Maehara Eye Surgery & Laser

Maehara Jeffrey R Md

• Bladeless Lasik Eye

  Bladeless Lasik Eye Surgery in Honolulu, HI Maehara Eye Surgery & Laser specializes in Bladeless LASIK eye surgery in Honolulu, HI performed with the Allegretto Wave® and IntraLase™ FS lasers. The accuracy and speed of this premier combination of lasers are nothing less than mesmerizing. Beyond equipment, we cannot over-emphasize the importance of a thorough safety evaluation of all LASIK in Honolulu, HI candidates. Safety is always our #1 priority. A close second priority is the absolute value for your money. We offer extremely competitive prices and physician-only care. This means Dr. Maehara will personally discuss your options, complete your pre-operative evaluation, perform your surgery, and carry through all post-operative care. <b?Only a consultation can help determine if LASIK is “safe and right” for you — call or contact us to schedule your free consultation today. See What Our Patients Are Saying: “Finally got my LASIK surgery done by Dr. J Maehara after going back and forth if it’s worth the money or just wear my glasses and contact lenses. It only took him 10 minutes and I now have a 20/15 vision! It was the best decision ever! Life-changing just being able to see clearly without squinting my eyes.” (Vitals.com Review)

  Video: Bladeless Lasik Eye

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• Glaucoma

  What is Glaucoma? Glaucoma is an eye disease in which pressure inside the eye (intraocular pressure) rises dangerously high, damaging the optic nerve and causing vision loss. In a healthy eye, fluid is produced in the ciliary body, enters the eye, and then drains through tiny passages called the trabecular meshwork. In people with glaucoma, these passages become blocked and intraocular pressure rises. Glaucoma Treatment Some cases of glaucoma can be treated with medications. For others, laser or traditional surgery is required to lower eye pressure. Common surgeries include: Laser Peripheral Iridotomy (LPI) – For patients with narrow-angle glaucoma. A small hole is made in the iris to increase the angle between the iris and cornea and encourage fluid drainage. Argon Laser Trabeculoplasty (ALT) and Selective Laser Trabeculoplasty (SLT) – For patients with primary open angle glaucoma (POAG). The trabecular passages are opened to increase fluid drainage. ALT is effective in about 75% of patients, and SLT may be repeated. Nd: YAG Laser Cyclophotocoagulation (YAG CP) – For patients with severe glaucoma damage who have not been helped with other surgeries. The ciliary body that produces intraocular fluid is destroyed. Filtering Microsurgery (Trabeculectomy) – For patients who have not been helped with laser surgery or medications. A new drainage passage is created by cutting a small hole in the sclera (the white part of the eye) and creating a collection pouch between the sclera and conjunctiva (the outer covering of the eye). Tube Shunt Surgery – May be recommended for patients with neovascular glaucoma, failed trabeculectomy, or susceptibility to developing scar tissue. A thin, flexible tube (a shunt) with a silicone pouch is inserted in the eye to facilitate drainage. Canaloplasty – the newest low-invasive filtering procedure. Delicate dilation and stretching of the drainage canals leads to decreased pressures without traditional “penetrating” techniques. Is Glaucoma Surgery Safe? Dr. Maehara routinely performs the following advanced glaucoma surgeries in addition to standard trabeculectomy: Non-penetrating deep sclerectomy with Aquaflow implant, in-office SLT laser, Ahmed glaucoma drainage devices, and Canaloplasty.

  Link: Glaucoma

• 

  Cataract Surgery

  Restore your Vision with Cataract Surgery Is your vision getting blurry? Do you have an increased sensitivity to glare? Do you feel there is a film over your eye? You may be developing cataracts. Over 22 million people over the age of 40 have cataracts, and this number is expected to swell to over 30 million by the year 2020. While the thought of losing your vision can be scary, Maehara Eye Surgery & Laser provides cataract surgery to the Honolulu and Waipahu areas. At Maehara Eye Surgery & Laser, we have vast experience with cataract surgery, removing the clouded lens and replacing it with a clear artificial lens called an intraocular lens (IOL). We want to help you restore your vision. What are Cataracts? A cataract is a dense, cloudy area that forms in eye’s natural lens, the transparent film that focuses the images as seen by the eye on the light-sensitive retina at the back of the eye. A cataract begins when proteins in the eye form clumps that prevent the lens from sending clear images to the retina. A cataract develops slowly, usually unbeknownst to the patient. When these clumps enlarge they begin to interfere with vision by distorting the passage of light through the lens. A person can develop cataracts in both eyes, but they usually don’t form at the same time or progress at the same rate. Symptoms Of Cataracts Cataracts cause a progressive, painless loss of vision, along with these symptoms: Blurry vision Trouble with night vision Fading of color Increased sensitivity to glare Halos surrounding lights Double vision in the affected eye A need to frequently change eyeglass prescriptions A feeling as if there is a film over the eye Risk Factors For Cataracts In addition to general aging, these risk factors increase a person’s risk for developing cataracts: Smoking Diabetes Obesity Excessive alcohol use Excessive sun exposure Exposure to radiation from x-rays and cancer treatments Family history of cataracts High blood pressure Previous eye injury or surgery Prolonged use of corticosteroid medications Types Of Cataracts Cataracts can be classified in several different ways. They may be partial or complete, stationary or progressive, or hard or soft. They can also be classified by the cloudiness of the lens. The main types of age-related cataracts are nuclear sclerosis, cortical, and posterior subcapsular. Nuclear sclerosis This is the most common type of cataract, its name coming from the central or “nuclear” part of the lens. Over time, cataracts form in the middle of the lens and cause it to become yellow or brown. These mainly affect distance vision, with reading less affected. Cortical cataracts These cataracts are wedge-shaped and form around the edges of the nucleus/center of the lens. When viewed through an ophthalmoscope, cortical cataracts look like white spokes on a wheel. These cataracts create problems with glare and light scatter at night. Posterior subcapsular These cataracts occur at the back of the lens. People with diabetes or those taking high doses of steroids have a greater risk of developing posterior subcapsular cataracts. While these are the most common, there are some other types of cataracts. An immature cataract has some transparent protein, but in a mature cataract, all of the lens protein is opaque. In a hyper-mature or Morgagnian cataract, the lens proteins have become liquid. Congenital cataracts, which are present at birth or develop during a baby’s first year, are far less common than age-related cataracts. How Are Cataracts Diagnosed? At Maehara Eye Surgery, we perform cataract screenings as a part of our comprehensive eye exams at our Honolulu offics. We can usually see cataracts as a part of this exam, but we check tonometry to measure the pressure inside the eye. The most common tonometry test uses a painless puff of air to flatten your cornea and test eye pressure. When we suspect cataracts, we also test for sensitivity to glare and your perception of color. Cataracts Treatment The only treatment for cataracts is surgery to replace the clouded lenses. Once affected, the lenses will not return to their former clarity. Still, if patients are not interested in surgery, we can help manage symptoms with stronger prescription eyeglasses, magnifying lenses, or sunglasses with an anti-glare coating. Surgery involves replacing the natural, clouded lens with an interocular lens implant (IOL). At Maehara Eye Surgery, we recommend surgery when cataracts are impacting your daily life, affecting activities such as reading or driving.

