There's no one-size-fits-all in laser eye surgery.

"Ophthalmologists use different lasers of different wavelengths to treat different problems," explained Dr. Philip Ferrone, attending physician and a retinal specialist in the Great Neck office of Long Island Vitreoretinal Consultants.

A laser is a concentrated beam of light that can be used to treat eye diseases and improve vision problems. Some lasers cut or sculpt tissue like a knife, and others produce heat to seal blood vessels, destroy abnormal tissue, repair torn tissue or create an opening in the eye, according to EyeCare America, a public service foundation of the American Academy of Ophthalmology.


TYPES OF LASERS AND SURGERY

Lasers have significantly advanced many eye surgeries, but most people know very little about the various lasers that ophthalmologists use or the procedures they perform, Ferrone said.

Red, yellow and blue-green lasers are thermal lasers that convert light into heat. An argon laser, which emits a blue-green light, is one type of laser used to treat open-angle glaucoma, a potentially blinding condition. The laser creates an opening to drain excess fluid from the eye, relieving eye pressure.

Either a blue-green (argon) or yellow (krypton) laser may be used to repair a torn or detached retina, Ferrone said.

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After cataract surgery, some people develop cloudiness in the eye tissue behind the lens. When that occurs, a YAG, or yttrium aluminum garnet, laser may be used to make a tiny hole in the tissue to allow light to pass into the eye, according to the U.S. National Eye Institute.

An excimer laser emits pulses of ultraviolet light, allowing the surgeon to reshape the cornea. Two popular vision-correction procedures - photorefractive keratectomy, known as PRK, and laser-assisted in-situ keratomileusis, or LASIK - use excimer lasers to correct nearsightedness, farsightedness and astigmatism.


BENEFITS AND RISKS

Laser eye surgery has several advantages. For one, laser light does not cause infection, according to EyeCare America. Laser surgery can be done in an outpatient setting, speeding the return home. And lasers give the surgeon great precision and control, it says.

The two-step LASIK procedure traditionally involves making a flap in the cornea with a blade device and then using a laser to vaporize tiny amounts of corneal tissue. At North Shore Eye Care in Smithtown, both steps are performed using lasers, and that has resulted in improved precision and fewer complications, said Dr. Jeffrey Martin, managing partner of the practice.

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Not that there aren't risks. Martin, an assistant clinical professor of ophthalmology at Stony Brook University School of Medicine, cautions patients that they might have dry eyes for a short time after LASIK surgery. There's also a small possibility that the procedure will not produce the desired results, requiring retreatment at some future date, he said.

In addition, some people are not good candidates for certain types of laser procedures. People with eye diseases or thin corneas, for example, should not have LASIK, Martin noted.


CURRENT THINKING

"The hottest thing now is called a femtosecond laser, which gives a very controlled cut for corneal surgery and for some cataract surgery," Ferrone said.

This type of laser generates light pulses at the speed of one-quadrillionth of a second, allowing for greater accuracy.

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The first such laser, for use in LASIK, cleared the U.S. Food and Drug Administration in 2001. In August 2009, another manufacturer received clearance for the first femtosecond laser for use in cataract surgery.

Ophthalmologists at North Shore Eye Care use a procedure that combines two laser treatments: a femtosecond laser to create a thin flap in the cornea and an excimer laser to perform LASIK vision correction.


THE LONG ISLAND SCENE

The American Academy of Ophthalmology has an online tool to help you find a local doctor who specializes in eye and vision care. Go to aao.org and click on "Find an Eye M.D."

For more detail on eye conditions and treatments, check the website of the National Eye Institute (www.nei.nih.gov).

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Who's who

 

This is the 23rd installment of a 26-week series in which Newsday presents Castle Connolly's list of top L.I. doctors. Today: ophthalmologists

