Shapiro Laser Eye Center: David Shapiro, M.D.

Want to learn more about LASIK while staying at home during the coronavirus crisis? We are offering tele-consults to help you learn more about LASIK and see if you could be a good canidate for surgery. You can schedule a tele-consult through our website www.shapirolaser.com or by calling Stacy, our office manager, at 805-339-0566 to arrange a one on one phone consultation with Dr. Shaprio.

NFL Quarterback Jameis Winston Has LASIK Ahead of His 2020 Free Agency Winston Has LASIK To Correct His Nearsightedness After Throwing League High 30 Interceptions Winston had been struggling with his nearsightedness (myopia) while playing as an elite quarterback since his college days. Last season, before having LASIK, Winston threw a league high 30 interceptions despite also throwing for a league-leading 5,109 yards. At the end of the season, Tampa Bay Buccaneers head coac...h Bruce Evens commented about Winston, he can’t read the scoreboard but he can see the guys in front of him. Obviously very talented, Winston decided to have LASIK to improve his eyesight to improve his game. Winston’s spokesperson said of his decision to have LASIK: Jameis did not want to count out any options that he had that could possibly help him with the game he loves so much. He doesn’t want to miss out on any opportunity that presents itself. This is the game he loves and he wants to be the best at it and if there are any options that can improve his game he is willing to do it. Before announcing his decision publically, Winston gave a big hint to his fans by posting a picture of himself on Instagram in post-operative dark glasses. At the bottome of the picture he wrote: They Know!!!!. Many professional athletes from NFL to NBA to MLB players to race car drivers, including many I have performed laser eye surgery on, have chosen to have LASIK or PRK to be able to make their vision the very best possible and not have to rely on glasses or contact lenses during the demanding challenges of professional sports. I fully expect Winston to be an even more formidable and effective quarterback next season with his new and improved eyesight! https://shapirolaser.com/nfl-tampa-bay-qb-jameis-winston-h/

US Military Wavefront PRK Study Shows Superb Results Customized Wavefront PRK is an area of extreme interest to the military was how Captain Elizabeth Hoffmeister, MD put it after presenting superb results of customized wavefront PRK (flapless LASIK) at the American Academy of Ophthalmology annual meeting. Dr. Hoffmeister presented a recently completed US Military study of 334 eyes of 167 patients undergoing customized wavefront PRK using the VISX Star S4IR excimer laser. T...his 1 year study included 7 military centers and was the first of its kind in the military in that centers from the Army, Navy, and Air Force all participated. The results were truly outstanding: 100% of subjects saw 20/40 or better (vision good enough to pass a driver’s test without glasses or contacts), 99% saw 20/20 or better, and 92% saw 20/16 or better in other words, better than perfect vision! This is consistent with a customized wavefront PRK study I presented at the American Society of Cataract and Refractive Surgery, conducted at the Shapiro Laser Eye Center. Our study of 50 patients undergoing customized wavefront PRK at our center showed 100% of patients said they saw as least as well as with their glasses or contacts and 96% said they said they saw better than they had ever seen with glasses or contact lenses. The US military performs 30-40,000 cases of laser vision correction each year with 75% being PRK and 25% being LASIK. Given these truly amazing results, the US military finds customized wavefront PRK to be of extreme interest. https://shapirolaser.com/us-military-wavefront-prk-study-s/

