Kensington Eye Center 4701 Randolph Road, #G-2 Rockville, MD (301)
|
|
- Prudence Arnold
- 8 years ago
- Views:
Transcription
1 Kensington Eye Center 4701 Randolph Road, #G-2 Rockville, MD (301) Natasha L. Herz, MD INFORMED CONSENT FOR DESCEMET S STRIPPING and AUTOMATED ENDOTHELIAL KERATOPLASTY (DSAEK) or PENETRATING KERATOPLASTY (PKP) OPERATION This information is provided so that you can make an informed decision about having eye surgery. Take as much time as you wish to make your decision about signing this informed consent. You are encouraged to ask questions about any procedure before agreeing to have the operation. INTRODUCTION Figure 1. Corneal edema The cornea is the clear window at the front of the eye that bends and helps focus light onto the back of the eye (the retina). In order for vision to be clear, the cornea must be clean and clear. Corneal disease can cause the cornea to become opaque or cloudy, preventing light from passing through clearly. Fuch's Dystrophy and bullous keratopathy (corneal edema) are conditions in which the cornea is cloudy (Figure 1). In these conditions, the innermost layer of the cornea, the endothelium, is failing and is causing the cornea to become swollen and cloudy. This layer needs to be replaced when the amount of corneal edema decreases the vision significantly. PENETRATING KARATOPLASTY (PKP) Until recently, the only way to replace the endothelial layer of cells was with a full thickness corneal transplant called Penetrating Keratoplasty or PKP. This surgery involves replacing the patient s diseased cornea with a cornea that has been donated by someone who has died (the donor cornea). Traditionally, a full-thickness disc or button of the diseased cornea is removed and replaced with a matching button of donor cornea, using sutures to sew it in place (Figure 2). a b c d Figure 2. Traditional Corneal Transplant a. cloudy cornea removed b. donor cornea replaced c. donor cornea with sutures d. actual photo of donor cornea with sutures Because of the size and thickness of the incision, these sutures cannot be removed for months and often cause the cornea to take on an irregular shape during the healing process that is difficult to correct with glasses or contact lenses. There is also an increased risk of rupture with moderate trauma. DESCEMET S STRIPPING and AUTOMATED ENDOTHELIAL KERATOPLASTY (DSAEK) Over the last several years, a technique has been developed to replace only the back layer of the cornea instead of replacing the entire full thickness cornea. A patient with Fuchs Dystrophy or bullous keratopathy is a candidate for this new procedure, called Descemet's Stripping Automated Endothelial Keratoplasty (DSAEK), because the back layer is the only layer that is diseased in this condition. When there is scarring throughout the cornea, a full-thickness transplant is still necessary (see Figure 2). Figure 3 on the following page demonstrates the DSAEK procedure.
2 Figure 3. Descemet s Stripping Automated Endothelial Keratoplasty (DSAEK) a b c d a. The damaged inner layer of the cornea is dissected and removed through a 4mm incision. b. & c. A new inner layer from a donor cornea is inserted into the eye and held in position with an air bubble. d. The incision is closed with 2-3 sutures and the air bubble dissolves on its own within hours. This new transplant technique has been shown to enable good vision and to have many potential advantages over full thickness transplants, including earlier return of vision, less refractive errors, fewer serious complications, and a more stable eye. This is because the incision is only 4 mm, requiring only 2-3 sutures which can be removed in 1-2 months. This allows visual rehabilitation to start at 3 months versus 18 months with PKP and decreases the risk of complications resulting from moderate trauma. It is likely that the patient s best vision will still be obtained with glasses or a contact lens, but it will be much easier to achieve given the smoother surface of the cornea (see Figure 4 for actual photo of eye after DSAEK surgery) Figure 4. a. Air bubble 24hrs after DSAEK surgery. b. Graft and sutures in place 1-2 weeks after DSAEK surgery. BENEFITS OF DSAEK VS. PKP (Please note not everyone is a candidate for DSAEK) In general, DSAEK surgery is a new transplant technique and has been shown to provide good vision and to have many potential advantages over full thickness transplants, including earlier return of vision, less refractive errors, fewer serious complications, and a more stable eye. 1) Patients who undergo full thickness corneal transplants usually must wait up to18 months or more before their vision is restored and stable enough to obtain new glasses. With DSAEK, a smoother surface for focusing usually results in improved vision much sooner - generally 3 months. 2) Full thickness corneal transplant surgery results in a change in the corneal curvature. Since the power of one's glasses is partially related to this curvature, strong glasses are often required to correct large amounts of nearsightedness, farsightedness and astigmatism. Sometimes, a rigid contact lens or even surgery is required to correct the astigmatism. In contrast, after DSAEK, the corneal surface remains smooth and relatively unchanged from the curvature before transplant surgery. Therefore, there is much less chance of requiring strong or thick glasses after DSAEK compared to full thickness corneal transplant surgery. 3) Patients who have full thickness transplant surgery require 16 sutures or more, some of which may be left in the eye for several years. These sutures can lead to problems such as surface irregularity, discomfort, blood vessel formation, infection, and corneal wound problems. In contrast, the 3 tiny sutures that are used in DSAEK are not irritating, usually do not cause problems, and are removed in 1-2 months.
