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2020@larrazabaleye.com....(6332) 412-2020 or 254-2020

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Cebu, Philippines
Dr. POTENCIANO LARRAZABAL III,MD.,D.P.B.O,M.A.H. DEPARTMENT OF OPHTHALMOLOGY CHAIRMAN LARRAZABAL EYE GROUP CHAIRMAN-CENTER FOR SIGHT CEBU DOCTORS' HOSPITAL WAVELIGHT REFRACTIVE STATION , NO BLADE LASIK

PTERYGIUM


WHAT IS A PTERYGIUM?
A pterygium is a wedge-shaped fibrovascular growth of conjunctiva (the surface tissue of the white of the eye) that extends onto the cornea. Pterygia are benign lesions that can be found on either side of the cornea.
WHAT CAUSES A PTERYGIUM TO FORM?
It is thought that prolonged exposure to ultraviolet light may contribute to the formation of pterygia. Pterygia are more often seen in people from tropical climates, but can be found in others as well. 
WHAT SYMPTOMS WOULD I HAVE FROM A PTERYGIUM?
In most cases, routine ocular evaluation reveals pterygia in asymptomatic individuals or in patients who present with cosmetic concern about a tissue "growing over the eye." In some instances, the vascularized pterygium may become red and inflamed, motivating the patient to seek immediate care. In other cases, the irregular ocular surface can interfere with the stability of the precorneal tear film, creating a symptomatic dry eye. Rarely, the pterygium may induce irregular corneal warpage, or even obscure the visual axis of the eye, resulting in diminished acuity.
Clinical inspection of pterygia reveals a raised, whitish, triangular wedge of fibrovascular tissue, whose base lies within the interpalpebral conjunctiva and whose apex encroaches the cornea. The leading edge of this tissue often displays a fine, reddish-brown iron deposition line (Stocker's line).
The vast majority of pterygia (about 90 percent) are located nasally. These lesions are more commonly encountered in warm, dry climates, or in patients who are chronically exposed to outdoor elements or smoky/dusty environments.
Pterygia must be distinguished from pingueculae, which are more yellow in color and lie within the interpalpebral space but generally do not encroach beyond the limbus. Pingueculae also lack the wing-shaped appearance of pterygia, the former being more oval or ameboid in appearance.
WHAT IS THE TREATMENT FOR A PTERYGIUM?
This depends largely on the size and extent of the pterygium, as well as its tendency for recurrent inflammation. Evaluation by an ophthalmologist will help determine the most optimal treatment in each case. If a pterygium is small but becomes intermittently inflammed, your ophthalmologist may recommend a trial of eye drops during acute inflammatory flares. If these drops are recommended, you should remain under the care of your ophthalmologist to ensure that you do not develop side effects from the use of these medications. In some cases, your ophthalmologist may recommend surgical removal of the tissue.
HOW DO YOU PREVENT PTERYGIUM? 
The best method of preventing pterygium is to regularly wear UV 400 rated sunglasses when outdoors in sunny conditions. Sunglasses with a wrap-around design provide better protection than those with large gaps between the sunglass frame and the skin around the eyes. Wearing a hat with a wide brim provides valuable additional protection.
PterygiumWHEN SHOULD A PTERYGIUM BE SURGICALLY REMOVED?
This will depend largely on the judgment of your physician. Removal will likely be advised if the pterygium is growing far enough onto the cornea to threaten your line of vision. Pterygia may also be removed if they cause a persistent foreign body sensation in the eye, or if they are constantly inflammed and irritating. In addition, some pterygia grow onto the cornea in such a way that they pull on the surface of the cornea and change the refractive properties of the eye, causing astigmatism. Removing the pterygium may decrease the astigmatism.
WHAT IS INVOLVED IN A SURGICAL REMOVAL OF A PTERYGIUM?
The removal may take place in a procedure room or operating room setting. The pterygium is carefully dissected away. In order to prevent regrowth of the pterygium, your ophthalmologist may remove some of the surface tissue of the same eye (conjunctiva) and suture it into the bed of the excised pterygium. Alternatively, an antimetabolite such as mitomycin may be applied to the site. Postoperatively, your ophthalmologist may recommend some eye drops for several weeks to decrease the inflammation and prevent regrowth of the pterygium.

