The latest technique in corneal transplantation

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The cornea is known as the “window of the eye,” protecting the eye from infection and foreign material and focusing or refracting light. The cornea needs to be clear and the correct shape for you to see accurately. When it becomes cloudy or misshapen, a cornea transplant may be necessary. Read on to learn about the latest technique in corneal transplantation called the DSAEK procedure.

What is DSAEK?

DSAEK is short for Descemet-Stripping Automated Endothelial Keratoplasty. It is a less-invasive procedure that gives the patient clear vision and a shorter recovery time than with traditional corneal transplantation methods. Conventional surgery requires 16 surgeries and a prolonged recovery time, plus many patients experience astigmatism after surgery, with full recovery taking up to two years.

What happens during the DSAEK Procedure?

During this outpatient procedure, the patient is given topical anesthesia so they don’t feel anything. The damaged endothelial layer is replaced, while the remainder of the cornea is left undisturbed. The new cornea is inserted through a tiny incision that needs one suture for closure. The surgeon then injects an air bubble underneath the cornea to make sure it is centered on the eye.

What is recovery like?

The DSAEK Procedure offers a shorter post-op recovery, fast visual recovery and less chance of rejection than conventional surgery. Patients will take antibiotics and steroid eye drops and return the next day for post-surgical follow-up. Some patients may need a second air bubble injection to re-center the cornea. Patients will need to use eye drops for several years to help with anti-rejection.

What will my vision be like after surgery?

You can expect blurry vision immediately after surgery due to swelling and the air bubble used to center the cornea. When the bubble dissolves and swelling dissipates, your vision will improve. Some patients will need to wear new glasses during healing.

When can I expect full results?

It may take up to three months for your best vision to reveal itself.

If you are interested in learning more about corneal transplants and the DSAEK Procedure, set up a consultation by calling Maehara Eye Surgery & Laser at 808.955.3937.

What’s the criteria to be considered a candidate for LASIK?

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Laser vision correction, or LASIK, is a type of refractive surgery that can help patients get rid of eyeglasses and contact lenses, but the surgery may not be right for everybody. If you’ve been considering LASIK, read on to learn whether you would be a candidate and what you need to consider as you weight your decision to undergo surgery.

  • You are 18 years old or older. Your vision can change throughout your youth and doesn’t stabilize until you reach adult age. LASIK is FDA-approved for people age 18 and older who have achieved ocular maturity.
  • You have a stable prescription, which means your prescription hasn’t changed for at least two consecutive years.
  • You should be generally healthy, free of diseases, injuries and infections.
  • You do not have pink eye, dry eye or another eye condition. These will need to be resolved prior to LASIK surgery.
  • You are not pregnant or nursing. Hormonal fluctuations can affect vision stability, so it’s important to wait at least three months after you’ve stopped nursing before considering surgery.
  • If you have a condition such as cataracts, diabetes, autoimmune diseases such as lupus or rheumatoid arthritis, LASIK may not be a good choice for you.
  • Certain medications such as corticosteroids and acne medications can affect the healing process, so you will need to share what medications you’re taking when you consult with your doctor.
  • If your cornea is too thin or misshapen, or if you have glaucoma or corneal scarring, you may not be a candidate for surgery.
  • If you have a positive outlook and realistic expectations for vision correction, then you may be a good candidate for LASIK.
  • You understand and you are OK with the fact that you may need to wear glasses when reading or driving at night.

If you want to learn more about laser vision correction and see if it’s right for you, schedule a consultation by calling Maehara Eye Surgery & Laser at 808.955.3937.

Glaucoma

What you need to know about glaucoma

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Glaucoma is one of the leading causes of blindness for people over the age of 60. When found early, glaucoma can be treated and slow or prevent vision loss. Read on to learn more about glaucoma, the signs and symptoms and treatment options.

What is glaucoma?

