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Consumer Guide for LASIK Eye Surgery

Table of Contents


Refractive Error Types

Myopia
Nearsightedness: is a vision defect in which distance objects appear blurry because the image that enters the eye is focused in front of the retina rather than on it.

Hyperopia
Farsightedness: is a vision condition in which distance objects appear clearer than near objects due to the eye being too short, thus causing the image entering the eye not to be clearly focused on the retina.

Astigmatism
A vision condition caused by the cornea of front surface of the eye to be shaped more oval (or oblong) like an egg or football rather than spherical (or round). This causes light rays to focus in two separate points on the retina rather than one causing a distorted and blurry image at both distance and near.

Presbyopia
A vision condition caused by the aging process in which the natural lens inside the eye gradually losing its flexibility and results in blurry vision for reading and near work.


Are you a good candidate for LASIK Surgery (Patient Criteria for LASIK)

The following are criteria used to determine if you would be a good candidate to proceed with the evaluation for LASIK.
  1. You need to be at least 18 years old
  2. Your vision/prescription has been stable for at least one year
  3. You need a prescription of certain strength to see clearly in the distance and that strength must meet FDA-approved guidelines for nearsightedness, farsightedness, and astigmatism. You also must be willing to accept the potential risks, complications and side effects.
  4. You should have a healthy cornea, retina, and eye pressure.
  5. The cornea must also have sufficient thickness.
  6. You should have no other major eye diseases.
  7. You should have no evidence of collagen vascular or autoimmune disease.
  8. You should not be pregnant or nursing.
  9. You should not have a recent history of herpes infection of the eye.
  10. You should have realistic expectations about the outcome of surgery.
The following patients would not be considered candidates of LASIK surgery.
  1. Active eye inflammation or infection
  2. Severely dry eyes
  3. Excessive corneal disease or scarring
  4. Degenerative disease of the cornea (e.g. keratoconus)
  5. Uncontrolled diabetes
  6. Pregnant and Nursing mothers
  7. Inadequate corneal tissue
  8. Certain rheumatological conditions (e.g. lupus, rheumatoid arthritis, Sjorgens Disease)
  9. Pupils larger than 7mm in the dark - due to increased risk of glare and halos at night and decreased night vision


Custom Wavefront LASIK

Custom Wavefront LASIK surgery takes advantage of the latest laser vision technology and uses 3-dimensional measurements of the eye to enhance the lasers ability to re-shape the front surface of the eye (cornea). This allows for precise, individualized vision correction outcomes to be achieved that are not able to be achieved with traditional LASIK surgery.

With custom LASIK, your eye's ability to focus light rays is measured from front to back, and a 3-D map is created that demonstrates irregularities in the way your eye processes images. Information contained in the map guides the laser in customizing the treatment to reshape your eye's corneal surface so that these irregularities can be corrected.

Adapted from technology that allows land-based telescopes to produce images comparable to those generated by the Hubble Space Telescope, Wavefront LASIK consists of a sensor and a laser.

All of these visual irregularities are then displayed as a 3-D map, referred to as a wavefront map. This information is then electronically transferred to the laser (in Wavefront-guided systems), and computer-matched to the eye's position, enabling the surgeon to customize the LASIK procedure to your unique visual requirements.

A wave of light from a laser beam is sent through the eye to the retina. This light is reflected back through the vitreous, the lens and the pupil. The sensor measures the irregularities at the front of the wave of light as it emerges from the eye. This produces a precise three-dimensional map of the eye's visual system, including the cornea's imperfections or aberrations.

Wavefront technology is groundbreaking because it has the potential to improve not only how much you can see, visual acuity measured by the standard 20/20 eye chart, but also how well you can see, in terms of contrast sensitivity and fine detail. This translates into a reduced risk of post-LASIK complications, such as glare, halos, and difficulty with night vision.

How much you see depends on vision defects known as lower-order aberrations associated with common refractive errors including myopia, hyperopia, and astigmatism, which traditional LASIK can treat.

How well you see can depends on presence of the type and numbers of visual distortions known as higher-order aberrations, which can include irregularities other than common refractive errors. These higher-order aberrations can create problems such as decreased contrast sensitivity or night vision, glare, shadows, and halos. However, higher-order aberrations do not always affect vision. Unlike traditional LASIK, custom LASIK treats both lower- and higher-order aberrations.

