ReLEx SMILE-A New Future For Laser Vision Correction

Well, it finally happened.  I have been working for almost 10 years on the next big advance in laser vision correction, and it just got approved by the FDA for patients in America.  During this long development, and over the last several years the technology was approved in virtually all the rest of the world, and as a result, there now have been over 600,000 procedures performed.  That’s a lot of procedures and should help ease the minds of anyone who is concerned about trying something new.

So what is this new procedure?  It is called, somewhat cryptically, ReLEx SMILE.  It really could be called either, but Zeiss, who is behind the brainy people that invented this technology, wanted to use both names.  ReLEx stands for refractive lens extraction, and SMILE means small incision lenticule extraction.  So what is this all about?

Here it is in a nutshell.  Most have heard of LASIK, where a corneal flap is made, with either a blade or a laser, and then after peeling back the flap, the inner surface of the cornea is treated with another type of laser, an excimer laser, to reshape the eye.  Flap is flipped back, and viola, vision is corrected.  It has been done millions of times worldwide.  But there are occasional issues with LASIK.  Without going into all the detail, there can be problems with making or healing of the flap, and it can move during the early days after the procedure in rare cases creating “wrinkles” that need to be surgically fixed.  Also, some nerve endings are cut creating a temporary dry eye for some, and other things that are unlikely but real nonetheless.  All of this has scared many of the faint of heart away from LASIK.  Some just don’t like the idea of “burning away” tissue from their eye, although there really is not burning going on with LASIK.  Nonetheless, many, especially the so called Millennials, have been waiting for the next generation procedure to show itself.

Enter SMILE.  Here, a tiny incision can be used to remove a very small piece of tissue that is cut by the laser, to restore vision, and without a flap!  The laser, made only by Zeiss is called appropriately enough, the VisuMax.  In about 35 seconds, the laser precisely cuts the shape of a small contact lens from within the cornea, and then the surgeon removes this piece of tissue. The eye is permanently reshaped, to a front surface which is very similar to that obtained by wearing a soft contact lens, and clear vision is restored.

AAO Zeiss booth Jon AAO Zeiss poster

A photo of Dr. Dishler at the American Academy of Ophthalmology, 10-15-16. Dr. Dishler was invited to make an introductory speech at the Zeiss booth launching the celebration of the FDA approval of ReLEx SMILE. 

Currently ReLEx SMILE is approved for about 99% of all nearsightedness cases, so even very bad eyes can be fixed.  It does not yet correct astigmatism, but another study, that is almost complete, will hopefully expand the range to include these peeps also.  When this happens we will have a viable alternative to LASIK for almost everyone seeing laser vision correction.

very detailed questionnaire So how were the results.  In a word, they were great.  Both the vision results were superb, the complications were few, and a about the experience of study subjects revealed that most everyone was very satisfied.

What does Dr. Dishler have to do with all of this?  He (I) was the medical monitor of the study for Zeiss, overseeing and stewarding the study before, during, and after to this point of approval.  We also treated our fair share of the patients as an investigative site.  We learned first-hand in both this study, and the astigmatism one that followed, just what makes this procedure work well, and we are happy to make it available to the right people very soon.

Who are these “right people”?  Part of this is easy, it is the people who fit the criteria of any voluntary refractive eye surgery, of healthy eyes other than nearsightedness.  In addition, such folks as policemen/women firefighters, avid sports nuts, and anyone who might get hit in the eye makes the most sense.  This is why the US military is so excited about ReLEx SMILE, and why they are starting their own study very soon for military personnel.  Their study will bring further validation to the process, since people like pilots will be treated and combat ready troops.

To begin with the ReLEx SMILE will be offered by the six investigative sites, then a select group of prestigious doctors and institutions, and a short time later it will be rolled out to several doctors in most communities throughout the country.  A year from now this should be widely available.  If you have an interest in finding out if you are a good candidate for this new refractive procedure, then please make an appointment for a consultation with our staff.  We expect a lot of interest and will be placing qualified people on a wait list in the order that they are seen.  If you are an early adopter of new technology (look down and see if you have an iPhone 7 for instance) then this might be calling your name.  Come on in for a chat.

Want to learn more?  Check out these links for more information of this new eye opening option.  ReLEx SMILE, contact lenses out – forever.

Useful Links:

FDA approves Femtosecond laser for SMILE 

FDA approves VisuMax femtosecond laser to treat myopia

SMILE has fewer adverse effects on corneal parameters then femtosecond LASIK



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20th Anniversary of the 1st LASIK in Colorado thanks to Dr. Dishler

April 2015 is a special month for us at Dishler Laser Institute. This month marks a milestone as Jon G. Dishler M.D., F.A.C.S. celebrates being the first ophthalmologist in Colorado to perform LASIK utilizing an Excimer laser he had built for correcting nearsightedness!  