CATARACT


WHAT IS A CATARACT?
Contrary to what many people think, a cataract is not a growth or film over the outside surface of the eye. In fact, the cataract is the lens which has become opaque or clouded. This interferes with vision by blocking out light. It is most often due to the normal aging process. A cataract clouds vision by preventing light from passing through the lens to focus on the retina at the back of the eye. The lens of the eye works much like the lens of a camera. If the lens of your camera is dirty or fogged, then the picture taken will be hazy or blurred. A cataract causes the light focusing on the retina to be blurred in the same manner. 
There are currently two methods used to remove Cataracts: The traditional Phacoemulsification and Laser assisted Cataract Surgery. We were one of the few centers back in 1996 that started doing PHACO cataract procedures under topical anesthesia.  We are currently doing nearly 2,000 cataract procedures yearly.  Our average surgical time is between 4 to 7 minutes. It may however take longer in special cases.  The procedure does not involve needles as we use only anesthetic drops to numb the eye.  We do not also patch the eye post op. Instead, we provide protective eye goggles. LARRAZABAL EYE GROUP is the FIRST and ONLY eye facility in Cebu and the rest of the Visayas and Mindanao to offer a blade free option for Cataract Surgery. For more infor on No Blade Cataract Surgery below, scroll below.
HOW DO CATARACTS AFFECT VISION?
Shown is a normal, clear field of view as seen through the clear lens of the eye. When a cataract is present (place cursor over image), vision becomes darkened, cloudy, yellow and blurred.
DO I NEED A SURGERY?
Cataract surgery is an outpatient procedure usually done at the hospital or ambulatory surgical center. The procedure uses local anesthesia in the form of eyedrops to ensure comfort. Patients are awake during the surgery. Eye patches are not required after surgery, and restrictions are minimal.
Successful cataract surgery can greatly improve the quality of life by giving people the freedom to see clearly to once again enjoy day and night time activities. Driving, reading, shopping and recreation can again become pleasurable activities.
To decide whether or not you need cataract surgery, you must first have a complete eye examination. There are several indications for cataract surgery, but rarely will a cataract need to be removed immediately or as an emergency. Because the procedure is elective, most cataract surgery can be scheduled at the individual’s convenience. Some of the more common reasons an individual chooses cataract surgery are:
  • Decreased vision - such as difficulty seeing the street signs, or problems reading fine print.
  • Foggy vision - some people report that their vision appears to have a fog or film over it.
  • Halos around lights - some people have difficulty in particular with night driving due to glare from oncoming automobile headlights.
  • Glare - problems with light sensitivity going from a darkened room to bright light.
  • Decreased ability to perform daily tasks - such problems as reading medication instructions, failure to pass a driver’s visual examination, problems seeing to play cards, bowl or play golf are common.
After consultation with your ophthalmologist, you may decide that you wish to have cataract surgery. Before your make this decision, however, you need to be informed about the health of your eyes, the risks and complications of surgery, and the alternatives as well as the potential benefits for you. You also need to know what you can reasonably expect for visual improvement following the procedure. Although millions of people have undergone safe and successful cataract surgery, complications, though rare, can and do occur. The most serious complication of eye surgery is blindness, due to infection, retinal detachment or technical problems with the surgery and your eye. You must be fully informed about the surgery and its attendant risks before making an informed decision to proceed.
WHAT IS INVOLVED IN THE CATARACT PROCEDURE? 
For most patients, cataract treatment involves the placement of a synthetic lens inside the eye. Typically, this involves making a small incision in the eye, and then dissolving and removing the cataractous lens with ultrasound (often referred to as phacoemulsification). A clear, synthetic lens is then put in place. We evaluate each patient carefully. Any special treatment or instructions will be discussed prior to surgery. If you are found to have cataracts in both eyes a cataract surgery procedure will only be done usually on one eye at a time but in special cases, it can be done simultaneously 30 minutes apart.
Larrazabal Eye Group is focused on your comfort and the best possible care.