Custom LASIK's advantage
  • Greater chance of achieving 20/20 vision
  • Greater chance of achieving better than 20/20 vision
  • Reduced chance of losing best-corrected vision
  • Reduced chance of losing visual quality or contrast sensitivity
  • Reduced chance of night-vision disturbances and glare and halos
Studies have shown that with wavefront LASIK the visual results are more predictable than with traditional LASIK.

Studies comparing results of wavefront LASIK with conventional LASIK found that 90 to 94 percent of patients receiving wavefront LASIK achieved visual acuity of 20/20 or better, whereas over 80 percent of those receiving conventional LASIK achieved 20/20 or better.

In August 2004 the U.S. Navy announced that patients at its refractive surgery center were achieving better distance vision and night vision after custom LASIK than after traditional LASIK.

Wavefront LASIK may not be for everyone. Because wavefront LASIK removes more corneal tissue than conventional LASIK, patients with thin corneas may not be good candidates. Also there is a limit to the degree of correction that can be achieved by the wavefront software. So some patients with higher degrees of myopia, hyperopia, and astigmatism may not be candidates for custom LASIK. However, these patients may still be good candidates for conventional. The custom LASIK eye surgery cost is a modest amount more than the traditional LASIK pricing.


IntraLase

The IntraLase laser for creating cornea flaps appears to enhance the safety of LASIK vision correction by using laser energy to replace the microkeratome blade traditionally used to create a thin flap in the clear front covering of the eye (cornea).

In LASIK, the flap is lifted, and the excimer laser is applied to reshape the cornea to achieve sharper focus. The flap then is replaced to serve as a type of natural "bandage" for healing.

While LASIK complications are relatively rare, they are sometimes associated with the oscillating blade used with traditional microkeratomes. Metal blades might create uneven flap edges, resulting in abnormal corneal surfaces and vision defects such as irregular astigmatism.

IntraLase creates flaps through infrared laser energy that inserts a precise pattern of tiny, overlapping bubbles just below the corneal surface. The IntraLase laser operates at extremely high speeds (pulses of one quadrillionth of a second), allowing tissue to be targeted and divided at a molecular level without heat or impact to surrounding tissue.

The resulting corneal flap is created at a precise depth and diameter pre-determined by the surgeon. As occurs with a mechanical microkeratome, a small section of tissue at one edge of the flap is left uncut, forming a hinge that allows the surgeon to fold back the flap so that the cornea can be accessed and reshaped for vision correction.

The time needed (up to a minute) for the suction ring to remain on the eye for the laser flap to be completed with the IntraLase is longer than the microkeratome and may slightly increase chances of bleeding (hemorrhage). This type of temporary eye bleeding is not vision-threatening, and it resolves on its own.

Studies have shown that IntraLase results in fewer overall LASIK complication rates. This difference in flap structure may reduce the chance of cells growing underneath and pushing up the flap (epithelial ingrowth) to create an irregular corneal surface with accompanying vision defects. Nevertheless, eye surgeons recently have reported one postoperative complication using IntraLase of unusual light sensitivity such as photophobia that appears unique to the use of the IntraLase in LASIK.

However, surgeons report that the photophobia complication is temporary and can be resolved with steroid treatment (eye drops) lasting a few weeks. Surgeons favoring IntraLase emphasize that light sensitivity is a transient side effect that soon resolves.

Study results have shown that LASIK with IntraLase may produce a lower incidence of post-operative dry eye. Fewer enhancement ("touch-up") procedures appear to be required when LASIK is performed with IntraLase.

However, the tradeoff for potentially increased safety with the use of IntraLase is accompanying additional LASIK procedure costs of about $300 per eye, according to Review of Ophthalmology.

With IntraLase, people with thin corneas who once were unsuitable for LASIK may now be candidates due its precision, and its ability to consistently producing corneal flaps thin enough to treat those patients who were previously not candidates.


PRK

Photorefractive keratectomy (PRK) is a procedure in which the surface of the cornea is reshaped using an Excimer laser. This process removes only 5-10% of the thickness of the cornea for mild to moderate myopia - about the thickness of 1 to 3 human hairs.