We are very proud and honored to work with Dr. Dishler.  All of us here want to spread the word plus acknowledge his hard work, foresight and diligence that has gotten him to where he is today. Join us in wishing Dr. Dishler congratulations and continued success in the contributions to the advancement of laser vision correction! 


Dr. Dishler is known for his ingenuity and inventiveness, and has received numerous awards for his scientific expertise and contributions to laser vision correction. He reflects on this significant landmark in Colorado’s refractive history. 

“Having great vision is one of the most important aspects of our quality of life, and the major thrust of my career has been to improve our patient’s vision making their lives better.  At the intersection of technology and medicine we now have precise lasers which return the eye to the function it was designed to perform.  Over the last 20 years I have seen the word “LASIK” evolve from something no one heard of into a very familiar concept. Now we are on the frontier of even more groundbreaking changes to vision correction, and I am proud to be a part of the continuing journey.”- Jon G. Dishler M.D., F.A.C.S.     

A specialist in refractive surgery, Dr. Dishler has personally performed over 60,000 LASIK and vision correction procedures during the last 15 years. He has participated in the original development of the Excimer laser within the framework of the FDA approval studies. In fact, he was the first laser vision surgeon and only ophthalmologist in Colorado to develop an FDA approved Excimer laser. 

From the very beginning, Dr. Jon Dishler contributed to the development of the Femtosecond laser. He was awarded the Pioneer award laser for perfecting the design of the Femtosecond laser technology by the IntraLase Corporation.  Currently, he is the first of 25 LASIK centers in the United States to perform LASIK with the Zeiss M.E.L. 80 Excimer and VisuMax Femtosecond laser platform.

Dr. Dishler is an internationally -known and respected refractive surgeon. He has been awarded several patents for inventions in his specialty including the FDA approved Dishler Excimer Laser, Excimer beam profiler, Insertion system for corneal implants, and surgical visual feedback and eye fixation method and apparatus.

Jon Dishler M.D is the Principal investigator for 10 FDA studies for laser manufacturers such as Bausch and Lomb, ReVision Optics, Meditec Carl Zeiss, and the Dishler Excimer laser. About Dr. Dishler (

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Jon G. Dishler MD Named “The Authority For Training Surgeons on Zeiss VisuMax Laser Technology”

Jonat-VMaxwkatie-1024x768 When one of our staff members answers the phone, “Dishler Laser First in LASIK,” this is not just a slogan but an authentic statement.

Consider the fact that in 2001, Dr. Dishler was the First in Colorado and third nationally to introduce IntraLase, the laser flap maker, and as an investigator helped perfect its design. Then in 2007, he was the first in all of North America to acquire and help develop the Zeiss VisuMax femtosecond laser. While other refractive surgeons were still performing bladed LASIK, Dr. Dishler was an early adapter of all laser Lasik technology.

We are proud to announce that Carl Zeiss Meditec has just officially named Dr. Jon Dishler as the regional authority for skills transfer and training of other eye surgeons who are starting to use the Zeiss optic laser technology. .

With this accomplishment, this truly is another “Dishler Laser First in LASIK”

Jon G. Dishler MS FACS at the helm of the Zeiss VisuMax laser at his licensed ASC.

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56,000 Denver LASIK and Counting

“It was April 1, 1995 when I performed the first LASIK surgery ever in Colorado, and one of the first in the United States. But the planning began well before this, over 20 years ago today. Before the first laser treatment, we had to design and build the laser. A laser physicist, Dr. Paul Van Saarloos flew over from Perth, Australia with nothing more than a backpack and a plan. I had accumulated a long list of pieces and parts. There was a dental chair from Norway, a pile of optical parts from various manufacturers, and most importantly a laser engine from Lambda Physik that was imported for “research purposes”. Paul and I worked long hours putting his design together, buying whatever other things we needed and two weeks and hundreds of hours later we were ready.

This is a picture with Dr. Hans Hallenkamp, inventor of the Hansatome Microkeratome, and Dr. Tibor, inventor of the Intralase femtosecond laser flap creator who were both visiting my office at the same time.  This is the only picture of these two generations of inventors together!”