Glaucoma is a group of eye conditions responsible for damaging the optic nerve, which is essential for good vision. It is caused by abnormally high pressure in the eye. 

Signs and symptoms

Unfortunately, many forms of glaucoma have no waning signs. The change is so gradual that you may not notice anything is wrong with your vision until the condition has reached an advanced stage. 

If you have frequent, patchy blind spots in your peripheral or side vision or central vision or tunnel vision, you may have open-angle glaucoma. Acute angle-closure glaucoma presents with severe headache, eye pain, nausea and vomiting, blurred vision, halos around lights and eye redness. 

Regular eye exams

If left untreated, glaucoma will eventually cause blindness. Since glaucoma often comes with no warning signs, it’s vital to have regular eye exams. An eye exam should include measurements of your eye pressure. When a diagnosis can be made in the early stages of glaucoma or any eye disease or condition, it can be treated more appropriately. If glaucoma is caught early, vision loss can be slowed or even prevented. 

Prevention

In addition to getting regular eye exams, it’s important to know your family’s eye health history, as genetics play a role in glaucoma development. Follow a moderate exercise program. Take prescribed eye drops regularly, even if you don’t exhibit any symptoms. Also wear eye protection as serious eye injuries can lead to glaucoma.

Treatment

If you are diagnosed with glaucoma, the damage done cannot be reversed. Treatment options may include prescription eyedrops, oral medications, laser surgery or traditional surgery. 

If you are concerned about glaucoma and want to learn more about prevention or treatment, it’s important to schedule an eye exam today by calling Maehara Eye Surgery & Laser at 808.955.3937. 

Are you at risk for cataracts?

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If your vision has been getting blurry or you have an increased sensitivity to glare, you may be starting to develop cataracts. Over time, this slow-progressing condition will interfere with your vision and may lead to cataract surgery. Can you prevent cataracts? Read on to learn more about cataracts and treatment.

What are cataracts?

The lens of your eye is normally clear. It’s positioned behind the colored part of the eye called the iris. The lens focuses light that passes through your eye and produces clear images on your retina. The retina function like the film in a camera. Age-related conditions and other medical conditions can cause tissues in the lens to break down, causing a clouding within the lens. A cataract develops slowly as the clouding becomes denser and consumes a larger part of the lens. Over time, your vision will become blurred.

What are the risk factors?

Age, smoking, consuming excessive amounts of alcohol, high blood pressure, obesity, diabetes and excessive exposure to sunlight are some of the risk factors for cataracts. Previous eye injuries or surgery also increase your risk. Prolonged use of certain medications may be a factor as well.

Can you prevent cataracts?

While there isn’t a way to prevent cataracts, there are some things you can do to improve your risk factors. Be sure to have regular eye examinations based on your age and family history. If you smoke, quit. It’s important to manage certain health conditions such as diabetes, obesity and high blood pressure that increase your risk. Consume a healthy diet rich in fruits and vegetables. If you drink, reduce your use of alcohol. Be sure to wear broad-spectrum sunglasses that block ultraviolet B rays when you’re outside.

What are the treatment options?

Once your lenses have started to cloud, they will not stop and won’t return to their original clear condition. The only treatment for cataracts is surgery to replace the lenses. Surgery consists of replacing the clouded lens with an intraocular lens implant, or IOL. It’s a minimally invasive, small-incision, no-stitch procedure. Vision begins to improve a few days after surgery, and full healing can take up to two months. If both eyes require surgery, the second surgery will be done 1-2 months after the first surgery.

If you’re concerned about cataracts or other eye conditions, schedule an eye exam today by calling Maehara Eye Surgery & Laser at 808.955.3937.

Am I a candidate for LASIK?

