Hoopes Vision is best known for LASIK and laser cataract surgery. However, in our ongoing commitment to provide the most advanced surgical vision correction available, our cornea and refractive surgery specialists are also highly skilled in a variety of other procedures. Some of these advanced procedures are not widely available elsewhere.
Since its introduction in the 1990s, LASIK has helped millions of people to see better, free from glasses and contact lenses. It is a fast, safe procedure with a speedy recovery time and excellent patient results.
However, there are a number of people who are not suitable candidates for LASIK due to factors such as extreme nearsightedness, thin or irregular corneas, or extremely dry eyes. For these patients, there is another option: implantable collamer lenses, or ICLs. These lenses, available in the United States since 2005, are currently approved for the treatment of moderate to severe myopia (nearsightedness). Hoopes Vision is one of the most experienced ICL implanting surgical providers in the country.
In the ICL procedure, a corrective lens similar to a contact lens is placed within the eye itself. Early versions of the ICL lens were implanted in front of the iris, in what is called the anterior chamber of the eye, leaving the lens visible from close range. However, modern implants such as the Visian ICL are placed in front of the eye’s natural lens but behind the iris, so that they are invisible to outside observers.
Visian ICL is currently available in the United States for myopic patients with prescriptions between -3.00 and -20.00 without significant astigmatism. (Sometimes it is possible to use LASIK or PRK to correct astigmatism in an ICL patient.) ICL implants that correct astigmatism and farsightedness are currently available in Europe and Asia and may one day be approved for implantation in the U.S.
Advantages of this procedure include its speed – the procedure takes only minutes per eye – and the remarkably clear vision it provides the patient. An additional advantage of ICL is that, since it does not remove tissue like laser surgery, it is completely reversible in the rare event that the patient’s vision changes significantly later in life.
While most people are great candidates for LASIK surgery and obtain great results with it, ICL is an exciting new option that gives more people than ever before the opportunity to see the world without the need for contact lenses or glasses.
Keratoconus is a degenerative eye condition that causes the shape of the cornea to change from a round dome to an irregular cone shape as the central cornea becomes progressively thinner and weaker. Keratoconus affects about 1 in 2000 people. Keratoconus causes impaired vision as the condition progresses, often reaching a point where glasses and contact lenses are no longer able to provide adequate vision. Historically, up to 25 percent of keratoconus cases eventually require a corneal transplant.
However, over the past several years, new treatment options for keratoconus have been introduced. These treatments can delay or prevent the necessity of corneal transplantation. The board-certified corneal specialists at Hoopes Vision are at the forefront of these advanced technologies. One such new treatment option is the Intacs procedure. Intacs are small, curved, clear plastic inserts that are placed into the outer edges of the cornea. These inserts strengthen and reshape the cornea, slowing or stopping the progression of keratoconus, improving vision and helping the patient to tolerate contact lenses.
Intacs were first approved by the FDA in 1999 and given further approval as a therapeutic device in 2006, making it easier for patients to secure insurance reimbursement for this sight-saving procedure. In the Intacs procedure as performed at Hoopes Vision, the channels into which the rings are inserted are created using a fast, extremely accurate femtosecond laser. The surgeon then places into those channels a set of Intacs devices that have been selected for the correct size to change the shape of the patient’s cornea, reducing the steepening of keratoconus and adding stability.
The KAMRA® inlay is an advanced vision correction technology that is revolutionizing the way presbyopia, or “after-40 vision,” is treated. Hoopes Vision has been closely involved with this device since the early research phase and was, in fact, the largest single participant in the FDA trials in terms of patients treated. Our surgeons and staff are uniquely well-qualified to assess patients’ candidacy for the KAMRA inlay.
The KAMRA™ corneal inlay is a device that restores near vision and frees patients from the constant frustrations of reading glasses. It is a small, round ring, measuring 3.8 mm in diameter, which is placed in a small tunnel in the center of the cornea. Once placed, this ring is nearly invisible to outside observers. The KAMRA™ inlay allows patients over the age of 40 to see clearly in the distance as well as close up, reducing or eliminating the need for reading glasses, bifocals, or monovision. It is a safe, quick, and reversible procedure.
The tunnel into which the KAMRA inlay is placed is created by a computer-guided femtosecond laser, the same type of laser used in blade-free LASIK. The surgeon then carefully places the inlay into that tunnel, centering it over the patient’s pupil. Once placed, the inlay is virtually invisible to observers.
In spite of all the advancements that have been made in the treatment of keratoconus in recent years, some patients still require cornea transplants in order to preserve or restore vision. Patients who lose vision due to injury or scarring of the cornea may also require transplants. Until recently, the only form of transplant procedure appropriate for these patients was penetrating keratoplasty, or PK, where a circular disc of corneal tissue is removed from a donor cornea, placed into a similarly-sized space in the recipient’s cornea, and secured with sutures. While PK still comprises the vast majority of corneal transplant procedures, there have been several recent advancements in transplant technology.
In the early 2000s, a new procedure, deep anterior lamellar keratoplasty (DALK), was introduced. DALK differs from PK in that the recipient’s innermost layer of corneal tissue, or endothelium, is left intact, with only the central and outer layers being replaced with donor tissue. DALK represents an advance over PK in that the probability of the patient’s body rejecting the corneal graft is much lower.
In the past three years, there has been yet another advance in corneal transplant technology. Dr. Michael J. Bradley, a corneal specialist and surgeon at Hoopes Vision, is one of a select handful of corneal surgeons performing the advanced, laser-assisted FLEDALK corneal transplant procedure. FLEDALK, which stands for Femtosecond Laser Enhanced Deep Anterior Lamellar Keratoplasty, is a version of the DALK procedure. FLEDALK differs from the conventional DALK surgery in that a femtosecond laser, similar to those used to create corneal flaps for LASIK patients, is used to harvest the donor cornea, as well as make the tissue cuts that prepare the patient’s eye to receive the donor tissue. The femtosecond laser offers improved accuracy and precision compared to the manual incisions used in the standard DALK procedure, leading to better tissue alignment, a stronger wound, and faster visual recovery.
Cornea transplants are typically covered by insurance. Intacs can be covered by insurance, but usually require additional applications and paperwork (which our office is happy to help with). Corneal cross-linking and ICL are not currently covered by insurance.
ICL candidates are between the ages of 20 and 45, have stable myopic (nearsighted) prescriptions of between -3.00 and -20.00, and do not have significant astigmatism. Our free consultation for ICL surgery includes all the necessary testing to determine whether ICL surgery is a good option for you.
There were 47,530 corneal transplants performed in the U.S. in 2014. Since 1961, more than 1,500,000 men, women, and children ranging in age from 9 days to 100+ years have had their sight restored.
Hoopes Vision’s Salt Lake City-area facility is also home to EyeSurg of Utah, a state-of-the-art, Medicare-approved ambulatory surgery center (ASC). Patients come to EyeSurg from all over Utah and around the country for such procedures as cataract surgery, including the newest custom laser cataract procedures, lens implants like the Visian ICL, and corneal transplants including cutting-edge partial thickness transplant surgeries that are available in only a handful of clinics in the world.
At Hoopes Vision, we realize that finding the money to pay for your surgical procedure can be challenging. In order to help our patients obtain their life-changing and miraculous surgery, we offer a variety of different financing options and ways to reduce the cost while still maintaining superior quality care. Whether through 0 percent interest 24-month financing, or low-interest payments for up to five years, patients can undergo elective vision correction procedures at a reasonable, affordable cost. Our practice has a plan to fit your budget. Our counselors provide complete financing information during your VIP consultation and will help you find the financing plan best suited to you and your needs.