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  1. Location Queensland Laser VisionSuite 315 Level 3St Andrew's Place33 North StreetSpring HillBrisbane QLD 4000 Telephone: (07) 3831 8299 Toll Free: 1800 66 20 20 Facsimile: (07) 3831 8365 Website: www.qlv.com.au Email: paul@qlv.com.au

  2. Surgeons • Our surgeons are all highly qualified and respected eye surgeons who were trained at the University of Queensland and then underwent extra study in Britain, Canada and the United States. • They have performed thousands of successful eye surgery procedures including Cataract surgery and lens implants, Laser Vision Correction and Corneal Transplants. • All are respected members of the Australian Medical Association, The Royal Australian and New Zealand College of Ophthalmology and the Australian/American and International Societies of Cataract and Refractive Surgeons.

  3. Dr. Andrew Apel Dr Andrew Apel (MB. BS (QLD), FRACO) • Dr Andrew Apel has particular interests in corneal and refractive surgery. He has been performing laser surgery since 1992. After completing his ophthalmology training in Brisbane, he undertook two years of subspecialty in a Corneal and External Diseases Fellowship at the University of Toronto, Canada. • Dr Apel performs surgeries, which include corneal transplants, cataracts, combined cataract and glaucoma filtering operations, pterygia excision with conjunctival autografts, epikeratophakias and anterior segment trauma repair. • Dr Apel Operates out of Wickham Terrace and Walker Street, Bundaberg, and is also a Snr VMO at Princess Alexandra Hospital. • This training has given him the ability and skills to adapt easily to the most advanced techniques used in refractive surgery.

  4. Dr. Diana Conrad Dr Diana Conrad(MB.BS.(Hons) (BMedSci) (QLD) FRACO) • Graduated from the University of Queensland in 1984 with first class Honours. • Her Ophthalmology training has been worldwide including Brisbane, London and San Francisco. • Her special interests include cataract and refractive surgery, glaucoma, and ocular inflammation. • Dr Conrad operates private a practice at Wickham Terrace, in Brisbane and is a Visiting Medical Officer at the Royal Brisbane Hospital. • Memberships of the Australian Medical Association (AMA), Royal Australian and New Zealand College of Ophthalmologists (RANZCO), American Society of Cataract and Refractive Surgeons and the American Academy of Ophthalmologists (AAO).

  5. Dr. Bill Glasson Dr William Glasson (MB,BS (QLD), FRANZCO, FRCOphth, Dip App Sci (Optom) QIT • Studied optometry and medicine in Brisbane and London. • Began his work with Queensland Laser Vision (Excimer Group) in 1996 and his interests include cataract and refractive surgery. • Member of Australian, American and International Societies of Cataract and Refractive Surgeons. • He is visiting Medical Officer to The Brisbane Mater Hospital, the Longreach Hospital and the 2 Field Hospital at the Enoggera Barracks. • Private practice at Wickham Terrace.

  6. Dr. Kevin Vandeleur Dr Kevin Vandeleur (MB.BS (QLD), FRANZCO, FRACS) • Dr Vandeleur is a foundation member of the Queensland Laser Vision, (Excimer Group) which was established in 1991. He has held a position of Director since this time. • He is actively involved in refractive surgery and is one of the pioneers of the Lasik procedure in Australia. • Memberships: Oceania Retinal Association (ORA) and the International Society of Cataract and Refractive Surgeons (ISCRS). • Dr Vandeleur is also currently Queensland's designated investigator for the Implantable Contact Lens (ICL) Australian TGA trial. This technology offers hope for patients that experience high degrees of myopia and hypermetropia.

  7. Our Philosophy • We have been a respected laser eye surgery facility in Brisbane since 1991. • We have a reputation for high quality surgery. • All surgeons are Brisbane based, have general ophthalmology practices and are available for follow up at all times. • We are conservative and only treat patients who we expect to get excellent results. Approximately 50% of all interested patients aren’t suitable. • Our surgeons own their practice and are not employees for a company. You can be sure that the decisions they make are independent and vital to their reputation and their continued success as eye surgeons. • Many eye surgeons perform Laser Vision Correction. There are many styles of Laser centre – from the large “supermarket style” practices to the small single man operations. Our eye team offers both personalised attention and the latest modern technology to make your procedure a success and a pleasure.

  8. Philosophy • We update our ideas and surgical approach according to the most recent research and evidence - to ensure that you are receiving the latest ‘best practice’ of treatment. We have a passion for our work and no stone goes unturned in getting the best outcome for you. • We use only the current technology in the assessment and performance of our LASIK surgery. We want every advantage technology can bring us to deliver the best possible results. • Patients should not rush the decision to proceed. At our clinic, many patients are brought back for a second or third visit during the decision making process. If the surgery doesn’t feel right for the patient, then it is not right for us. • Beware of a laser centre which rushes patients through the process and hurries them into a quick decision. If you feel like a ‘number’ then you probably are. • Never have the initial consultation and the surgery rushed through on the same day. A cooling off period is vital to allow you to reconsider the procedure after talking to friends or family.

  9. Assessments • Conducted at QLV by optometrists or at the surgeons rooms by optometrists. • Check previous/current prescription. • Measure VA & Refraction. • Slit-lamp exam. • Corneal Topography with Nidek OPD Scan and /or Orbscan. • Pachymetry with Oculus Pentacam. • Dilated Fundus Exam, Schirmer test, Tonometry. • Education about the procedure, the possible risks and examining your lifestyle to match your desired outcome to your current and future needs. We have to find out what you want - and decide if it is possible. • Patients found to be suitable candidates for Lasik have an appointment scheduled with a surgeon to review the results and further discuss their options. This appointment is scheduled on another day for most patients. We encourage this because we want you to feel completely comfortable with your decision.

