Broad beam / Superficial PRK Laser Operation:お知らせ

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2011年10月22日

Broad beam / Superficial PRK Laser Operation

カテゴリー: English — 奥ノ山医院

Please view a video of  operation on the right side.

The operation includes 3 steps. Note: The Video shows Step 2 and 3.

Step 1. Apply the ring to fix the eye movement.
Step 2. The photochemical vaporization, laser procedure starts under the observation of my college and I. We monitor the depth of the vaporization throughout the procedure as every eye is unique.
Step 3. Remove the ring and apply eye drops  which includes MMC and a protective contact lens which will stay in place for a week.

Video 1: Broad Beam laser (superficial PRK) Shows an actual procedure

Reasons for development

I created the Broad Beam / Superficial PRK operation out of concern for my patients. I wanted a simple procedure which will give my patents a better quality of life.
This is a Russian Broad Beam Laser not an American laser with its inherent central Island problems.
All Lasik Doctors know the inherent risks of Lasik.
As you can see in the video the Broad Beam Laser is a solid laser and not a scanning  laser.
It photo chemically vaporizes gradually and smoothly creating a refractive surface which no other operation in the world can provide at this point in time.
Each ring has a slightly different amount of energy distribution which is customized for different eye profiles.

Please consider your patients and their vision 20 plus years from now.

Dr. Kodo Okuyama.
My name is Dr. Kodo Okuyama.  You can find more information at  Sangubashi.com
I was operated on by Prof. Fyodrov  using RK (Radial Keratotomy) 27 years ago.
The early form of RK was a one step incision (single depth incision) which I now realize helped to create a multi focal refractive surface for me.
The later RK operations included two or three step incisions of various depths which were more effective however the results had a tendency to be mono-focal.
I am now 63 years old and still have wonderful vision. I was inspired by Prof. Fyodrov’s dream to provide and develop an operation which will have very few side effects, this lead me to develop Flapless Lasik ( Superficial PRK / Broad Beam Laser plus MMC, anti haze agent ).
I am very happy with the results, minimal risk and the multifocal quality of my operation.
Below are pictures of my left and right Keratotopograms
Please consider your patients and their vision 20 plus years from now.

Picture E: Keratotopogram   My Right Eye, Post RK 27 y.a.

Picture F: Keratotopogram   My Left Eye, Post RK 27 y.a.

Lasik Flapless creates a multifocal refractive surface

カテゴリー: English — 奥ノ山医院

Purpose:

To report a case of spectacle-free reading in presbyopic patient post Broad Beam laser operation.
(Superficial PRK).

Methods:

A 46 year old man, who had his left eye operated on using superficial PRK 5 years ago, in 2005.

His right eye has not been operated on and he has continued to use the same power contact lens.
Use of the Profile 500 created by the Fyodrov Institute for the superficial PRK. Keratotopography TMS-ⅡN and other routine exams pre and post refractive surgery.

Picture A: Broad Beam laser (superficial PRK)

Results:

Pre operative data for the left eye SE -6.00D / BCVA 1.2 / UCVA 0.03 in distance.

  • Post operative data at 5 years, for the left eye: SE -0.5D / BCVA 1.2 / UCVA 0.9 in distance. Near vision 0.5 at 40 cm.
  • The un-operated right eye using a contact lens -5.00D / BCVA 1.2 / UCVA 0.05 in distance. Now, near vision with contact lens is 0.3 and without contact lens 0.7 at 40 cm.
  • The keratotopogram of the left eye shows the three post operative corneal zones:
  • Central zone: mostly blue color indicating a less refractive power zone.
  • Para central zone: light green ring indicating a small refractive power zone.
  • Peripheral zone: yellow to reddish ring indicating a high refractive power zone.

Broad Beam Laser:

Comparative to superficial PRK but a non scanning laser.
Plus points:

  • Create a multifocal refractive surface.
  • Less risk of infection.
  • Less risk of irregular astigmatism.
  • Less risk of keratectasia.

Picture B: Keratotopogram of the patient left eye

Conclusions:

Post operated left eye using superficial PRK was successful with both near and far vision.

This finding leads me to hypothesize that I have created an aspheric refractive multifocal corneal surface similar to a multifocal refractive IOL.

Points to consider:

1.Broad Beam Laser using one very powerful , solid multi intensity laser which creates a kind of photochemical vaporization.
2.Multifocal abrasion via smooth laser energy distribution to create a multifocal refractive surface.
3.Transepitherial superficial PRK is a One Step operation combining both the epitherial and stromal mode.
4.Flapless operation gives me the ability to use the greater (diameter and depth) refractive corneal surface to maximize the patients potential multifocal refractive surface.

    Picture C: Laser energy distribution of the Broad Beam laser(Superficial PRK)

    Picture D: Post Broad Beam laser under an electron microscope

    The Sangubashi Eye Clinic.

