Services
Our office provides comprehensive eye care. Our staff of highly trained optometrists, together with Dr. Goldstein provides a full range of services for routine eye care, medical and surgical eye problems, and contact lenses. We offer examinations for children, teens and adults. We treat all of our patients with care, compassion and respect. Surgical emphasis is on LASIK, Epi-LASIK, PRK and Conductive Keratoplasty (CK) procedures.
Refractive Surgery
LASIK
Laser refractive surgery refers to a variety of surgical procedures designed to improve vision. They are very effective. LASIK is the best known of these procedures, and is the one most frequently performed by Dr. Goldstein.
Dr. Goldstein has performed laser refractive procedures since these procedures were approved by the FDA in 1997. To date, he has performed over 1500 LASIKs with excellent success. He has been listed as one of Denver's outstanding LASIK surgeons by a Denver TV station and by a prominent Denver magazine.
Patient expectations about refractive surgical outcomes are most important. Patients must understand that these procedures serve to greatly improve vision, but may not necessarily provide perfect vision. Some patients may still need glasses for certain situations such as night driving, theater, or other activities requiring long distance vision. Patients with presbyopia, the loss of near vision, will require reading glasses after LASIK.
LASIK is a surgical procedure. Complications are possible, and have been reported.
Patients who are interested in LASIK receive a free consultation which consists of a discussion about the procedure, a review of patient needs and expectations, as well as an evaluation of the patient's prescription, corneal thickness, and corneal curvature. These factors determine whether LASIK is appropriate for that individual. Once the patient has decided to proceed, a LASIK work up is scheduled. This consists of a thorough dilated eye exam to be sure the eyes are medically suitable for LASIK surgery, a determination of the exact prescription to be corrected, along with a discussion of potential complications. Happily, complications are extremely rare.
After surgery, one year of follow-up is included in our office by our staff of doctors. We provide very personal individual care. Enhancements are occasionally needed, and are included within the first year. We have a very low enhancement rate. The vast majority of LASIK patients are quite pleased with their visual outcomes.
Please see www.allaboutvision.com for more information on LASIK.
Custom Wavefront LASIK
Custom Wavefront LASIK is an advanced LASIK technique now available for my patients. Using sophisticated WaveScan digital technology it is possible for us to more precisely measure our patients' corneas to ascertain individual aberrations and distortions, which may affect vision. These wavefront measurements are transferred to the laser and are used to determine the laser pattern during LASIK, thus allowing corneal sculpting specific for the individual patient. Patients should have a better chance to achieve a more precise level of vision correction and better contrast sensitivity compared to results with conventional LASIK. Dr. Goldstein recommends Custom Wavefront LASIK for all patients who wish to have LASIK, and who fall under the FDA approved guidelines for the custom procedure.
Photorefractive Keratectomy (PRK)
PRK, is a refractive procedure which is effective for myopia, ( nearsightedness), hyperopia,( far sightedness), and astigmatism. In contrast to LASIK, no cutting is done, and no flap is made. Instead, the surface cells of the cornea are removed. The exposed cornea is then sculpted with laser, just as in LASIK, and the surface cells are allowed to reheal, a process which takes about 5 days. Both eyes are usually done at the same time. Custom wavefront technique can be done with PRK for suitable patients.
EPI-LASIK
EPI-LASIK is a modification of PRK. This procedure works for the same indications as PRK and LASIK. The difference is the way the surface cells are treated. After applying suction to the eye, a blunt instrument, is passed across the cornea so as to separate the surface cells from the underlying tissue. The surgeon pushes the surface layer of cells to the side. The laser is then used to sculpt out the underlying cornea, just as in PRK and LASIK. The layer of surface cells is then slid back over the corneal surface, thus acting as a natural bandage for the eye. Both eyes are usually done at the same time, and the healing time is usually 4 to 5 days. Custom wavefront can be done in conjunction with EPI-LASIK.
Conductive Keratoplasty (CK)
CK corrects mild to moderately farsighted eyes, (Hyperopia), and has been approved by the FDA for this purpose. CK has also been found effective in correcting the loss of reading vision (Presbyopia) in patients who have normal distance vision without glasses, including those who have had LASIK or Cataract surgery. Presbyopia correction was approved by the FDA in 2004.
Conductive Keratoplasty is an extremely precise, virtually painless office procedure performed under local anesthesia. No cutting or laser is involved. A fine probe is used to apply radiofrequency energy to the cornea. The effect is to alter the curvature of the central cornea. Healing is rapid. Visual recovery is usually noted within a few days, however the final vision may take 6-12 months to stabilize.
Patients must have reasonable expectations. CK works by creating blended vision between the two eyes by creating modified monovision. For reading-vision correction, one eye is done. The result is functional vision, good useful vision for normal activities of daily living, thus providing reduced dependence on reading glasses. Patients are able to see both far and near. Patients may still need supplemental glasses for occasional use, such as for very fine print, or in poor lighting conditions.
Please see www.refractec.com for more information on CK.
Medical Eye Care
Medical ophthalmology is an important aspect of our practice. We treat a variety of eye related medical problems including, glaucoma, dry eyes, infections, injuries, visual disturbances and eye conditions related to systemic medical disorders.
Contact Lenses
Contacts
Our office provides comprehensive soft and gas permeable contact lens care. We specialize in contact lenses for the correction of myopia (nearsightedness), hyperopia (farsightedness), and astigmatism. In addition, we can prescribe multifocal contact lenses which reduce the need for bifocals. We also treat patients with corneal disorders requiring custom contact lenses.
Corneal Refractive Therapy (CRT)
Nearsighted eyes can now be corrected without surgery. CRT involves the use of a newly designed therapeutic contact lens which reshapes the cornea during sleep. The lens is removed in the morning, and replaced at night. After the initial cornea adjustment period, which takes 7 to 14 days, the patient will notice excellent vision throughout the day, without the use of either glasses or contacts. Patients with presbyopia, (the natural loss of near vision with age), will continue to require reading glasses. During the transition period the patient wears the contact during the day, gradually reducing the wearing time, until the reshaping is complete. The result is completely reversible by discontinuing the lens for several days.
This is an excellent modality for vision correction for those who cannot have LASIK, especially those who are too young, such as teens, patients with corneas too thin for LASIK, or those who do not want surgical vision correction.