  10. The ideal candidate • Over 18 years of age and have had a stable glasses or CL Rx for two years. • Corneal thickness over 500 microns. • Schirmer >5.0mm and no history of dry eyes or OSD. • No corneal scarring. • No autoimmune disease/steroids/immunosuppressants. • Not pregnant or breastfeeding. • No history of ocular herpes. • No diseases such as cataract, glaucoma, corneal diseases, corneal ectatic disorders eg Keratoconus/Pellucid Marginal Degeneration. • Gives informed consent. • Has realistic expectations.

  11. Keratoconus

  12. Form Fruste

  13. Pellucid Marginal Degeneration

  14. Surgery • LASIK – the most common operation performed world-wide. • PRK - with improvements in laser technology, computer software and understanding of corneal wound healing, the PRK method improved and has had a renaissance. It is now used in approximately 10-20% of cases. Mainly for patients who have thin corneas or who have irregular corneal topography. • EPILASIK –similar to LASIK but with slightly different benefits. Considered safer than LASIK as the flap is very superficial and thin, the surgeon cuts fewer corneal tissue and nerve cells than in LASIK. Used for patients with thin or abnormal corneas, who cannot qualify for LASIK, or for patients suffering from dry eyes. Like LASIK the visual recovery is fast. • PTK - a number of disorders affecting the corneal surface may be successfully treated by taking advantage of the Excimer laser's ability to meticulously remove superficial corneal tissue. These include a variety of corneal degenerations and dystrophies, corneal irregularities, and superficial scars.

  15. Other treatment options Include: • ICL or phakic IOL - >-7.00D or +4.00D. • Refractive Lensectomy – over 50 + hyperopes + NC2 cataract. • Astigmatic Keratotomy.

  16. Post - Op LUBRICANT DROPS CELLUVISC: • Day 1 & 2– one drop every ½ hour (while awake) CELLUFRESH: • Day 3 – 3 months–1 drop every 2-3 hours a day (while awake), • 3 months – 12 months–1 drop every 8-10 hours a day. MEDICATED DROPS OCUFLOX (antibiotics): • Day 1- one drop every 2 hours (while awake) • Day 2 – 7 – 1 drop every 4-6 hour's then stop. F.M.L.(anti–inflammatory Do not use until you see your doctor post-operatively. • Usual dose is one drop 4 times daily for one week.

  17. Outcomes • The major visual aim is for independence from wearing spectacles on a day to day basis. • This has special relevance to patients who are totally dependent on their glasses just to get around. • Our results show that 98% will end up 6/12 (20/40) or better and of these 98% there will be 90% who end up with 6/6 (20/20) vision or better. • Enhancement rate currently 4% ,therefore it is largely a very successful operation. • Some patients still find that a "fine tuning" pair of weak spectacles is necessary for demanding tasks such as night driving, but they are free of spectacles for everyday activities like walking, working, swimming and going out with friends.

  18. Nidek OPD Scan • Wavefront Analyser.Corneal Topography.Auto Refractor & Keratometer.ALL-IN-ONE. • Multiple, simultaneous functions avoid instrument alignment problems and reduce examination time.Leading the industry with 1,440 measuring data points in only 0.4 seconds. • The principle of skiascopic phase difference for refractive map measurement.The retina is scanned with an infrared light slit beam, and the reflected light is captured by an array of rotating photo detectors over a 360° area. • The corneal topography function via Placido disk technology.

  19. Oculus Pentacam Principle of Measurement The Pentacam images the anterior segment of the eye by a rotating Scheimpflug camera measurement. This rotating process supplies pictures in three dimensions. The centre of the cornea is measured very precisely because of this rotational imaging process. The measurement process lasts less than two seconds and minute eye movements are captured and corrected simultaneously. By measuring 25,000 true elevation points, precise representation, repeatability and analysis are guaranteed.

  20. Nidek EC5000CX • Custom ablation software. • Receives data from OPD Scan and target correction. • Performs simulation of post op corneal shape. • Generates shot data. • High speed 200Hz eye tracking system. • Torsion Error Detector. • Multipoint ablation allows Wavefront aberration correction.

  21. Amadeus II Keratome • The Amadeus™ II microkeratome is a highly advanced instrument used during the LASIK procedure. Before the surgeon applies the laser to reshape the cornea, the computer-driven microkeratome is used to precisely cut a flap in the outer layer of the cornea to expose the softer tissue underneath. The Amadeus™ II microkeratome builds on the Amadeus™ legacy of virtually fail-proof assembly and unsurpassed material integrity with some critical new improvements, including voice-confirmation of readiness.

  22. Intralase vs Keratomes “Having managed a series of complications arising from cases in which other surgeons have used the FS laser, I question the connection between reduced risk and absence of blade.” “Today, surgeons are using the concept of bladeless LASIK to attract patients, but they’re using it without documented evidence that it is better.” “There’s no question that a surgeon can create an excellent flap with either the Amadeus microkeratome or the Intralase FS laser…I’d have to say there’s no distinguishable difference in flap quality with either technology.” “Two types of surgeons will buy an Intralase: The surgeon who’s having problems with a microkeratome and wants to improve surgical outcomes and the surgeon who’s getting great LASIK results with a microkeratome but who wants the Intralase for practice development”.

  23. How much? The initial assessment visit is free. LASIK costs $2495 per eye. PRK costs $2495 per eye. Cost includes: - Pre-operative eye examination. - All scans (pachymetry, corneal mapping, wavefront analysis). - Education and counselling. - LASIK surgery. - All postoperative medication. - All follow-up visits. - Any enhancement surgery within the first post-operative year.