1. A very small "No Stitch" incision is made in the side of the cornea. Such an incision promotes fast and more comfortable recovery.

2. The bag of the lens is opened and a special ultrasonic probe (phacoemulsifier) removes the cloudy lens.

3. A small foldable artificial lens is inserted through the small incision to replace the cataract lens.

4. The final replacement lens is shown in place. It is not required to suture the small "No Stitch" incision.






WHY USE A LENS IMPLANT? 
When we perform a cataract surgery, the ultrasound dissolves and removes the cataract, which is the lens. Therefore, we use a special intraocular lens or lens implant to replace the lens that was removed.
IS THE LENS IMPLANT PERMANENT?
The lens is intended to be permanent and in most cases will not need to be removed.
WILL I FEEL A DIFFERENCE WITH THE LENS IMPLANT? 
No, the lens becomes a part of you. It is as natural in appearance, comfort and durability as your natural lens had been prior to the development of the cataract.
WILL INJECTIONS OR STITCHES BE NEEDED? 
The eye is desensitized without injections. We use anesthetic drops to numb the eyes. This eliminates the pain and bruising of the eye associated with injections. Because the incision is so small, it usually does not require stitches.
CAN BOTH EYES BE DONE ON THE SAME DAY? 
Yes, both eyes can be operated on the same day at times but usually it is done at least one day apart.
WHAT ABOUT CAPSULAR OPACITIES? 
A secondary cataract does not involve the lens. In patients with secondary cataracts, the clear membrane that separates the front and back of the eye has become cloudy. To restore visual clarity, an opening is made in the center of the membrane with a Yag laser. The laser dissolves the cloudiness of the membrane and allows light to pass through to the retina. 

LASIK


WHAT IS LASIK?
LASIK stands for LASER IN-SITU KERATOMILEUSIS. It is a form of laser surgery that is capable of correcting nearsightedness, farsightedness, and astigmatism. The procedure uses a computer controlled excimer laser to reshape the cornea to correct your vision. The laser reshaping is done under a protective flap of tissue to promote a very rapid recovery of vision and minimize discomfort. There are currently 2 methods of doing LASIK : The Traditional LASIK using a Microkeratome with blade and the All Laser- LASIK ( No blade LASIK). LARRAZABAL EYE GROUP is the FIRST and ONLY eye facility in Cebu and the rest of the Visayas and Mindanao to offer No Blade All Laser LASIK. Scroll below for more details.
screeningWHAT ARE THE TYPES OF LASIK?There are currently 2 types of LASIK. The Traditional LASIK involves creating a Corneal Flap by use of a Microkeratome with Blade. The All-Laser LASIK uses a Femtosecond Laser to create a Corneal Flap. The same Excimer Laser machine is then used for treatment.
HOW IS LASIK USED TO TREAT REFRACTIVE ERRORS?
The Excimer laser removes microscopic layers of corneal tissue to change its shape, allowing light rays to focus more directly on the retina.