3 4) Patients who undergo full thickness transplant surgery are much more susceptible to wound rupture and serious injury from any kind of trauma since the long, full thickness corneal incision never fully regains normal strength. With DSAEK, because there is only a small peripheral incision, the eye usually heals to become be much stronger and less susceptible to serious injury from trauma. 5) If you need transplants in both eyes, DSAEK allows you to have the second transplant within months, versus a year or more if you were to have a conventional PKP transplant. WHAT TO EXPECT ON SURGERY DAY You should arrive at the surgery center about an hour prior to your procedure. Once you have been checked in, you will meet your anesthesiologist who will be giving you conscious sedation and local anesthetic during the surgery. Rarely, a patient may need general anesthesia. You will then be prepared for surgery. The area around your eye will be cleaned and a sterile drape will be applied around your eye. A small incision will be made to allow the surgeon to strip away the diseased Descemet's membrane and damaged endothelial cells. Next, the bottom 10% - 20% of a donor cornea that has healthy endothelial cells attached to its Descemet's membrane will be inserted through the same incision. After it is placed in position, an air bubble will be used to hold the transplanted tissue in place (see Fig 3ac, Fig 4). The central disc of cloudy cornea will be removed and replaced with a donor disc of clear cornea cut to match the size of the disc that was removed. This clear disc is sewn into place with sutures (see Fig 2a-d). AFTER YOUR SURGERY Immediately after the procedure, you will be taken into recovery where you will lie down for about an hour to let the air bubble continue to press against the tissue to secure it in place. Your eye will be patched before you leave. Antibiotic eye drops will be used for a week or so to help prevent infection, and a mild steroid eye drop will need to be used for approximately one year to help prevent rejection. Immediately after the procedure, you will have a patch and shield placed over your eye. You will stay in the recovery area for about an hour until your anesthesiologist verifies that your vitals are stable and discharges you home. Antibiotic eye drops will be used for a week or so to help prevent infection, and a mild steroid eye drop will need to be used for approximately one year to help prevent rejection. FOR BOTH: You should be able to resume normal activities the day after your surgery. Strenuous activities will be restricted until 3 weeks after surgery. With conventional corneal transplantation, your vision typically does not improve for months, while with DSAEK, you may experience visual improvement within weeks. In order to make your transplant procedure a success, it is important that ALL scheduled follow-up appointments be kept and ALL medications are used as directed. Any pain, redness, or reduced vision should be reported immediately. RISKS, SIDE EFFECTS, AND DISCOMFORTS The decision to have DSAEK or PKP is an important one that only you can make. The goal of any vision restoration procedure is to improve your vision; however, we cannot guarantee you will have the results you desire. Risks and problems that may occur with both full PKP and DSAEK surgery include: 1) There is often mild pain for one week after surgery that may be treated with Tylenol or another drug by mouth. Immediately after surgery your eye will be red. There may be temporary discomfort to you from the follow-up eye examination or eye drops. This may include stinging, redness or itching. 2) For many reasons, the vision after any type of corneal transplant is never perfect. Sometimes, strong glasses are needed to correct refractive errors. The glasses may be difficult to tolerate. Sometimes, glare and distortions are noted, or the vision is still somewhat blurred, even with a clear corneal transplant. The goal is to provide the best visual acuity and overall vision quality possible, while minimizing the risks.
4 3) In approximately 10 percent of patients, the body's immune system produces an inflammation of the donor cornea. This is often called a "rejection" reaction. The rejection reaction is usually reversible if treated promptly but sometimes it leads to a failure of the transplant. Rejection could happen (although rarely) at any time in the future. However, if the transplanted tissue should be rejected, it is usually possible to have the procedure successfully repeated. 4) The transplant may become cloudy either because of rejection, as described above, or for other reasons. If this happens it may be necessary to have another transplant. The risk of the transplant failing varies depending upon the current corneal condition. 5) The donor cornea is obtained from a certified Eye Bank. A past medical history is obtained from the donor who is screened carefully for evidence of potentially transmissible infectious or neurologic diseases. Blood is drawn and tested for hepatitis, AIDS, and other diseases. Every effort is made to exclude donors that could transmit diseases. The risk of getting a serious disease from a donor cornea is extremely small. Nevertheless, it is still possible that a serious disease could be transmitted from the donor cornea. RISKS UNIQUE TO DSAEK 1) Dislocation of the donor corneal transplant tissue within the eye can occasionally occur. Dislocated tissue is usually noted on the first day after surgery, and a repositioning procedure is generally performed within the next week. If the tissue cannot be repositioned, a full thickness corneal transplant (Penetrating Keratoplasty) may be necessary. 2) DSAEK is a relatively new procedure and long term results are not known. Although we have tried to list all possible risks and discomforts, there may be others that we do not know about at this time. FREQUENTLY ASKED QUESTIONS ABOUT DSAEK and PKP Will I need to be hospitalized? DSAEK and PKP are performed as an outpatient surgery. No overnight hospitalization is required. Will I be awake during surgery? You will have an anesthesiologist who will administer a sedative during the procedure that enables you to relax and even sleep, but you will still be breathing on your own. The eye is numbed with local anesthesia. How long does the procedure last? The total time you will be in the surgery center is approximately 2 to 2.5 hours. Once you are taken to the operating room the procedure is completed in 30 to 60 minutes. Additional time may be necessary if other procedures are also planned such as cataract surgery or intraocular lens replacement. For DSAEK only: After the procedure is completed, you will be taken to the recovery room where you must lie on your back for 45 to 60 minutes. This allows the air bubble that has been placed in the anterior chamber of your eye to fix the transplant into position. When will I need to return for a follow-up office visit? The first office visit is scheduled the next day in the office so that the doctor can check the eye pressure and the graft position. If everything is in proper order you will start your post-operative eye drops as directed and return for a second visit in 1 week. For DSAEK only: If the graft is in good position at your first follow-up visit, this is a very good sign that it will take. There is a 10 percent chance that it will not take the first time, and will need to be repositioned within a week of surgery by injecting another air bubble. This procedure will be performed in the office several days after the original surgery and takes about 1-2hrs. However, if everything is in proper order you will start your post-operative eye drops as directed and return for a second visit in 1 week.