Dr. Philip Aries

375 E. Main St.

Bay Shore

631-665-1330

Dr. Stanley Berke

360 Merrick Rd.

Lynbrook

516-593-7709

Dr. Stanley Bogaty

251 E. Oakland Ave.

Port Jefferson

631-473-5329

Dr. Vivien Boniuk

600 Northern Blvd.

Great Neck

516-470-2020

Dr. Robert Broderick

585 Plandome Rd.

Manhasset

516-627-3232

Dr. Jack Cook

305 Hillside Ave.

Williston Park

516-747-4011

Dr. Alfred Cossari

311 Barnum Ave.

Port Jefferson

631-928-6400

Dr. Gerard D'Aversa

65 Roosevelt Ave.

Valley Stream

516-374-4199

Dr. Frank Di Leo

365 County Rd. 39A

Southampton

631-283-3677

Dr. Fadi Elbaba

33 Research Way

East Setauket

631-444-4090

Dr. David Fastenberg

600 Northern Blvd.

Great Neck

516-466-0390

Dr. Philip Ferrone

600 Northern Blvd.

Great Neck

516-466-0390

Dr. Perry Garber

800 Community Dr.

Manhasset

516-627-6630

Dr. Anthony Girardi

8 Medical Plaza, Bldg. 8

Glen Cove

516-676-4596

Dr. Leslie Goldberg

2110 Northern Blvd.

Manhasset

516-627-5113

Dr. Alexander Hatsis

2 Lincoln Ave.

Rockville Centre

516-763-4106

Dr. William Kasper

520 Franklin Ave.

Garden City

516-742-3937

Dr. Alan Marks

2110 Northern Blvd.

Manhasset

516-627-5113

Dr. Jeffrey Martin

260 Middle Country Rd.

Smithtown

631-265-8780

Dr. Peter Michalos

365 County Road 39-A, Ste. 14

Southampton

631-283-8604

Dr. Robert Morris

222 E. Main St.

Smithtown

631-724-4488

Dr. Richard Nattis

150 East Sunrise Hwy.

Lindenhurst

631-957-3355

Dr. David Nelson

2000 N. Village Ave.

Rockville Centre

516-766-2519

Dr. Grace O'Malley

186 Old Towne Rd.

Southampton

631-283-3533

Dr. Samuel Packer

600 Northern Blvd.

Great Neck

516-465-8400

Dr. Henry Perry

2000 N. Village Ave.

Rockville Centre

516-766-2519

Dr. Louis Pizzarello

137 Hampton Rd.

Southampton

631-283-5152

Dr. Arnold Prywes

4212 Hempstead Tpke.

Bethpage, 516-731-4800

Dr. John Romanelli

222 E. Main St.

Smithtown

631-724-4488

Dr. Kenneth Rosenthal

310 E. Shore Rd.

Great Neck

516-466-8989

Dr. Charles Rothberg

331 East Main St.

Patchogue

631-758-5300

Dr. Laurence Rubin

4277 Hempstead Tpke.

Bethpage

516-796-4030

Dr. Steven Rubin

600 Northern Blvd.

Great Neck

516-465-8444

Dr. Gideon Schneck

2500 Rt. 347 17B

Stony Brook

631-246-9140

Dr. Patrick Sibony

Stony Brook Ophthalmology

33 Research Way

East Setauket

631-444-4090

Dr. Gerald Stoller

251 E. Oakland Ave.

Port Jefferson

631-473-5329

Dr. Richard Sturm

360 Merrick Rd., Fl. 3

Lynbrook

516-593-7709

Dr. Paul Svitra

3003 New Hyde Park Rd.

New Hyde Park

516-327-0505

Dr. Ira Udell

LI Jewish Med. Ctr.

Dept. Ophthalmology

600 Northern Blvd.

Great Neck

516-470-2020

Dr. Pamela Weber

1500 William Floyd Pkwy.

Shirley

631-924-4300

Dr. Joseph Weinstein

Eye Care Assoc.

4212 Hempstead Tpke.

Bethpage

516-731-4800

Dr. Lawrence Zweibel

260 Middle Country Rd.

Smithtown

631-265-8780

 

How they were picked

 

Castle Connolly Medical Ltd. is a health care research and information company founded in 1991 by a former medical college board chairman and president to help guide consumers to America's top doctors and hospitals. Castle Connolly's established survey and research process, under the direction of a doctor, involves tens of thousands of doctors and the medical leadership of leading hospitals.

Castle Connolly's team of researchers follows a rigorous screening process to select doctors on national and regional levels. Using mail and telephone surveys, and electronic ballots, they ask physicians and the leadership of top hospitals to identify exceptional doctors. Careful screening of doctors' educational and professional experience is essential to the committee. Newsday is not part of the selection process.

Doctors do not and cannot pay to be selected and profiled as Castle Connolly Top Doctors.

 

To see the whole list . . .

 

Who else is on the list of Top Doctors? More than 6,000 listings are in the New York Metro Area edition of "Top Doctors," published by Castle Connolly Medical Ltd. The soft-cover list price is $34.95. For more information, go to castleconnolly.com, or call 800-399-DOCS.