Surgeries We Perform Overview - Laser Refractive Surgeries - LASIK and PRK in Milwaukee

As a highly skilled and accomplished LASIK and PRK (Advanced Surface Ablation) Milwaukee surgeon, Dr. Hale specializes in a variety of advanced vision correction procedures. As the first surgeon to bring the Intralase femtosecond bladefree LASIK system to Milwaukee in 2004, he had multiple years of experience performing iLASIK. He also performs all available types of laser treatments such as PRK and monovision. Most importantly, a thorough understanding of both laser and implant technology is essential to provide patients with the widest range of options for the correction of their unique visual needs. There are situations in which the combination of lasers and implants are necessary to achieve the ultimate result, so knowing only one phase of this two pronged approach is not sufficient. Dr. Hale's reputation for examining all potential options and a very open and honest discussion concerning the possibilities has made him a resource for patients even outside of our area. At most Laser Vision Correction Centers laser is all they do, and you are either a candidate for some form of laser treatment or you are not. At TLC Milwaukee/Hale Vision we don't offer good/better/best options that can be confusing to patients. We pride ourselves in utilizing the finest equipment in the area to perform the highest quality treatment we can in every case. The following pages will describe in detail the different options available through Hale Vision for the correction of almost any refractive problem in an otherwise healthy eye.
CONTOURA - Blade Free LASIK by WaveLight
This is the combination of the WaveLight FS200 femtosecond laser to create a corneal flap using infrared light followed by the Wavelight EX500 excimer laser to reshape the cornea using ultraviolet light. This represents the most advanced form of LASIK available today. In combination with WaveLight's topographic guided treatment for myopia, and astigmatism, the procedure is called CONTOURA.
PRK (PhotoRefractive Keratectomy)
Corneal surface ablation with the excimer laser (Wavelight) may be performed in some cases where creating a flap may be difficult or undesirable. This can be done using the Wavelight laser in the Wavefront Optimized mode (on-label) or in the CONTOURA topography-guided mode (off-label). See The PRK Procedure.
Phakic IOL - Visian Implantable Collamer Lens
Some patients, for a variety of reasons, are not good candidates for laser surgery but still desire vision correction surgery. For a number of years now, the FDA has been testing a new class of implantable lenses that can be used to reduce nearsightedness, farsightedness and eventually astigmatism. There are several models of these implants and one was approved in late 2004 for the treatment of nearsightedness without significant accompanying astigmatism. Another model will hopefully be approved early to mid 2005. These two approaches to the same problem are somewhat different. The first phakic IOL approved for refractive use is called the Verisyse by AMO. This implant is inserted through an incision in the cornea and clips onto the colored iris for stabilization and positioning. The probable second to receive approval will be the Visian lens by Staar Surgical. This implant is inserted through a very small incision in the cornea and is placed behind the colored iris.
Toric IOLs Implants - Corrects Astigmatism
Toric IOLs are similar to standard single focus implants but are different in that they incorporate astigmatism correction into the implant. Thus, astigmatism may be improved to the point that further correction with either laser vision correction, corneal relaxing incisions, or glasses may not be required. As of yet, this toric or astigmatism correction is not available in the accommodative or pseudo-accommodative implants but will be in the future.
Multifocal IOL Implants
A new era in implantable lenses is upon us. The FDA approved the first "accommodative" IOL in November 2003. This new type of IOL attempts to restore the eye's ability to focus on near objects without the need for reading glasses, while still allowing the patient to see well in the distance. At Hale Vision Laser & Implant Center, we believe that over the next decade we will see tremendous advancements in this area, and this type of surgery will become the surgery of choice for our Milwaukee IOLs patients over fifty-five.

The Crystalens AT-45was the first "accommodative" IOL approved by the FDA in 2003. It was followed in 2006 by the first modification called the Crystalens Five-O. The Crystalens HD was announced in 2008 and the latest version, the Crystalens AO, was approved in 2010.

While the Crystalens was the first in this catagory, it lacks the near focusing power required to make most of us free from all glasses. Newer types of lenses in this category are in development, such as the Sychrony lens, and will be passing through the FDA approval system in the next few years.

Pseudo-Accommodative IOLs include the ReZoom lens, the ReStor lens, and the Technis Multifocal lens. These lenses attempt to provide the patient with distance, intermediate, adn near vision by creating different focus points due to variable power from the stationary implant, rather than the implant flexing or changing position in the eye the way the Accommodative implants do.
All intraocular lenses will have accompanying complications that are different than those of laser treatments, as the lens are placed within the eye and laser treatments are performed on the surface or under a thin surface flap corneal tissue. Be sure to discuss these issues with your surgeon before having any one of these procedures.
Specialty Procedures
TLC Milwaukee/Hale Vision is involved in the constant evaluation of new and advanced treatments for old and complicated problems. One of those problems is a condition called Keratoconus. This can be an inherited or sporadic condition of the cornea that causes progressive changes in vision with slow degradation of the overall visual quality, which, in its worse cases, lead to corneal transplantation. There has progress in the treatment of keratoconus involving the use of insert-able acrylic arc segments that act as structural supports within the cornea to stabilize the changes and improve the vision. Another advancement in this field is called Corneal Cross-linking. This involves a photo-chemical process that is used to cause an inhanced binding of the structural elements in the cornea, this improving their resistance to shape change.

Intacs for keratoconus are already being performed with the use of the femtosecond laser to fashion the corneal channels in which the intac segments are placed and the Pentacam imaging system to enhance the placement depth of these structural supports.

The FDA granted approval of Corneal Cross-linking in the United States for the treatment of keratoconus and we are currently evaluating the possibility of adding this to our list of available treatments.
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First and foremost, I'd like to say thank you to Dr. Lanny Hale and his team for changing my life for the better. I had grown so tired of the daily h... Read More

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20350 Watertower Blvd, Suite 200
Brookfield, WI 53045
Phone (262) 789-9179

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