LASIK is a refractive surgery, performed by an opthalmologist, who uses a laser to reshape the eye in order to improve vision. For many patients, LASIK is an alternative vision correction that removes dependence on glasses and contact lenses.
We have outlined some of the most common questions below. If you have a specific question regarding LASIK procedures, you may also contact us.
Am I a suitable candidate for Laser Vision Correction (LVC)?
This is the most commonly asked question asked by those who are seeing to decrease their dependence on glasses and contact lenses.
Do you insist on being absolutely and completely independent of glasses and contact lenses? Am I too picky? ⎕ Yes ⎕ No If the answer is yes, then you may be expecting too much and may not bean optimal candidate. Even with the most successful laser procedure, there is often an eyeglass prescription that make make your vision even better. (eg 20/20+ without glasses after LASIK but 20/10 with a small prescription). For people that are less than forty years old, a LASIK or LASIK type procedure giving excellent distance vision will likely make you independent of glasses and contacts. However, after age forty or so, even after the most successful laser eye surgery simple “drugstore” reading glasses may be required for good vision closer than two or three feet. Is your eyeglass or contact lens prescription appropriate for LVC? For the vast majority of people who wear glasses and contact lenses, the answer to this question is yes. However, if you prescription is very small and you don’t need to wear glasses to drive and don’t wear glasses for many activities, then it must be asked whether you really need a surgical procedure. On the other hand, if your eyeglass or contact lens prescription is extreme, then a procedure other than LVC may be the best way to achieve good vision. Your doctor should be able to offer you options for non-laser procedures eg. nearsighted implants, refractive/clear lens extraction if that is a better option for you. A doctor who performs only one type of surgery is like a workman with only one tool in his toolbox; not an optimal situation and one with inherent conflicts regarding best medical judgment. What is your age? ⎕ Too old? ⎕ Too young? If you are less than 21 years old there is a pretty reasonable chance than your eyeglass or contact lens prescription may not be fully stable; you may not have reached your full amount of nearsightedness. It's a good idea to look for three or more years of the same prescription before considering a vision correction procedure. LVC is a better college than high school graduation gift. If you are over 50 years old, you may be better served by a lens based surgical procedure than a corneal laser procedure (LVC). This is especially true if there are any signs of early cataract formation; a condition in which lens surgery will be required anyway. Again, if over 50 years old, you should ask your doctor whether he or she performs lens based procedures and whether that might be a better option for you. What is your corneal structure? If you are a candidate for laser eye correction your cornea needs to have normal structure if you and your doctor are to expect a good a predictable result after LASIK. This is checked by measuring corneal thickness during your exam and comparing that to the amount of nearsighted correction which is required. And checking the curvatures and structure of your cornea via corneal topography. If there is any question as to your cornea being too thin or if there is any suggestion of imperfect structure, it should start of discussion about whether the PRK/Advanced surface ablation variant of LASIK should be considered. Or whether a nearsighted implant might be the best answer. Again, your doctor should have the experience in order to be fully agile and comfortable in performing any of the available laser and implant procedures for you. Is there anything truly unusual about my eyes? Are you eyes too dry for LVC? If this is suspected, it can be checked by asking about your ability to wear contacts lenses, by the microscopic appearance of your eye, and an actual measurement of your tears as well. Are there any other eye problems? Corneal scars, cataract, glaucoma, and other unusual eye problems can have an impact on which procedure might be best for you or whether you should hold off on having an elective eye procedure. Do I only have one good eye? This is an unusual situation but we really need both eyes capable of very good vision before serious consideration of a elective vision correction procedure. Even if the chance of an unwanted complication is remotely unlikely, the remotely unlikely chance that something might happen to your “good” eye and leave you only with a “not so good”eye is enough to usually dissuade us from performing LASIK and other elective (non-mandatory) vision correcting procedures on people with a “lazy” eye or other conditions in which life’s activities could not be fully enjoyed if left with vision only in the “bad” eye
Can I go blind after LASIK?
This is a question asked surprisingly often during initial evaluations for Laser Vision Correction (LVC).
My best answer is probably not.My usual explanation is that the worst conceivable thing that could happen after a bilateral (both eyes, same day) LASIK procedure is that both eyes would become infected.Now infection after LASIK is incredibly rare, especially infacilities like ours in which gloves and gowns and masks are utilized.......we treat LASIK like the true surgical procedure it is; with all appropriate precautions. Let’s say that despite all the precautions, both eyes were to get an infection.The infection would be in your cornea, the front outside layer of your eye.Well, we are fellowship trained corneal specialists and we would not have to refer you elsewhere for treatment.We’d treat the infection and if were to leave substantial scarring, we have the training and experience to perform the required corneal transplant to restore vision. So, even after the most devastating remotely rare (hasn’t happened in our facility, ever) catastrophe, following expert medical attention and corneal surgery if required, you would still have vision in the affected eye(s). Thus, my answer is a qualified “no”; you really can’t go completely blind after a LASER vision correction procedure.