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If you’ve been wearing glasses or contacts but are wondering what life would be like to be able to see without them, you should talk to your doctor about LASIK laser vision correction. A comprehensive consultation with Dr. Maehara will determine if you are a good candidate for LASIK or other vision correction options. Here are some criteria to consider:

  • You have a stable prescription, which means your prescription hasn’t changed for two consecutive years or longer. Once your prescription stabilizes, there is less likelihood of your nearsightedness or farsightedness progressing and negating any benefit from LASIK vision correction.
  • You are 18 years old or older and have achieved ocular maturity, which means your eyes have fully developed. LASIK is FDA-approved for people ages 18 years and older. The only way to know if your eyes have achieved ocular maturity is to have a consultation with your eye doctor to discuss laser vision correction.
  • Your eyes are healthy, free of diseases, injuries and infections, and you are in good general health. If you have an ocular disease such as cataracts, diabetes or autoimmune diseases like lupus or rheumatoid arthritis, LASIK and other laser vision correction options make not be a good choice for you. It’s also important that you share your entire health history and current medical conditions with your doctor to determine whether you are a good candidate for surgery. Pregnancy and certain medications such as acne medications and corticosteroids may affect the healing process.
  • You have realistic expectations. It’s important to understand the limitation of laser vision correction and to have informed expectations for the procedure, recovery and results.

If you’re wondering if you’re a good candidate for LASIK, now is the time to have a conversation with your eye doctor and share your vision goals. Dr. Maehara will help you understand what your options are for laser vision correction and map out a plan. Schedule a consultation with Dr. Maehara at Maehara Eye Surgery & Laser today by calling 808.955.3937.

Protecting your eyes from the sun year-round

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So much attention is given to protecting your skin in the sun, but it’s just as important to protect your eyes from the sun. Dangerous ultraviolet radiation from the sun can damage your eyes and delicate skin surrounding them. Read on to learn more about eye health and sun exposure and what you can do to protect your eyes.

Eye conditions related to sun exposure

UV radiation is a cause of several serious eye conditions. At least 10 percent of cataract cases can be attributed to UV exposure, according to the Skin Cancer Foundation. Cataracts cloud and yellow the lens of your eye, leading to progressive vision loss and blindness. Macular degeneration is a common cause of vision loss for people over the age of 60. It’s due to cumulative UV damage to the central portion of the retina.

Did you know you can sunburn your eye? UV exposure can cause a corneal sunburn, called keratitis. The cornea is the clear surface that admits light and images to the retina. This condition occurs in skiers and hikers because of how the sun reflects off of water, snow and ice.

Conjunctival eye cancers were once rare but are increasing, especially in older people.

Damage to the eyelids

UVA and UVB rays from the sun and indoor tanning produce DNA changes that can cause premature aging on the skin around your eyes and can lead to skin cancer on the eyelids. Eyelid skin cancer most often occurs on the lower lid because it receives the most sun exposure. Eyelid cancers usually respond well to surgery and post-surgical care when diagnosed and treated early. Left untreated, eyelid cancers can cause tissue damage and blindness.

How to protect your eyes in the sun

There are simple things you can do to protect your eyes and skin every day while also enjoying the outdoors:

  • First and foremost, wear sunglasses that block 99-100 percent of UVA and UVB light. Make sure you wear them anytime you are out in the sun and year-round as sun damage can occur any time of year. Also, be aware that the sun’s harmful rays can pass through clouds, so wear sunglasses even when there’s cloud cover.
  • Wear a wide-brimmed hat to protect your face and the top of your head.
  • Use a broad-spectrum sunscreen with an SPF of 15 or higher. Select one that is safe and for your face and eyes.
  • Seek shade whenever possible. The sun is most intense between 10 a.m. and 4 p.m.

If you’re experiencing problems with your eyes, call 808.955.3937 today to schedule an appointment with Dr. Jeffrey Maehara at Maehara Eye Surgery & Laser.

Risk factors for glaucoma and what you can do about them

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Glaucoma is an age-related eye disease where increased pressure in the eye damages your eye’s optic nerves, getting worse over time. Too often, the people who have the most common type of glaucoma do not have any warning signs. By the time they notice symptoms, it’s usually in the later stages of the disease. Glaucoma is one of the leading causes of blindness for people age 60 and older. Read on for risk factors and what you can do to reduce your risk factors and protect your vision.

