What is iStent?

The iStent Trabecular Micro-Bypass stent is a new surgical therapy for glaucoma that is designed to improve aqueous outflow to safely lower IOP and may reduce medication burden; but this will be at the discretion of your physician.

iStent is the smallest medical device ever approved by the FDA and is placed in your eye during cataract surgery. It is so small, you won’t be able to see or feel it after surgery but it will be continuously working to help reduce your eye pressure.

How can iStent help me?

Every day, you are probably taking one or more eye drops to control your eye pressure. By improving the outflow of fluid from your eyes, iStent works to help control your eye pressure. After implantation of iStent, many patients are able to control their eye pressure.

Controlling eye pressure is extremely important to reduce the risk for vision loss due to glaucoma. If you forget to take your eye drops or ‘skip a dose’, this can cause large changes in your eye pressure. Large changes in eye pressure can increases the risk for vision loss.

If you have both glaucoma and cataracts, ask your eye doctor if iStent is right for you.

http://www.glaukos.com/patients

 

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Jeffrey S. Karlik, M.D.

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Troy M. Karlik, D.O.

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Steven B. Rogers, M.D.

Dr. RogersSteven B. Rogers, M.D. graduated summa cum laude from Ohio State University with a B.S. in Microbiology. Following this, Dr. Rogers completed medical school at Wright State University in Dayton, Ohio. His post-graduate training as a medical intern and ophthalmology resident were completed in Pittsburgh at the Saint Francis Medical Center. He is board certified by the American Board of Ophthalmology. He is a member of numerous state and national professional societies and has published and presented at ophthalmic meetings.

Prior to joining Karlik Ophthalmology, Dr. Rogers was the primary teaching attending at the Saint Francis Ophthalmology Residency. He maintained this position until the Saint Francis Ophthalmology Residency was absorbed into the University of Pittsburgh Ophthalmology Residency. While working at Saint Francis, Dr. Rogers was responsible for the clinical and surgical training of over thirty ophthalmologists. These ophthalmologists that Dr. Rogers trained work in academic centers and in private practice throughout the country. In fact, Dr. Jeffrey Karlik is proud to have been trained by Dr. Rogers and thrilled that Dr. Rogers has associated with Karlik Ophthalmology.

In addition to training ophthalmologists, Dr. Rogers has been active with missions providing surgical eye care to communities and countries in need. He has traveled numerous times to the island of Montserrat in the Caribbean Sea. This island has been decimated by volcanic eruptions, which has left the remaining island inhabitants without adequate medical care. He traveled to Montserrat on a mission providing surgical and medical eye care with Dr. Troy Karlik in March of 2005. On another medical mission, Dr. Rogers traveled to Samara, Russia in 2000. During this academic exchange of expertise between some of the leading ophthalmologists of the former Soviet Union and the Saint Francis Medical Center, he performed surgery in the hospital of the late Dr. Svyataslov Fyodorov, considered the father of refractive surgery for his development of radial keratotomy (RK).

Karlik Ophthalmology is proud to have the medical expertise and humanitarian endeavors of Dr. Steve Rogers associated with our practice.

 

David J. Kobaly, MD

Kobaly

David J. Kobaly, MD graduated from Carnegie Mellon University with a B.S. in Chemistry. After this, Dr. Kobaly completed medical school at the University of Pittsburgh School of Medicine. He completed his post-graduate training at Mercy Hospital of Pittsburgh, St. Francis Medical Center, and Scheie Eye Institute.

Dr. Kobaly is board certified by The American Board of Ophthalmology. He is a member of the American Academy of Ophthalmolology, the Pennsylvania Academy of Ophthalmology, the Pennsylvania Medical Society, and the Allegheny County Medical Society. 

 

Tiffany M. Chamberlin, OD
 

 

What is a cataract?

A cataract is a clouding or discoloration of the natural lens.

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Does the cataract have to be “ripe” prior to surgery?

No, the cataract has to be visually significant before cataract surgery. The longer the cataract is in the eye, the harder it is to remove.

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Will cataract surgery hurt?

Generally cataract surgery does not hurt. Cataract surgery is performed with a local anesthetic, therefore you should not feel pain. Occasionally, you might feel some slight discomfort. If you should experience any discomfort, please make your doctor aware.