PRK does not involve creation of a corneal flap utilizing the microkeratome, and therefore, the protective superficial layers of the cornea must heal post-operatively. This generally means that patients who undergo PRK will require significantly more time than LASIK patients to achieve their best vision.

PRK may be used to treat myopia (nearsightedness), hyperopia (farsightedness), or astigmatism. The outcomes of PRK and LASIK are quite comparable at the 6 month post-operative visit. But there is a greater risk of scarring (haze) and unpredictable healing of the cornea with PRK. The risk of infection is also slightly higher with PRK than with LASIK, although infections following either procedure are rare. Many surgeons prefer PRK for patients with larger pupils or thin corneas.

PRK was invented in the early '80s. The first FDA approval of a laser for PRK was in 1995, but the procedure was practiced in other countries for years prior.

Your vision may be blurry for the first few days after your PRK treatment as the corneal surface heals. Avoid rubbing your eye (your doctor will tell you how long). You will probably wear a special "bandage" contact lens, use antibiotic drops for a few days, and apply anti-inflammatory drops for several weeks.

THE PRK PROCEDURE

A few minutes prior to the PRK procedure, anesthetic drops will be applied to the eye to numb the eye and prevent pain during the procedure. A speculum will be placed to hold the lids apart for the procedure, eliminating any concern that blinking during the procedure would present a problem. The eye surgeon will then gently remove the surface corneal cells (epithelium) and proceed with the laser aspect of the procedure. The laser, being computer driven for accuracy and precision, is programmed based on the patient’s refractive error (nearsightedness, farsightedness, astigmatism).

The laser delivery takes less than one minute for most patients. Once the refractive ablation is completed, i.e., the corneal curvature is reshaped, the surgeon will place a bandage contact lens on the eye for improved comfort along with anti-inflammatory and antibiotic eye drops.

This contact lens is worn for the first 2 to 3 days until the surface epithelium is healed. Expect at least a few visits with you surgeon during the first month following surgery, with the first visit being the next day surgery. When the surface epithelium is healed, the eye will be comfortable, and the bandage contact lens is removed. Vision may be still blurry at this time. Your vision will gradually improve. Generally, vision will be good enough to drive a car within a week or two, but your best vision may not be obtained for up to 6 weeks to 2-3 months following surgery.

Post-operatively, most patients will need to be re-evaluated one day, three days, one week, one month, two to three months, and four to six months following the PRK procedure.

PRK results are very similar to LASIK results, at least for patients up to approximately ¬6.0 diopters of myopia (nearsightedness). However, in general, PRK patients will have a somewhat slower recovery of their best vision than LASIK patients. Studies at the 6 month postoperative visit in LASIK and PRK patients show essentially equivalent results with this range of myopia.


LASEK Eye Surgery

LASEK (laser epithelial keratomileusis) is a variation on the techniques for PRK and LASIK. Also called epithelial LASIK or E-LASIK, LASEK is ideally used for people with corneas that are too thin or too flat for LASIK. It decreases the chance of complications that can occur when making the flap during LASIK when the cornea is not the ideal thickness.

In LASEK, the epithelium, or outer layer of the cornea, is removed using finer blade called a trephine instead of the microkeratome used in LASIK. The surgeon then covers the eye with an alcohol solution (perhaps one part alcohol and four parts sterile water) for around 30 seconds. The solution loosens the edges of the epithelium.

After removing the alcohol solution from the eye, the surgeon then lifts the edge of the epithelial flap and folds it back similar to LASIK. Then he or she uses an excimer laser to reshape the corneal tissue underneath. Afterward, the epithelial flap is placed back on the eye.

Then a bandage contact lens is put into the eye to allow the flap edges to heal. As in PRK the bandage contact lens is worn for about three days. You may feel eye irritation during the first day or two afterward. The vision will take a longer time to recover compared to LASIK, but will recover faster than PRK, usually about four to seven days.

The patient will need to use drops (topical steroid) drops for a few weeks after the treatment to control healing rate.

The vision results with LASEK are similar to LASIK, the time it takes to achieve full clarity is longer than LASIK.