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• Corneal Transplantation

  The cornea is the clear covering on the front of the eye which bends, or refracts, light rays that focus on the retina in the back of the eye. A certain shape or curvature is required in order for light to focus exactly on the retina, rather than in front of it or behind it. An improperly curved cornea may be corrected surgically or non-invasively to reduce or eliminate the need for eyeglasses or contact lenses. A thorough eye examination and consultation are necessary before a treatment decision can be made. Corneal transplantation, or keratoplasty, is recommended when the cornea’s curvature is too steep or flat to be treated with other methods, or when extensive damage has occurred due to disease, infection or injury. Who would be a good candidate for a corneal transplant? Corneal eye disease affects over 10 million people worldwide; it is the fourth most common cause of blindness. When disease or injury damages the cornea, it can become swollen, scarred, or severely misshapen, and this distorts the quality of the person’s vision. In these cases, eyeglasses or contact lenses are used as the first treatment options. But when these can no longer provide the degree of correction needed, a corneal transplant could become necessary. In other cases, swelling can become so painful that a transplant is the only route forward. These conditions could all be reasons for a corneal transplant: An outwardly bulging cornea Fuch’s dystrophy A thinning cornea Clouding of the cornea Cornea scarring from injury or infection Swelling of the cornea Corneal ulcers Complications from previous eye surgery How is Corneal Transplantation Surgery Performed? Transplantation involves replacing the damaged cornea with a healthy one from a donor (usually through an eye bank). Keratoplasty is a low-risk procedure – it is the most common type of transplant surgery and has the highest success rate. During the procedure, a circular incision is made in the cornea. A disc of tissue is removed and replaced with healthy tissue; these discs may be thin (lamellar keratoplasty) or as deep as the entire cornea (penetrating keratoplasty, the technique used in almost all corneal transplants). Local or general anesthesia may be used. The entire procedure lasts only 30-90 minutes. What results can be achieved with a corneal transplant? A cornea transplant can restore vision, reduce pain, and improve the appearance of a damaged or diseased cornea. What you can expect to achieve with these surgeries with Dr. Maehara depends in part upon the reason you needed the surgery, as well as your overall health. As mentioned above, your initial vision will be worse than before your surgery. It will take several months for your vision to improve. Once the outer layer of your cornea has healed, Dr. Maehara will work to make adjustments to further improve your vision, if possible. These may include correcting any unevenness in the cornea (astigmatism). These can be due to stitches that hold your donor cornea in place. Dr. Maehara can release some of these stitches and tighten others. Refractive errors that remain can be corrected with glasses, contact lenses, or, in some cases, laser eye surgery. What is recovery like after a corneal transplant? Although Dr. Maehara performs mostly penetrating keratoplasty, or full-thickness transplants, he also sometimes performs transplants where he doesn’t replace the entire cornea, but different degrees of its depth. Because of that there is a different recovery timeframe between full thickness transplants or partial thickness (such as DSEK), but patients need to be patient in either case. Recovery after a cornea transplant takes time, up to a year or even longer. With DSEK, thanks to the lesser amount of transplanted tissue, patients can have their best vision in about three months after their procedure. This can vary by the patient. In the beginning, your vision will likely be even worse than it was prior to your surgery because your eye takes time to get used to the new cornea. This can be disconcerting to patients, but this is where you need patience. Your vision will improve, and you’ll begin returning to your normal routines. You’ll use steroid eye drops for several months after your transplant to help your body accept the new corneal graft. You’ll also need to protect your eye at all times with either a shield or eyeglasses; you can’t inadvertently bump your eye. Dr. Jeffrey Maehara also performs a modern version of corneal transplantation called DSEK (descemet stripping endothelial keratoplasty). This is a partial thickness transplant to treat conditions where the inner layer of corneal cells are not healthy and don’t function properly. Only the inner layer of the cornea is replaced through a small incision. This less invasive procedure has the advantage of quicker visual recovery, less induced astigmatism, and less change in the glasses prescription.

  Link: Corneal Transplantation