The first patient, I don’t really remember his name, was a very high myope with severe amblyopia in the eye we treated for free. His best corrected vision was 20/400 and his other eye was normal. I believe he was about a -10.00 Diopter correction. We used the same microkeratome that I had used for doing ALK procedures prior to this time (Automated Lamellar Keratectomy – but that is another story). After successfully making a flap and the laser performing a self- check, I centered the aiming beams on his cornea and 30 seconds later we were done. The patient was immediately thrilled with the improvement as were we, and a few days later we began treating sighted eyes with amazing success compared to what had come before. While the rest of the country was waiting for PRK, and companies like VISX were just working on clinical trials, we had boldly stepped ahead. Soon we had a waiting list that was months long. Today we are 56,000+ procedures down the road from that Spring day two decades ago.

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Pulling the Trigger on LASIK

The ARSC (American Refractive Surgery Council) has gathered data about LASIK preferences and satisfaction in consumers. After almost 20 years of providing this medical service, even I was surprised at some of the outcomes of their survey. For instance, 38% of eyeglass users reported being concerned about finding their glasses in an emergency, and 51% of contact wearers were worried about eye infections or eye damage from contact. This represents a high level of concern about current options for these visually impaired people. To make the decision to consider LASIK, 85% report a life event, such as having a baby, losing weight, graduating, or getting married as a time to make this change and 71% believe that the ability to not wear glasses would improve their life.

No surprisingly, most thought that surgeon experience was the most important factor in choosing a LASIK surgeon, but cost was a close second in that selection process. Perhaps the most interesting finding was that those who went ahead and had LASIK, patient satisfaction grew over time. Those who had the procedure over 7 years ago were as or more satisfied than those who more recently had it. An overwhelming majority (almost 80%) of people who had LASIK believe that more people should have it as well.

When deciding whether LASIK is for you, it is important, on balance to also consider what the AAO (American Academy of Ophthalmology) has said in their publication:

  1. Do not make the decision based solely on price.
  2. Carefully weigh your options and know the risks vs benefits
  3. Read carefully the available information published on eye lasers.
  4. Seek several opinions before making this decision.

5. Be wary of centers promising 20/20 or money back results.

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Eyes are on You Special

We are extending the lowest price of the year to all of our potential patients, but hurry, because this offer ends at midnight on December 31st 2012! Basically, we have honored our servicemen, firefighters, police officers, and teachers with special pricing and we are extending that offer to everyone until the end of this year. This is NOT discount LASIK, but rather bringing world class vision correction to everyone who wants or needs it at an affordable price. Beware of others who raise their prices by thousands of dollars and then offer big discounts. With $500 off of our already competitive LASIK pricing, this represents a true value.

Many of our patients travel from far distances and seek out our advanced technology and vast experience in this field. One visit to our office demonstrates to most just how much different our approach is to laser vision correction. We use the most advanced technology along with caring, trained professionals who provide you the opportunity to see your very best. If you have been thinking about vision correction then please read some of the reviews on this site, and visit us for a complimentary no cost consultation.

If you have your consultation before the end of the year, and schedule your procedure by January 31st 2013, then we can extend this offer to you.

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Types of Refractive Errors

man_smilingRefractive errors are common vision problems that many people experience. Some people may not have heard the phrase “refractive error” before, however. The team at our Denver LASIK center would like to take a moment right now to look at what refractive errors are and what can be done to treat them.

About Refractive Errors

Refractive errors refer to vision problems that are caused by irregularly shaped corneas. You know these vision issues better by the names myopia (nearsightedness), hyperopia (farsightedness), and astigmatism. These irregularities in corneal shape alter the way that light passes through the eye en route to the retina. Vision can seem blurry or unclear as a result.

How Refractive Errors Differ from Other Vision Issues

Since refractive errors involve issues with corneal shape, they can be dealt with using treatments that reshape the cornea or change the way that light passes through the eye. Other vision problems such as presbyopia and cataract surgery involve different parts of the eye. (The lens in those cases.) Whatever vision issue you face, we will use advanced LASIK technology and other therapies to ensure you get the treatment that you need.

About Nearsightedness (Myopia)

Nearsightedness is a refractive error in which a person can see nearby objects perfectly fine but has problems seeing objects that are at a distance. These objects look blurry. Nearsightedness is caused by light focusing short of the retina.

About Farsightedness (Hyperopia)

Farsightedness is a refractive error in which a person can see objects at a distance perfectly fine but has problems seeing objects that are nearby. These objects look blurry. Farsightedness is caused by light focusing behind the retina.

About Astigmatism

Astigmatism refers to an irregular/uneven shape to the front of the cornea, leading to a general blurriness of vision. Astigmatism often accompanies both nearsightedness and farsightedness.