5 What type of eye drops will I need after surgery? You will continue using antibiotic eye drops (Vigamox) that you started 3 days prior to surgery. Use the Vigamox 3 times per day for one week after surgery unless otherwise instructed. You will also use a steroid eye drop (Omnipred 1%) 8 times per day until otherwise instructed. The steroid drops are required to prevent rejection of your new transplant. If you are also using glaucoma eye drops, continue to use them after surgery unless otherwise instructed. When will I see an improvement in my vision? Visual recovery varies depending on the rate of healing, but most patients will notice an improvement in their vision within 3 to 6 months of surgery, with optimal recovery of vision in months. Visual recovery varies depending on the severity of your corneal cloudiness prior to surgery. Most patients notice improvement in their vision during the first 2 weeks after surgery with continued improvement during the next 4-6 weeks. This recovery is a dramatic improvement over the time required following conventional corneal transplant surgery (PKP), which usually takes 6-12 months. Some DSAEK patients may not notice visual improvement as quickly as they would like, because they have other ocular conditions such as cataract or retinal problems that must also be addressed. Can my transplant undergo rejection? The rate of rejection for DSAEK and PKP are approximately the same. The signs and symptoms of such rejection episodes are the same for both procedures and include increased redness, light sensitivity and blurred vision. If you experience these, you may be having a rejection episode and should call the office so that you can be evaluated immediately. Most rejection episodes are successfully terminated by using steroid eye drops. The sooner a rejection is treated the better chance for transplant survival. CONSENT FOR CORNEAL TRANSPLANT SURGERY In giving your permission for a corneal transplant, whether full-thickness (PKP) or partial-thickness (DSAEK), we want to make sure that you understand the following information: Corneal transplant surgery is the removal of your diseased cornea and the replacement of it with a donor cornea in your eye. With any eye surgery, there is a rare possibility that a loss of best corrected vision or even the eye itself could occur. This could be due to hemorrhage (bleeding), loss of corneal clarity, infection, detachment of the retina, glaucoma, or double vision. (Please sign and return to the office prior to surgery.) SIGNED CONSENT I have read and understand the above information, and have decided to have the corneal transplant surgery by the following method: full-thickness transplant (PKP) partial thickness transplant (DSAEK) Patient s signature: Legal guardian s signature: (if indicated) Witness signature: Physician s signature: Place of surgery (circle one): Washington Adventist Hospital Montgomery Surgery Center Suburban Hospital Date of surgery: Time of surgery:
CONSENT FORM. Procedure: Descemet s Stripping Automated Endothelial Keratoplasty (DSAEK)
CONSENT FORM Procedure: Descemet s Stripping Automated Endothelial Keratoplasty (DSAEK) Surgeon: Jeffrey W. Liu, M.D. Peninsula Laser Eye Medical Group 1174 Castro Street, Ste. 100 Mountain View, CA 94040
More informationDescemet s Stripping Endothelial Keratoplasty (DSEK)
Descemet s Stripping Endothelial Keratoplasty (DSEK) Your doctor has decided that you will benefit from a corneal transplant operation. This handout will explain your options to you. It explains the differences
More informationDescemet s Stripping Automated Endothelial Keratoplasty (DSAEK)
Descemet s Stripping Automated Endothelial Keratoplasty (DSAEK) John D. Goosey, MD Introduction DSAEK is a corneal transplant technique where the unhealthy, diseased, posterior portion of a patient s cornea
More informationINFORMED CONSENT FOR PHAKIC IMPLANT SURGERY
INFORMED CONSENT FOR PHAKIC IMPLANT SURGERY INTRODUCTION This information is being provided to you so that you can make an informed decision about having eye surgery to reduce or eliminate your nearsightedness.
More informationINFORMED CONSENT TO HAVE LASIK
A Division of Scott & Christie and Associates INFORMED CONSENT TO HAVE LASIK This information is to help you make an informed decision about having Laser Assisted Intrastromal Keratomileusis (LASIK), an
More informationALTERNATIVES TO LASIK
EYE PHYSICIANS OF NORTH HOUSTON 845 FM 1960 WEST, SUITE 101, Houston, TX 77090 Office: 281 893 1760 Fax: 281 893 4037 INFORMED CONSENT FOR LASER IN-SITU KERATOMILEUSIS (LASIK) INTRODUCTION This information
More informationINFORMED CONSENT FOR PHAKIC LENS IMPLANT SURGERY
INTRODUCTION INFORMED CONSENT FOR PHAKIC LENS IMPLANT SURGERY This information is being provided to you so that you can make an informed decision about having eye surgery to reduce or eliminate your nearsightedness.
