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About the
Caster Eye Center
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The Lasik eye doctors at Caster Eye Center in
Beverly Hills, California, specialize exclusively in laser vision
correction. For more information about Lasik vision correction
in the Los Angeles and Beverly Hills area call us at (310) 274-1221.
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Dr.
Caster has performed more than 12,000 laser vision correction
procedures.
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The
Caster Eye Center is dedicated exclusively to refractive
surgery.
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Many
world-class professional athletes, including top professionals
in basketball, tennis, golf, boxing, and soccer, have entrusted
Dr. Caster to improve their vision and performance with Lasik.
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With
over 150 surgeons in the Los Angeles area performing Lasik,
Dr. Caster was selected by Los Angeles Magazine as the “Best
Laser Eye Surgeon in Los Angeles.” According
to Los Angeles Magazine, to be selected as “Best of L.A.”,
“you simply have to do something much better than anyone else
does.”
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W
Magazine
recently selected Dr. Caster as one of two top Lasik laser
eye surgeons in the United States.
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At
the Caster Eye Center, we will only treat you if we believe
that we can obtain an excellent result.
Approximately 30% of the patients that come to us for
Lasik are advised not to have the procedure, because we believe
they are not ideal candidates.
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Caster
Eye Center offers two lasers: the LadarVision laser
by Alcon and the Visx S3. Because the Alcon LadarVision
treatment zones are much larger than those of any other laser,
it virtually eliminates the occurrence of haloes and glare
in nighttime vision.
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Dr. Caster’s book,
The Eye Laser Miracle: The Complete Guide to Better Vision,
is now in its 5th printing and is the most widely-read book
in the United States on the subject of laser vision correction.
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Dr. Caster is one of only a few Lasik surgeons in Southern
California (and one of less than 100 in the entire United
States) to meet the extremely high quality standards required
to become certified by the Council for
Refractive Surgery Quality Assurance.
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People travel to
the Caster Eye Center from across the United States and from many other
countries. In fact, our patients have come from every continent in the world (except Antartica).
These people know that at the Caster Eye Center they will receive
the highest quality laser vision correction available anywhere in the world. |
Superior results require the highest quality equipment, as well as a commitment to quality in every step of the process.
At the Caster Eye Center we use only the highest quality FDA-approved lasers - the Alcon LadarVision laser and the Visx laser.
These lasers use sophisticated scanning technology to produce the largest and smoothest treatment
patterns.
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A
commitment to the highest quality goes far beyond using the most
advanced equipment. Our laser room is temperature and humidity
controlled to a degree unmatched by other centers. Attention
to detail (such as calibration, maintenance, and technician
quality), use of the finest equipment, and Dr. Caster's extensive
knowledge and experience combine to produce our highly accurate
results.
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| In addition
to treating thousands of patients, Dr. Caster has had his own
nearsightedness and astigmatism corrected with the Lasik technique. This
personal experience helps Dr. Caster to understand your needs and concerns in a very personal way. |
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About
Our Doctors
FDA
Studies at the Caster Eye Center
The
Caster Eye Center was one of twenty Visx laser sites in the United States
conducting research studies using new excimer laser treatment
techniques.
This research, conducted through the organizational efforts of
CRS Clinical Research, has been instrumental in gaining
FDA approval for more advanced uses of the Visx laser.
We
at the Caster Eye Center are proud of our role in helping to advance the
science of excimer laser treatment, and in helping to develop and test
new techniques that will improve the vision of patients everywhere.
Technology at the Caster Eye Center
No one has technology that surpasses the Caster Eye Center. We have a commitment to using the most advanced and up-to-date equipment available, and we have been at the forefront of technology since laser vision correction began.
Of course, the manner in which the technology is used -- how it is programmed, how it is maintained, the many choices made by the physician -- is more important than the raw technology itself.
LadarVision Laser
Caster
Eye Center is proud to use the LadarVision
laser by Alcon. Developed from Star Wars technology, the
LadarVision laser by Alcon incorporates an active eye tracker
and small spot scanning to maximize the effectiveness of Lasik.
Over the past 7 years, Dr. Caster has used the Summit, Visx S3, and LadarVision lasers, and the most accurate results have been obtained with the LadarVision laser. For 6 months, we conducted a head-to-head comparison of the Alcon LadarVision laser versus the Visx laser; these tests yielded substantially better results with the Alcon LadarVision laser.
ACTIVE EYE TRACKING
The LadarVision Active Eye Tracking System consists of an infrared laser that measures the eye position 4,000 times per second, and adjusts the treatment accordingly. This makes Lasik more precise and alleviates any fear a patient may have about eye movement during the procedure. The other commonly used lasers track at only 60 times per second, and many do not track the eye at all.
EXPANDED TREATMENT ZONE
The LadarVision laser provides a larger treatment zone than any other excimer laser. This is extremely important, for it results in dramatically better night vision, especially for people with larger pupils (People want to see as well as possible during the day and the night!).
When we go into the dark, our pupils enlarge to let more light into our eyes. If the pupil is substantially larger than the area of laser treatment, then light rays will pass around the area treated with the laser and will enter the pupil. Light rays which are not focused by the treated cornea cause blurring of vision in the dark, halos around lights, and glare.
The LadarVision laser has larger treatment zones than other lasers, which substantially lessens problems with night vision, including glare and halos. The difference in treatment zone size is dramatic, and this results in a dramatic difference in night vision. For a patient with nearsightedness and a moderate amount of astigmatism, the largest treatment with the Alcon LadarVision laser is 8mm x 10mm; with the Visx, the largest treatment for this person is 8.2mm x 8.2mm. Of the entire treatment, with the LadarVision laser the “prescription” portion of the treatment (the portion of the treatment that has the prescription in it) will be 8mm x 8mm, but on the Visx it will be only 5.0mm x 6.5mm. (The remainder of the treatment is a “blend” zone to smooth out the edge.)
