Frequently Asked LASIK Questions
How do I know if I am a good candidate for LASIK Eye Surgery?
A large percentage of nearsighted, farsighted, and astigmatic patients are potential candidates for LASIK. Patients who are 18 years of age or older, have healthy eyes that are free from retinal problems, corneal scars, and any eye disease are suitable. Along with being medically suitable, the best candidates are people with a lifestyle or occupation in which they are dissatisfied with their contact lenses or glasses. By having an evaluation, examination, and consultation with you, the doctor will be able to determine if you are a good lasik candidate.
How Long Does LASIK Take?
In our practices, LASIK is performed as an office procedure in the comfort and convenience of an excimer laser eye surgery suite. The entire treatment takes about 5 to 7 minutes per eye or approximately 15 minutes for both eyes.
Is the Effect of LASIK Eye Surgery Permanent?
Yes. Following an initial healing period of two to three months, the effect of the treatment is lifelong.
Will I Need Reading Glasses After the Treatment?
Generally, patients under 40 years of age read well without glasses following the treatment. Patients over 40 may need magnification for reading fine print. Presbyopia is the term that refers to the natural weakening of the focusing muscles that occurs in our early to mid 40s, causing us to need the magnification that reading glasses provide. The LASIK treatment does not correct or prevent presbyopia. We also will be glad to discuss another option called monovision.
How Many Times Do I Need To be Seen Following the Treatment?
Most patients are usually seen the day following the treatment and then at least 1 month and 3 months following the treatment. Some patients require more visits. Remember, we are available 24 hours a day when you have any questions, concerns or need attention.
How Soon After The Treatment Can I Bathe or Take a Shower?
Your LASIK Surgeon will advise you as to the specific, however typically you can bathe the same day as the treatment but you should not shower for 2 days after the treatment. As always, avoid getting soap or water directly into your eyes. Avoid rubbing your eyes during the first month after surgery.
When Can I Drive After The Treatment?
You should not drive the day of treatment. After that, you may drive when you feel confident that your visual acuity and eye comfort allow you to drive safely.
How Soon Can I Use Eye Makeup?
You may resume wearing eye makeup starting 1-2 weeks after your treatment. We strongly recommend that you purchase new eye makeup, specifically mascara, to avoid potential infection following your treatment.
How Soon After The Treatment Can I Exercise?
Non-contact sports can be resumed as soon as you feel capable. Eye protection is always recommended for racquet sports or rough sports where there is a risk of being hit in the eye.
How Soon Can I Swim?
You should stay out of swimming pools for one week after your treatment, and rivers, lakes and oceans for two weeks following your treatment.
What Kind of Anesthesia is Used During the Treatment?
Numbing eye drops are used. Sometimes an oral medication is used to help with relaxation. Don't worry - no needles or intravenous drugs are used.
Can you Have Both Eyes Treated at the Same Time?
LASIK Treatment can be performed on both eyes on the same day. This decreases the troublesome effect of being nearsighted in only one eye between the two treatments. You may elect to have one eye done at a time.
Does LASIK hurt?
The LASIK treatment itself is painless because we put a few numbing drops in your eyes to make you even more comfortable. You will feel pressure on and around the eye during treatment. With LASIK, some patients may experience a feeling of "something in the eye" for a day or so after treatment.
Can I See the LASIK Treatment as it is Being Performed?
You will be "awake" but very relaxed. You will not be able to see any of the details of the LASIK treatment. You will see a number of lights, but the images will be blurred.
Will I Experience Pain after The LASIK Treatment?
Some patients experience a feeling of burning or scratchiness. This feeling generally lasts from one to three hours following the treatment. Most people feel fine if they can take a nap soon after the treatment.
How Soon After Surgery Will I See Well?
Each patient is different. The eye drop medications cause some blurring, but most patients notice a dramatic improvement even as they leave the office. More than 4 out of 5 patients can pass a driving test without glasses or contact lenses after the treatment.
Will My Eyes be Patched?
No, but clear, protective eye shields will be placed over your treated eye(s) following the treatment, and will be removed in our office the next morning. You will continue to wear these eye shields at bedtime for 1 week for protection.
When Can I Go Back To Work?
Most patients are back to work full-time the day after treatment. An additional day or two is rarely required before returning to work. If you can we, recommend that you take it easy for a couple of days.
Will I Need Glasses or Contact Lenses After The LASIK Treatment?
The goal of refractive surgery is to reduce your dependence on glasses and/or contact lenses, but LASIK patients still may benefit from reading glasses or distance glasses when they desire perfect near or distance vision. A nominal percentage of patients wear a thin pair of prescription glasses for night driving.
Should I have a Custom LASIK Eye Surgery Treatment or a Conventional Treatment?
The best treatment for you depends on the measurements we take from the Aberrometer and your other clinical measurements and vision complaints. This will indicate the presence and severity of aberrations, or distortions, which will necessitate a Custom Laser Eye Surgery treatment. You may have specific complaints that are related to the optical aberrations that are not corrected by your current glasses or contact lenses. Finally, Custom Laser Eye Surgery is usually indicated for anyone who has had previous corneal surgery.
