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Interview with Dr. William Ellis

Why Dr. William Ellis?

Dr. Ellis brings with him many years of experience in laser vision correction and surgical ophthalmology. He is also experienced in cosmetic procedures of the face and eyelids. Besides being board certified in ophthalmology, he did his premedical studies in electrical engineering at the University of California at Berkeley. His medical training was at Washington University St. Louis, and in the Department of Surgery of Duke University. He served as a commissioned officer at the Heart Institute of the National Institute of Health in Bethesda Maryland. He trained and completed residency in ophthalmology at Stanford University.

Thus, Dr. William Ellis is not only an expert in laser design and function because of his engineering background but was among the first to perform laser procedures and laser vision correction in the United States. Dr. Ellis brings to you a total concept and understanding of laser procedures. This is because he is both a medical doctor with skills in ophthalmology and an engineer knowledgeable in laser design and performance.

Dr. Ellis is known for his gentle, kind and caring approach to patient care and treatment. So place yourself in the healing hands of Dr. William Ellis whether it be for vision correction or facial cosmetic procedures. He usually offers a complimentary evaluation for new patients who qualify for the treatments he performs. Our friendly patient counselors would be happy to answer your questions concerning appointments and treatments. Call us to see if you qualify for a free initial evaluation.

Interview With Dr. William Ellis

QUESTION: Tell us, Dr. Ellis, how did you happen to become one of the pioneers in refractive surgery?
ANSWER: It goes back a long ways to my engineering training at UC Berkeley. Back when I was a young engineering student, I realized that there was very little technological input in medicine. In those days we had Sputnik and the space race, but technical knowledge somehow wasn’t getting into medicine.

QUESTION: So it was your goal to help bring technical knowledge into medicine?
ANSWER: Yes, it was always my plan to go through engineering and to continue on into medicine. I’m lucky I completed my engineering and pre-med in four years. Most people took five years to get through engineering, but I knew I had to move quickly because of the training involved.

QUESTION: Where did you go for medical school?
ANSWER: After my initial training I went to the National Heart Institute in Bethesda, Maryland, where I helped to do research on the artificial heart. I became increasingly concerned about problems of vision and blindness and decided to pursue ophthalmology.

QUESTION: Is that how you happened to meet Professor Fyodorov, the world-famous Russian eye surgeon who developed radial keratotomy?
ANSWER: While traveling the globe to meet the greatest surgeons, I learned about a new procedure in Moscow on how to correct nearsightedness called radial keratotomy.

I began my work in vision correction with my collaboration with Prof. Fyodorov and co-authored a surgical textbook on Keratotomy with him. The book became a vehicle to teach other surgeons the procedure and I am proud to have trained many hundreds of eye surgeons internationally to perform the RK procedure. Prof. Fyodorov personally attended many of my surgical courses to help teach this new method of vision correction with Dr. Ellis.

Laser Vision Correction

QUESTION: Tell us about your work in laser vision correction.
ANSWER: When laser vision correction was in its earliest inception I began to study its applications because of my background in electrical engineering prior to studying medicine. I was among the first in the U. S. to import one of the very first excimer lasers and to commence experiments with laboratory animals in its application to vision correction. When the laser received FDA approval I was among the first to successfully treat patients to correct nearsightedness. Now, many years later, I am proud to have corrected vision in over eighty thousand eyes.

QUESTION: Is laser vision correction only for nearsightedness?
ANSWER: As the field of laser vision correction progressed scientific advancements followed and allowed for the correction of astigmatism and later farsightedness. Today laser vision correction is one of the most successful surgeries done on an outpatient basis. It frequently takes only a matter of days to recover and often experience freedom from glasses and contact lenses.

QUESTION: How new is the LASIK procedure?
ANSWER: The LASIK procedure evolved from lamellar refractive surgery or ALK. Automated Lamellar Keratoplasty was invented in 1948 by Professor Barraquerer, oe of the most famous names in refractive surgery. Both Professor Barraquerer and Professor Fyodorov are recognized as the two founders of refractive surgery. I am proud to have known both Professor Barraquerer and Fyodorov for almost 20 years. In fact, Professor Fyodorov co-authored a refractive surgical textbook with me. Professor Barraquerer quotes my textbook in his surgical textbook.

QUESTION: How was the LASIK procedure evolved?
ANSWER: The LASIK procedure was developed as a refinement of Dr. Barraquerer’s work. He began his procedures almost 50 years ago. That’s a long track record! LASIK represents a combination of procedures. An ALK flap is raised and the cornea is sculpted by the laser underneath this protective flap. When the procedure is done, the flap is simply laid back over the cornea. This helps promote faster healing. A very precise instrument called the microkeratome is used to produce the flap.