Treatments for Refractive Errors

There are several treatment options out there for refractive errors. Contact lenses and glasses are one option to consider. They help ensure that light focuses properly on the retina when passing through the eyes. Sometimes artificial lenses and lens implants will be used (e.g., Denver ICL surgery) to enhance vision as well.

One of the most popular options for vision correction is refractive surgery. This includes LASIK, PRK, LASEK, and Epi-LASIK. During each of these surgeries, a laser is used to safely reshape the corneal surface. This helps precisely train light on the retina.

Making the Best Decision for You

Not all patients are the same, so it’s important that you make the best decision for your needs. When you come in for a consultation, we will be sure to let you know if a treatment like LASIK laser vision correction is right for you. If not, we’ll discuss alternatives at length so that you can make an informed decision about your vision.

Learn More About Your Options for Eye Care

For more information about various eye care issues and what you can do to improve your overall vision, contact a Greenwood Village, CO ophthalmologist today. A member of our team looks forward to meeting you in person and helping you see clearly.

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LASIK Cost and Financing Options

piggybankLASIK surgery is one of the most popular treatment options for refractive errors. You probably know refractive errors better by their more common names: myopia (nearsightedness), hyperopia (farsightedness), and astigmatism. Of course, we at our Denver LASIK surgery practice understand that paying for surgery can place a financial burden on some households. This is especially true given today’s economic realities. For that reason, we are more than happy to provide payment options and financing plans to patients. Let’s look at some of these cost and payment concerns right now.

What is the average cost of LASIK surgery?

In the greater Denver area, a LASIK surgery can usually range from $1500 to $2500. The range in price is usually determined by the surgeon performing LASIK, the technology involved in the LASIK procedure, and the nature of the patient’s case. When you visit our Greenwood Village LASIK surgery center for a consultation, we will be able to give you a more accurate estimate about the cost of your surgery and how the costs will break down.

What if I cannot afford LASIK surgery?

We understand that LASIK is expensive and may be cost prohibitive for some people. In such cases, some patients opt for corrective lenses rather than LASIK surgery. If that is the ultimate decision that you make, we understand and hope to help you achieve your eye care goals in some fashion.

However, we want to work hard to be as accommodating as possible to patients of all means. We believe that the benefits of LASIK are worth the investment in your eyes, and that reducing dependence on corrective lenses can have many great benefits to you. That’s why we are more than happy to offer various options for financing and monthly payments.

How do these payments plans and financing option work?

In general, these LASIK financing and payment plans are run through a trusted third party. This third party will break up the total cost of the LASIK surgery into a series of affordable monthly payments. Patients will be able to budget accordingly based on this monthly payment plan, which is helpful.

Do financing options apply to all refractive surgery procedures?

Yeah, these financing plans and payment options apply to LASIK surgery as well as Denver PRK. You can even consider financing for other eye care needs. It’s common for such financing plans to be applied to many different kinds of medical procedures as needed.

Other Factors to Consider

Before you make any decision about eye care or vision correction of any kind, we want to make sure that you make the best possible and best-informed decision regarding treatment. If you have any questions about how these plans work or if they’re right for you, be sure to ask them during your visit. We’ll be more than happy to answer your questions in full detail.

Learn More About Laser Vision Correction

If you would like more information about laser vision correction and how you can achieve excellent vision, be sure to contact our Greenwood Village laser vision correction office today. The entire team here looks forward to helping you achieve excellent eyesight.

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ICL Recovery Process

eyeglassesFor some of our patients in Denver, LASIK is not a suitable treatment for nearsightedness. For these patients, Visian Implantable Collamer® Lenses (also widely known as implantable contact lenses) may be used to restore excellent vision at all distances. One of the greatest benefits of Visian ICL® phakic intraocular lenses is that they do not replace the natural lenses of the eyes, but rather augment them. For many patients, Visian ICL® phakic intraocular lenses are an outstanding alternative to LASIK surgery and, depending on the unique needs of our Denver PRK patients, may also be recommended as an alternative to patients considering PRK.

The function of Visian ICL® phakic intraocular lenses is similar to that of contact lenses, but instead of being placed over the eye, it is implanted into the eye. There are many benefits to patients when using Visian ICL® phakic intraocular lenses. Vision is improved and the quality of vision is enhanced, with vision becoming sharper and more vivid with greater depth and dimension. Patients with a wide range of myopia may be treated, including myopia ranging from -3.0 diopters to -20.0 diopters. Because Visian ICL® intraocular phakic lenses are small and foldable, the incision used during placement is quite tiny. Because of this, sutures are typically not required. Visian ICL® intraocular phakic lenses are placed in the posterior chamber of the eye, behind the iris. This placement is aesthetically pleasing and allows the iris to function normally.