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Is cataract surgery performed with a laser?

No, cataracts are removed with rapid frequency sound waves called ultrasound. This process is termed phacoemulsification. A laser, however, is used in other areas of treatment for the eye.

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Can you do cataract surgery on both eyes?

No. Because of the very small risk of infection, it is important to wait at least two weeks before operating on the second eye.

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How long will I be at the Hospital Surgery Center for my cataract surgery?

The surgical procedure itself takes approximately 30 minutes, but cataract surgery patients can expect to be at the hospital surgery center approximately two to four hours for the preparation and recovery period.

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Will I receive a lens implant?

Yes, an intraocular lens (IOL) implant is used to replace the human lens. This prevents the patient from wearing thick glasses or contact lenses after cataract surgery.

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If I have regular implants now, can I have Crystalens® or ReSTOR® implants put in later?

No. Once implants have been placed in the eye and they have healed in place, they are very difficult to remove. Crystalens®, ReSTOR®, and other newer types of implants are best suited for people who have never had cataract surgery before.

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Will I have sutures after cataract surgery?

In many cases we perform no-stitch cataract surgery at Karlik Ophthalmology. If the doctor feels it is beneficial to the patient, the doctor may use a suture, though usually just one. This suture, if needed, is easily removed in the office.

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Does the cataract grow back?

The cataract will not grow back, but at a later time the tissue behind the lens implant may become clouded. This condition is known as capsular fibrosis and it can be painlessly treated with a laser in the offices of Karlik Ophthalmology. This procedure is called a posterior capsulotomy.

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How long will the intraocular lens implant last in my eye?

The lens implant will last for the rest of your life.

 

Will I have to wear glasses after cataract surgery?

In most cases you will require glasses after cataract surgery, especially for reading. You may require a very thin lens to see distant objects along with normal reading glasses. Deluxe IOLs are now available to reduce a patient’s dependence on glasses. The cost of these lenses is not currently covered by Medicare or other insurances. The doctor’s at Karlik Ophthalmology may discuss this option with you.

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When will I receive my new glasses?

You will receive a new pair of glasses usually four weeks after cataract surgery. This will give the eye time to heal, giving you the best possible vision after surgery.

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When can I go back to work?

Your ability to return to work usually depends on your occupation. Most people can return to work the day after cataract surgery once a doctor has given his approval.

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When can I drive after cataract surgery?

Each patient's case is evaluated on an individual basis, though generally patients can drive 24 hours after cataract surgery. Please ask your doctor at Karlik Ophthalmology for more information.

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When can I wash my hair after cataract surgery?

You can wash your hair right after cataract surgery, but do not let the water run directly into the eyes.

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After cataract surgery, when can I play golf, bowl, exercise, and engage in other physical activity?

You will usually be able to engage in physical activity the day after cataract surgery. You should consult your doctor at Karlik Ophthalmology for more information on your individual case.

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After cataract surgery, when can I swim?

You may swim two weeks after cataract surgery.

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When can women wear eye make-up?

You should avoid wearing eye make-up for at least one week after cataract surgery.

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Can I use my Medical Savings / Flex Spending Account for LASIK?

In most cases, yes! Check with your employer or plan provider to verify the details of your plan, but this is a great way to pay for LASIK using you pre-tax income.

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What is LASIK?

LASIK stands for LASER IN-SITU KERATOMILEUSIS. The procedure uses a computer-controlled excimer laser to reshape the cornea to correct your vision. The laser reshaping is done under a protective flap of tissue to promote a very rapid recovery of vision and minimize discomfort.

How long has LASIK been performed?
The first keratomileusis procedure was done on humans in 1963. The procedure has evolved and improved since then. The excimer laser has been used for over 10 years and has received FDA approval for photorefractive keratectomy (PRK), a procedure in which the laser is used to sculpt the surface of the eye. Eye surgeons have been creating a protective flap of tissue for over 30 years. These two techniques were first combined in 1991 to create a new form of refractive surgery -- LASIK. Most of the experience with LASIK has been obtained outside of the United States, where regulatory oversight is not as stringent.

Who is LASIK useful for?
LASIK can be performed for a wide range of nearsightednessfarsightedness and astigmatism.

