The Shapiro Laser Eye Center is committed to using the most advanced, most accurate, and most safe technology possible. Dr. Shapiro has authored scientific papers on new technologies in refractive surgery and has served as an FDA clinical investigator to evaluate the safety of various formats of LASIK surgery.

VISX CUSTOMVUE WAVESCAN ABERROMETER:

This technology incorporates sensors capable of accuracy 25 times greater than conventional glasses or contacts measuring devises. The Wavescan Aberrometer allows highly precise wavefront based three dimensional maps of the unique "fingerprint" distortions in the patient's optics. This information can be digitalized and downloaded into the VISX S4 Excimer Laser to guide the laser beam to sculpt the tissue with billionth of an inch accuracy to tailor a customized, individualized correction to the corneal tissue.

The VISX Wavescan is used by Dr. Shapiro to create the three dimensional map of the wavefront image, or "optical fingerprint" of the your eye. An invisible infra-red laser is shined into the eye and over 200 sophisticated sensors map out the returning reflection of this laser from the back surface of the eye. To ensure accuracy, four distinct wavefront maps are created within milliseconds and they are cross-checked to be sure they correlate with each other. The complex three dimensional map is then downloaded directly into the laser, which can replicate it in the corneal tissue with billionth of an inch accuracy. This allows a level of precision of treatment which is beyond that of glass or contact lenses.

VISX S4 EXCIMER LASER

Dr. Shapiro uses the VISX S4 excimer laser system and the Autonomous LADARVision system. For nearly all cases, however, he prefers the VISX S4. The S4 VISX laser is the newest and most advanced excimer laser made. Although it can also be used for conventional LASIK, the S4 VISX laser was engineered to be technologically capable of incorporating the Wavescan Waveprint custom wavefront LASIK mapping and then applying it to the surface of the cornea with billionth of an inch precision.

Dr. Shapiro prefers the VISX S4 Excimer Laser as his laser of choice. This new, state of the art laser, incorporates variable spot scanning "smart beam" technology, three dimensional eye tracking, and billionth of an inch accuracy. It can be used in either a conventional or wavefront format.

In order to achieve the level of precision needed to create wavefront based sculpting, the VISX S4 has several technological breakthroughs:

• THREE DIMENSIONAL EYE TRACKING:
  
  This advanced technology utilizes a computer guided three dimensional eye tracking system which allows billionth of an inch accuracy on a very rapidly moving target. The three dimensional eye tracker supersedes older two dimensional systems. During the laser procedure, this revolutionary eye tracker locks onto the eye, following its most minute movements in three dimensional space. It drives a laser guidance system which allows perfect placement of the laser beams to the eye, even if the patient is unable to hold still or look consistently ahead. Eye movement during surgery is now no longer a concern. With this new generation eye tracking system, the eye does not need to be dilated during the procedure, as was the case with older two-dimensional systems.

Eye movement during surgery is no longer a concern. Advanced computerized tracking technology allows the laser beam to actually follow even the eye's fastest and most minute movements to allow perfect placement of each laser pulse regardless of eye movement, improving both the accuracy and the safety of laser vision correction.

• AUTOMATIC CENTRATION
  
  The laser's computer not only allows three dimensional eye tracking, but is able to perfectly "lock-on" with the eye tracker on the exact center of the pupil, allowing the treatment to be perfectly centered. In this way, the waveprint treatment as measured and calculated by the Wavescan aberrometer is exactly lined up in the correct position on the cornea. This automatic centration feature is unique to the VISX S4 system.
  
  
• VARIABLE SPOT SCANNING
  
  The VISX S4 utilizes a seven beam scanning array laser beam with variable spot sizes and shapes which has been shown to produce the smoothest laser pattern of any of the excimer lasers. The variable spot size and shaped technology technology, also called "SmartBeam" technology, allows a computer controlled, customized mixture of laser beams ranging from 0.65 mm in diameter to 6.5 mm in diameter and allows a wide total laser ablation diameter of up to 9.0 mm for patients with large pupils. When a wavefront based LASIK procedure is performed, advanced microprocessors perform over one billion calculations to determine the mathematically optimal combination of laser pulse sizes and shapes to most perfectly created the desired tissue sculpting. Variable spot scanning is unique to the VISX excimer laser.

Dr. Shapiro employs variable spot scanning laser technology. Using "Smart Beam Technology" software, this advanced laser system allows the computer to use eye-tracked laser pulses ranging in size from 0.65 mm to 6.5 mm to most optimally sculpt the complicated nuances of shape required for wavefront treatments.

 OTHER LASIK TECHNOLOGY

Before surgery, every patient's eye is measured in various ways. Each patient undergoes wavefront analysis with the VISX Wavescan to produce the patient's unique Waveprint, or customized depiction of both the internal and external optics of the eye. Corneal topography, or corneal contour mapping, is performed and computerized statistical analysis is performed on these topographical maps to try to detect any shape anomalies which could increase surgical risk and therefore be contraindications to surgery. The refraction is measured four times prior to surgery to ensure accuracy. Pupil sizes are measured before surgery and corneal thickness is measured using a high performance, high frequency ultrasonic pachymeter. Dr. Shapiro personally examines every patient before surgery.

LASER SUITE ENVIRONMENT:

Also of great importance to achieving the most accurate and reproducible results is the environment the eye is in during surgery. Dr. Shapiro, in conjunction with laser engineers, has developed a unique laser laboratory in which the procedure is performed. In this laser suite, sophisticated microfiltration systems and environmental controls are used to optimize air purity, temperature, humidity and flow rates -- all critical to achieving the best possible results. The Shapiro Laser Eye Center has one of the few such environmentally regulated laser laboratories in California.

SURGICAL TECHNICIANS:

The surgical technicians at the Shapiro Laser Eye Center are an important part of the equation of your success. They calibrate the sophisticated instrumentation used by Dr. Shapiro and assist him in surgery. Dr. Shapiro's highly trained technicians and surgical assistants have been with him for 15 years and over 10,000 cases. With Dr. Shapiro, they form a team dedicated to your best possible outcome and highest possible levels of safety.