LASIK ANIMATION
LASIK animation
MYOPIA (Nearsightedness)
Myopia or nearsightedness occurs when light rays are focused in front of the retina instead of directly on the retina.
To treat nearsightedness, the cornea must be made flatter. This is accomplished by removing tissue from the center of the cornea.
HYPEROPIA (Farsightedness)
Hyperopia or farsightedness occurs when light rays are not bent enough to focus on the retina. To treat farsightedness, the central cornea must be made steeper. This is accomplished by directing the laser beam to remove tissue from around this area.
ASTIGMATISM
Regular astigmatism occurs when light rays are focused at more than one point on the retina. To treat astigmatism, the cornea must be made more spherical. By changing the pattern of the beam, tissue is removed in one direction more than the other.
HOW DO I KNOW IF I AM A CANDIDATE?
The treatment is for patients 18 years or older who have myopia (nearsightedness) with or without astigmatism, or hyperopia and meet certain visual and medical criteria. In addition to the visual and medical requirements, the best candidates tend to be people who are dissatisfied with their contact lenses or glasses and are motivated to make a change, whether it's due to occupational or lifestyle reasons.
A thorough eye examination is performed to assess the health of the eye. The corneal contour and thickness are precisely measured in order to rule out any unseen abnormalities. Centre for Sight LASIK Surgeon Dr. Yong Larrazabal personally answers all of your questions and reviews all of your options. The results of this evaluation will help Dr. Larrazabal customize the treatment for your specific procedure.
screeningWHAT IS DONE AT A CONSULTATION? 
A complete eye examination and specialized computer measurement of the shape of your cornea is performed. The ophthalmologist reviews this information in light of your visual needs for work and leisure and provides you with options and recommendations for refractive surgery.
In order for your cornea to return to its natural shape by the time of this examination, you must leave your soft contact lenses out for 3 days to 1 week and gas permeable (hard) lenses out for 3 to 4 weeks prior to your consultation.
HOW LONG DOES THE PROCEDURE TAKE? 
About 5 minutes per eye.
screeningDOES IT HURT? 
Anesthetic drops usually allow the operation to be performed with minimal or no discomfort. Afterwards, the eye is a bit scratchy, but patients typically do not require any pain medications and are often able return to work the day following the procedure.
WHAT ARE THE RESTRICTIONS FOLLOWING SURGERY?
You must wear a protective shield to bed for the 3 nights. You should not swim for one week after surgery, although bathing and showering is fine. No eye makeup should be applied for 7 days. All other activities-including exercise-may be resumed on the first day following surgery.

WHEN CAN I GO BACK TO WORK? 
The day after the procedure, as your vision permits.
screeningCAN I PLAY SPORTS AFTER LASIK SURGERY?
You can resume most normal activities immediately after surgery. However, for at least two weeks you will need to avoid activities that would cause perspiration to run into the eyes. You should wear safety glasses while playing contact sports whether or not you have had surgery. But if you do not routinely wear safety glasses, we recommend wearing them for at least one month after LASIK. You will also need to avoid such activities as contact sports and swimming for several weeks.
CAN THE PROCEDURE BE PERFORMED ON BOTH EYES AT ONCE? 
YES! Many patients choose this option, as it is far more convenient.
Marking HOW LONG IS FOLLOW-UP NEEDED? 
Follow up checks are required at one day, 1 week, 1 month, 3, 6, and 12 months. Examinations up to 3 months are included in the charge for the procedure.
WHAT ARE MY CHANCES OF NOT WEARING GLASSES AFTER THE PROCEDURE? 
This will depend on a number of factors, including your refractive error, your visual needs, and even your personality. It is important to understand that LASIK does not eliminate the need for reading glasses as one grows older.
WHEN WILL MY VISION STABILIZE? 
After LASIK, vision usually stabilizes very quickly. Our results thus far indicate that there is little or no change after the two week postoperative examination. Patients with large refractive errors may take up to six weeks or more to stabilize.
After LasikWHAT IS THE % OF PATIENTS THAT NEED ENHANCEMENTS? 
Based on our experience so far, you have about a 1 % chance of needing an enhancement. The likelihood of needing an enhancement is sometimes dependent on the degree of refractive error. More highly myopic eyes are more likely to need an enhancement.
CAN I ALSO HAVE MY ASTIGMATISM TREATED? 
Yes, astigmatism correction can be addressed during the course of the procedure. There are several methods available to correct astigmatism. The doctor will discuss individual patient options at the time of the complete eye examination.
IF I AM NEARSIGHTED AFTER THE PROCEDURE, CAN I BE TREATED AGAIN? 
It is possible to have an enhancement after the initial procedure if the doctor deems it necessary and beneficial to the patient. Should an enhancement be necessary, it will be performed at no charge to the patient within the first year following the procedure.
IF I AM FARSIGHTED, CAN IT BE TREATED? 
Yes. LASIK is the most advanced refractive procedure and with it Dr. Larrazabal can treat farsightedness.
ALCON WAVELIGHT REFRACTIVE STATION
ALCON WAVELIGHT REFRACTIVE STATION_FS200 FEMTOSECONDCentre for Sight has been at to forefront of Refractive Surgery since 2002 and has performed the most number of LASIK Procedures outside Metro Manila (>10,000 procedures to date). To maintain its status as one of the premiere eye facilities in Asia, we recently updated to a brand new state of art ALCON WAVELIGHT REFRACTIVE STATION.