How does LASIK correct astigmatism?
Astigmatism can be corrected by using a laser with software that is capable of ablating an oval pattern on the cornea.

Who does this surgery?
Our Lasik Ophthalmologist Dr. Jeffrey Karlik  performs the LASIK procedure.

How can I get more information about refractive surgery?
Chris Hussar is the LASIK Coordinator and can be reached at (412) 931-8101.

How do I know if I am a candidate for LASIK?
In order to determine whether you are eligible for laser surgery, you must have a consultation and comprehensive pre-operative exam. Please contact us if you have questions or wish to schedule an appointment.

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Who is a good candidate for LASIK?

A good candidate for LASIK must:

  • Be at least 18 years old
  • Have a stable prescription 
  • Have no pre-existing corneal diseases
  • Not have certain pre-existing conditions
  • Not be pregnant or nursing
  • Have realistic expectations about laser vision correction (see below)

What is done at a pre-op exam?
A complete eye examination and specialized computer measurement of the shape of your cornea is performed. Dr. Karlik reviews this information in light of your visual needs for work and leisure and provides you with options and recommendations for refractive surgery.  It may be necessary for your contac lenses to be removed for a period of time in order for your cornea to return to its natural shape by the time of this examination.  Dr. Karlik will discuss this with you at the time of your consultation. 

How long does the procedure take?
You will be in the surgery room approximately 15 minutes to complete the procedure on both eyes.  Expect to be at our surgery center approximately one to two hours.

Does it hurt?
Anesthetic drops allow the operation to be performed without pain. It is normal to feel some pressure during the procedure. Afterwards, the eye is a bit scratchy, but patients typically do not require any pain medications and are often able return to work the day following the procedure.

What are the restrictions following surgery?
You must wear a protective shield the first two nights following surgery. You should not swim or get into a hot tub for two weeks after surgery, although bathing and showering is fine. All other activities -- including exercise -- may be resumed on the first day following surgery.

After laser vision correction is performed, patients are sent home with a sleeping pill and are asked to rest with the eyes closed as much as possible until the follow-up visit the next day. Patients with lower amounts of myopia may have vision good enough to drive the next day but should be cautious. Patients who have higher degrees of myopia may actually be overcorrected initially and may experience somewhat blurry vision. This usually lasts for days to weeks depending on the amount of correction.

When can I go back to work?
Most patients return to work the day after the procedure, if your vision permits.

How long is follow-up needed?
Follow-up checks are required at approximately 1 day, 1 to 2 weeks, and 3, 6, and 12 months. These examinations are included in the charge for the procedure.

What are my chances of not wearing glasses after the procedure?
This will depend on a number of factors, including your refractive error, your visual needs, and even your personality. It is important to understand that LASIK does not eliminate the need for reading glasses as one grows older.  (See chart)

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Is LASIK surgery safe?

Yes, the extremely low complication rate has been a primary reason for the popularity of LASIK worldwide. The risk of a serious problem resulting in any loss of vision is about 0.01 percent. More common but less serious problems include under or over corrections, flap-related problems, infection, dry eyes, and night vision problems.

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Is LASIK surgery painful?

There is minimal discomfort with LASIK. Some patients even report absolutely no discomfort during the laser vision correction procedure. At Karlik Ophthalmology, topical anesthetic (numbing) eye drops are used prior to the procedure. As the microkeratome is applied to the surface of the eye, some patients may experience a pressure sensation. The cutting of the flap itself is painless, as is the laser treatment. After laser vision correction, some patients may experience a foreign body sensation, like an eyelash in the eye, for several hours.

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Can LASIK be performed on both eyes at once?

Most patients are opting to have LASIK performed on both eyes on the same day, although this is an individual choice. Advantages include convenience, decreased time lost from work, and easier visual recovery because there is no imbalance between the two eyes when they are both corrected. Disadvantages include safety concerns (for instance, in the rare event of infection, both eyes may be affected) and accuracy concerns (if an overcorrection occurs in one eye, it is likely to occur in the other). An ophthalmologist at our laser vision correction offices can further discuss the advantages and disadvantages of having LASIK performed on both eyes during one visit.

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What can I expect after laser vision correction?

