success rates may vary due to pre-existing conditions in your eye, technological advancements have increased your chance of success. Approximately 90% of corneal transplants are successful, and the new cornea will stay healthy for an average of 10 years. In the unlikely event that your surgery is not successful, or if your cornea does become cloudy again, you can always receive another transplant.

What To Expect During A Full Cornea Transplant (Penetrating Keratoplasty)

During the corneal transplant surgery, Dr. Farhat will remove an eight-millimeter central portion of the cloudy or damaged cornea and replace it with a new, clear one. Your new cornea will often come from an eye bank after being screened for suitability and infectious diseases.

Your surgeon will place the brand new cornea in the opening left from removing the old cornea and secure it in place with a very fine suture. These tiny sutures will remain in your eye for a few months while the eye heals, and then will be removed easily and gradually during visits to our office.

Post Cornea Transplant

Your surgeon will prescribe you eye drops to use after surgery to help your eye heal and to prevent infection. Your vision will be blurry at first due to stitches and post-operative swelling, but most people are able to return to work and daily life about a week after surgery. Full visual recovery can take up to a year, and it is vital that patients take their medication as directed, keep follow-up appointments and pay close attention to any increased redness, discharge, sensitivity to light, pain or blurring. This can be an indication of transplant rejection and should be reported to our office immediately so that we may be able to reverse the condition.

What Are The Alternatives To A Corneal Transplant?

• Phototherapeutic Keratectomy (PTK)
  Phototherapeutic keratectomy is one of the latest advances in eye care. It allows patients with corneal dystrophies, corneal scars, and certain corneal infections to avoid a corneal transplant.
  
  These procedures combine the precision of the excimer laser (the same laser used in LASIK procedures) with the control of a computer, allowing Dr. Farhat to vaporize microscopically thin layers of diseased corneal tissue and etch away the surface irregularities associated with various corneal dystrophies and scarring. PTK surgery removes the epithelium, along with some of the underlying corneal stroma. This new procedure allows the patient to keep his or her cornea, and new tissue will grow over the surface that has been smoothed.
  
  The primary goal of a PTK is to produce a smoother and clearer cornea. You may still need to wear glasses to attain your best vision, but PTK should make dramatic improvement.
  
  
• EK (Endothelial Keratoplasty)
  Endothelial Keratoplasty, also known as Descemet Stripping Automated Endothelial Keratoplasty (DSAEK), is a newer method of corneal transplantation and only involves replacing some of the posterior or inner layers of the cornea, instead of its full thickness as in standard corneal transplantation. For this reason, if your disease affects the full thickness of the cornea, you are not a candidate for EK.
  
  While EK is a relatively new surgery and therefore hasn’t been studied as thoroughly as the standard procedure, there are many advantages. Compared to the standard transplant procedure, your surgeon can make a smaller incision in the eye so fewer stitches are needed. Your recovery is drastically shortened with the eye healing in 3-6 months, as opposed to a year. Your eye will have less chance of injury during surgery, and with fewer stitches, there is less chance of infection.
  
  
• Descemet Membrane Endothelial Keratoplasty (DMEK)
  A Descemet membrane endothelial keratoplasty is very similar to DSAEK, except that the implanted donor tissue does not include any stromal tissue. A DMEK is an exciting option to treat decreased vision and swollen cloud corneas and it is a pure replacement of endothelium. There are three generations in the evolution of corneal transplantation and DMEK is the third and newest and has become the standard of care for Fuch’s dystrophy. DMEK is the most anatomical repair of the three generations of corneal transplantation with just one cell layer and a thin membrane, all of which are only 15 to 20 microns thick. Dr. Farhat is one of the only corneal specialists in the Kansas City area offering this new procedure.
  
  During DMEK surgery, the diseased innermost layer of the cornea is removed and the thin layer from a healthy donor cornea is put in its place. The transplant is then held in place by only an air bubble. Patients will be required to lay flat on their backs with their faces directed upwards immediately after surgery to float the bubble into place. DMEK has been shown to offer patients the best chance to see 20/20 and resume their daily activities quickly.
  
  
• Deep Anterior Lamellar Keratoplasty (DALK)
  Deep Anterior Lamellar Keratoplasty is an additional newer method of corneal transplantation. It only replaces the superficial layers of the cornea, so there is less risk of damage to the eye. You are a good candidate if you have a disease that only affects the outermost layers of the cornea, like keratoconus. Because this procedure is extremely technical, the success rate is approximately 75%. Fortunately, if the cornea does not divide optimally at the time of the procedure, a full-thickness keratoplasty remains an option to rehabilitate vision. The advantages to DALK include greater structural integrity of the eye and decreased the chance of rejection.

Selective Laser Trabeculoplasty – click here

Selective Laser Trabeculoplasty (SLT) is a gentle alternative treatment option for glaucoma. Treatment is critical for eye health and eyesight preservation because blocked drainage in the eyes increases intraocular pressure, resulting in open-angle glaucoma, the most common form of glaucoma. SLT is a very effective, painless laser procedure that reduces intraocular pressure, performed in our office and usually taking five minutes or less.  

SLT involves targeting the melanin, or pigment, in your affected eye with short pulses of low-energy light from a specially designed microscope. Before your SLT procedure, you’ll receive mild anesthesia drops in your eye. After the laser pulses, your body’s natural healing process kicks in to rebuild the laser-targeted eye cells. Immediately following the procedure, you might be given anti-inflammatory eye drops. One to three days post-procedure, drainage is improved and pressure is released, leaving the rest of your eye unaffected. It takes 4-6 weeks for the full pressure lowering effect. Your doctor will check progress during a follow-up visit and continue to recheck pressure during your future eye appointments.

Since SLT is mild, non-invasive and non-thermal, the treatment can be repeated when and if necessary, unlike other glaucoma laser treatments. If it’s difficult to take or you’re unable to tolerate glaucoma medications or other treatments have failed, SLT can be an effective option for you.