More informationExplanation of the Procedure
Informed Consent Cataract Surgery with Intraocular Lens Implant Please initial below indicating that you have read and understand each section Introduction The internal lens of the eye can become cloudy
More informationTucson Eye Care, PC. Informed Consent for Cataract Surgery And/Or Implantation of an Intraocular Lens
Tucson Eye Care, PC Informed Consent for Cataract Surgery And/Or Implantation of an Intraocular Lens INTRODUCTION This information is provided so that you may make an informed decision about having eye
More informationCONSENT FOR CATARACT SURGERY REQUEST FOR SURGICAL OPERATION / PROCEDURE AND ANAESTHETIC
CONSENT FOR CATARACT SURGERY REQUEST FOR SURGICAL OPERATION / PROCEDURE AND ANAESTHETIC Your doctor has indicated that the condition of your eye appears stable and your cataract surgery and/or implantation
More informationEye Associates Custom LASIK With IntraLASIK Correction Of Nearsightedness, Farsightedness, and Astigmatism Using IntraLase TM Technology
Eye Associates Custom LASIK With IntraLASIK Correction Of Nearsightedness, Farsightedness, and Astigmatism Using IntraLase TM Technology INDICATIONS AND PROCEDURE This information is being provided to
More informationINFORMED CONSENT FOR LASIK SURGERY
IMPORTANT: READ EVERY WORD! This information is to help you make an informed decision about having laser assisted in-situ keratomileusis (LASIK) surgery to treat your nearsightedness, farsightedness and/or
More informationIntraLase and LASIK: Risks and Complications
No surgery is without risks and possible complications and LASIK is no different in that respect. At Trusted LASIK Surgeons, we believe patients can minimize these risks by selecting a highly qualified
More informationExcimer Laser Eye Surgery
Excimer Laser Eye Surgery This booklet contains general information that is not specific to you. If you have any questions after reading this, ask your own physician or health care worker. They know you
More informationINFORMED CONSENT FOR LASER IN-SITU KERATOMILEUSIS (LASIK) USING INTRALASE TM BLADE-FREE TECHNOLOGY
EYE PHYSICIANS OF NORTH HOUSTON 845 FM 1960 WEST, SUITE 101, Houston, TX 77090 Office: 281 893 1760 Fax: 281 893 4037 INFORMED CONSENT FOR LASER IN-SITU KERATOMILEUSIS (LASIK) USING INTRALASE TM BLADE-FREE
More informationCataracts. Cataract and Primary Eye Care Service...215-928-3041. Main Number...215-928-3000. Physician Referral...1-877-AT-WILLS 1-877-289-4557
Main Number...215-928-3000 Physician Referral...1-877-AT-WILLS 1-877-289-4557 Emergency Service...215-503-8080 Cataract and Primary Eye Care Service...215-928-3041 Retina Service... 215-928-3300 Cataract
More informationConsent for Bilateral Simultaneous Refractive Surgery
Consent for Bilateral Simultaneous Refractive Surgery Please sign and return Patient Copy While many patients choose to have both eyes treated at the same surgical setting, there may be risks associated
More informationAssociated Eye Surgeons
Associated Eye Surgeons 45 Resnik Road, Suite 301 Plymouth, MA 02360 Henry J Kriegstein MD, FACS Board Certified Lois M. Townshend, MD, FRCSC Board Certified Kristin S. Kenney, OD LASIK CONSENT FORM I.
More informationCorneal Transplant Surgery A Guide for Patients
Corneal Transplant Surgery A Guide for Patients Table of Contents Introduction... 1 What Is Corneal Transplant Surgery?... 2 The Donor Cornea... 3 The Surgery... 4 After Surgery... 5 Graft Rejection...
More informationGlenn B. Cook, M.D., Ph.D. DIPLOMATE AMERICAN BOARD OF OPHTHALMOLOGY Coronado Eye Associates
Glenn B. Cook, M.D., Ph.D. INFORMED CONSENT FOR CATARACT OPERATION AND/OR IMPLANTATION OF INTRAOCULAR LENS INTRODUCTION: RIGHT / LEFT This information is given to you so that you can make an informed decision
More informationINFORMED CONSENT FOR LASER IN-SITU KERATOMILEUSIS (LASIK)
Lasik Center 2445 Broadway Quincy, IL 62301 217-222-8800 INFORMED CONSENT FOR LASER IN-SITU KERATOMILEUSIS (LASIK) INTRODUCTION This information is being provided to you so that you can make an informed
More informationInformed Consent for Refractive Lens Exchange (Clear Lens Replacement)
Mark Packer, M.D. Informed Consent for Refractive Lens Exchange (Clear Lens Replacement) This surgery involves the removal of the natural lens of my eye, even though it is not a cataract. The natural lens
More informationLong Island Vision Experts
GENERAL INFORMATION Long Island Vision Experts 2 Lincoln Avenue, Suite 401 Rockville Centre, NY 11570 (516) 763-4106 INTACS INFORMED CONSENT Intacs (Keratoconus) The following information is intended to
More informationSt. Louis Eye Care Specialists, LLC Andrew N. Blatt, MD
St. Louis Eye Care Specialists, LLC Andrew N. Blatt, MD 675 Old Ballas Rd. Suite 220 St. Louis, MO 63141 Phone: 314-997-3937 Fax: 314997-3911 Toll Free: 866-869-3937 PEDIACTRIC CATARACT SURGERY A cataract
More informationINFORMED CONSENT FOR PHOTOREFRACTIVE KERATECTOMY (PRK)
INFORMED CONSENT FOR PHOTOREFRACTIVE KERATECTOMY (PRK) This information and the Patient Information booklet must be reviewed so you can make an informed decision regarding Photorefractive Keratectomy (PRK)
More informationInformed Consent for Cataract Surgery and/or Implantation of an Intraocular Lens (IOL)