This is almost a 100% difference in the size of the “prescription” portion of the treatment! The much larger size of the “prescription” treatment with the LadarVision laser yields better vision in the dark, when the pupil enlarges. Since we use our eyes in the light and the dark, this is very important.
ASTIGMATISM ACCURACY ADJUSTMENT
When patients lie down or focus on close objects, their eyes have a tendency to rotate – some more than others. This rotation is referred to as cyclotorsion. The LadarVision laser by Alcon has the ability to adjust for this rotation. This increases the accuracy of correcting astigmatism by aligning the treatment zone with the angle of your astigmatism.
Outcome Analysis
One of the most important (but most difficult) tools to improve the accuracy of the results is through Outcome Analysis. Caster Eye Center has been an industry leader in Outcome Analysis, using this technique continuously since 1991. In 1994, Dr. Caster was honored with the UCLA Department of Ophthalmology Alumni Research Award for his development and use of Outcome Analysis.
Each laser is supplied with software formulas that tell the laser how many pulses to use for any given level of nearsightedness, farsightedness, and astigmatism. These formulas, however, represent an average number of pulses needed for the typical surgeon using this laser, using a typical technique, in a room with typical temperature and humidity. The problem is: no two surgeons/techniques/rooms are identical, so reliance on the laser software produces average (but not exceptional) results. Many surgeons alter the laser formulas, but not in a reliable, scientific way.
Outcome Analysis is the systematic collection and mathematical analysis of results in a way that allows for adjustment in laser formulas. It is very time consuming and involves use of computer programs that perform multiple regression analysis. By routinely analyzing the multiple regression analyses of these outcomes, we are constantly making small modifications in our laser formulas. This dramatically improves our results. It is an on-going quality improvement feed-back loop that is very difficult and time-consuming, but is one of the most important ways that we produce the most accurate results possible. It only useful in a setting where the technique – the surgeon, the equipment, the room temperature and humidity – are held constant.
Pupil Size Assessment
One of the most troublesome aspects of laser vision correction has been the relatively poor night-time vision that some patients experience. Poor night vision may be the result of the treatment area being too small in relation to the size of the fully dilated pupil (your pupil dilates – enlarges – when you go into the dark). The LadarVision laser allows for dramatically larger treatment zones, resulting in much improved night vision.
It is essential to have an accurate way of measuring the pupil size in the dark. If you shine a light onto the eye to measure the pupil size, then the pupil gets smaller in response to the light, and you are not measuring the true maximum size of the pupil.
The Caster Eye Center was one of the first practices in California to use the Colvard pupillometer to measure pupil size in the dark. This device uses light amplification technology to allow an accurate assessment of the pupil size in the dark. We continue to perform this test on every patient.
A new, more accurate device is now available to measure pupil size in the dark – the Procyon 2000SA Pupillometer. The Caster Eye Center is the first practice in California to own and use this technology. This computerized device makes ten different pupil size measurements at each of three different light levels, and uses imaging software to precisely assign a size to each measurement. This has taken pupil size determination to a much higher level.
Flap Creation
Creation of the Lasik flap is the part of the procedure that seems to concern most patients. At the Caster Eye Center, we use two methods to create the Lasik flap: the IntraLase laser and the keratome. Most patients can have the flap made using either technique, and there is really very little difference. In skilled and experienced hands, each method is extremely safe and accurate. Each has small advantages and disadvantages, and we will discuss the appropriateness of each technique for you during your consultation. If you have a preference for one technique or the other, we are happy to accommodate you (unless there is a technical reason which makes that choice inadvisable). In either case, after the flap is created, the cornea is then reshaped using either the LadarVision laser or Visx laser.
The IntraLase laser is a laser that creates a Lasik flap. When the flap is made this way, the procedure is often called IntraLasik or “all laser” Lasik. The flap is created by thousands of tiny laser pulses applied over the course of a minute.
The keratome is the more traditional method for creating flaps. The flap is created over a 15-second period. We use the Hansatome brand of keratome, which is considered the “gold standard” of keratomes.
In either case, the creation of the flap is not painful. Most people say that they had a feeling of pressure (not pain) during the flap creation. Also, you are not able to see the flap being made. After the procedure is complete, the flap is simply laid back into position, where it sticks down in place by itself without stitches or glue.
CleanRoom
As each laser pulse hits the cornea, a small stream of material (known as the laser plume) is released into the air above that spot. This plume will partially block the next laser pulse, slightly decreasing the accuracy of the treatment. Small-spot scanning lasers, such as the Alcon LadarVision laser, minimize this problem by applying each pulse to a location away from the previous pulse; indeed, this is one of the techniques that allows the small-spot scanning lasers to be more accurate than their broad-beam cousins. However, even with the small-spot lasers, the plume still creates a small variability in results. All lasers are equipped with small air vacuums; unfortunately, these only partially remove the plume.
CleanRoom goes one step farther in eliminating the plume problem and thereby improving the accuracy of the laser treatment. CleanRoom is a small, high volume air pump that is placed near the eye during the laser treatment. This air pump rapidly removes the plume created by the laser, decreasing interference that the plume creates and further improving the accuracy of the laser treatment.
LOCATION
AND DIRECTIONS TO CASTER EYE CENTER
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