What are the advantages of LASEK?
    Complication associated with flap done in LASIK are avoided
    LASEK caused less frequency of dry eye than LASIK
    Able to treat cornea that can’t be treated with LASIK due to being too thin or too flat
What are the disadvantages of LASEK?
    Longer healing time than LASIK
    LASEK causes more discomfort than LASIK


What to Expect During Your Procedure

LASIK has become the most common and successful refractive procedure in the world with recent studies showing that 90-94% of patients having the Custom/Wavefront procedure achieving 20/20 vision or better.

What makes LASIK so popular and success has to do with the quick visual recovery (most patients are able to drive the next day) and the lack of pain associated with the procedure.

The procedure is able to treat most patients who are nearsighted, farsighted, or have astigmatism.

BEFORE THE PROCEDURE

You will need to choose a LASIK surgeon and have a through evaluation to determine if you are a good candidate for the procedure.

As part of the LASIK evaluation you will fill out or answer questions related to any health problems you may have. Certain health issue can disqualify you from being a candidate for LASIK

During the evaluation the doctor will evaluate the health of both the outside portion of your eye (where the treatment will take place) as well as the inside of the eye (the retina) for possible problems by dilating you pupil. They will determine the correct amount of vision that needs to corrected by evaluation you prescription. They will also test you for glaucoma.

A corneal topographer will be used to map out the shape of the cornea. The topographer will show any shape irregularities that must be treated during the procedure

Once this is completed the doctor will usually go over the surgical informed consent form and then schedule the procedure.

THE LASIK PROCEDURE

The LASIK procedure is a painless. The procedure will take about 30 minutes and the laser itself will be on for less than a minute.

Before the procedure the doctor will use drops to anesthetize the eyes so you don’t feel the procedure.

IN THE LASER ROOM

You will be greeted by the laser engineer or technician who will direct you to the laser chair and give you some initial instruction.

The laser engineer will then calibrate the laser. During this calibration, you will hear the "sound" that the laser will make during the procedure.

During the procedure the laser engineer will stand near the laser and will be counting down to you and to your surgeon, "Ten more seconds, five more seconds," etc.

Your surgeon will sit behind you during the procedure.

During the procedure, the surgeon, laser engineer, and technicians will be working around your face and eyes, and they people will be talking to you and giving you instructions.

The surgeon will insert another set of drops.

THE PRE-LASER PROCEDURE

When your right eye is being treated, your left eye will be patched during, and vice versa.

An eyelid holder or lid speculum will be inserted around your eyelids to keep you from blinking. You may feel a slight awareness when it is inserted.

Your surgeon will ask you to stare at a red light in the laser machine. The surgeon's will activate the laser by pressing on a foot pedal. If for some reason you should look away from the red light, the surgeon will stop the procedure.

MICROKERATOME

The next step is to create a flap to lift the outside layer of the cornea using a microkeratome.

A vacuum ring will be placed on your eye which will keep your eyes from moving.

During this process, your vision will dim or even darken completely. You will then hear the gears of the microkeratome moving as the flap is created.

After the flap is created the microkeratome will be removed, and your vision will return.

The flap is then lifted by your surgeon, exposing the middle layer of your cornea which will be treated.

This process takes only about 10 seconds to complete.
THE LASER PROCEDURE

Your laser treatment is specifically designed by your surgeon based on measurements gathered at the pre-operative evaluation.

The laser will be applied to the cornea for about 10-45 seconds. This is determined by the calculation made by your surgeons prior to your procedure and entered into the laser. During this time you will stare at the red light in the laser.

When the laser treatment is finished, your surgeon will reposition the corneal flap on your eye and rinse it with liquid. You may feel the urge to blink from the liquid but the eyelid holder will keep you from blinking.

Your surgeon will them let the flap reattach to the surface of your eye. This will take about 30-60 seconds. During this time the surgeon and technician will remove the eyelid holder and any tape from your eyes.

Your surgeon will then ask you to blink a few times.

The surgeon will now repeat the procedure on your other eye. The eye that was just treated will have a patched placed over it.

After the entire LASIK procedure has been completed, your surgeon will have you sit up in the surgical chair and give you some information of what you might expect shortly after the procedure.
AFTER YOUR LASER PROCEDURE

Your vision most likely will not be clear for the first several hours. It should be significantly improved after the first night sleep.