Bruce H. Brumm, MD, PC 6751 North 72 nd Street, Ste 105 Omaha, NE 68122 (402) 572-2020 800-775-5909 www.brummeye.com Informed Consent for Cataract Surgery and/or Implantation of an Intraocular Lens (IOL)
More informationAdvanced Eyecare of Orange County Kim Doan, M.D. Eye Physician & Surgeon
Advanced Eyecare of Orange County Kim Doan, M.D. Eye Physician & Surgeon Patient Information Sheet: Cataract Surgery And/Or Implantation of an Intraocular Lens This information is given to you so that
More informationRefractive errors are caused by an imperfectly shaped eyeball, cornea or lens, and are of three basic types:
Tips on Lasik Eye Surgery If you re tired of wearing glasses or contact lenses, you may be considering Lasik eye surgery one of the newest procedures to correct vision problems. Before you sign up for
More informationSeeing Beyond the Symptoms
Seeing Beyond the Symptoms Cataracts are one of the leading causes of vision impairment in the United States. 1 However, because cataracts form slowly and over a long period of time, many people suffer
More informationWelcome to the Verisyse Seminar
Patient Seminar Welcome to the Verisyse Seminar Today we ll answer some of the most common questions about the Verisyse Phakic Intraocular Lens (IOL) including: Who is a candidate How the procedure is
More informationINFORMED CONSENT FOR CATARACT AND LENS IMPLANT SURGERY
INFORMED CONSENT FOR CATARACT AND LENS IMPLANT SURGERY 1. GENERAL INFORMATION This information is given to you to help you make an informed decision about having cataract and/or lens implant surgery. Once
More informationINFORMED CONSENT FOR LASER ASSISTED SUBEPITHELIAL KERATOMILEUSIS (LASEK)/PHOTO-REFRACTIVE KERATECTOMY (PRK)
INFORMED CONSENT FOR LASER ASSISTED SUBEPITHELIAL KERATOMILEUSIS (LASEK)/PHOTO-REFRACTIVE KERATECTOMY (PRK) Please read the following consent form very carefully. Please initial each page where indicated.
More informationCONSENT FOR INTRALASIK CORRECTION OF NEARSIGHTEDNESS, FARSIGHTEDNESS, AND ASTIGMATISM USING INTRALASE TM TECHNOLOGY BY AMJAD KHOKHAR, M.D.
CONSENT FOR INTRALASIK CORRECTION OF NEARSIGHTEDNESS, FARSIGHTEDNESS, AND ASTIGMATISM USING INTRALASE TM TECHNOLOGY BY AMJAD KHOKHAR, M.D. INDICATIONS AND PROCEDURE This information is being provided to
More informationPatient information factsheet. Cataract surgery. Consent for cataract surgery
Patient information factsheet Cataract surgery Consent for cataract surgery This leaflet gives you information that will help you decide whether to have cataract surgery. You might want to discuss it with
More informationINFORMED CONSENT FOR LASER IN-SITU KERATOMILEUSIS (LASIK)
Drs. Fine, Hoffman and Packer, LLC PHYSICIANS AND SURGEONS, EyeMDs OPHTHALMOLOGY I. Howard Fine, M.D. Richard S. Hoffman, M.D. Mark Packer, M.D. 1550 Oak Street, Suite 5 www.finemd.com Eugene, OR 97401-7701
More informationTHE EYES IN MARFAN SYNDROME
THE EYES IN MARFAN SYNDROME Marfan syndrome and some related disorders can affect the eyes in many ways, causing dislocated lenses and other eye problems that can affect your sight. Except for dislocated
More informationInformed Consent for Refractive Lens Exchange (Clear Lens Replacement)
Drs. Fine, Hoffman and Packer, LLC PHYSICIANS AND SURGEONS, EyeMDs OPHTHALMOLOGY I. Howard Fine, M.D. Richard S. Hoffman, M.D. Mark Packer, M.D. 1550 Oak Street, Suite 5 www.finemd.com Eugene, OR 97401-7701
More informationHow To Treat Eye Problems With A Laser
1550 Oak St., Suite 5 1515 Oak St., St Eugene, OR 97401 Eugene, OR 97401 (541) 687-2110 (541) 344-2010 INFORMED CONSENT FOR PHOTOREFRACTIVE KERATECTOMY (PRK) This information is to help you make an informed
More informationBACKGROUND INFORMATION AND INFORMED CONSENT FOR CATARACT SURGERY AND IMPLANTATION OF AN INTRAOCULAR LENS
OMNI EYE SPECIALISTS A Madison Street Company Proudly Owned by Employees Specializing in Medical and Surgical Care of the Eye 55 Madison St, Suite 355 Denver CO 80206 303-377-2020 800-GO-2-OMNI www.omnieye.com
More informationConsent for LASIK (Laser In Situ Keratomileusis) Retreatment
Consent for LASIK (Laser In Situ Keratomileusis) Retreatment Please read the following consent form very carefully. Please initial at the bottom of each page where indicated. Do not sign this form unless
More informationA PATIENT GUIDE TO EYE SURGERY
A PATIENT GUIDE TO EYE SURGERY RISKS ASSOCIATED WITH SURGERY There is a one in 1000 or less than one percent chance that a cataract surgery patient will experience complications that lead to blindness
More informationCONSENT FOR CATARACT SURGERY
CONSENT FOR CATARACT SURGERY INTRODUCTION The natural crystalline lens can become cloudy due to aging, trauma, disease or medications. This condition is called a cataract. When cataracts become visually
More informationPatient Information Cataract surgery
Patient Information Cataract surgery Introduction This leaflet has been written to help you understand more about surgery for a cataract. It explains what the operation involves, the benefits and risks
More informationDr. Booth received his medical degree from the University of California: San Diego and his bachelor of science from Stanford University.
