| Can
Anyone Guarantee 20/20 Vision? No. No honest surgeon
can absolutely guarantee a certain result from the surgery. We can quite accurately let
you know the probability of you achieving 20/20 vision based on large domestic and
international studies using this exciting technology.
95% of patients with low through moderate ranges of nearsightedness
and/or astigmatism achieve normal or near normal natural vision from just one surgery with
LASIK. For those who do not achieve this quality of vision from one surgery, enhancement
surgery can usually give the rest of the desired correction.
People with high ranges 8 to 15 diopters of nearsightedness; 3 to 5
diopters of astigmatism also have a very good probability of achieving good natural
vision, but an enhancement surgery is more likely to be necessary for full correction.
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What
is the right age to have LASIK laser vision correction?
There is no strict age requirement. However, most
individuals by the age of 20-21 have reached a point at which their glasses prescription
will remain relatively stable. The key to being a good candidate is that your glasses
and/or contact lens prescription should be relatively stable.
We have treated patients 19-70 years of age with LASIK.
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Does LASIK
Laser surgery hurt?
No. The laser procedure itself is virtually painless. You will be
aware of a support which helps to hold your eye open. A slight pressure may be felt during
the procedure. You will be aware of the laser sounds while you watch a red flashing
light..
The majority of patients experience no significant discomfort.
Approximately 10% of patients experience more significant eye discomfort and may need to
take recommended medications to relieve it. Little to no discomfort is associated
with LASIK.
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Give me a
step-by-step of the LASIK procedure?
Throughout the procedure you are awake. Eye drops are the only
anesthesia. Sedation is not necessary, but you may take an oral tranquilizer. Your eyelids
and lashes are cleansed for sterility and a sticky drape keeps your lashes out of the way.
Your lids are gently opened. You look at a blinking red light which keeps your eye
properly positioned. During the flap creation phase you have a sensation of pressure and a
grayness of vision. Then the laser is used and you will hear a rapid clicking sound. The
flap is replaced and it takes about 3 minutes for it to stick down. After the procedure,
you will leave with an eye shield and eye drops to help your eye heal. Also, your
vision may be a little blurry for a few days. The procedure takes under 10 minutes
per eye.
Most patients are able to return to work in 24 hours, and over three
or four weeks, have continuing improvement in their vision.
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How long will the correction last?
The laser correction will probably last for the rest of your life.
The cornea is a very stable tissue. Current studies show that once the cornea has been
modified by the current Excimer laser protocol such as LASIK, it tends to remain stable
and stay modified permanently, as best we can determine through studying many thousands of
patients. There are rare cases of regression, which may be corrected with further surgery,
but the vast majority of corrected eyes remain stable.
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How accurate
is the Excimer laser?
This is a human hair which has been sculpted by the Excimer Laser.
Each pulse of the 193nm laser will ablate or eliminate one three-thousandths of one
millimeter using cold energy. It is this level of unparalleled accuracy which allows the
programmed Excimer laser to precisely sculpt the human cornea to reduce nearsightedness.
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What does the
patient experience during the procedure?
Each patient goes through a comprehensive series of eye tests and
examinations before consulting with the surgeon to discuss and plan the specifics of
personal visual correction.
For the laser surgery itself, patients sit comfortably in a
professional chair which is reclined to a horizontal position. Experience with new topical
anesthetics and analgesics mean that no injections are necessary. The eye is anaesthetized
with drops, to ensure a painless experience. The lids are gently held open with a lid
support. Patients watch a flashing red light while the laser uses cold energy pulsed to
precisely vaporize microscopic layers of tissue to correct the focus. Actual laser surgery
time ranges from 10 to 90 seconds in most cases. Most patients are in the surgery suite
for about 15 minutes.
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Are there any
negative long term effects?
The medical community can only speak for the future by assessing the
data from the surgeries performed under formal studies. Such studies on Excimer Laser
refractive surgery have been carried out in the US under FDA scrutiny and by the
international medical community. The Excimer Laser data to date reveals a very positive
healing response of the eye giving doctors no reason to be significantly concerned about
effects beyond ten years of study.
The laser penetration is so shallow and precise that it appears not
to have a significant effect on living cell function even immediately beneath the treated
optical zone. After healing, these eyes have not shown negative effects, giving doctors
even more confidence about the ongoing health of the eye after LASIK surgery.
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What are the
risks and side effects of laser LASIK surgery?
LASIK or Laser Assisted In-situ Keratomileusis adds a controlled
lamellar keratectomy to the refractive laser ablation. The laser power treatment is thus
performed under the surface of the cornea with some change in risks and benefits of the
procedure. Possible risks of LASIK include:
- Creating a cap of corneal tissue instead of a flap by fully removing
the top of the cornea rather than just lifting it -- This removed tissue still heals back
into place but requires extra care in positioning.
- Loss or damage of the corneal cap.
- Infection -- Very rare and usually controlled with medications.
- Induced regular or irregular astigmatism
- Epithelial tissue growth underneath the new corneal flap -- This can
usually be solved by lifting the flap and gently removing these tissue cells.
- Increased or decreased response to surgery -- Surgery can usually be
enhanced or modified by lifting the cap and removing more tissue with the laser. Sometimes
other types of surgery can be combined with LASIK to give improved results.
Side effects are generally minimal following LASIK surgery since
most of the surface of the cornea has not been affected by the procedure. However, people
who have the surgery may experience some light sensitivity and glare for a few days or
weeks. Full visual stabilization may take several weeks.
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If I require
surgery to correct defects, can both eyes to be treated at the same time?