Why should I have Custom LASIK Eye Surgery when conventional Lasik Eye Surgery worked fine for my friends?
Conventional Lasik Eye Surgery has provided excellent results for literally millions of people. However, if you are a patient who has unusual aberrations not readily corrected by conventional Lasik Eye Surgery, customized laser eye surgery is the best choice for you. The best thing to do is to come in for a Complimentary Consultation and together, the LASIK surgeon and you, can determine which treatment option is necessary and best suited for your individual needs.
What is the real difference between conventional Laser Eye Surgery and Custom LASIK Eye Surgery?
Conventional Laser Eye Surgery treats the vast majority of common optical aberrations called "lower order" aberrations. These are responsible for causing nearsightedness, farsightedness and astigmatism. Custom LASIK Eye Surgery provides a more precise treatment for patients who have "higher order" aberrations, which we can now measure with the Aberrometer. For these patients, customized laser eye surgery may provide a better quality of vision by measuring and addressing all of these aberrations as part of the treatment plan.
Why is Custom LASIK sometimes more expensive?
Custom LASIK represents the application of advanced technology to conventional Lasik Eye Surgery and may provide a better quality of vision by measuring and addressing visual distortions that previously could not even be measured. Our practices have incorporated the advanced measurement technology, the Aberrometer measurement system, and the Custom LASIK Laser Eye Surgery software necessary to provide these treatments. This advanced technology adds a modest cost but may deliver the best vision quality.
How Much Does Laser Vision Correction Cost? Can I Afford It?
Our practice policy is to arrange affordable monthly payments in order to help fit LASIK into your budget. As compared with eyeglasses and contact lenses LASIK can pay for itself in a few years time. Eyeglasses usually have to be replaced once a year or so and contact lenses, depending on the type, can be extremely costly. Speak with our Refractive Surgery Coordinator for more financing information. In most cases you can qualify FOR AN AFFORDABLE MONTHLY PAYMENT PLAN.
Your Company May Be Able To Help You Pay for LASIK!
Many companies have implemented healthcare options that make elective surgeries such as LASIK an affordable alternative. These insurance programs are referred to as Flex Plans, cafeteria plans or alternative health plans. These plans designate a limited amount of pre tax dollars to pay for the employees predetermined elective surgery. Generally the employee must decide which surgery they are planning to have and declare this to their employer. You can contact your human resource office to find out when your company's enrollment period begins.
In order to make a decision as to whether LASIK vision correction surgery is a good alternative for you, it is important to understand the potential risks. If performed by an experienced surgeon, the risks are low--it is one of the safest surgeries performed today. In contrast to PRK, most risks in LASIK are related to the creation and re-adhesion of the corneal flap. The trade-off for these risks is fast visual recovery with less discomfort. And, in most cases, LASIK is the easiest procedure to fine tune with an enhancement.
The following are several potential risks and side effects of LASIK :
It is possible that not all of an individual's prescription will be corrected by the treatment. Some of the original eye prescription may remain; this is called undercorrection. If you are undercorrected, your distance vision will still be improved over your uncorrected pre-treatment vision. If a myopic patient is in the average range of presbyopia, they will still be able to read comfortably without reading glasses. For mild undercorrection, glasses may be prescribed. For significant undercorrection, further treatment (called "enhancement") may be recommended. Another alternative is to wear glasses or hard contact lenses.
The treatment could correct more of your prescription than intended. This is termed overcorrection. A mild amount of over correction of myopia is usually well tolerated so that distance and reading vision are minimally affected. If a significant overcorrection for myopia occurs, distance vision is blurry, and near vision is also blurry, especially if the patient is in the presbyopic age range (over 40). This condition is hyperopia. For significant overcorrection, further treatment (called "enhancement") may be recommended. Another alternative is to wear glasses or hard contact lenses.
Glare, Halos, Double Vision
Early side effects of any corneal treatment include light sensitivity and glare. These symptoms are usually gone within days of treatment, but they have been reported to last for months. The cause may be due to poor healing of the surface of the cornea, infection, an allergic or toxic reaction to the post-treatment eye drops or surface cells trapped within the layers of the cornea. Another cause may be decentration of the optical center of the procedure compared to the patient's actual visual center. Treatment is directed towards the cause.
Ghost images may also occur, particularly during the early healing phases. As the eye heals, the initial unevenness (or irregularity of the treated cornea) will significantly smooth out so that ghost images or halos are rarely annoying.
If the laser beam is not centered on the patient's cornea, double vision may result. Glasses or contact lenses may reduce or eliminate these symptoms.
Any vision correction treatment carries risk of infection. After treatment, antibiotics are used to prevent infection, but an infection within the cornea could lead to permanent loss of vision that could be corrected only by a repeat of treatment or a corneal transplant. Our physicians use every precaution to prevent infection at the time of treatment, including the antibiotics that are prescribed after treatment to prevent infection.