After laser vision correction is performed, patients are sent home with a sleeping pill and are asked to rest with the eyes closed as much as possible until the follow-up visit the next day. Patients with lower amounts of myopia may have vision good enough to drive the next day but should be cautious. Patients who have higher degrees of myopia may actually be overcorrected initially and may experience somewhat blurry vision. This usually lasts for days to weeks depending on the amount of correction. Prescription eye drops will be used for one week following the surgery at which time the patient will be seen again. Barring any difficulties, the follow-up visit will be at one to two weeks.

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Why should I choose Karlik Ophthalmology for laser vision correction?

By affiliating with the LASIK Vision Institute of Pittsburgh, Karlik Ophthalmology is one of the most experienced providers of laser vision correction in the tri-state area. Our affiliation with the LASIK Vision Institute of Pittsburgh allows for continuous investment in the latest technological advancements, which ensures the latest and most advanced lasers and treatments will always be available to our patients. Additionally, Karlik Ophthalmology offers comprehensive medical and surgical eye care. In keeping with this comprehensive philosophy, our refractive surgeons offer all currently available refractive surgical procedures.

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What type of laser does Karlik Ophthalmology use for laser vision correction?

At Karlik Ophthalmology, we currently use the WaveLight Ex 500 Excimer Laser with pupil tracking.  The laser is kept in a dedicated laser suite, which constantly monitors temperature and humidity to ensure the highest possible accuracy in our treatments.

https://www.myalcon.com/products/surgical/wavelight-refractive-suite/excimer-laser-speed.shtml

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Will I achieve 20/20 vision after LASIK surgery?

The most important thing a patient must have prior to any refractive surgical procedure is realistic expectations. The goal of these procedures is to decrease one's dependence on corrective lenses (glasses or contact lenses). The vast majority of our patients (approximately 98 percent) will see 20/40 or better after LASIK, but there is no guarantee of the outcome. In addition to the many variables related to the surgery itself, every eye heals differently. If the vision is not satisfactory after the initial treatment and there is a residual refractive error, this can possibly be corrected with a retreatment (enhancement). It is also important to know that the correction of distance vision is independent of near or reading vision. The inability to read without glasses (presbyopia) normally occurs after the age of 40 and this is not corrected by refractive surgery. In addition, the correction of the distance vision in many patients over age 40 may result in the need for reading glasses at an earlier age.

When will my vision stabilize?
After LASIK, vision usually stabilizes very quickly. Our results indicate that there is little or no change after the two week post-operative examination, however it is possible for your vision to fluctuate for up to three months after your surgery.

What is the percentage of patients that need enhancements?
The national enhancement rate is around 5 to 10%, and Dr. Karlik's enhancement rate is below the national average.  Enhancements are performed after the three month examination. The likelihood of needing an enhancement is dependent on the degree of refractive error. Patients with a higher degree of myopia or hyperopia are more likely to need an enhancement. Enhancement procedures will be performed at no additional charge if performed within 12 months of the initial surgery.

What are the risks of surgery?
Like any surgical procedure, LASIK carries some risk of complications. Risks include an infection which could damage your cornea and result in loss of vision, although this is extremely unlikely. As part of your evaluation for the procedure, we will give you an informed consent document which details potential risks and complications of surgery.

If necessary, can I wear contact lenses after LASIK?
LASIK does not modify the cornea in a way that would prevent contact lens wear. However, many patients elect to have refractive surgery because they were unable to wear contact lenses. In this case, you can expect to have problems after the surgery just as you did before it.

Are the effects of LASIK permanent?
To date, there is data reflecting over 15 years regarding LASIK.  All studies show that LASIK is a permanent procedure.

What is the difference between LASIK and PRK?
Both procedures use the excimer laser to reshape the cornea and correct nearsightedness. The difference is that, in PRK, the laser is used on the surface of the cornea and, in LASIK, the laser is performed under a protective flap of tissue. Our surgeons believe that the use of the laser under a protective flap produces faster visual recovery and less pain. In PRK, the laser is used on the surface of the eye, and it takes several weeks for the surface to heal and become smooth, allowing good vision. Steroid drops are necessary (usually for about six week) to help regulate healing. For reasons of patient convenience, LASIK has become the refractive surgical procedure of choice in the United States. However, PRK is the preferred procedure for many patients for reasons ranging from occupation, amount of correction, or corneal anatomy. Both LASIK and PRK procedures can be enhanced, if necessary.