We've developed this handbook to help our patients become better informed about the entire process of laser vision correction. We hope you find it helpful and informative. Dr. Booth received his medical
More informationCongratulations! You have just joined the thousands of people who are enjoying the benefits of laser vision correction.
Dear Valued Patient, Thank you for choosing Shady Grove Ophthalmology for your laser vision correction procedure. Our excellent staff is committed to offering you the highest quality eye care using state
More informationInformation For Consent For Cataract Surgery
Information For Consent For Cataract Surgery Your Ophthalmologist has diagnosed you with a visually significant cataract. The following handout will explain your condition and give you the information
More informationInformed Consent for Cataract Surgery or Clear Lens Extraction with Implantation of an Intraocular Lens
Informed Consent for Cataract Surgery or Clear Lens Extraction with Implantation of an Intraocular Lens Please read the following pages carefully, and initial and sign where indicated. Please do not sign
More informationWHAT IS A CATARACT, AND HOW IS IT TREATED?
4089 TAMIAMI TRAIL NORTH SUITE A103 NAPLES, FL 34103 TELEPHONE (239) 262-2020 FAX (239) 435-1084 DOES THE PATIENT NEED OR WANT A TRANSLATOR, INTERPRETOR OR READER? YES NO TO THE PATIENT: You have the right,
More informationLASIK. What is LASIK? Eye Words to Know. Who is a good candidate for LASIK?
2014 2015 LASIK What is LASIK? LASIK (laser in situ keratomileusis) is a type of refractive surgery. This kind of surgery uses a laser to treat vision problems caused by refractive errors. You have a refractive
More informationThe New Vision Confidence
At New Vision Laser Center you get our Unlimited LASIK 20/20 Plan! The Clear Choice for Laser Vision Correction We focus on results! Our exclusive Unlimited LASIK 20/20 Money Back Guarantee Plan provides
More informationCall today at 1 877 702 2020
Call today at 1 877 702 2020 VISIAN ICL LASIK is a well known, successful, and accurate laser vision correction procedure which has been FDA approved in the U.S. for 15 years. The majority of patients
More informationPATIENT INFORMATION BOOKLET
(060110) VISIONCARE S IMPLANTABLE MINIATURE TELESCOPE ( BY DR. ISAAC LIPSHITZ ) AN INTRAOCULAR TELESCOPE FOR TREATING SEVERE TO PROFOUND VISION IMPAIRMENT DUE TO BILATERAL END-STAGE AGE-RELATED MACULAR
More informationLASIK What is LASIK? Am I a good candidate for LASIK? What happens before surgery? How is LASIK done?
LASIK What is LASIK? Laser assisted in situ keratomileusis, or LASIK, is an outpatient surgical procedure used to treat myopia (nearsightedness), hyperopia (farsightedness), and astigmatism. With LASIK,
More informationBladeless LASIK and PRK
Bladeless LASIK and PRK Bladeless LASIK and PRK The specialists at North Shore-LIJ Laser Vision Correction understand how valuable your sight is to you, which is why we use the safest, most advanced technology
More informationVerisyse Phakic IOL. Facts You Need to Know About Implantation of the Verisyse Phakic IOL (-5 to -20 D) for the Correction of Myopia (Nearsightedness)
Verisyse Phakic IOL Facts You Need to Know About Implantation of the Verisyse Phakic IOL (-5 to -20 D) for the Correction of Myopia (Nearsightedness) Patient Information Brochure This brochure is designed
More informationInformed Consent for Refractive Lens Exchange (Clear Lens Extraction)
Informed Consent for Refractive Lens Exchange (Clear Lens Extraction) This form is designed to ensure that you have all the information you need to make a decision about whether or not you wish to undergo
More informationGlaucoma filtration surgery (Tube surgery)
Oxford Eye Hospital Glaucoma filtration surgery (Tube surgery) Information for patients page 2 This leaflet gives you information that will help you decide whether to have glaucoma tube surgery. You might
More informationConsent for Bilateral Simultaneous Refractive Surgery PRK
Consent for Bilateral Simultaneous Refractive Surgery PRK Please sign and return Patient Copy While many patients choose to have both eyes treated at the same surgical setting, there may be risks associated
More informationInformed Consent For Cataract Surgery And/Or Implantation of an Intraocular Lens
Informed Consent For Cataract Surgery And/Or Implantation of an Intraocular Lens INTRODUCTION This information is given to you so that you can make an informed decision about having eye surgery. Take as
More informationVision Correction Surgery Patient Information
Vision Correction Surgery Patient Information Anatomy of the eye: The eye is a complex organ composed of many parts, and normal vision requires these parts to work together. When a person looks at an object,
More informationVitrectomy Eye Surgery
Vitrectomy Eye Surgery Delivering the best in care UHB is a no smoking Trust To see all of our current patient information leaflets please visit www.uhb.nhs.uk/patient-information-leaflets.htm Vitreous
More informationUNDERSTANDING CATARACT SURGERY AND ITS BENEFITS
UNDERSTANDING CATARACT SURGERY AND ITS BENEFITS Regaining A Clear Outlook At Sutton Linder & Sutton and Eye Surgical Associates, our focus is on you. Every patient is unique and faces unique challenges,
More informationHow To Know If You Can See Without Glasses Or Contact Lense After Lasik
The LASIK experience I WHO CAN HAVE LASIK? To be eligible for LASIK you should be at least 21 years of age, have healthy eyes and be in good general health. Your vision should not have deteriorated significantly
More informationWang Vision Institute 1801 West End Avenue Nashville, TN 37203 615/321-8881
Wang Vision Institute 1801 West End Avenue Nashville, TN 37203 615/321-8881 The purpose of this consent for is to educate you on the Phototherapeutic Keratectomy (PTK) and Photorefractive Keratectomy (PRK)
More informationAgain, thank you for trusting Shady Grove Ophthalmology!