You will likely experience a foreign body sensation awareness like having some in the eye (ie. eyelash) for the first few hours after the procedure. If you have some pain after the LASIK procedure you may choose to have Tylenol, Advil, Motrin, etc. if needed. Taking a nap after the procedure can help alleviate or miss some of the awareness or foreign body sensation.

It is common to experience light sensitivity, tearing and/or dry eye sensation, and fluctuating vision during the first few weeks after the procedure.

The next morning you will notice a big change in your vision. You will go to the office the day after the procedure so the surgeon can examine your eyes. Most patients are able to see 20/40 or better and may feel comfortable enough to drive the day after surgery.

After your follow-up exam with you surgeon the next day, you will be scheduling further post LASIK visits. It is important to attend all follow up visits.

Vision fluctuations and temporary dryness are common over the next few weeks after LASIK. If, at any point after your procedure, your vision noticeably worsens or becomes blurry, please call the surgeon's office.

GENERAL HYGIENE

Avoid getting anything in the eye for the first week after the procedure other than your eye drops. Do not use eye makeup for one week after the procedure. You can wash you face with soap and water, but avoid getting soapy water in your eyes. DO NOT RUB YOUR EYES!

EYE DROPS

You will be using eye drops four times a day or according to your doctor’s schedule for one week following the procedure. The drops may sting on instillation. You will also be given lubricating drops to use after the procedure to help with any temporary dry eye symptoms. Wash your hands before instilling drops and do not touch the dropper bottle to your eye(s).

PHYSICAL ACTIVITY

Avoid contact or racquet sports for one month following the procedure. No mountain climbing or scuba diving for at least one month after your procedure. It is recommended that you wear protective eye wear while playing contact or racquet sports to better protect your treated eyes. Avoid swimming, hot tubs, saunas or any other contact with possibly contaminated water for two weeks after surgery. You may resume jogging, weight lifting, or aerobics one day after the procedure, but do not increase your level of exercise for two weeks. DO NOT RUB YOUR EYES!


LASIK Risks and Complications

As with any surgery there are risks associated with LASIK, though most are not significantly vision threatening. Recent data has shown that the complication rate with LASIK is less than 1% and most of those patients can be corrected with a second treatment or an enhancement. Rarely do the complications cause significant or permanent vision loss producing less corrective vision than prior to the procedure.

Below are a list of potential complications with their resulting symptoms and treatment options.

OVERCORRECTION AND UNDERCORRECTION

Because every eye is different, every eye heals differently. The treatment plan for a patient is based on average healing responses. Patients who are either aggressive healers can results in undercorrection and those who are slow healers may experience an overcorrection.

In general, the higher the correction treated, the more likely to experience either and over or undercorrection. In most cases, both over and undercorrection can be treated with an enhancement or retreatment procedure. However, eyes with very thin or steep corneas or high degrees of refractive errors may not be eligible for enhancements. Therefore, patients should be sure to speak with their physicians about their potential eligibility for an enhancement. In those few cases where a retreatment is not an options glasses or contact lenses can be used to correct the over or undercorrection.

FLAP COMPLICATIONS

The first step in the LASIK procedure is the creation of a flap on cornea. This is usually performed with a surgical tool called a microkeratome. The microkeratome is placed on the surface of the cornea and is held in place with suction. A surgical blade within the instrument cuts the flap, leaving a small hinge to keep the flap partially attached to the rest of the cornea.

Flap complications can occur if suction is lost while the microkeratome blade is cutting or the instrument malfunctions in some manner.

Types of flap complications include:
  • Irregular or incomplete flaps
  • Flaps that are too small or too thin
  • Buttonholes (small holes or tears in the center of the flap)
  • Free caps (flaps without a hinge)
Research suggests the incidence of flap complications is 2 percent or less. In most cases, flap complications cause no permanent decrease in visual acuity. When a flap complication occurs, the surgeon will typically halt the LASIK procedure and re-position the flap. LASIK can then be re-scheduled a few months later after the flap has healed.