This station combined is one of the fastest systems in the world by breaking the speed barrier by doubling its firing rate. This offers one diopter (1.00 or 100 grade) of correction in just two (2) seconds, with a 6.5mm optical zone. It represents a new generation of refractive technology referred to as "High Performance Vision Correction," that allows patients to achieve exceptional results under all lighting situations, day and night, reducing incidents of "halos" and glare. Here's what LASIK patients have to say.
NEW BLADELESS, ALL-LASER LASIK
After LasikIntroducing the newest addition to our LASIK technology: The Alcon® WAVELIGHT® FS 200 Femtosecond Laser! Centre for Sight is proud to be the first and only LASIK provider in Cebu City, in Visayas and Mindanao to offer patients the world's fastest Femtosecond laser.
The computer-controlled laser lets our surgeons achieve the highest degree of corneal flap precision in 6 seconds or less. This innovative method allows the patient faster visual recovery with superb outcomes. Plus, a patient that previously was not a good refractive candidate may now be suitable for LASIK.
The Bladeless All-LASER LASIK offers patients a new sense of assurance and peace of mind through added safety and increased precision in a less invasive procedure.
Please take note while other eye facilities will offer you a "bladeless" procedure, this is in fact not LASIK but a mere PRK or EPILASIK procedure. Here, the Corneal Epithelium is scraped off the surface with a device. The disadvantage of which is delayed wound healing ( 3 to 7 days) and risk of Corneal Haze ( scar) formation.
The Alcon® WAVELIGHT® FS 200 Femtosecond Laser
Femtosecond laser in conjunction with the excimer laser is an integrated system called WaveLight Refractive Station. The femtosecond laser offers possibility of making the cornea flap considering a lot of factors, such as: diameters, shape, thickness, depth, angle and location of the hinge.
ALCON WAVELIGHT REFRACTIVE STATION_FS200 FEMTOSECONDThis instrument can do very big, up to 10mm aplanations, what is important in the surgery of a very high hypermetropia. It gives the surgeon a high level of a margin. The next advantage is the fact that there is no need to do the corneal pocket due to eliminate the cavitation gases. The laser automatically makes the tunnel in the flap’s hinge of the cornea to remove the gases outside.
This laser has got a few possibilities to improve the safety during the surgery. Firstly, the laser does it automatically, every day before the first surgery it programmes the right focal length. Addictionally, before every using it is tested by Beam Control Check. It sets the precise distance between the optic of the laser and the aplanation test. WaveLight®FS200 similar as the Perfect Puls system in the excimer laser screens the length and profile of the laser beam.
Some features of this system:
  • * Possibility of doing the 10mn corneal flap. It is important in case of people with a wide pupil and the hypermetropia.

  • * Automatical docking of the aplanation cone.
  • * The possibility of correction of the central area of the flap after putting the sucking ring ( 1mm).
  • * Minimizing of the Opacified Bubble Layer (OBL) - clouding of the stroma of the cornea in case the lack of removing CO2 ( carbodioxygen) which was made in photodysruption process. WaveLightFS 200 as the first part of making the flap, do the tunnel in which the gas is removed outside the flap.
  • * The time of making 9mm corneal flap lasts only 6 seconds ( it is over three times shorter than the other lasers).
  • * To do the flap the laser uses moderately of 80mW, it is two times less energy than our rivals.
  • * An automatical calibration of the cone before the surgery.
  • * WaveLightFS200 is equiped with optic of Carl Zeiss and it also has got the built-in video camera which can record all the surgery results.
ABOUT THE ALCON® WAVELIGHT® FS 200 FEMTOSECOND LASER
  • SAFE AND EFFICIENT
BLADELESS AND MORE PRECISETAILORED TO YOUR EYES
The WaveLight FS 200 Femtosecond Laser allows our surgeons to customize the refractive procedure for each patient’s needs. This innovative approach improves safety and efficiency when creating the corneal flap during this life-changing procedure.The femtosecond laser used in bladeless, all-laser LASIK directs tiny rapid pulses of infrared light to a precise, computer-controlled depth within the cornea to create the flap. The depth is determined and programmed by the AIO surgeon. These high-energy light pulses (15,000 per second) eliminate the need for a blade and result in faster flap creation.It also offers tailored performance, including adjustable hinge position and size, variable side-creation angles, and flap sizes and shapes. This allows our surgeons to expand their treatment options, and even offer refractive surgery to patients who may have not been a good candidate in the past.