Dear Valued Patient, Thank you for choosing Shady Grove Ophthalmology for your Cataract procedure. Our excellent staff is committed to offering you the highest quality eye care using state of the art technologies.
More informationLASIK. Cornea. Iris. Vitreous
LASIK Introduction LASIK surgery is a procedure that improves vision and can decrease or eliminate the need for eyeglasses or contact lenses. If you and your doctor decide that LASIK surgery is right for
More information790 Montclair Road Suite 100 Birmingham, Alabama 35213 P. 205.592.3911 www.alabamavisioncenter.com
ALABAMA VISION CENTER PRICE M. KLOESS, M.D. ANDREW J. VELAZQUEZ, M.D. 790 Montclair Road Suite 100 Birmingham, Alabama 35213 P. 205.592.3911 www.alabamavisioncenter.com PHOTOREFRACTIVE KERATECTOMY PRE-OPERATIVE
More informationTABLE OF CONTENTS: LASER EYE SURGERY CONSENT FORM
1 BoydVision TABLE OF CONTENTS: LASER EYE SURGERY CONSENT FORM Risks and Side Effects... 2 Risks Specific to PRK... 3 Risks Specific to LASIK... 4 Patient Statement of Consent... 5 Consent for Laser Eye
More informationYCATARACTSURGER ACTSURGERYCATAR
YCATARACTSURGER ACTSURGERYCATAR What is a Cataract? A cataract is a clouding or opacity of the lens of the eye. In order to understand about a cataract and its effect on vision, it is important to understand
More informationAdvanced Cataract Surgery. We Bring Life Into Focus
Advanced Cataract Surgery We Bring Life Into Focus What is a Cataract? Standard Cataract Surgery A cataract is the clouding of the normally clear lens of the eye, which prevents light entering the eye
More informationSt. Louis Eye Care Specialists, LLC Andrew N. Blatt, MD
St. Louis Eye Care Specialists, LLC Andrew N. Blatt, MD 675 Old Ballas Rd. Suite 220 St. Louis, MO 63141 Phone:314-997-EYES Fax: 314-997-3911 Toll Free: 866-869-3937 STRABISMUS SURGERY (Post-Op Strabismus
More informationINFORMED CONSENT LASER IN SITU KERATOMILEUSIS (LASIK)
Edward C. Wade, M. D Christopher D. Allee, O. D. Ting Fang-Suarez, M. D. Jill Autry, O. D. Mark L. Mayo, M. D. Amanda Bachman, O. D. Randall N. Reichle, O. D Julie Ngo, O. D. INFORMED CONSENT LASER IN
More informationInformed Consent For Photorefractive Keratectomy (PRK)
Edward C. Wade, M. D Christopher D. Allee, O. D. Ting Fang-Suarez, M. D. Jill Autry, O. D. Mark L. Mayo, M. D. Amanda Bachman, O. D. Randall N. Reichle, O. D Julie Ngo, O. D. 6565 West Loop South Suite
More informationCustom Cataract Surgery. Laser and Lens Options
Custom Cataract Surgery Laser and Lens Options What is a Cataract? More than fifty percent of people over the age of 60, and quite a few younger than that, suffer from cataracts. In fact, cataracts are
More informationCataract Information for Patients
Cataract Information for Patients http://www.gov.pe.ca/health and click on Wait Times tab Page 1 What is a Cataract? A cataract is a clouding of the eye s naturally clear lens. When the lens becomes cloudy,
More informationOregon Eye Specialists, PC YOUR GUIDE CATARACT SURGERY. Improving VISION. Improving LIFE.
Oregon Eye Specialists, PC YOUR GUIDE TO CATARACT SURGERY Dinelli M. Monson, M.D. Comprehensive Ophthalmology Physician and Surgeon Tualatin Clinic: 19250 SW 65 th Ave, Ste 215 503.692.3630 Newberg Clinic:
More informationHow To Consent To Laser Eye Surgery
Please review all instructions for your Lasik/ASA procedure carefully. Call our office (425-899-2020) with any questions you may have before the day of your procedure. If you are a gas permeable or hard
More informationInformed Consent Enhancement Laser In Situ Keratomileusis (Lasik)
Edward C. Wade, M. D Christopher D. Allee, O. D. Ting Fang-Suarez, M. D. Jill Autry, O. D. Mark L. Mayo, M. D. Amanda Bachman, O. D. Randall N. Reichle, O. D. Julie Ngo, O. D. 6565 West Loop South Suite
More informationLASIK EPILASIK FEMTOSECOND LASER. Advantages
LASIK EPILASIK FEMTOSECOND LASER Advantages There are many advantages to having laser vision correction. Laser vision correction gives most patients the freedom to enjoy their normal daily activities without
More informationVISION PATTERN. What Can you Expect from the ReSTOR procedure?
RESTOR Presbyopia is the normal aging process that everyone experiences over the age of 40 which affects near vision. This usually results in the need for reading glasses or bifocals. The crystalline lens
More informationClearVision. Pacific ClearVision Institute. Informed Consent For Cataract Surgery And/Or Implantation of an Intraocular Lens
ClearVision Pacific ClearVision Institute Informed Consent For Cataract Surgery And/Or Implantation of an Intraocular Lens INTRODUCTION This information is given to you so that you can make an informed
More informationWAKE FOREST BAPTIST HEALTH EYE CENTER. LASIK Consent Form
1 WAKE FOREST BAPTIST HEALTH EYE CENTER LASIK Consent Form 1. GENERAL INFORMATION The following information is intended to help you make an informed decision about having Laser In-Situ Keratomileusis (LASIK).
