Q: What is Laser Vision Correction?

A: Laser Vision Correction is a precise computerized procedure that uses the VISX Star laser to correct nearsightedness, farsightedness, and astigmatism. During the treatment, the laser’s cool beam of ultraviolet light removes a small amount of tissue, usually less than the thickness of a human hair. Short pulses of this cool beam laser light change the curvature of the cornea, allowing images to be more sharply focused.

Q: What are Nearsightedness, Farsightedness, and Astigmatism?

A: Nearsightedness occurs when the curve at the front portion of the eye, known as the cornea, is too steep, resulting in blurred images in the distance. In a normal eye, the cornea and the lens of the eye focus light to form an image on the back surface of the eye, known as the retina. In a nearsighted eye, the eye focuses or refracts light too much, causing images of distant objects to form in front of the retina and appear blurry; with farsightedness, the opposite is true – weaker focusing power causes the image to theoretically focus behind the retina, also making them appear blurry. Astigmatism results in blurred vision as the result of irregular curvature of the cornea.

Q: Am I a candidate for Laser Vision Correction?

A: Candidates for Laser Vision Correction should be 18 years or older with stable vision, healthy eyes, and a refractive vision problem within the range of effective treatment. You will need an initial evaluation followed by a comprehensive exam to help you and your doctor decide what procedure is right for you.

Q: What are the real benefits of Laser Vision Correction?

A: Laser vision correction is the modern alternative to glasses or contact lenses. The goal of LVC is to reduce or eliminate your dependence on contact lenses and glasses.

Q: I wear bifocals now, and my doctor says that I’ll still need to wear reading glasses even if I have LASIK done. Why is this?

A: Most people in their 40s or older will need reading glasses if their eyes are corrected for distance because the eye’s lens loses flexibility as we age. This condition, called presbyopia, cannot currently be treated by surgical methods.
Some patients in this age group select monovision, such as is done with contact lenses. This option allows patients to use one of their eyes for distance and the other to see up close. Although monovision proves to be satisfactory for some patients, many are not comfortable with this arrangement. Patients need to discuss the options with their physicians.

Q: If I’m corrected for distance, will I lose ability to see well up close?

A: If you have LASIK done to correct your distance vision, you can expect to have very clear overall vision. However, images close to you may not appear as clear after having LASIK if you are over 40 years of age.

Q: Does insurance cover this surgery?

A: Although LASIK is not considered a cosmetic procedure, it is considered an elective surgery. Such surgeries are covered in many European and Asian countries. However, most United States, Canadian, and Latin American insurance policies will not cover the procedure, nor will Medicare usually cover it. If you reside in the U.S., you should check with your insurance company to see if your policy offers partial or full coverage. In many cases, the cost of the procedure can be covered by medical flex plans or medical cafeteria plans that allow pretax dollars to be set aside for medical expenses. You should check with your employer to see if your company offers this type of benefit. It is possible that the cost of LASIK may be deducted from your U.S. federal income taxes. You should check with your accountant to see if you can take LASIK as a deductible health expense.

Q: What do I do NEXT?

A: Your next step is to learn about your vision correction needs. Call us today to book a laser vision consultation. If you need more education, drop by and pick our informative package about LVC. At McManus-Shumake Eye Institute – LASIK Vision Center – we are committed to helping you make an informed decision about laser vision correction.

Q: Can I have both eyes done with LASIK at the same time?

A: You can have bilateral simultaneous LASIK (both eyes done at the same time), but the choice to do so depends on the surgeon’s approach and your requirements. Some surgeons prefer to wait a few days to several weeks between eyes in order to evaluate the results of the first eye. While this practice affords the patient an opportunity to see clearly with at least one eye before the other is done, it somewhat inconveniences the patient. Some surgeons will do both eyes on the same day in order not to inconvenience the patient; however, others maintain that there may be additional risks associated with bilateral surgery. Patients should discuss their options with their ophthalmologist.

Q: If I have one eye done at a time, what will my vision be like in between the first and second surgeries?

A: There are a number of different options to help patients deal with their vision between procedures. Some patients who do not have bilateral surgery will begin wearing a contact lens in the eye that has not undergone surgery. This practice gives them an opportunity to use their two eyes simultaneously. However, the contact lens will need to be removed at least five days prior to the second surgery.
Others function by using the operated eye immediately without the use of a contact lens in the opposite eye. This solution may work for nearsighted patients with a refractive error of fewer than six diopters. A patient with a refractive error above six diopters who does not wear a contact lens may be unable to use both eyes together due to the large difference in refractive error between the eyes. Removing one lens from a pair of glasses is usually not useful. Doing so could cause double vision and eyestrain.

Q: Can I play sports after LASIK surgery?

A: You can resume most normal activities immediately after surgery. However, for at least two weeks you will need to avoid activities that would cause perspiration to run into the eyes. You should wear safety glasses while playing contact sports whether or not you have had surgery. But if you do not routinely wear safety glasses, your surgeon may recommend wearing them for at least one month after LASIK. You will also need to avoid such activities as contact sports and swimming for several weeks. It is important to talk specifically with your doctor about limitations on activities after LASIK.