QUESTION: Dr. Ellis, what does the microkeratome do?
ANSWER: The microkeratome raises a thin flap of cornea in the LASIK procedure. Therefore, instead of using the laser to remove tissue from the outer surface of the cornea, the laser can sculpt the cornea underneath this protective flap. When the laser PK is finished, the flap is replaced over the ablation site. Healing is usually quicker this way. In contrast to surface ablation, there is no open wound on the surface of the cornea. In surface PK, an open would is left which must heal. This healing is often slow in contrast to the rapid healing we see with LASIK.

QUESTION: Dr. Ellis, tell us again what the difference is?
ANSWER: When we perform surface ablation on the cornea, we simply put the patient under the laser, set the computer, aim and fire. It’s just that simple. Some surgeons remove the outer most covering of the cornea called the epithelium, and others ablate right through it. Regardless of the technique, at the end of the procedure you have a wound that requires 6 or 7 days for the epithelium to recover it. That usually means wearing a bandage contact lens and the recovery period. The contact lens speeds healing and adds considerable comfort. Because PRK does not make a flap, less tissue is taken leaving a thicker corneal bed. Thus, it is possible to perform higher optical corrections than with Lasik. Because there is more corneal tissue there is less chance of complications such as irregular astigmatism. On the other hand, healing is slower than with Lasik. The difference in time of healing between the two surgical methods is usually not more than a week. Thus, most ophthalmologists consider PRK to be safer and less likely to develop complications. The downside is a slightly longer period of recuperation.

QUESTION: Tell us about the various types of Laser Vision correction (LVC)
ANSWER: There are two basic methods of performing LVC. The first was PRK, or photo-refractive keratectomy. In PRK the this (40 micron) epithelial layer of the anterior cornea is first removed and then the laser is used to sculpt a new optical surface on the underlying cornea which is precisely calculated to correct nearsightedness, farsightedness, and astigmatism. A soft contact lens is then placed on the cornea with antibiotic drops to act as a bandage during the initial healing period, and at the same time allow the patient to see through the operated eye. After a week the contact lens is removed and the patient’s eye continues to heal on its own.

QUESTION: Tell us more about LASIK, Dr. Ellis
ANSWER: The LASIK procedure is a modification of PRK. Instead of removing the epithelium a device called a microkeratome is used to produce a thin flap of corneal tissue consisting of overlying epithelium and corneal stroma approximately 120 to 140 microns thick. The flap is folded back and the laser used to sculpt the underlying cornea to perform the optical correction. Next the corneal flap is folded back into place. Because the flap still has its epithelial covering there is less discomfort and faster healing than with PRK. The flap is not taken all the way off the cornea, but remains hinged towards the nose. The laser then precisely removes a small portion of underlying corneal tissue, which is often less than the thickness of a single human hair. The corneal flap is then folded back and re-aligned on the corneal surface, just the way it was before the surgery. This flap often heals quickly and aides in speeding up the entire healing process. Suturing is rarely required. In most instances our patients feel quite comfortable the next day. I’ve been amazed that even when looking at the eye through a microscope, it is sometimes difficult to detect the flap even on the first day following surgery.

QUESTION: Dr. Ellis, how does this compare to surface PK?
ANSWER: In surface PK, the laser ablation creates an open wound on the very front surface of the eye. The epithelial covering of the cornea usually takes about a week to cover the defect. Actual healing often takes much longer. Corticosteroid drops are used to help control the healing. These steroid drops are thought to help reduce haze in order to achieve a better result. However, there can be side effects from the steroid drops which usually disappear when the drops are stopped.

RK

I began my work in vision correction with my collaboration with Prof. Fyodorov and co-authored a surgical textbook on Keratotomy with him. The book became a vehicle to teach other surgeons the procedure and I am proud to have trained many hundreds of eye surgeons internationally to perform the RK procedure. Prof. Fyodorov personally attended many of my surgical courses to help teach this new method of vision correction with Dr. Ellis.

Laser Vision Correction

QUESTION: Tell us about your work in laser vision correction
ANSWER: When laser vision correction was in its earliest inception I began to study its applications because of my background in electrical engineering prior to studying medicine. I was among the first in the U.S. to import one of the very first excimer lasers and to commence experiments with laboratory animals in it’s application to vision correction. When the laser received FDA approval I was among the first to successfully treat patients to correct nearsightedness. Now, many years later, I am proud to have corrected vision in over eighty thousand eyes.

