New Happenings in Refractive surgery

New Developments in Refactive Surgery

Thursday, April 20, 2006


I have decided to take a position as the Ophthalmic surgeon for Doctors Vision Center In Greenville, NC. Where is that???? you may ask .. Greenville is a wonderful community in north eastern North Carolina, home of Eastern Carolina University near the outer banks area of the state. Doctors Vision Center is a MD-OD practice with offices in SC,NC and Virginia. The practice delivers the highest quality eyecare that I have ever witnessed outside of my Own private practice. I am very proud to be associated with all of my new collegues. I will be providing a full range of ophthalmologic services including Cataract, Glaucoma,Lasik and Refractive lens surgery. If you live in the area and have an intrest in ICL surgery come by and we can see if you qualify. You may qualify for this surgery even if you have been told you don't qualify for Lasik

Saturday, January 14, 2006

Hurray the wait is over!! The FDA has approved the STARR Visian phakic IOL for use in the USA.

You can read about the facts on the Staar website at

We are accepting patients for the proceedure, you will have to go through a screening exam to qualify. Many finance options are avalible.

I expect the first patients to be done somtime in early April although it could be as early as the end of Febuary.

Please Visit my practice website at

You can contact Our refractive coordinator Elizabeth at 252 752-2171 or emal at . Let her know that you are calling to make an appointment with Dr. Titone for ICL evaluation this will expidite your appointment. We will also be able to help you with financial arrangements if nessesary.

I will be looking foward to seeing you and to help you see!!!!

Friday, November 05, 2004

The wait goes on!

Seems like STAAR is stuck in a FDA quagmire! There will be a short wait till it all gets worked out. Amo on the other hand is going full speed ahead with their ICL Program. Keep checking back for the latest news!

The wait goes on!

Well as AMO gets their ICL program rolling, STAAR remains in a FDA quagmire! Apparently there are some issues that have to be worked out! more delays. Hopefully the wait will be short.
Keep checking back for more news.

The wait goes on!

Well as AMO gets their ICL program rolling, STAAR remains in a FDA quagmire! Apparently there are some issues that have to be worked out! more delays. Hopefully the wait will be short.
Keep checking back for more news.

Friday, October 29, 2004

Update from the refractive front

We are anxiously awaiting the FDA's response that will allow the final approval for US marketing of their ICL..could be in the next couple of days!! Keep refreshing to get the newest Blog.
Doc T.

Saturday, October 16, 2004

Today's Happenings

Well this is the inaugural issue of my blog...
What is it all about??? Refractive Surgery happenings..
Who am I??? Charles W. Titone, MD an Ophthalmologist
Well the past year has been busy with the introduction of wavefront corrected laser ablations for the big three laser companies ( Visx, Bausch&Lomb and Alcon). A newcomer Wavelight AG marketed a wavefront corrected laser with a prolate beam profile. After all is said and done each laser can be used to achieve excellent results. There are patients that might have special needs that may be treated better with one laser over the others and this is true of all of the above mentioned lasers but each laser is better able to give excellent results than the last generation. The big story will be ICL's (Implantable Contact Lenses) more on that later
The big evolution this year will be twofold, the automated tracking will get a big boost when Visx releases it's Iris registration of wavefront corrections coupled with it new Fourier transform driven wavefront capture device. This will leave the other manufacturers scrambling to catch up. This upgrade will increase the ability to detect distortions and the registration will allow them to meaningfully be corrected. It is one thing to measure the aberrations but there is no benefit to applying the correction if it is not exactly lined up to where it is needed.
The future holds some promise for multi focal ablations.. ie laser treatments to correct distance and near vision in each eye. Right now the best we can do is Mono vision, one eye sees distance and the other near the brain sorts all this out and the patient functionally has "normal" vision. There is a loss of depth perception and some decrease in night vision. Multi focal ablation would improve on this. Some early trials have shown promise. One way to achieve these results right now is an off label use of CK (Conductive Keratoplasty marketed by Refractec) The surgeon treats a patient with previous myopic lasik with 8 spots of CK an more often than not the patient retains good distance vision and gains near vision. There are only a few CK doctors doing this as it is an off label procedure and it can only be done if there is enough residual cornea in the treatment zone >500um.
Well Now comes the real exciting NEWS... ICL's!
Two company's have developed an ICL for the US market to be introduced this year, both are FDA approved the AMO Verisyes released to market 2 weeks ago and the STAAR Visian ICL just receiving its approval. The Verisyes is a variant of an old design, the Iris Claw anterior chamber lens. Surgeons clamp AMO's Verisyes lens directly to the front of the iris. It's inserted through a 7mm incision and sits close to the tissue responsible for keeping the cornea clear. That means perfect surgical technique is mandatory. This lens will be recommended only for high myopia. The Verisyes has been used in Europe successfully over the past several years. The STAAR Visian ICL is a new revolutionary design that allows it to be placed behind the iris for exceptional stability and biocompatibility. This lens is a foldable design allowing it to be passed through a much smaller incision (3mm) than the AMO lens.
Now that there are Two Choices Laser or ICL which should you choose??
Well ultimately the decision is made by you and your Ophthalmologist but people with cornea's that were too thin for laser treatment and were rejected during an evaluation should be able to have an ICL implanted. Persons with myopic (nearsighted) eyes above the treatable range of laser and some within the treatable range, ie > -8.00 would probably have better vision with an ICL because it induces little or no aberrations unlike laser in these higher range corrections. Even the lower minus corrections can have ICL's but in this range it is probably a personal choice as the outcomes are virtually identical.
Where can I get more information??? treatment??
Well stay tuned right here
You can go take a look at and