Q: How long will it take before I can see well, and how long will it take before I have my best vision?

A: Fast visual recovery characterizes this operation. Most patients achieve good vision the day of the surgery and find that their eyes feel fairly normal within a day. However, vision can continue to improve, and best vision can still take two to three months to occur. If necessary, adjustments to the surgery (called enhancements) can be done.

Q: Will I need to wear glasses once my eyes have healed?

A: Most patients who have LASIK do not wear classes for their daily activities. However, patients may need to wear reading glasses if they are over the age of 40. This is caused by the normal aging of the eye known as presbyopia. This condition occurs with or without LASIK. Some patients may need a minimal prescription for some activities such as night driving.

Q: How safe is the LASIK procedure?

A: Most studies show that LASIK produces minimal risk of serious complications. However, LASIK is a surgical procedure done on a delicate part of the eye, and complications can occur. Risks and complications will be further discussed with you during your LASIK consultation.

Q: Are the results achieved from LASIK permanent?

A: The effects of LASIK are permanent. The effects of LASIK do not wear off. But it is important to realize that a person’s eye can change internally. That is why many surgeons recommend having the procedure done after the major eye changes have occurred in one’s life. For instance, LASIK is not recommend on children because their eyes change a great deal. They would need the vision fine-tuned in a few years. If the procedure is performed after the age of 18, the chance of long-term stable correction is more likely. Even the eyes of patients over the age of 18 can still be changing.
Therefore, we recommend a good conversation with your surgeon so they can review the changes you have had and help you make a decision whether or not you should wait until the changes have slowed down. Patients should also note that while results are usually stable, they can be modified by enhancement procedures – procedures performed after the initial one – if necessary.

Q: If I have LASIK and my vision changes later in life, can it be redone?

A: Retreatment may a viable solution to vision changes later in life, and other treatment options exist. You would need to see your ophthalmologist to determine the cause of the change and to determine which option is best for you.

Q: How long will the LASIK procedure take?

A: The whole procedure takes about 10 to 15 minutes for two eyes, including creating the flap and performing the laser under the flap.

Q: Can I drive immediately after having LASIK?

A: Patients may experience some discomfort and/or blurred vision for a few hours after surgery, and most patients receive a sedative prior to surgery. Therefore, you cannot drive home after undergoing the procedure, and you should plan not to drive for at least twenty-four hours.

Q: What type of anesthetic is used for LASIK?

A: The procedure is done with a topical anesthetic (eye drops) to numb the eye. Patients may be given a small amount of oral sedative to help them relax.

Q: Does the LASIK procedure hurt?

A: Patients are given a topical anesthetic (eye drops) to numb the eye, so they experience no pain. When the surgeon applies the vacuum ring, the patient experiences a sensation of pressure just before his or her vision fades for a few seconds. The microkeratome – the instrument the surgeon uses to create the flap – and the laser do not cause any pain or discomfort. For several hours after the procedure, many patients describe a mild burning sensation, such as after opening the eyes while swimming in chlorinated water. After the first few hours, this uncomfortable feeling usually subsides.

Q: How long will I be out of work after having LASIK?

A: It depends on your occupation. Certain jobs that require intense clarity of vision (dentistry and surgery, for example) may be difficult to perform for one or two days. Most patients can return to work the next day, assuming their vision is adequate for their job. However, some people may feel fatigued for a day or so following surgery.

Q: Is LASIK investigational?

A: No. LASIK has been performed outside of the United States for approximately ten years and in U.S. clinical trials with excellent results since 1991. It is now the most commonly performed refractive procedure in the United States. Long-term studies indicate that LASIK is safe and effective. LASIK is “outside the scope of current approved labeling” in the United States, and the FDA considers the decision to conduct LASIK as the “practice-of-medicine.” This means that physicians can perform LASIK should the physician and the patient make the joint decision to do so.

Q: Why is LASIK performed as a practice-of-medicine in the United States?

A: The FDA approves drugs and devices. The FDA has approved the use of microkeratome. It has also approved the excimer laser for surface treatment of nearsightedness (myopia), farsightedness (hyperopia), and astigmatism in the United States. PRK underwent the FDA clinical trials. However, the FDA has not approved the use of these two instruments in the same procedure. Here is why: Laser manufacturers would have to repeat the expensive and time-consuming approval process with LASIK that was already completed and approved for PRK. Since the approved lasers and microkeratomes have proven safe and effective, surgeons are allowed to perform LASIK if both the surgeon and patient believe that this procedure best serves the patient. Therefore, most manufacturers have opted not to undergo the process.
Nevertheless, some manufacturers are going through the effort of working with the FDA to put LASIK in the specific labeling for excimer laser so that it would not be considered an off-label procedure.

Q: Is LASIK an off-label use of the excimer laser?

A: Since VISX received FDA approval for its STAR S2 Excimer Laser system for LASIK for the treatment of nearsightedness up to –14.0 diopters with or without up to-5.0 diopters of astigmatism, LASIK is no longer considered off-label for this application. LASIK correction of hyperopia, however, is still an off-label use. The use of devices during a procedure deemed a practice-of-medicine is called an “off-label” use of these devices. Because the approved lasers and microkeratomes have proven safe and effective in other procedures, ophthalmologists can use them off-label if it is in their patient’s best interest to do so.