Because Laser Vision Correction procedures temporarily break the protective skin (epithelium) of the surface of the cornea, that surface has to heal back over the treated site to give the best possible vision and to restore the protective mechanisms of the eye. If the surface fails to heal properly, there is an increased risk of infection, poor quality of vision and glare. If infection progresses uncontrolled, it is possible that the cornea could melt or perforate making it necessary to perform a repeat treatment or a partial or complete corneal transplant. Permanent corneal scarring and any of the above complications are rare but could lead to permanent vision loss. Other complications may be possible, and you should ask your doctor about them.
Rarely, some of the corneal surface cells (epithelium) may grow beneath the flap created during the LASIK procedure. These cells typically do not create any problem, but occasionally they can cause postoperative blurred vision or irritation. This problem can be easily identified and treated by gently lifting the flap and removing the trapped epithelial cells.
Regression refers to the tendency of the eye to drift back slightly toward its original prescription. This occurs more commonly in patients who have had PRK but occasionally occurs in patients with higher amounts of myopia, hyperopia, or astigmatism who have undergone LASIK.
If a significant regression does occur, enhancement procedures may be performed to "tune up" the original treatment, provided your cornea is thick enough to allow retreatment. Enhancements for regression are usually performed three to six months following the original procedure to allow time for the patient's new refraction to stabilize. In some cases, glasses for night driving may be all that is needed.
Diffuse Lamellar Keratitis (DLK)
Diffuse lamellar keratitis--also known as the "sands of the Sahara" syndrome--is a general inflammation that sometimes arises between the corneal flap and the underlying corneal stroma.
Diffuse lamellar keratitis (DLK) is an extremely rare inflammatory reaction that leaves small white deposits underneath the corneal flap after LASIK. The cause of this reaction is unknown. Depending on the amount of inflammation, you may have no symptoms or you may note some haziness in your vision.
Prevention requires maintaining a clean interface between these two areas. This is aided by meticulously draping the eyelids with sterile tape to keep the eyelashes out of the surgical field and by irrigating (rinsing) the cornea to remove any debris that may be in the tear film before making the microkeratome cut. When folding back the flap, it is important to try to prevent any unwanted debris from accumulating on the interface surface. Irrigating under the flap following the application of the laser may also help to assure a clean interface.
Despite meticulous surgical technique, sebaceous secretions from the patient's own eyelid border may collect beneath the flap. This is usually of no consequence. Occasionally, microfibers from the sterile drapes or swabs may appear. Airborne particulate fibers are also occasionally seen as well as an occasional metallic fragment from the high speed keratome blade. Fortunately, most particulate matter does not cause problems unless it is in the visual axis. By drying around the edges of the eye, the surgeon insures that when the corneal flap is folded back, it will not be sitting in a pool of dirty fluid.
Postoperatively, a topical corticosteroid (medicated drop applied to the surface of the eye) is used to suppress inflammation. The steroid is applied for one week because diffuse lamellar keratitis peaks two to five days after surgery. Likewise, a single drop of a nonsteroidal, anti-inflammatory eye drop at the conclusion of surgery is essential. It serves to dramatically reduce pain during the first six hours after surgery.
When present, most cases of diffuse lamellar keratitis respond to treatment with corticosteroid drops. More severe cases may require that the surgeon lift the corneal flap and irrigate beneath it to remove the inflammatory cells. When recognized and treated properly, DLK rarely affects the ultimate visual outcome; in rare cases, DLK will cause a loss of best corrected vision.
A different form of lamellar keratitis has recently been reported, central lamellar keratitis or CLK. CLK appears within the first twenty-four to forty-eight hours and results in a severe central collection of inflammatory debris. At times the underlying stroma is also involved. Treatment is similar to DLK. However, vision may be more often affected, resulting in the need for additional enhancements after recovery.
At the time of this writing, the exact causes of DLK and CLK are unknown. Speculation of causative factors include an inflammatory reaction related to the patient's own sebaceous secretions, reactions to methlycellulose drops, antigens from bacteria, and even immune reactions to byproducts of the laser treated cornea.
Infection or Severe Inflammation
Although infection is the most feared complication, it is extremely rare. As with any surgery, it is avoided through proper surgical technique. If it does occur, it manifests itself in the first forty-eight to seventy-two hours after treatment. That is why it is important to avoid any contact with substances that may cause infection, such as eye makeup, hot tubs, and swimming pool water, for the first week. Additionally, it is imperative that you go to all of your follow-up visits, even if everything seems to be fine. You will be using antibiotic drops postoperatively to help prevent infection. Starting these drops two days prior to surgery can further reduce your risk.
LASIK is the procedure of choice for virtually all but the most extreme myopes and hyperopes. In addition, most degrees of astigmatism can be treated. It is a very precise procedure and allows for accurate enhancements when needed.