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Contacts & Specialty Lenses PDF Print E-mail
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Dr. Edward Boshnick maintains a cutting edge practice devoted to the restoration of vision and comfort lost as a result of refractive eye surgery (including LASIK and Radial Keratotomy), keratoconus, corneal transplant surgery, pellucid marginal degeneration, extreme dry eye, corneal dystrophies, corneal trauma and Stevens-Johnson Syndrome.

Specializing in contact lens care, children's vision, orthokeratology and vision care for the partially sighted (low vision). Dr. Boshnick has been a clinical investigator for both the FDA and several major contact lens manufacturers for over 20 years. Dr. Boshnick has also lectured extensively and authored a number of professional articles dealing with contact and scleral lenses and orthokeratology.


Treatment for Post-Surgical Vision Loss

How best to treat a patient who has suffered vision loss due to LASIK, RK or some other surgical procedure depends on a number of factors. Some of the symptoms and issues facing the doctor and patient included but are not limited to the following:

  • Reduced best corrected visual acuity
  • Irregular or distorted corneas
  • Open wounds and/or weakened corneal flap
  • Higher order aberrations
  • Decentered optic zones
  • Corneal ectasia
  • Extremely dry eye
  • Ocular pain and headaches
  • Vitreous floaters
  • Reduced contrast sensitivity
  • Dramatically reduced night vision
  • Visual phenomena such as glare, flare, halos around lights, starbursts
  • Overcorrection of the pre-surgical refractive error
  • Emotional issues due to many of the above factors

At the present time there is no cure for many of the above. However, there are a number of specialized lenses now available that will allow post-surgical patients to function on a much higher level with a much greater level of comfort. While there are a number of soft lens and gas permeable lens designs included in the "specialized lens" category, I have come to rely on two major lens designs to address the vision and comfort issues that most post-refractive surgical patients are facing. These lens designs are the new Synergeyes Post-Surgical Lens and Post-Surgical Scleral Lenses.

 

Synergeyes Post-Surgical Lens on Left Eye Synergeyes Post-Surgical Lens on transplanted cornea with two RK procedures followed by cataract surgery Synegeyes Post-Surgical lens on post-RK cornea

Synergeyes Post-Surgical Lenses are "hybrid" lenses. This lens consists of a highly oxygen permeable central area "married" to a soft periphery. The geometry of the lens is designed to fit over the irregular cornea without irritating the compromised corneal tissue. The soft peripheral portion of the lens gives superior comfort while at the same time creating a stable fit. Unlike previous hybrid lenses, the interface or juncture where the soft and rigid portions meet is extremely resistant to tearing or damage. In addition, the Synergeyes Post-Surgical lens is hundreds of times more oxygen permeable than it's predecessors.

 

Scleral lens on post-refractive surgical cornea.

Scleral lenses are large gas permeable lenses which vault over the compromised cornea and rest on the white portion of the eye (the sclera). Comfort and vision are extremely good. A special liquid fills the space between the back surface of the lens and the front of the cornea. This type of lens, when fit correctly, very often allows the dried cornea to heal. Often, traumatized corneal tissues don't heal due to the blinking action of the eyelids and various irritants in the environment (air conditioning, dust, allergens etc.). Scleral lenses protect the compromised corneal tissue allowing the eye to heal while providing vision that no other type of lens can provide.

There is no way of knowing before hand which type of technology will work best. Very often I will fit a post-surgical patient with both types of lenses at the initial session. If a patient has a weakened Lasik flap or if there is incomplete healing, a scleral lens may work out best. To save time and reduce the number of follow-up office visits, I will very often order both types of lens designs and evaluate both at the dispensing visit.

The above lens designs provide superior vision due to the fact that there is a rigid material in front of the pupil and along the line of vision. They essentially replace the cornea as an optical surface. Soft lenses, while providing good comfort, take on the same shape as the irregular cornea. Crisp, sharp vision, therefore is not possible with soft lenses. In addition, soft lenses lie on top of the dried-out, distressed cornea, very often making matters worse by drying out the tissue and preventing the tissue from regenerating.