It is possible for most candidates to have surgery on
both eyes on the same day, conditional on the surgeon's approval and the patient's careful
informed consent. Even the safest surgery carries some small statistical risks. Therefore,
it is most conservative to separate surgeries for the two eyes by some measure of time,
depending on patient need and situation.
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What
are the long term effects of LASIK?
The 9 year follow-up of patients undergoing laser
vision correction procedures is very stable. In fact the behavior of an eye that has had
LASIK parallels the behavior of a normal eye that has not had surgery. LASIK has been
performed since 1991. Based on what we have learned from performing eye surgery over time,
we know that if an eye is "stable" in its vision at 2 years, then it should
remain stable at 20 years and beyond. The eye behaves in a predictable manner. Since
visual results from laser vision correction procedures have been stable after 9 years,
then they should remain stable over a lifetime.
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How
long do I have to wait until I drive and return to work after the surgery?
A patient is legal to drive with at least one eye 20/40
or better. However, most importantly, a patient should refrain from driving until they
feel comfortable with the vision having changed in their operated eye.
Returning to work is largely dependent upon the
individual and the type of work they do. Most people can return to work within 2 to 4 days
of the surgery. Many choose to do light work, as in computer use, within hours of laser
treatment. Obviously, operating heavy machinery or higher risk activities requires
stability and adaptation to vision changes.
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What
is the recovery time after the procedure and what can I expect?
All patients immediately after LASIK will see blurry.
In fact, for the first six hours after LASIK normal symptoms include: blurred vision,
light sensitivity, eye irritation (similar to the sensation that an eyelash is trapped
between the eye and lid), and tearing. After the first six hours, these symptoms resolve.
All patients are instructed to use antibiotic and
steroid eyedrops for about one week after surgery.
One cannot hurt the eye by using it after surgery.
Therefore, watching TV, computer work, reading, etc will not affect the outcome of LASIK.
Restrictions after LASIK: no eye or eyelid rubbing or
forceful eyelid closure (squeezing), no eyelid makeup, no swimming for 4 days.
Normal activity that does not include pressure on the
eye such as walking, jogging, routine work is allowed the day after LASIK.
Discomfort is rare and minimal. Usually vision is
immediately improved but may fluctuate for several weeks. For a week a shield is worn over
the eye at night until complete healing occurs. The eyes and lids cannot be rubbed to
protect the flap. Drops are used for several weeks. Glasses, if necessary, for reading and
distance are prescribed in two weeks. Retreatment occasionally is necessary and is
performed as soon as the eye is stable but usually no sooner than two months.
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Can
I wear contact lenses after LASIK?
Most patients do not require the use of contact lenses
after LASIK. There are some circumstances where contacts may be desirable or beneficial
after refractive surgery. Generally, if a patient were able to wear contact lenses
comfortably prior to surgery, they will be successful in wearing them again after surgery.
As with initial lens wear, it may require some time to build up to the same number of
hours that a patient was able to wear contact lenses before surgery.
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Will
LASIK surgery be any good for me because I am over 50?
Laser LASIK corrective surgery work effectively to correct the
general focus of eyes, no matter what your age. However, the fine focusing lens inside
your eye firms with maturity and no longer provides the capability of clear reading vision
past 50 years of age. This means that even if you have surgery, you will still need
reading glasses to see clearly up close from about age 50 or 55 years of age. Laser
surgery may be able to give you clear vision for all the other focal distances, without
regular glasses, for the rest of your life. You may also wish to consider monovision.
If you are over 60 years of age, and have any degree of cataracts,
you may benefit from waiting to have your vision corrected at the time of your cataract
surgery. The lens placed in your eye at the time of cataract surgery can correct your
nearsightedness or farsightedness. Most people develop cataracts sometime between 60 and
85 years of age. Arrangements can sometimes be made to have your cataract surgery early,
even before you develop a noticeable cataract, for the sake of enhanced focusing benefits.
However, health care plans will not cover any expense unless a significant cataract has
developed. The earliest signs of cataracts are increasing glare such as with night
driving, reading, and driving into sunset or in inclement weather. A careful eye
examination will reveal the best option for your particular circumstance.
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Is
this surgery permanent?
Yes, the results of LASIK are permanent. They are
however "adjustable" such that future correction of near-sightedness,
far-sightedness or astigmatism can be performed to "touch-up" the original
procedure.
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Can my vision
be worse than before the procedure?
In very rare cases, yes. In order for vision to turn out worse than
it was before the surgery, a significant complication would need to arise. In our
experience, these complications have not lead to loss of vision but in a slight reduction
in the quality of vision and are generally associated with astigmatism or haze resulting
from the surgery. Some of these complications are treatable with further surgery, but some
are not.
In large studies approximately 3 patients in 100 will experience a
measurable decrease in their best corrected vision. These uncommon patients most
often have a significant improvement in their uncorrected vision. This
means that they see better without glasses or contacts than they did before surgery,
however the very best they can see with correction is diminished. In some cases this can
be due to a temporary film related to healing. Other causes may be amenable to enhancement
or further treatment. Finally, as with any surgery, there are some risks of
significant complications which encourage you to seek care by most highly trained and
experienced surgeon.
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What is the
worst possible complication from the surgery?
Amongst the worst possible complications of LASIK is a
serious infection which could lead to a scarring of the cornea or possibly even loss of
the eye. Infections only very rarely occur because the laser is performed under sterile
surgical conditions immediately followed by the application of prophylactic antibiotics.
When the rare infection does occur, it can usually be controlled with topical antibiotics
resulting in little or no ultimate loss of vision. Even if the cornea should happen to
become seriously scarred because of an infection, corneal transplants are usually possible
to restore clear vision again.
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