There are factors that may be discovered during the course of your exam which might lead me to suggest that the PRK/Advanced Surface Ablation variant of LASIK would be a better option than traditional LASIK.
PRK (PhotoRefractiveKeratectomy) is a procedure using the same excimer vision correcting laser as LASIK but the laser sculpting is done on the surface of the eye rather than in the corneal substance. i.e instead of creating a LASIK corneal flap and doing the sculpting inside the LASIK corneal “sandwich”, the sculpting is done on the corneal surface after removing the corneal surface cells and exposing the substance (stroma) of the cornea. PRK is equal to LASIK in terms of achieved visual acuity. But the recovery after PRK is more gradual and is associated with more irritation during the first few days following the procedure. What are the factors that would lead us to choose PRK over LASIK? The most common scenarios include when we determine that your cornea is a slightly thin or has a non-standard curvature. This is especially true with younger patients and high levels of nearsightedness. In these situations, a correction with PRK has the advantage of using less of your corneal substance (stroma) than the combination of a LASIK flap and excimer sculpting. For someone involved in contact sports and occupations in which eye trauma is common eg. martial arts, professional basketball, military special forces, etc, PRK is sturdier than LASIK in there is no corneal flap that can be moved as part of a severe eye injury. So, please feel free to ask whether PRK might offer any advantage over LASIK in your particular situation.The only real disadvantage of PRK is that good vision and good comfort take a few days longer than with LASIK.
What should I expect after PRK?
This is a commonly asked question which should be answered accurately to set expectations after PRK.
The actual PRK procedure is actually even easier to undergo than LASIK; the flap creating laser with its suction ring is not necessary for PRK and thus the pressure sensation of the LASIK procedure is eliminated. At the end of a PRK procedure a bandage soft contact lens is inserted which you wear for the first week. It stays in place and does not have to be removed by you. During the first few days your vision should be as good or often much better than it was before the PRK procedure. But you won’t have the real quality vision yet. Thus, we strongly recommend a relaxed schedule in terms of your not be required to drive or read small print or travel during the first week or two after the procedure.The speed of vision recovery during the first two weeks is incredibly variable with some people taking on a full schedule and others needing some down time. The irritation is often the greatest on the second and third days after the procedure. Sometimes its helpful during this time to have the bandage contact lens changed to improve comfort. By the time you reach the fourth day after PRK, you should be fairly comfortable with rapidly improving vision. On the six or seventh day after PRK we will see you in the office and remove the bandage contact lens. Usually there is enough healing not to have to place a new contact lens. You will then be placed on tapering schedule of eye drops. The vision should really start coming in between seven days and two weeks after the procedure. I usually tell patients that PRK vision after two weeks is about the same as LASIK vision after a day or so. The LASIK patient sees better and faster but by 1-3 months, the PRK patient catches up and the visual outcome is generally equal and outstanding for both. So, if there are factor in your exam which indicate that you would do better with PRK than LASIK, just remember that it will be a more gradual improvement than LASIK and you will have more irritation during the first few days. But you will get to the same good place as your LASIK brethren pretty quickly.
Presbyopia - Why have my arms become too short?
This is a somewhat difficult issue to explain.
Let’s start that its a fact of life that all people with distance vision (natural, with glasses, with contact lenses, and after LASIK) will require something “extra” between age 40 and 50 in order to be able to read. The natural mechanism for close focusing of your eyes begins to fail at around your 45th birthday.For most people with natural good distance vision this usually means a trip to the drug store to pick up the first pair of reading glasses. For those that wear glasses for distance vision, it means that bifocals or progressive lenses will be needed.For contact lens wearers, it means reading glasses or bifocal contact lenses or wearing one contact lens for distance and the other for reading (monovision). What does this mean when we are considering laser vision correction? If you are 40 years old or younger, other than telling you that you will need readers (like all normally sighted people) when you get older, no special discussion is needed. For those that have already reached the “short armed” age and are contemplating surgical vision correction, we have some of the same choices as a contact lens wearer; either both eyes for full distance or one eye for reading and one for distance. Everyone is different and the ability to adapt to monovision (one distance and one reading eye) should be proven before targeting monovision as laser goal. In general, despite the need for reading glasses at two feet or closer, those people whose occupation or avocation is all about high quality distance vision (eg pilots, athletes, golfers), surgical vision correction should target best distance vision in both eyes. For those at age forty or older who haven’t tried monovision in contact lenses, a trial of contact lens monovision can be a good idea before laser vision correction.