The costs of a LASIK or PRK procedure are identical.

What are the costs of the surgery?

The cost of the procedure is reasonable if one considers the costs associated with glasses or contact lenses over one's lifetime.

 Cost reflects a  “global fee” which means that the one cost is all inclusive.  The costs include the pre-op exam, surgery, post-operative kit and sunglasses, follow up care for 1 year, and any enhancement treatments if necessary during the first year. It does not, however, include the cost of temporary glasses or prescription pain medicines.

The global fee does not include the cost of any unrelated eye disorders which may arise. However, these visits would be billable to one’s medical insurance.

We have multiple payment plans available. The Refractive Surgery Director can review the options with you.

http://www.carecredit.com/

 

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Is LASIK affordable?

The cost of the procedure is reasonable if one considers the costs associated with glasses or contact lenses over one's lifetime. Although many patients pay the costs up front, financing options are available. We will be more than happy to discuss financing and other payment options for laser vision correction.

https://www.qualsight.com/

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How can I learn even more about laser vision correction?

Contact us for more information on laser vision correction.  You may qualify for an examination free of charge with  our surgeon. The examination will include dilation of the eyes, measurement of the cornea, and a review of medical history to check for pre-existing diseases. It is imperative to discontinue the use of contact lenses (at least two weeks for soft lenses and four weeks for rigid gas permeable lenses) prior to the evaluation in order for the cornea to return to its natural shape. After your visit, you may continue using the contact lenses again, but will be asked to remove them at least several days before the laser vision correction surgery.

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Eyelid surgery is a common method of treatment for entropion (inward turning of the eyelid), ectropion (outward turning of the eyelid), ptosis (drooping of the eyelid), dermatochalasia (excessive eyelid skin), and some eyelid tumors.

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Before and after photos of ectropion repair.

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Before and after photos of Ptosis repair.
 
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Eyelid entropion.

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Eyelid tumor.
 

The surgeons of Karlik Ophthalmology work with their patients to determine when eyelid surgery is necessary. Eyelid surgery is usually an outpatient procedure with local anesthesia. Risks of surgery are rare, but include asymmetry of the eyelids. Differences in healing between the eyes may cause some unevenness after surgery.

After eyelid surgery, a black eye is common but goes away quickly. It may be difficult to close your eyelids completely, making the eyes feel dry. This irritation generally disappears as the surgery heals. Serious complications are rare but include vision loss, scarring, and infection. To most people, the improvement in vision, comfort and appearance after eyelid surgery is very gratifying.

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Before and after functional blepharoplasty for repair of dermatochalasia.

Photodynamic therapy (PDT) was the first treatment for some cases of the wet form of age-related macular degeneration that provided hope of improvement of vision with treatment. It involves injecting a light-sensitive chemical into the arm. The chemical travels to abnormal blood vessels in the retina where it is activated with a special light. The activated chemical destroys the abnormal blood vessels without causing damage to the normal retinal tissues nearby. This allows PDT to be used in some cases where conventional laser treatment would cause too much damage to surrounding retinal tissue. 

PDT can slow the loss of vision and sometimes improve vision.

Now there are drugs available that, when appropriate, can be injected into the vitreous cavity of the eye to stabilize or even improve the vision in patients with macular degeneration. Studies have revealed they provide a greater benefit than PDT. This class of medication is referred to as Anti-VEGF Therapy and includes both Lucentis and Avastin.

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Anti-VEGF Therapy is for those:
  • who have been diagnosed with the wet form of age-related macular degeneration
  • whose doctor has determined that Anti-VEGF Therapy is the appropriate treatment for their condition
Realistic expectations:

Following treatments, some patients experience a temporary reduction of vision, which will improve over the next few weeks. This is a relatively new procedure. Serious complications with Anti-VEGF Therapy are extremely rare, but like any medical procedure, it does have some risks.

The greatest concern in any patient with macular degeneration is continued progression of retinal damage with additional loss of vision. The doctors of Karlik Ophthalmology will determine when Anti-VEGF Therapy is indicated. However, it is vital that all patients with macular degeneration monitor their vision for any change from baseline (with use of an Amsler Grid) and report any change immediately to the office of Karlik Ophthalmology.

Eye Conditions:

No resources available.