FLAP IRREGULARITIES

Small wrinkles called striae (pronounced stri’-e) can occur in the flap after LASIK surgery. Usually they do not interfere with a patient’s vision and not treatment is needed. However, sometimes the striae are serious enough to decrease visual acuity. In such instances, the surgeon might lift the flap, irrigate beneath it and lay it back down in the proper position. This is usually enough the correct the condition.

There are a number of causes of striae. They appear to be more common when LASIK is performed on eyes that are very nearsighted. Sometimes rubbing the eyelids before the flap has had a chance to bond can cause subtle wrinkles. Patients can reduce this risk by avoiding rubbing their eyes for several weeks after surgery.

GLARES AND HALOS

Glare and decreased contrast sensitivity are common side effect which occurs in the first few following LASIK. Usually these problems diminish with time. Glare is a dazzling sensation produced by relatively bright light, which causes discomfort and/or interferes with visual acuity. Glare is often reported as halos around lights (particularly vehicle headlights and tail-lights at night) and starbursts or streaks around streetlights. Pupil size affects the quality of vision after LASIK. Patients with large pupils may experience more glare halos than patients with smaller pupils. And since pupils dilate in dim lighting, LASIK patients may notice a reduced quality of vision in a darkened environment compared to well-lit surroundings.

DRY EYES

It is not uncommon for patients to experience some symptoms of dryness after their LASIK procedure during the first few weeks as part of the corneal healing process. Any patient who has a pre-existing dry eye condition needs to have that fully evaluated before their procedure. In some cases those patients with previous dry eye conditions become worse after their treatment.

Some of the possible symptoms a patient may experience include:
  • A sandy, gritty feeling to the eyes.
  • A foreign body sensation—the feeling that something is in your eye
  • A burning sensation
  • A "heavy" feeling to the eyes
  • Sensitivity to light
  • Occasionally, pain in the eyes
It’s believed that one reason dry eye symptoms occur after LASIK is because the creation of the corneal flap during the procedure severs some of the corneal nerves that provide feedback to the tear glands. This causes a decrease in the flow of tears to the eyes. As your eyes heal after LASIK, the corneal nerve endings regenerate, and the tear volume gradually returns to normal and the symptoms disappear.

Patients who have mild or moderate dry eyes prior to surgery may experience symptoms for several months or longer and may have their dry eye condition worsen. This is why some individuals with previous dry eyes may not be good candidates for LASIK surgery.

EPITHELIAL INGROWTH

Epithelial ingrowth is a LASIK complication in which cells from the surface of the cornea (epithelial cells) begin to grow underneath the flap.

Epithelial ingrowth appears to occur in less than one percent of LASIK procedures. However, the incidence of epithelial ingrowth appears to be higher after enhancement LASIK procedures. Most epithelial ingrowth is self-limiting and doesn’t affect visual acuity. In these cases, no treatment is required. But in less than 10 percent of cases, the epithelial cells will continue to grow and interfere with vision. In cases where vision is affected, doctors will sometimes prescribe drops to minimize the effects, when this is not sufficient the surgeon will lift the flap, remove the epithelial cells and treat the area under the flap to decrease the likelihood of a recurrence. A bandage contact lens may be placed on the eye for a few days to help the flap reattach securely.

Most cases of epithelial ingrowth appear 1 to 3 months after surgery. For this reason, it’s important for LASIK patients to return to their doctor’s office for follow-up exams for at least three months after LASIK.

DIFFUSE LAMELLAR KERATITIS (DLK)

Diffuse lamellar keratitis (DLK) is a unique and relatively rare post-operative condition following LASIK. This only occurs in appoximatey1% of cases. The causes of DLK are unknown. A number of names including Sands of the Sahara have been used to describe this condition. It occurs when accumulation of inflammatory cells develop under the flap. It usually occurs about one to three days after LASIK. In most cases patients most likely will not experience any symptoms related to the condition, and only with at doctors exam could this condition be detected.

When caught early, DLK is easy to treat. Patients should be aware, however, that while the majority of cases clear up within the first 24 to 48 hours, it could take several weeks until the condition completely subsides.

DLK is most often treated without any significant visual loss when it is detected and treated early. Therefore it is imperative that all patients maintain their surgeon's recommended post-operative follow-up examination schedule.