LASIK Invented 30 Years Ago, FDA Approved 20 Years Ago In 1989, 30 years ago this year, the US Patent and Trademark Office awarded a patent for peforming LASIK to Gholam Peyman, MD. This patent represented nearly 100 years of evolution of eye surgery to correct vision. I had the opportunity to assist on the first case of LASIK in the Western United States, performed in 1992 by Charles Casebeer, MD, my fellowship mentor. Laser vision correction, in the form of PRK, was approve...d by the FDA for use in the United States in 1995. LASIK itself recieved formal FDA approval in 1999, 20 years ago. Since the time that patent was awarded 30 years ago, and 20 years since FDA approval, an estimated 40 million cases of LASIK have been performed worldwide with a success rate of 99.5%. Over the past 20 years, LASIK has undergone incredible evolution. In 2003, the FDA approved the next generation of LASIK, customized wavefront LASIK, which incorporated NASA-derived technology to measure the optics of the eye and customize the laser treatment to an individual’s unique optical characteristics. Since that time, there have been three generations of customized wavefront technology: original cusomized wavefront LASIK, ultra-high resolution customized wavefront LASIK, and ultra-high resolution customized wavefront LASIK using iris registration systems for targeting and alignement of the laser on the cornea. We also now have the ability to peform topography guided LASIK in which a map of the cornea is used to direct the laser beam. Today’s latest generation customized wavefront and topography guidedl LASIK technology are incredibly precise and results are significantly improved from the already impressive results we achieved 20 years ago. Today, the lastest version of LASIK truly represents one of the miracles of modern medicine. https://shapirolaser.com/lasik-invented-30-years-ago-fda-a/

Eye Drops to Cure Reading Glasses (Presbyopia)? PRESBYOPIA: THE NEED FOR READING GLASSES FROM AGING Presbyopia or aging of the eye is the age-related loss of our ability to see up close. It happens to everyone eventually, typically starting around age 40 and progressing gradually until the early 60’s. It is caused by the lens inside the eye getting physically stiffer with age so it becomes less and less flexible and unable to adjust focus to different distances....Continue reading

What Causes Myopia (Nearsightedness)? Nature More Than Nurture? Genetics More Important Than Environment in Becoming Nearsighted? Previous studies have suggested that there is a strong genetic component to why children become nearsighted as they grow into adulthood. A study from 2003, for example, suggested that genes are the main factor in determining who developes nearsightedness (myopia). This study looked at 388 8th grade children. The results showed that the higher the n...umber of parents that have myopia, the greater the chance the child will become nearsighted, although the researchers were quick to point out that even having both parents being nearsighted does not guarantee the child will be nearsighted. Environmental factors did have a small role in determining who would become nearsighted in this study. Interestingly, in this study, nearsighted children performed higher overall than their non-nearsighted peers on reading and language skills testing. Nurture More Than Nature? Environment More Important Than Genetics in Becoming Nearsighted? Other studies have suggested that environmental factors are most responsible for determining which children will develop nearsightedness as they mature into adults. A landmark study from Taiwan showed that children who were required to spend recess outdoors in school were less likely to develop myopia than those who stayed indoors. This has led to speculation whether this is a direct effect of sunlight, physical activity, or even Vitamin D levels from sunlight. A New Study Links Low Physical Activity and Screen Device Time to Nearsightedness A new study adds support to theory that environmental factors play a large role in causing nearsightedness (myopia) to develop. This European study, conducted in Denmark, looked at 1,443 16-17 year old adolescent children, 45% boys and 55% girls, and found that those children who were physically active less than 3 hours a week had a doubling of their chances of developing nearsightedness! Those who used computer screen devices more than 6 hours per day also doubled their chances of developing nearsightedness. Unfortunately, it seems societal trends are toward less physical activity and greater time in front of computer screens and phone screens. An Epidemic of Nearsightedness? In 2000, 23% of the world’s population was nearsighted. By 2050, it is expected that 50% of the world’s population will be myopic. Given that the genetics of the human of the human population likely will not have changed in that time, this suggests that the enviromental factors of a less active, more computer screen oriented, more indoors world likely is the cause of so much nearsightedness. The good news, of course, is that with the latest generation of customized wavefront LASIK and customized wavefront PRK, we have outstanding ways to treat this growing epidemic of nearsightedness. https://shapirolaser.com/low-physical-activity-screen-devi/

LASIK and PRK vs REFRACTIVE LENS EXCHANGE (RLE) FOR VISION CORRECTION In patients who are in their mid-50s or older, the question often comes up whether to correct vision by LASIK or by refractive lens exchange (RLE). LASIK involves reshaping the outter side of the cornea with an extremely precise laser beam and does not enter into the inside of the eye. RLE, on the other hand, is essentially cataract surgery, but before there is an actual cataract. A cataract is a clouding u...Continue reading