Patient Videos from Dr. Edward Boshnick's website

  1. POST-LASIK ECTASIA PATIENT WEARING SCLERAL LENSES
  2. CORNEAL TOPOGRAPHY EXPLAINED
  3. SYNERGEYES LENS DESIGN EXPLAINED
  4. CORNEAL TRANSPLANT AND KERATOCONUS PATIENT WEARING SPECIALTY LENSES
  5. PATIENT WITH CORNEAL TRANSPLANTS WEARING SCLERAL LENSES
  6. PATIENT WITH STEVENS-JOHNSON SYNDROME WEARING SCLERAL LENS
  7. PATIENT WITH VISION LOSS DUE TO LASIK WEARING SYNERGEYES LENSES
  8. PATIENT WITH VISION LOSS DUE TO MULTIPLE REFRACTIVE SURGICAL PROCEDURES
  9. PATIENT WITH ADVANCED KERATOCONUS WEARING ROSE K AND SCLERAL LENS (SPANISH)
  10. PATIENT WITH ADVANCED KERATOCONUS WEARING SCLERAL LENSES
  11. PATIENT WITH ADVANCED KERATOCONUS WEARING SCLERAL LENSES
  12. PATIENT WITH ADVANCED KERATOCONUS SPEAKING IN CREOLE
  13. EXTREMELY FAR-SIGHTED PATIENT WEARING SPECIALTY SOFT LENSES
  14. PATIENT WITH ADVANCED KERATOCONUS WITH HYDROPS WEARING SCLERAL LENSES
  15. PATIENT WITH ADVANCED KERATOCONUS WEARING ROSE K LENSES
  16. PATIENT WITH ADVANCED KERATOCONUS WEARING ROSE K LENSES
  17. PATIENT WHO UNDERWENT 2 R-K PROCEDURES FOLLOWED BY 2 LASIK PROCEDURES WEARING SCLERAL LENSES.
  18. PATIENT WITH ADVANCED KERATOCONUS WEARING ROSE K LENS AND A SCLERAL LENS.
  19. PATIENT WITH ADVANCED PELLUCID MARGINAL DEGENERATION WEARING SCLERAL LENSES.
  20. PATIENT WITH POST-LASIK CORNEAL ECTASIA WEARING SYNERGEYES POST-SURGICAL LENSES.
  21. YOUNG BOY WITH ADVANCED KERATOCONUS WEARING ROSE K LENSES (SPANISH).
  22. PATIENT WITH BILATERAL CORNEAL TRANSPLANTS WEARING SCLERAL LENSES
  23. PATIENT WITH ADVANCED KERATOCONUS WEARING A SCLERAL LENS AND A ROSE K LENS.
  24. PATIENT WITH ADVANCED KERATOCONUS WEARING ROSE K LENSES.
  25. PATIENT WITH A HIGH VISUAL ERROR IN ONE VERY DRY EYE WEARING A 1-DAY MOIST ACUVUE LENS.
  26. PATIENT WITH POST-LASIK CORNEAL ECTASIA WEARING SYNERGEYES POST-SURGICAL LENSES.
  27. PATIENT WITH PELLUCID MARGINAL DEGENERATION WEARING SCLERAL LENS.
  28. PATIENT WITH ADVANCED KERATOCONUS WITH INTACS (WHO ALSO UNDERWENT COLLAGEN CROSS-LINKING THERAPY) WEARING SCLERAL LENS.
  29. PATIENT WITH ACHROMATOPSIA (SEVERE COLOR BLINDNESS) WEARING SPECIALLY COLORED SCLERAL LENSES. (SPANISH).
  30. PATIENT WITH POST-LASIK CORNEAL ECTASIA WEARING 1-DAY ACUVUE MOIST LENSES.
  31. PATIENT WITH ADVANCED KERATOCONUS WEARING SYNERGEYES LENSES (SPANISH).
  32. PATIENT WITH ADVANCED KERATOCONUS WEARING ROSE K LENSES.
  33. POST-LASIK CORNEAL ECTASIA PATIENT WEARING SYNERGEYES HYBRID POST-SURGICAL LENSES.
  34. KERATOCONUS PATIENT WEARING REVERSE-GEOMETRY SOFT LENSES.
  35. ADVANCED KERATOCONUS PATIENT WEARING SYNERGEYES HYBRID KERATOCONUS.
  36. PATIENT WITH HIGH MYOPIA (NEARSIGHTEDNESS)WEARING CRT (CORNEAL REFRACTIVE THERAPY) LENSES DURING SLEEPING HOURS ONLY .
  37. ADVANCED KERATOCONUS PATIENT WEARING SYNERGEYES HYBRID KERATOCONUS DESIGNED LENSES (SPANISH).
  38. ADVANCED KERATOCONUS PATIENT WEARING SYNERGEYES HYBRID KERATOCONUS DESIGNED LENSES.
  39. ADVANCED KERATOCONUS PATIENT WEARING MENICON GAS PERMEABLE LENSES (SPANISH).
  40. NEARSIGHTED(MYOPIC)PATIENT WEARING CRT(CORNEAL REFRACTIVE THERAPY) LENSES ONLY DURING SLEEPING HOURS.
  41. ADVANCED KERATOCONUS PATIENT WEARING SCLERAL GAS PERMEABLE LENSES.
  42. PATIENT WITH SCARRED IRREGULAR CORNEA DUE TO CORNEAL ULCER WEARING SCLERAL GAS PERMEABLE LENS.
  43. EXTREMELY ADVANCED KERATOCONUS PATIENT WEARING SCLERAL GAS PERMEABLE LENS.
  44. PATIENT WITH ADVANCED KERATOCONUS WEARING ROSE K GAS PERMEABLE LENSES.
  45. PATIENT WITH POOR VISION AT FAR AND AT NEAR WEARING ACUVUE BIFOCAL DISPOSABLE SOFT LENSES (SPANISH).
  46. PATIENT WITH EXTEMELY HIGH VISION ERROR WEARING MENICON GAS PERMEABLE LENSES.
  47. PATIENT WHO UNDERWENT TWO SEPARATE R-K PROCEDURES FOLLOWED BY TWO SEPARATE LASIK PROCEDURES SUCCESSFULLY WEARING SCLERAL GAS PERMEABLE LENSES.