INFECTION

The risk of eye infections related to LASIK surgery is minimal. You will be given an antibiotic eye drop medicine to use for approximately one week after LASIK to prevent infection during the early stage of healing.


FAQ

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 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?

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 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.

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.

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 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.

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 amount to the LASIK pricing but may deliver the best vision quality.

Can you guarantee me 20/20 vision?

We cannot guarantee a certain result from the surgery, but we can accurately predict the probability of you achieving 20/20 vision. 95% of our patients with low or moderate ranges of myopia and/or astigmatism achieve normal or near normal natural vision from just one surgery. For those who do not achieve this quality of vision from one surgery, enhancement surgery can usually give the rest of the desired correction. There is no extra charge for necessary enhancement surgeries for a year at Nationwide Vision Laser and Eye Center.

Is this procedure permanent?

The laser procedure should last for the rest of your life. Medical experience shows that once the cornea has been modified, it tends to stay modified permanently. There are rare cases of regression, which may be corrected with further surgery, but the vast majority of corrected eyes continue to stay in focus. You may however, through the natural process of aging, develop a cataract late in life that will need cataract surgery. If this occurs your cataract surgery will be the same as in a person who did not have laser surgery.

What is laser vision correction?

It is a surgical procedure that uses a cool (non-thermal) beam of light to gently reshape the cornea — the surface of the eye — to improve vision. The laser removes microscopic bits of tissue to flatten the cornea (for nearsightedness), steepen the cornea (for farsightedness), and/or smooth out corneal irregularities (for astigmatism). The goal is to shape the cornea so it does a better job of focusing images onto the retina, for sharper vision. LASIK and PRK are two types of laser vision correction.

Are LASIK and PRK safe?

The FDA recognizes LASIK and PRK as proven, safe and effective. Laser vision correction uses a cool (non-thermal) beam of light that is computer controlled. The surgeon turns the laser on and is able to turn it off at any moment. There are many safeguards in place to reduce the risk of error. However, there are risks associated with any surgical procedure.

Although no one knows the exact number of complications, studies suggest that the incidence of minor difficulties such as dry eyes and nighttime glare is around 3% to 5%, while the risk of serious incidents such as lost vision is thought to be less than 1%. There are no known cases of blindness from LASIK or PRK.

What happens before laser eye surgery?

Your eyecare practitioner will give you a thorough eye exam to make sure your eyes are healthy and you're a suitable laser vision correction candidate. He or she will test for glaucoma, cataracts and other disqualifying conditions. He or she will also use a machine called a corneal topographer to photograph and electronically map your eye. The surgeon will use this map to plan your surgery for the most precise results possible.

What happens on the day of treatment?

LASIK and PRK are outpatient procedures which means you'll spend around an hour at the surgeon's office and walk out afterwards. Someone else should drive you home, since your vision might be a little blurry right after surgery.

You'll lie down in a reclining chair. The surgeon will place anesthetic drops in your eye, position your head under the laser and place an eyelid speculum (retainer) in your eye to hold the lids open.

In LASIK, the surgeon creates a thin flap in the top of the cornea, folds it back out of the way, uses the laser to remove some corneal tissue, then puts the flap back in place. If you're having PRK, the laser removes the outer layer of the cornea.

In both procedures, the pre-calculated amount of corneal tissue removed by the laser is microscopic — less than the thickness of a human hair.

What happens afterward?

The surgeon will place drops or ointment in your eye. You may relax for a little while, then go home and rest. You'll probably notice clearer vision immediately, and it may improve even more as the weeks go by.

Are there any side effects?

Some people experience dry eye, which usually is alleviated with drops and disappears over time. Others may experience starbursts or halos around lights, especially at night. Usually this effect lessens or disappears over time, too. In a small number of people (probably less than 1%), their vision worsens rather than improves.

How many checkups will I need after LASIK?

Depending on your surgeon, you will probably return the next day, then one week or one month later and then three months later. Your doctor will let you know if more visits are necessary after that.

For more information concerning our low LASIK pricing, call one of our LASIK Counselors at 1-877-305-2010.

We have made the LASIK pricing affordable so you can enjoy the benefit of LASIK.

Call us at
1-877-305-2010
to schedule your free initial consultation