Q: When LASIK is an off-label use, why do surgeons opt to do this procedure?

A: LASIK has significant advantages over other methods for many patients. The safety and accuracy of LASIK equals or exceeds that of PRK. Because of the wide range of correction and the rapid visual recovery associated with LASIK, it is already the most common refractive surgical procedure in the United States.

Q: What results can I expect from LASIK?

A: LASIK improves the uncorrected vision – one’s visual capacity while not wearing corrective lenses – in most patients who have the procedure. Almost all patients can expect to achieve 20/40 vision, which most states and provinces consider good enough to drive without having to wear contacts or glasses, and many can expect to achieve 20/20 vision or better.
However, there are no guarantees that you will have perfect vision. People who are most satisfied with the results of laser correction clearly understand the potential risks and complications and possess realistic expectations of what their vision will be like after surgery.

Q: Will my eyes look different after LASIK?

A: No. Your eyes will look exactly the same.

Q: What does Laser Vision Correction cost?

A: When compared to non-surgical alternatives, refractive surgery is surprisingly cost effective. Ask our staff to discuss our charges and all finance options available to you.

Q: Is Laser Vision Correction affordable for me?

A: YES! The affordability of laser vision correction has never been greater. First, consider the cost of replacing your eyeglass frames and lenses or the repetitive costs of disposable contact lenses. With laser vision correction you can receive the greatest value: clear vision without glasses or contact lenses! Ask about our many affordable financing options that are available. Contact our refractive coordinator today to learn more.

Q: How is LASIK done?

A: LASIK combines the use of two technologies: the microkeratome and the excimer laser. The microkeratome is a device that has been used for many years in corneal eye surgery to create a flap in the cornea. Once the flap is made it is folded back to allow the excimer laser to treat in the corneal bed. The benefits of this procedure include minimal pain, rapid visual rehabilitation, and less change due to healing (regression).

Q: What does the term LASIK mean?

A: LASIK is the acronym for laser in situ keratomileusis, sometimes referred to as laser assisted in keratomileusis. The name refers to the use of a laser to reshape the cornea without invading the adjacent cell layers. In situ is Greek for “in the natural or normal place.” Medically, in situ means confined to the site of origin without invasion of neighboring tissues. Kerato is the Greek word for cornea and mileusis means “to shape.”

Q: How long has LASIK been performed?

A: LASIK has been performed internationally for approximately 10 years. It was first performed in clinical trials in the U.S. in 1991. It is important to note that major components of the procedure have a long history. Ophthalmologists have been reshaping the cornea for over 50 years, creating a protective layer of tissue for over 35 years, and using the excimer laser since the 1980s.

Q: Why is LASIK considered an advancement in refractive surgery?

A: LASIK combines the precision of the excimer laser that is used in PRK (Photo Refractive Keratectomy) surgeries with the flap technique that characterizes ALK.

Q: Whom can LASIK benefit?

A: LASIK can benefit a great number of people with myopia, hyperopia, and astigmatism. Candidates should have a strong desire to be less dependent on corrective lenses and be willing to accept the risks of surgery.

Q: What can I expect on the day of my Laser Vision Correction procedure?

A: Laser vision correction is the modern alternative to glasses or contact lenses. The goal of LVC is to reduce or eliminate your dependence on contact lenses and glasses. Once you become accustomed to the sound of the laser, anesthetic drops will be placed in your eye to numb it. In the laser room, you will be seated in a reclining chair, the physician will position your head under the laser, and a retainer will be placed between your eyelids to gently hold them open during the treatment. Access to the cornea will be performed. Once completed, you will be asked to focus on a blinking red light while the laser removes microscopic amounts of tissue from the cornea. The laser will treat your eye for less than one minute and your total time in the laser area will be about 30 minutes. After your laser treatment is complete, some drops and a protective bandage or lens will be placed on your eye for protection and comfort. While the actual procedure is painless due to the numbing of the eye drops, you will experience some slight irritation during the immediate post-operative period.

Q: How do I choose a surgeon?

A: Be an informed consumer. Ask questions regarding the surgeon’s background, experience, and the outcomes they have had in delivering vision correction. Ask your optometrist for a recommendation. Attend informational seminars and complimentary evaluations. Ask the surgeon questions specific to your visual needs and expectations. The surgeons at MSEI–LASIK Vision Center–have extensive experience in delivering results consistent with your needs. As leaders in the field, our surgeons are involved in clinical investigation of advancements such as hyperopia (farsightedness) treatments.

Q: What are the risks associated with Laser Vision Correction?

A: The most common side effects during the immediate post-operative period are pain, light sensitivity, blurred vision during healing, inadequate correction, over correction, glare, haze, star burst, and induced astigmatism. These side effects usually diminish as the eye heals. While significant complications are very rare, the following are some of the problems that can occur. These include infection, intraoperative complications, inadequate healing, persistent irregular astigmatism, and unstable vision. This is not a complete list of side effects or complications. It is very important to discuss the potential risks with your doctor prior to consenting to surgery.