QUESTION: Is laser vision correction only for nearsightedness?
ANSWER: As the field of laser vision correction progressed scientific advancements followed the allowed for the correction of astigmatism and later farsightedness. I am proud to have been present to help advance these historical advances. Today laser vision correction is one of the most successful surgeries done on an outpatient basis. It frequently takes only a matter of days to recover and experience reduced dependence on eyeglasses and contact lenses.

QUESTION: Tell us about the various types of Laser Vision correction (LVC)
ANSWER: There are two basic methods of performing LVC. The first was PRK, or photo-refractive keratectomy. In PRK the thin (40 micron) epithelial layer of the anterior cornea is first removed and then the laser is used to sculpt a new optical surface on the underlying cornea which is precisely calculated to correct nearsightedness, farsightedness, and astigmatism. A soft contact lens is then placed on the cornea with antibiotic drops to act as a bandage during the initial healing period, and at the same time allow the patient to see through the operated eye. After a week the contact lens is removed and the patient’s eye continues to heal on its own.

QUESTION: What is Lasik?
ANSWER: The lasik procedure is a modification of PRK. Instead of removing the epithelium a device called a microkeratome is used to produce a thin flap of corneal tissue consisting of overlying epithelium and corneal stroma approximately 120 to 140 microns thick. The flap is folded back and the laser used to sculpt the underlying cornea to perform the optical correction. Next the corneal flap is folded back into place. Because the flap still has its epithelial covering there is less discomfort and faster healing than with PRK.

QUESTION: What are the differences between PRK and Lasik?
ANSWER: Because PRK does not make a flap, less tissue is taken leaving a thicker corneal bed. Thus, it is possible to perform higher optical corrections than with Lasik. Because there is more corneal tissue there is less chance of complications such as irregular astigmatism. On the other hand, healing is slower than with Lasik. The difference in time of healing between the two surgical methods is usually not more than a week. Thus most ophthalmologists consider PRK to be safer and less likely to develop complications. The downside is a slightly longer period of recuperation.

QUESTION: What is Epilasik?
ANSWER: Epilasik represents the newest development and combines the advantages of traditional Lasik and those of PRK. It is basically a modification of the PRK procedure. Instead of creating a 140 micron flap consisting of surface epithelium and a partial thickness of underlying corneal stroma to cover the healing laser ablation only the this corneal epithelium (approximately 40 microns thick) is raised as a single sheet. It is folded to the side and then the excimer laser ablation of underlying stromal tissue is performed which adds the optical correction calculated to achieve the change in vision needed for better eyesight. Finally the epithelium is folded back over the lasered stroma and a bandage contact lens applied to aid in healing and reduce postoperative discomfort. The advantages of epilasik are that less corneal stroma is disturbed allowing larger amounts of refractive correction and greater postoperative stability decreasing the possibility of complications such as irregular astigmatism and keratoconus. The patient must understand that complications can occur with any laser vision procedure but can almost be eliminated by proper patient selection and choice of the operative procedure. However patients must understand that with any surgery rare complications can occur.

QUESTION: What is Wavefront Correction?
ANSWER: Basic Laser Vision Correction is for first order visual aberrations consisting of nearsightedness (myopia), farsightedness (hyperopia) and astigmatism. Wavefront correction can now be done to correct higher order aberrations. These optical aberrations are harder to explain to laymen but their correction may give a significantly better result in some patients. Ask your doctor if you wish to learn about correction of higher order aberrations by Wavefront laser ablation.

QUESTION: What medications are used to help postoperative healing?
ANSWER: With our experience in performing lasik, epilasik, and PRK we have learned to use various medications to help obtain the best visual outcomes. Here is a partial list:

  1. Mitomycin drops. Mitomycin is an antimetabolite which helps to reduce the incidence of haze following laser ablation of the cornea. It is particularly important for Epilasik and PRK. It can rarely have side effects however only a small amount, consisting of a few drops at the time of surgery, are used and it is very unusual to see these. Ask your doctor about side effects if you are concerned.
  2. Corticosteroid drops are used in varying concentrations postoperatively. They speed healing and prevent hazing. Rarely they can raise intraocular pressure which usually subsides when the drops are stopped. Ask your doctor about side effects if you are concerned.
  3. Antibiotic drops to prevent infection.
  4. Lubricating drops for comfort.

QUESTION: Dr.Ellis, your engineering background is certainly an asset to you.
ANSWER: Yes, it has been an asset and we at the Ellis Eye and Laser Centers plan to continue to perform PK surgery in the very best manner, so that we can achieve the best results possible for our patients.

Thank you, Dr. Ellis

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