State-of-the-art Cataract Surgery
A cataract is a cloudy area in the normally clear lens in the front of the eye. Cataracts are caused by a chemical change of unknown origin in the eye, and cause blurred or distorted vision. They cannot be prevented from forming, but early detection through regular eye exams can help maintain the clearest vision possible.

People at risk for developing cataracts are over 55 years old, have had eye injuries or disease, have a family history of cataracts, smoke cigarettes or use certain medications. There is no pain associated with the condition, but there are several symptoms that indicate failing vision due to cataracts. These include:

• Blurred/hazy vision
• Spots in front of the eye(s)
• Sensitivity to glare
• A feeling of "film" over the eye(s)
• A temporary improvement in near vision

Vision loss from cataracts can often be corrected with prescription glasses and contact lenses. For people who are significantly affected by cataracts, replacement surgery may be the preferred method of treatment. During cataract replacement, the most common surgical procedure in the country, the lens is removed and replaced with an artificial one called an intraocular lens or IOL.


Glaucoma Surgery with New Express Shunt devices
Glaucoma is an eye disease in which intraocular pressure – that is, pressure inside the eye – is too high, causing vision loss and damaging the optic nerve. In a healthy eye, fluid is produced in the ciliary body, enters the eye, and then drains through tiny passages called the trabecular meshwork. In people with glaucoma, these passages become blocked and intraocular pressure rises.

Some cases of glaucoma can be treated with medications. For others, laser or traditional surgery is required to lower eye pressure. Dr. Espaillat performs many glaucoma surgeries including Laser Peripheral Iridotomy (LPI), Argon Laser Trabeculoplasty (ALT) and Selective Laser Trabeculoplasty (SLT), Cyclophotocoagulation (YAG CP), and Filtering Microsurgery (Trabeculectomy). He also offers the new Tube Shunt Surgery for patients with neovascular glaucoma, failed trabeculectomy, or susceptibility to developing scar tissue. During the procedure, a thin, flexible tube (a shunt) with a silicone pouch is inserted in the eye to facilitate drainage.

Cosmetic Eyelid Surgery (Blepharoplasties)
Blepharoplasty can rejuvenate puffy, sagging or tired-looking eyes by removing excess fat, skin and muscle from the upper and lower eyelids. It may be performed for cosmetic reasons or to improve sight by lifting droopy eyelids out of the patient's field of vision. The procedure is usually performed in an office with local anesthesia in as little as 45 minutes. Blepharoplasty can be combined with a facelift or BOTOX® treatments to raise the eyebrows or reduce the appearance of wrinkles, crow's feet or dark circles under the eyes.


BOTOX® Treatments
BOTOX® Cosmetic is commonly used to reduce or eliminate the appearance of facial wrinkles. It is injected under the skin into areas surrounding the eyes, forehead and mouth to smooth crow's feet, frown and worry lines, and lines on the neck. Made from a purified protein, BOTOX® injections block nerve impulses, weakening muscles to relax wrinkles and give the face a rejuvenated look. BOTOX® may also be useful for migraine headaches, excessive sweating, and eye and neck muscle spasms.


Refractive surgery including LASIK
The cornea is the clear covering on the front of the eye which bends, or refracts, light rays that focus on the retina in the back of the eye. A certain shape, or curvature, is required in order for light to focus exactly on the retina rather than in front of it or behind it. Corneal curvature may be surgically corrected using LASIK, LASEK or other refractive procedures to reduce or eliminate the need for eyeglasses or contact lenses. A thorough eye examination and consultation are necessary before a treatment decision can be made.

LASIK is a safe, reliable and painless way to improve vision without the need for glasses or contact lenses. LASIK, which stands for laser assisted in-situ keratomileusis, is a form of refractive surgery that changes the way light is bent, or refracted, as it passes through the cornea so that it focuses properly on the retina in the back of the eye and objects can be seen clearly. The procedure is effective for many patients with nearsightedness (myopia), farsightedness (hyperopia) and astigmatism.

During the procedure, a device called a microkeratome creates a flap in the outer layer of the cornea called the epithelium. Patients are given topical anesthesia and a mild sedative so they are awake but calm and cannot feel the instruments. The epithelial flap is lifted and an excimer laser beam adjusts corneal curvature so objects no longer appear blurry. The cornea is steepened for hyperopic patients, flattened for myopic patients, and made more spherical for patients with astigmatism. The flap is then closed.

Diabetes Eye Care including Laser Surgery to the Retina
Patients with diabetes are at an increased risk of developing eye diseases that can cause vision loss and blindness, such as diabetic retinopathy, cataracts and glaucoma. These and other serious conditions often develop without vision loss or pain, so significant damage may be done to the eyes by the time the patient notices any symptoms. For this reason it is very important for diabetic patients to have their eyes examined once a year. Diagnosing and treating eye disease early can prevent vision loss. It is also important to maintain a steady blood-sugar level, take prescribed medications, follow a healthy diet, exercise regularly and avoid smoking.

Diabetic retinopathy is a complication of diabetes that weakens the blood vessels that supply nourishment to the retina (the light-sensitive lining in the back of the eye where vision is focused). When these weak vessels leak, swell or develop thin branches, vision loss occurs. Laser surgery is the treatment of choice.

Focal laser coagulation may be recommended for patients with clinically significant macular edema (CSME) – swelling of the central retina, called the macula. The laser coagulates, or dries up, the fluid that is causing the swelling. A similar procedure called scatter laser photocoagulation (also known as pan-retinal photocoagulation or PRP) destroys abnormal blood vessel growth in patients with proliferative diabetic retinopathy (PDR). If there is blood in the eye obscuring the laser, a vitrectomy may be performed to drain the blood in preparation for photocoagulation.