Pilots and Professional Athletes and LASIK
Should those special people with special visual needs whose special careers depend on their exceptional vision have LASIK? The answer is yes and no.
My current recommendation is that if a pilot or professional athlete enjoys superior vision with the use of contact lenses and the contact lenses can be worn during flight or games without any awareness or irritation, then there is no need or advantage to substituting LASIK for successful contact lens use.This is especially true for people in their young 20’s who may not be fully “grown” in terms of their final amount of nearsightedness and a laser procedure at age 20 might be followed by an enhancement procedure just a few years later. This equation is somewhat different for young people who otherwise meet military requirements for flight training and must achieve excellent vision without glasses or contact lenses to achieve their dream of becoming a military pilot. Laser vision correction, either LASIK or PRK, can be performed in such cases assuming that a reasonable degree of refractive stability has been achieved and they are otherwise good candidates. We are immensely proud of the many young people that have trusted us to perform their vision correction and achieve their goal of military service as a pilot. Pilots who have imperfect tolerance of their contact lenses or a preference not to be dependent on glasses and contact lenses can be considered for laser vision correction.Of course they must qualify as excellent candidates and must have at least two weeks of non-flying status following the procedure before they can be returned to flight duty. I am especially honored by referrals for LASIK that I receive from airlines and fellow aviation medical examiners of professional pilots.
LASIK is too expensive! What about the cheap LASIK places?
A great question. I’m frequently asked “why here?” “why you?” and “why not just use this coupon and do it at a much lower price?”
Our price for LASIK has been the same since the procedure was introduced over twenty years ago. No increase, no decrease, but much more of the fee is going to the manufacturers and developers for patent fees related to a much more sophisticated technology than we used in the mid 1990’s. What is the “value”in paying “full price” for LASIK? Immodestly, the fee buys you me and us. You are paying for my three decades of vision correction surgical experience as well as the fact that LASIK is the easiest thing that I do.....I am a fellowship trained corneal transplant surgeon. There really isn’t anything that can happen to you during surgery that we haven’t seen and solved before. Indeed, we are the ones that get the referrals from other LASIK centers when they have complications and problems. Similarly, my technicians are an elite group with decades of experience. In addition to our skills and experience, we use a checklist and error-prevention protocol based upon my aviation background to help eliminate the possibility of any unwanted event which could prevent an outstanding visual outcome. But what if you absolutely can’t afford the “best”. Do you need to clip the coupon and go to the discount place? No! We can offer an alternative. It is our privilege to provide training in LASIK and corneal transplantation of a very talented post-graduate ophthalmologist; our “fellow”. Our post-graduate fellow is a fully trained ophthalmologist who is directly supervised by me. Our fellows have training from the best residencies in the world and have graduated from our program to become some of the best and most famous LASIK surgeons. We do have a limited number procedures that can be scheduled with our fellow acting as the primary surgeon with me as the co-surgeon. Very controlled, very safe, very much like the major airlines when the co-pilot is flying and backed up by the senior captain. If we agree that you are a good candidate for a “fellow performed procedure”, we can offer your LASIK at a very attractive price. These procedures are highly subsidized by our center so that the number of “fellow performed procedures” is limited. Please contact firstname.lastname@example.org if you want to be considered. Our full price LASIK is a sensational value given the team and technology behind the procedure and the importance of a lifetime of good vision. And we are fortunate indeed to be training tomorrow’s surgical superstars who can help those less financially able to have the quality vision correction procedure that they desire.
Unlike other LASIK centers which allude to surgery on professional athletes and “Provider” relationships, we will not tell you about our famous patients and the teams for whom we provide services.We have never paid athletes or teams to choose us or to have surgery with us nor do we pay them to leverage their fame to promote our practice.That has always seemed ugly and misleading making you think that they simply selected us rather than our paid to provide their services.
I will say that as honored as I am concerning the many thousands of people that have chose us for their vision correction, there are some very special people with very special eyes who are among our very happiest post-ops.You might see some pictures in my private office but never in common areas or our exam rooms. Being the medical monitor of one the first LASIK studies done in the US over twenty years ago, I was able to get a very early head start in treating some pretty impressive athletes and luminaries. By my count we have performed surgery on at least three athletes that now reside in the MLB Hall of Fame, a bunch that are headed that way, famous players from non-Atlanta professional teams that traveled to us for their laser surgery, Academy award and Grammy award winners.The word is out on some of this....if you wish you can Google and find out.