More informationALABAMA VISION CENTER
ALABAMA VISION CENTER Price M. Kloess, MD Andrew J. Velazquez, MD 7191 Cahaba Valley Road, Suite 203 Birmingham, Alabama 35242 888-841-EYES www.alabamavisioncenter.com LASIK PRE-OPERATIVE INSTRUCTIONS
More informationTHE GUIDE TO REFRACTIVE LENS EXCHANGE SEE CLEARLY.
THE GUIDE TO REFRACTIVE LENS EXCHANGE SEE CLEARLY. EVERYBODY WANTS TO SEE CLEARLY Many of us take our sight for granted, whether it s forgetting how often we rely on it to guide us through our day-to-day
More informationWe look forward to see you & thanks for trusting us your eyes to us.
MEDICATIONS VIGAMOX (OCUFLOX) PURPOSE PREVENTS INFECTION DOSAGE USE 1 DROP 4 TIMES DAILY STARTING 1 DAY PRIOR TO SURGERY VALIUM (Diltiazem 5 mg) AMBIEN (ZOLPIDEM) RESTASIS (if prescribed) Provides relaxation
More informationRecovering. www.silversteineyecenters.com
Recovering from Vision Surgery www.silversteineyecenters.com Whether you are considering LASIK or PRK surgery to correct your vision, or you re thinking about lens implants to rid yourself of cataracts,
More informationLASIK Wavefront Guided idesign LASIK with IntraLase
LASIK Wavefront Guided idesign LASIK with IntraLase What is LASIK? LASIK (Laser Assisted In-Situ Keratomileusis), commonly referred to as laser eye surgery or laser vision correction is a safe High Definition
More informationCataract Surgery Patient Information
Cataract Patient Information 1. Within the human eye, there is a normal structure called the lens. In youth, this lens is clear, and light rays pass through and are focused by this lens as well as the
More informationCATARACT AND LASER CENTER, LLC
CATARACT AND LASER CENTER, LLC Patient Information Date: Patient Name: M F Address: Street City State Zip Home Phone: Work Phone: Cell Phone: E-Mail : Referred by: Medical Doctor: Who is your regular eye
More information1801 West End Avenue Suite 1150 Nashville, TN 37203, USA Office: 615.321.8881 Fax: 615.321.8874
1801 West End Avenue Suite 1150 Nashville, TN 37203, USA Office: 615.321.8881 Fax: 615.321.8874 T he purpose of this consent form is to educate you on the bladeless (Intralase) LASIK procedure. It is not
More informationA Patient Guide to Cataracts and Cataract Surgery
A Patient Guide to Cataracts and Cataract Surgery Kelly D. Chung, M.D. Oregon Eye Specialists To schedule surgery, contact our St. Vincent Clinic: (503) 292-0848 If you would like to help save trees and
More informationI have read and understood this page. Patient Initials
INFORMED CONSENT FOR PHOTOREFRACTIVE KERATECTOMY (PRK) AND ADVANCE SURFACE ABLATION (ASA) This information and the Patient Information booklet must be reviewed so you can make an informed decision regarding
More informationPATIENT CONSENT FOR LASER IN-SITU KERATOMILEUSIS (LASIK)
INTRODUCTION: You have been diagnosed with myopia (nearsightedness) or hyperopia (farsightedness) with or without astigmatism, or astigmatism alone. Myopia is a result of light entering the eye and focusing
More informationGuide to Cataract Surgery
Guide to Cataract Surgery According to Prevent Blindness America s Vision Problems in the U.S. report, more than 24 million Americans age 40 and older have cataract. By age 80, more than half of all Americans
More informationCataracts & Cataract surgery
Cataracts & Cataract surgery Normal Vision What is a cataract? Light passes through the cornea-the curved, clear front surface of the eye. It then passes through the pupil and the lens. The curved surface
More informationRisks and Limitations of LASIK Procedure
Drs. Fine, Hoffman & Packer, LLC 1550 Oak Street, Suite #5 Eugene, OR 97401 541-687-2110 From Drs. Fine, Hoffman, & Packer Risks and Limitations of LASIK Procedure Infection, serious injury, or even death,
More informationSince the mid 1990s, ReVision LASIK and Cataract Surgery Center has helped individuals from the Midwest and around the world enjoy great vision with
Refractive Surgery Options Since the mid 1990s, ReVision LASIK and Cataract Surgery Center has helped individuals from the Midwest and around the world enjoy great vision with the latest technologies and
More informationConductive Keratoplasty
Conductive Keratoplasty Conductive Keratoplasty Until recently, if you were one of the millions of people with a refractive error, eyeglasses and contact lenses were the only options for correcting vision.
More informationYour one stop vision centre Our ophthalmic centre offers comprehensive eye management, which includes medical,
sight see OLYMPIA EYE & LASER CENTRE Your one stop vision centre Our ophthalmic centre offers comprehensive eye management, which includes medical, At the Olympia Eye & Laser Centre, our vision is to improve
More informationYour Prescription for a New Beginning
Your Prescription for a New Beginning Now is the time to stop letting poor vision stand in between you and life's most meaningful moments. Surgeons at TLC Laser Eye Centers specialize in the latest vision
More information