In healthy eyes, fluid is produced in the ciliary body, enters the eye and drains through tiny passages called the trabecular meshwork. If you have glaucoma, these passages become blocked and pressure in the eye rises.

What are the risk factors?

Risk factors for glaucoma include:

  • Ancestry is African American, Irish, Japanese, Hispanic, Russian, Inuit or Scandinavian descent
  • Over the age of 40
  • Family history of glaucoma
  • High blood pressure, heart disease, diabetes or sickle cell anemia
  • Poor vision
  • Eye injury
  • Corneas are thinner than usual
  • High eye pressure
  • Nearsighted or farsighted

 Can I prevent glaucoma?

 You can help slow the progress of glaucoma or detect it in its early stages by doing the following:

  • Get comprehensive eye exams. You should get one every 5-10 years if you’re younger than 40; every 2-4 years for those ages 40-54; everyone 1-3 years for those ages 55-64; and every 1-2 years for those 65 and older. If you’re at risk of glaucoma, you’ll need more frequent screening. Your doctor can recommend the right screening schedule for you.
  • Regular exercise can help prevent glaucoma by reducing eye pressure. Ask your doctor for recommendations.
  • Know your family health history. Glaucoma tends to run in families, so you may need more frequent screening if you are at increased risk.
  • Wear eye protection. Eye injuries can lead to eye conditions and diseases such as glaucoma, so protect your eyes when playing certain sports or using power tools.

 Glaucoma treatment

Some cases can be treated with medication. Other cases may require laser or traditional surgery to lower eye pressure.

Regular eye exams will help you stay on top of any eye conditions or diseases so you can address them at the earliest, most treatable stages. Call 808.955.3937 today to schedule an appointment at Maehara Eye Surgery & Laser.

6 simple steps to improve your eye health

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It’s essential to be good to your eyes, especially as you age. Even if your eyes feel healthy and you don’t wear glasses or contacts, you need to think about how to maintain and improve your eye health. Here are six simple steps you can take to keep your eyes healthy and stave off age-related vision problems for as long as possible:

Eat a well-balanced diet. Eating well has many health benefits. Nutrients such as omega-3 fatty acids, lutein, zinc and vitamins C and E may help prevent or delay the onset of vision problems such as cataracts or macular degeneration. Green leafy vegetables, oily fish such as salmon and tuna, eggs, nuts, beans and oranges or other citrus fruits are easy ways to get those essential vitamins and nutrients.

Maintain a healthy weight. Obesity can increase your risk for type 2 diabetes, which is a leading cause of cataracts and diabetic retinopathy, which can cause vision loss and blindness in adults.

Watch your blood pressure. High blood pressure can increase your risk of some eye diseases such as hypertensive retinopathy. This is when hypertension causes damage to the blood vessels in the retina of the eye.

Quit smoking. Smoking makes you more prone to getting cataracts and other eye diseases. Talk to your doctor about smoking cessation programs and medications to help you kick the habit.

Wear sunglasses and wide-brimmed hats. Protecting your eyes from the sun’s harmful ultraviolet rays is an easy way to maintain eye health, as too much UV exposure increases your chances of cataracts and macular degeneration. Sunglasses that block 99-100% of UVA and UVB rays are most helpful. Polarized lenses are designed to reduce glare while you’re driving.

Take a break from your computer and phone. Staring at a computer or phone screen for too long can cause eye strain, blurry vision, dry eyes, trouble focusing at a distance, and more. Be sure you take breaks every 20 minutes to rest your eyes. Look 20 feet away for 20 seconds at a time.