ICL Surgery

Visian ICL® phakic intraocular lenses are implanted on an outpatient basis. The procedure is usually performed in thirty minutes or less. The eyes are numbed with a topical or local anesthetic. If necessary, a mild sedative may be given to patients experiencing anxiety. A tiny incision is made on the far edge of the cornea. The Visian ICL® phakic intraocular lenses are then inserted. The ICL unfolds into place behind the iris and natural lens of the eye. Because of the placement of the incision, the risk of the incision interfering with vision is minimal.

ICL Recovery Process

Within the same day of the placement of the Visian ICL® phakic intraocular lenses, most patients will see an improvement in their vision. Many patients are able to see without the aid of contact lenses or eyeglasses, even during periods of low light such as nighttime, after the placement of Visian ICL® phakic intraocular lenses. Within 24 hours of surgery, Denver ICL recovery patients are required to return to our office for a follow-up visit. You may be required to use special eye drops or to wear a protective eye shield after the placement of Visian ICL® phakic intraocular lenses. This is to protect your eyes during the healing period. Any discomfort experienced after surgery can be relieved with over-the-counter pain medications. Most patients experience a minimal amount of discomfort after the placement of Visian ICL® phakic intraocular lenses. Many patients achieve optimal results within a week after the placement of Visian ICL® phakic intraocular lenses, with full recovery taking one to two months. Side effects and complications are extremely rare. If your prescription should change or if you experience a negative side effect or complication, Visian ICL® phakic intraocular lenses may be removed and replaced if necessary.

Learn More about Visian ICL® Phakic Intraocular Lenses

For further information about Visian ICL® phakic intraocular lenses, please contact Denver ophthalmologist Jon Dishler today.

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Custom vs. Conventional LASIK

laser-systemAs one of the great medical innovations of the past two decades, LASIK has effectively helped millions of people bid farewell to their glasses and contact lenses and see the world around them more clearly than ever before. Nevertheless, conventional LASIK, even with its remarkable record of safety and success, has some limitations. While it is highly effective at treating such common visual errors as myopia (nearsightedness), hyperopia (farsightedness), and astigmatism, it cannot treat higher order aberrations – those often minute flaws in the shape of the cornea that do not follow any predictable pattern and are unique to each individual eye. Those LASIK patients who continued to require visual aids after their surgery usually did so because of these higher order aberrations.

Fortunately, at our laser vision correction center in Denver, LASIK can be customized to address these higher order aberrations, leading to more precise correction of corneal flaws and a much higher chance of achieving excellent unaided vision. You, too, can find independence from glasses and contact lenses thanks to custom LASIK.

How We Can Customize Your LASIK Treatment

At our ophthalmology practice in Denver, custom LASIK begins with the creation of a highly detailed map of the patient’s eyes. This map uses wavefront technology to capture even the most difficult-to-detect flaws in the shape of the cornea, flaws that conventional LASIK would simply not be able to correct. Custom LASIK will address these flaws as well as the more overarching visual errors corrected by conventional LASIK.

Once this intricate map of the eyes has been created, the data is fed into a computer that controls the excimer laser used to perform LASIK. The laser alters the shape of the cornea with exceptional precision, effectively eliminating the imperfections responsible for visual errors.

Advantages of Custom LASIK

In addressing higher order aberrations, custom LASIK not only results in sharper, clearer unaided vision, but it also minimizes the risks associated with LASIK surgery, including haloed vision and difficulty seeing at night. These risks can be further minimized when patients opt for all-laser LASIK, in which the flap created in the upper layer of the cornea is made with a laser rather than a handheld blade. Custom all-laser LASIK at our Denver practice is truly the most accurate and effective laser vision correction procedure currently available.

PRK: An Alternative to LASIK

Unfortunately, not everyone is a suitable candidate for LASIK, custom or otherwise. For those patients, however, we offer an equally effective procedure in the form of PRK. At our practice in Denver, PRK differs from LASIK only in how the underlying corneal tissue is accessed. While LASIK requires the creation in the epithelial, or uppermost, layer of the cornea, PRK involves the removal of this layer altogether. While healing from PRK can be longer and more uncomfortable than with LASIK, the procedure itself can be customized in precisely the same way, with similarly excellent results.

Contact Our Denver Laser Vision Correction Center

For further information about custom LASIK or custom PRK, we invite you to contact our Denver ophthalmology practice today.

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