Dr. Mandel uses both the Autonomous LADARVision Wavefront and VISX S4 with wavefront and iris registration.
Laser surgery is performed by Dr. Mandel at Horizon laser surgery centers in San Francisco, San Jose and San Leandro.
Traditionally, the excimer laser beam is centered on the eye in a team approach between the patient and the surgeon. Specifically, the patient is coached and encouraged to maintain fixation on a blinking light and the surgeon, using a joy stick and subtle manipulations of the patient's head, maintains fixation and centration on the patient's pupil.
Although most patients are concerned that they will be unable to fixate on the light, in reality most people fixate extremely well. However, there are some patients that have a difficult time fixating on the light. Additionally, there are some medical conditions of the eye such as nystagmus which prevent the patient from fixating. We use the latest technology to ensure your safety by employing only lasers with active tracking mechanisms. We perform surgery at one of the only laser centers in Northern California with both the VISX S4 Smooth Scan active tracking laser, and the Autonomous LADARVision excimer laser.
Both of these lasers (using slightly different mechanisms) actively track the patient's eye. For example, the Autonomous LADARVision excimer laser takes a "picture" of the patient's cornea 4,000 times per second and will not allow the laser to fire unless the eye is centered. Although the tracking mechanism of the VISX S4 Smooth Scan laser is slightly different, it is also extremely effective in maintaining fixation of the patient's eye during treatment.
We have been thrilled with the results of both the VISX S4 and the Autonomous LADARVision laser tracking systems. If, for no other reason, these systems have been very useful in allaying anxiety of patients afraid that they will not be able to "watch the light" during laser treatment.