Get an eye exam. Regular eye exams are essential to staying on top of any problems and spotting any diseases and conditions early, when they’re easier to treat. To learn more about improving the health of your eyes, schedule your next exam with Dr. Jeffrey Maehara at Maehara Eye Surgery & Laser today by calling 808.955.3937

Can you prevent cataracts?

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A cataract is a clouding in the lens of the eye that blurs vision and increases sensitivity to glare from lights. They develop as we age or when an injury to the eye changes the tissue that makes up the eye’s lens. Aging, family history, smoking, high blood pressure, having certain medical conditions like diabetes are some of the biggest risk factors for developing cataracts. There are no studies showing how to prevent or slow the progression of cataracts, but doctors do believe the following tips can help:

Have regular eye exams. Make sure you have a comprehensive eye exam every 1-2 years depending on your age and risk factors and whether you currently wear glasses or contacts. These exams are important as your eye doctor can diagnose and treat problems in the earliest stages.

Choose a healthy diet with lots of fruits and vegetables. Fruits and vegetables are full of antioxidants like vitamins C and E that can help maintain the health of your eyes.

Stop smoking and reduce alcohol consumption. Smoking and excessive alcohol use are associated with various health problems. If you smoke, there is a higher risk of developing cataracts. And studies show an increase in cataracts in those who consume more than two drinks per day.

Manage your health problems. If you have a medical condition such as diabetes, you have a higher risk for cataracts. Sugar levels that are too high for a long period can cause the lens of the eye to swell and cause damage. It’s important to discuss your medical history with your eye doctor and let him know whenever your medical history has changed.

Protect your eyes from the sun. Ultraviolet light from the sun can damage your eyes and contribute to the development of cataracts. It’s important to wear sunglasses that block UVB rays when you’re outside.

More than half of all Americans have a cataract or have cataract surgery by age 80. It’s important to schedule regular eye exams and see your eye doctor when you have vision changes to stay on top of your eye health. Schedule your next eye exam with Dr. Jeffrey Maehara at Maehara Eye Surgery & Laser today by calling 808.955.3937.

Differences between LASIK and PRK vision correction options

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While laser-assisted-in-situ keratomileusis (LASIK) is the most popular procedure to correct nearsightedness, farsightedness, and astigmatism, photorefractive keratectomy (PRK) was the first and most common type of laser surgery for vision correction and is still performed frequently today. So what are the differences? Here, we break down them down: 

 

Both LASIK and PRK reshape the cornea to correct refractive errors. With LASIK, a corneal flap is created using a laser or blade. A computer-controlled surgical laser reshapes the layers of the cornea to correct distorted vision. The flap is then put back into place over the cornea and heals over the next few days. With PRK, the outer layer of the cornea called the epithelium is removed to gain access to the cornea for the laser to reshape it. After surgery, the epithelium grows back over time. 

 

Because PRK doesn’t create a flap, it could be a better procedure for patients with thin or irregular corneas. PRK is also a good option for patients who have large pupils or concerns about complications related to the flap created during the LASIK procedure. 

 

PRK recovery is somewhat more involved than with LASIK. This is because the epithelium is removed with PRK. Recovery can vary from a few days to a few weeks as the epithelium grows back. In most cases, you can drive a car in one to three weeks, but it can take up to six months for your final results to stabilize. With LASIK, the flap that’s created in the corneal stroma has to heal, which happens more quickly. Most patients see normally within several hours after surgery, and it takes only a few days to return to functional vision after LASIK. 

 

The “Wavefront” technology with LASIK improves not only how much you can see but also how well you can see. This state-of-the-art technology creates a three-dimensional corneal map to guide the laser to treat your specific visual irregularities rather than a “one size fits all” approach to patients with the same prescription. This reduces the risk of post-surgery complications such as glare, halos, and problems with night vision. 

 

Both LASIK and PRK are safe and effective surgeries. Your consultation with Dr. Jeffrey Maehara will help you determine which option is best for you. To learn more about your options for permanent vision correction, call 808.955.3937 today.