People are ditching their contacts and eyeglasses in favor of corrective eye surgery in greater numbers than ever before. Until recently, LASIK was the only corrective eye surgery offered to patients, and not everyone was a good candidate for LASIK. However, today there are six additional surgeries available, increasing the field of potential patients.
To meet this growing demand, Dr. Lance Kugler founded Kugler Vision to specialize in the many varieties of corrective eye surgery.
After practicing ophthalmology in Omaha for four years, Kugler moved his family to Nashville for a year-long fellowship in refractive surgery with Dr. Ming Wang.
“I realized what was happening in the industry and that what we needed in this part of the country was a dedication to refractive surgery,” Kugler said.
After returning to Omaha, Kugler bought the assets of Dr. William Schlichtemeier in 2011, and Kugler Vision was born.
“It’s an exciting time in vision correction surgery because we’re able to help a higher percentage of people than we’ve ever been able to help before,” Kugler said. “LASIK used to be the only way to [surgically correct vision], and you were either a good candidate for LASIK or you were not.”
Tailoring Tech
Although LASIK — which reshapes the cornea to change its focusing power — is still the most commonly used method of corrective surgery, those who are not good candidates for the procedure may be helped by one of six other possible surgeries.
“We can tailor the technology to the patient’s needs so we’re able to deliver better results than ever before,” Kugler said.
One example is Photorefractive Keratectomy (PRK), which uses an excimer laser to reshape the cornea. The key difference between PRK and LASIK is that the epithelium, or tissue covering the front of the cornea, is removed and the laser is applied to the outer surface.
Small Incision Lenticule Extraction (SMILE), commonly known as keyhole LASIK, is designed to treat myopia, or nearsightedness. Another option is Implantable Collamer Lens (ICL), which is like a contact lens implanted in the patient’s eye.
Refractive Lens Exchange (RLE) removes the natural lens inside the eye and replaces it with a lens. Refractive Cataract Surgery is cataract surgery that also fixes the focus. Corneal Inlays is a technology that can also fix the focus in various ways.
Upswing in Surgeries
“Omaha has always been a leader in refractive surgery, but what was happening in 2009 when I made this change was that many of the things we were doing in the field were becoming refractive procedures,” Kugler said. “Back in 2009, LASIK was the only way we were fixing vision. It was clear that new technologies were coming, and rapidly, and I wanted to be in a position to specialize in that.”
People are choosing to have their vision corrected in higher numbers than ever before for several reasons, one being word of mouth.
“People are hearing from friends and family about how incredible the surgeries are. Another is cost savings,” Kugler said. “People are realizing that having their vision fixed is less expensive than buying glasses and contacts over the years.
“COVID has accelerated [the trend] because they have to wear masks in situations where eyewear is a barrier to them, so they’re looking for alternatives. Those things combined have led to a huge upswing in vision correction surgery over the past few years.”
Early in the pandemic, when many hospitals and outpatient surgical centers closed down or limited access, Kugler Vision established procedure centers in its office to better control the environment. The biggest change was moving a large percentage of patient interactions to telemedicine encounters.
“We wouldn’t necessarily have to continue that way now, but we have because patients love it. It’s also more efficient for us,” Kugler said. “We’re able to see more people in a shorter amount of time, and we’re delivering better quality because of the way we’re able to go over their test results with them.”
For Now, For the Future
With new technologies constantly being developed, Kugler Vision works hard to remain current.
“We’re training optometrists to help with refractive procedure management, and we train surgeons here to become refractive surgeons,” Kugler said. “We’re adding two new people to those programs this year. We’re also adding staff because of all the patients we’re seeing.”
Kugler, a Nebraska native, earned his undergraduate degree in computer science from DePauw University in Greencastle, Indiana, and attended Case Western Reserve School of Medicine in Cleveland. He did an internship in internal medicine at the University of Nebraska Medical Center (UNMC) in Omaha where he also did his residency in ophthalmology.
While in medical school, Kugler signed up for a project with an ophthalmologist who needed people with computer experience.
“Most med students don’t get any exposure to ophthalmology unless they seek it out because it’s not part of the regular curriculum in most med schools,” he said. “I was blown away by the field, partly because of how much computer science and engineering there is in the field. Most of medicine is heavily technology-oriented, but ophthalmology is on a whole other plane because of all the optics and lasers and computer-guided procedures, so it was a natural fit for me.”
Kugler is one of the original founders and the first president of the Refractive Surgery Alliance, an international organization comprised of over 350 of the world’s leading vision correction surgeons. He is also an associate professor of Refractive Surgery at UNMC’s Truhlsen Eye Institute.
402-558-2211 • 17838 Burke Street, Ste. 100, Omaha, NE 68118 • lasikomaha.com
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