WHAT SIDE EFFECTS ARE TYPICAL?Your vision will fluctuate during the few days following the surgery. You may notice some glare around lights at night. You will notice a dryness to the eyes also. rarely a patient may have persistence of one or more of these effects. These effects are usually worse during the first two weeks after surgery and then slowly disappear. With the Wavelight Refractive Station, these symptoms are now very rare while some even mention of having better and sharper night vision after Lasik.
WHAT ARE THE RISKS OF SURGERY? 
Like any surgical procedure, LASIK carries some risk of complications. Risks include an infection which could damage your cornea and result in loss of vision, although this is extremely unlikely. As part of your evaluation for the procedure, we will give you an informed consent document which details potential risks and complications of surgery.
ARE THE EFFECTS OF LASIK PERMANENT? 
YES! Long term studies have shown for 5 years and beyond.
WHAT TO EXPECT IN THE OPERATING ROOM
Vision correction surgery is virtually painless and is performed in an outpatient treatment room at Centre for Sight Refractive Surgery Center at Cebu Doctors' University Hospital. After you arrive at the Center, you will be seated in a comfortable chair in the surgical suite. An assistant will apply drops to numb your eye before the operation and then clean around your eye with a special antibacterial solution. You will be awake and comfortable throughout the surgery. We find a light sedative, such as Valium or Ativan, helps to take the edge off and allow you to nap the afternoon after surgery. 
The surgeon will position a spring-like device (lid speculum) between your eyelids which will make it easy to keep your eye open during the procedure. Depending on the plan you and your doctor have agreed upon in advance, one or both eyes may be operated on during the session. After the procedure, your post-operative instructions will be reviewed and your follow-up appointment will be scheduled.
RECOVERY
Immediately after surgery, your eye may be more sensitive to bright light. Your vision will be blurred. Within an hour or so after the procedure, you'll start feeling some minor discomfort-usually a scratchy sensation like there's something in the eye. This will be relieved by the rewetting drops.Recovery usually takes around 3 hours.
DO NOT RUB YOUR EYE! You should plan to relax the remainder of the day after surgery, and it is best to take a 1-2 hour nap. It will not harm your eyes to read or watch television, but you may not be able to see fine details.
On the first day after surgery, your doctor will check your eyes to ensure that they are healing properly. Most patients return to work on the first day following surgery.
Most activities may be resumed on the first day; however, you should not swim for "one" week. Depending upon your age and the result of the initial surgery, you may or may not need spectacles.
Temporary lenses can be obtained if necessary.
THE COST OF LASIK
The price you'll actually pay for your LASIK depends on a number of factors, including:
  • After Lasik* The type of laser technology you choose
  • The type of surgical instrument used to create the corneal flap
  • * Whether or not your pre-op exam and follow-up visits are covered in the fee
  • * Whether or not your post-op medications are covered in the fee
  • * Whether or not retreatments (if necessary) are covered in the fee
  • * The skill, reputation, and experience of your refractive surgeon
  • The community and area of the country you live in
  • Please call our office for a consultation 032-256-2020!


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HOW CAN I SCHEDULE AN APPOINTMENT? 
Simple. Just call the Clinic at (6332) 412-2020 or 254-2020, fax us at 253-2020 or email us at 2020@larrazabaleye.com. Allow about one and a half hours for your comprehensive evaluation. The professionals at the Larrazabal Eye Group and Centre for Sight can explain all of the refractive procedures available today and show you how affordable they are.