New NASA Orbiting Telescope To Use LASIK Wavefront Tech NASA’s James Webb Space Telescope is scheduled to launch in 2021. It will incorporate advanced LASIK technology to help improve its optical systems in order to peer more deeply and more accurately into the far universe once in orbit. At the core of the James Webb Space Telescope’s optics are highly polished mirrors with incredibly precise tolerances. In order to maximize the optical quality of these mirrors, NASA technic...ians use a measurement sytems based on Hartmann Shack wavefront sensors, a technology I use on a daily basis when performing customized wavefront LASIK and PRK. With these laser eye surgeries for vision correction, an invisible and harmless infrared measurement laser is shined into the patient’s eye and bounced off the retina in the back of the eye. The reflected infrared laser light comes back through the eye as a returning wavefront of infrared light. As this infrared wavefront travels from the back of the eye all the way to the front and ultimately out of the eye, it is distorted by all the nuances of that person’s eye’s optics. When the distorted wave of infrared light leaves the eye (called the optical fingerprint), it is measured by a grid of sensors, the same Hartmann Shack sensors that NASA is using. These sensors can determine the angle at which the infrared light rays are coming toward them and provide information on how the cornea needs to be reshaped to optimize the patient’s vision with an accuracy that far exceeds the normal which is better one or two test. NASA is using a similar system, based on Hartmann Shack sensor measurements, to guide the polishing of the space telescopes mirrors to refine the optics to a degree which is impossible without wavefront technology. In a way, NASA is performing customized wavefront surgery on their most advanced telescope! https://shapirolaser.com/new-nasa-orbiting-telescope-to-us/

Sunlight's Beneficial Roles for the Eye Sunlight is being shown to have many surprising benefits to the eye, probably via vitamin D. Previous studies have shown that outdoor sunlight exposure during childhood may actually decrease the chances a child will grow up to become nearsighted. A new study published this week in the newsletter of the American Academy of Ophthalmology looked at the role of Vitamin D blood levels in assessing how well artifical tears treat patients with... dry eye syndrome. Vitamin D can be synthesized by the body from sunlight or from obtained from nutritional sources such as vitamin D supplements or injections. Given our indoor lifestyle, many people in the United States are Vitamin D deficient. This study showed that while artificial tears improved dry eyes in both patients who had good blood levels of Vitaimn D and in those who had low blood levels of vitamin D, tear quality and tear performance markers were only increased in those patients with good blood levels of Vitamin D. The researchers concluded that their study may show that vitamin D may act synergistically with topical treatments to harmonize components of the tear film. A note of caution though. Of course, while overall sunlight may have beneficial effects for the eye via blood vitamin D levels, I always remind patients that direct UV light exposure to the eye from sunlight can be harmful. Some researchers feel UV light exposure, for example, over time is linked to cataract formation. Other studies have suggested an association between UV light exposure and the development of macular degeneration. Fortunately, good quality UV-blocking sunglasses that are appropriately labeled do an excellent job of blocking UV light from entering into the eye. And, of course, too much sunlight exposure, particularly during the highest UV times of the day, can lead to skin cancer as well. Sunlight seems to be of most benefit in moderation. https://shapirolaser.com/sunlights-beneficial-role-for-the/

SMILE vs Custom LASIK and PRK SMILE, LASIK, and PRK are forms of laser vision correction that reshape the cornea, the main focusing structure of the eye. While each of these versions of laser eye surgery uses a laser, they are different in how they go about their goal of improving vision. In SMILE (Small Incision Lenticular Extraction), an ultra-short pulse laser called a femtosecond laser is used to sculpt a lenticle inside the cornea, beneath the corneal surface. A small s...Continue reading

New Study of LASIK Myths: LASIK and Dry Eye I just returned from our largest annual international professional conference, the annual meeting of American Society of Cataract and Surgery held this year in San Diego. Over 10,000 ophthalmologists from all over the world attended. I heard an interesting study presented by Julie Schallhorn, MD, MS, who is Assistant Professor of Ophthalmology at UC San Francisco Medical School (the medical school I attended). Dr. Shallhorn’s study ...Continue reading