    カテゴリー: English — 奥ノ山医院

    In technical collaboration with the Fyodorov Eye Microsurgery Institute, Moscow,

    The Sangubashi Eye Clinic, Shimouma Setagayaku,Tokyo, has developed Flapless Lasik ( corneal abrasion is made by a broad beam laser, and does not use any knife or surgical instrument ) myopic refractive surgery using only an excimer laser.

    The Fyodorov Institute has conducted more than 100,000 cases of PRK treatment since 1987.

    In brief, Flapless Lasik is myopic refractive surgery, by flattening the convex curve at the center of the cornea through abrasion of an optical zone of about 6.7 mm in diameter with a volume three dimensional excimer laser.

    Due to using Flapless Lasik, we reached a high accuracy rate in refractive effect of more than 93% and get as close as possible to 100% using regenerative tissue control during post operative care.

    It is highly safe and effective.

    Depending on the degree of myopia and corneal thickness, the depth and the area of abrasion vary for different patients.

    In cases of extreme myopia and very thin cornea, Flapless Lasik re-operation may be called for.

    • The Process of Lasik Flapless(Movie)

    • The Process of Lasik(Movie)

    Map & Price list

    カテゴリー: English — 奥ノ山医院

    Please contact:

    The Sangubashi Eye Clinic

    2-21-26 Shimouma Setagaya-ku, Tokyo 154-0002
    Refractive Surgery Institute
    Tel.: (03) 3411-0005 Fax.: (03) 5486-0120
    Email:kodo@e-intralasik.com

    Price list of Flapless Lasik

    Degree of myopia Degree Price
    Mild myopia -0.5D ~ -3.0D 20MAN YEN+Tax【Both Eye】
    Middle myopia -3.0D ~ -5.0D 30MAN YEN+Tax【BE】
    High myopia -5.1D ~ -8.0D 40MAN YEN+Tax【BE】
    Severe myopia 【Level 1】 -8.1D ~ -9.0D 50MAN YEN+Tax【BE】
    Severe myopia 【Level 2】 -9.1D ~ -10.0D 80MAN YEN+Tax【BE】
    Severe myopia 【Level 3】 -10.1D over 100MAN YEN+Tax【BE】

    Dr.Kodo Okuyama

    カテゴリー: English — 奥ノ山医院

    Dr.Kodo Okuyama

    okuyama

    1974 Graduated from the Second Moscow Institute (Moscow University of Medcine).
    Received a Russian Medical licence.
    1975 Received a Japanese Medical licence.
    1976-1983
    Worked at Fujimi Hospital and Tokai University of Medicine.
    1983 Received Refractive eye surgery (RK) from Prof.Fyodrov Moscow.
    1983 Opened Sangubashi Eye Clinic (The first clinic in Japan which specialized in Refractive eye surgery).
    1989 First farsightedness operation in Japan at our clinic.
    1992 PRK (Photo Refractive Keratoplasty) at our clinic
    1995 Received a PHD in Refractive Eye surgery.
    1996 Received a specialist licence in Ophthalmology (Russia).

    Carier highlights: Guest Prof. at Kazakh Medical University.
    Ex W.H.O research center fellow.
    Editor of Eye Surgery Journal.

    Dr.K.Okuyama and his Clinic.
    Sangubashi Eye Clinic are now using the forth generation operation Developed by Dr.K.Okuyama.
    The generations are as fellows;
    1. RK 1984-1991
    2. PRK (Super-PRK) 1992-2004
    3. Flapless Lasik(Superficial-PRK+MMC) 2005-
    Generation 4 was developed by Dr.K.Okuyama and takes the operation to the next level in tissue care.

    Clinical history

    カテゴリー: English — 奥ノ山医院

    The Sangubashi Eye Clinic was founded as the first refractive eye surgery clinic in Japan in 1983.

    Refractive corneal surgery corrects nearsightedness, farsightedness, astigmatism and helps presbiopia, so called refractive errors by changing of corneal curvature using RK, PRK, Lasik,
    Intralasik or Flapless Lasik  operations.

    As a clinic specialising in refractive eye surgery.
    we pay attention to the following:

    1) Testing on myself, members of my family and staff. Checking to make sure it’s safe and effective.

    2) Visual Acuity: using cutting edge technology to give patients the best results possible.

    3) Quality of vision: to enhance everyday activities, jobs, sports etc.

    In 2011 our Clinic celebrated it’s 28th anniversary, until now more than 20,000 eyes have been operated on and not one eye lost.

    More than 200 Japanese eye doctors have attended our clinical conferences.
    Refractive corneal operations have become more popular and accepted as a common part of modern medicine.

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    〒154-0002 東京都世田谷区下馬2-21-26
    東急田園都市線 三軒茶屋駅(南口出口 徒歩約7分)
    東急世田谷線 三軒茶屋駅(徒歩約9分)

    奥ノ山医院
    国内初の近視手術専門医院・切らないレーシック