long has this technology been around?
Reshaping the cornea for the correction of refractive errors has been
known since the mid-1800s. But a practically beneficial operation goes
back to 1949. This old technique called keratophakia is similar to a permanent
contact lens. This procedure consists of taking away a layer of a donor
cornea, sculpting it and putting it on the patient's cornea to correct
it. It was done by stitches and from materials of donor corneas at that
time. In 1963 Barraquer invented a carpenter's plane-like device called
microkeratome. Then laserless LASIK-like operations have been performed.
The first working Excimer laser (which was created by Stuart Searles (IBM)
to etch circuits into computer chips without melting the silicon) was
available on earth in 1975. Later this laser was tested by the US military
on many materials even on the cornea. As far as we know, Trokel is the
first doctor to notice the potential of this new laser for the correction
of refractive errors and he began animal studies of Excimer laser in 1983.
But the honor to use it the first time on humans goes to Theo Seiler,
MD in April 1985. But routine PRK for myopia has started in 1987, and
turned to LASIK with stitches and free cap in 1989 by Buratto and today's
LASIK by Guimaraes in 1991. Interestingly LASIK's patent has been issued
to Gholam Payman in 1989 (patent application in 1985 from animal studies).
How do I know if I'm a candidate?
The ideal candidate is over 18 years of age with healthy eyes and stable
vision. LASIK treatment can correct a wide range of nearsightedness, farsightedness
Is there an upper age limit for laser eye surgery?
No! There is not an upper age limit but you should not have any cataracts.
I'm not eligible for LASIK operation, are there any other options available
operation is only one type of refractive surgery available to patients.
Although you may not be eligible for LASIK, you may be eligible for
a different procedure. You can discuss your options with our doctors.
have hyperopia. Can I benefit from LASIK treatment?
Yes. Hyperopia up to 6 diopters can be corrected with LASIK treatment.
If your prescription is higher than that you may have phakic intraocular
lens implantation or clear lens extraction.
If I have astigmatism, am I still a good candidate?
Yes, we are able to correct the astigmatism through reshaping of the
cornea with the laser.
Do I need a second procedure for my astigmatism to
No, astigmatism is also corrected during the course of the LASIK procedure.
If the astigmatism is extremely high, you might need a procedure called
astigmatic keratotomy (AK).
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I'm over 40 years old and use bifocals. Will I need
reading glasses after LASIK treatment?
As people add candles to their birthday cakes, at about the age of 40,
the natural autofocusing lens of the eye begins to lose its autofocus
capability. This is when reading glasses appear or nearsighted people
start lifting their glasses in order to see up close. When LASIK operation
removes a nearsighted person's nearsightedness, they will shortly if
not immediately see better in the distance for the first time and will
need help for seeing up close at some point after the age of 40, like
the rest of normal vision people over forty. The only exception to this
is "monovision," an unnatural condition where one eye is purposely
left slightly nearsighted. Some people can "switch eyes" according
to whether they are looking at distance or reading up close. Those who
can accomplish this task enjoy monovision and carry a pair of compensating
spectacles with them for times when they need both eyes working together.
If you are over 40, to know if you are a monovision candidate, we recommend
a contact lens trial of monovision to simulate the condition.
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What is monovision, and why might I want it?
People over the age of forty may need two separate prescriptions to
see clearly, one for the distance and a different one for reading. The
only options for Laser Vision Correction are to either correct both
eyes for good distance vision and wear reading glasses or to elect monovision
correction. In monovision correction, your dominant eye is corrected
for distance vision and your non dominant eye is corrected for reading
or intermediate vision. Monovision does not work for everyone, and it
is always best to try it with contact lenses before doing it surgically.
If it does work, it usually allows that person to function at most times
without glasses for most distances, although some patients will want
"night driving" glasses, "sewing glasses", and many
will eventually have to wear some reading glasses as they continue to
Can I have LASIK operation if I had a previous
corneal transplant or radial keratotomy?
With a skilled surgeon, as our surgeons at EyeSTAR, the answer is yes. Most reports
of LASIK after the corneal transplantation have been excellent. With
previous RK, LASIK treatment can give good results. However the procedure
may be complicated if the flap separates at the previous radial incisions.
I know that LASIK surgery will correct my refractive
error. Will it also treat my lazy eye?
Unfortunately, there is no definitive treatment for a lazy eye after
the age of 7-9 years. But to our experience, most of our patients with
lazy eyes have noticed an improvement in their vision and we have detected
gain of 2 or more lines at the visual acuity test.
Should I wait for refractive surgery to improve?
Refractive surgery is highly technologically driven. Just like in the
computer industry, there are constant advancements. The important question
is whether the technological advances translate into proportionate increases
in patient satisfaction. Because the level of patient satisfaction with
modern refractive surgery is already so high, there probably will not
be dramatic advances in the satisfaction for most patients. In many
cases, time spent waiting for the technological improvements also means
less time to potentially benefit from the refractive surgery. However,
a few patients should wait for more advanced technologies and we will
advise you whether you fall into this category.
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Does insurance cover LASIK operation?
LASIK treatment and other types of refractive surgery are considered
"cosmetic" by insurance companies and are usually not covered
by insurance at this time. However there are some exceptions and you
may call your individual insurance carrier directly if you have any
questions regarding your coverage.
How much does laser vision correction cost? Can
I afford it?
we would need to determine which procedure would work best for you.
When you think about the total cost of glasses, contact lenses, solutions,
etc., the advantages of laser vision correction are tremendous. As compared
with eyeglasses and contact lenses laser treatment 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.
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Are expensive places better?
In many instances, the more you pay the better quality care and service
you get. LASIK treatment is a professional service with variable quality.
Contrary to some advertising, it is not a product with consistency from
one place to another. Top surgeons and optometrists have professional
fees consummate with their expertise. Often, less-skilled doctors charge
less in order to attract more patients. However, this does not necessarily
mean the most expensive provider will always give you the best quality
care and service.
"Bargain basement" fees on LASIK sometimes do not include
medications, temporary prescription glasses, postoperative care after
3 months, enhancement procedures, the option to have one-eye done at
a time, and so on. Many of the discount centers work like assembly lines
where the patient-doctor relationships are minimal. Often, discount
centers do not allow you to choose your surgeon or the doctor that performs
your pre- and post-operative care. For most people, refractive surgery
isn't the most appropriate place to try to get a "good deal".
You can throw away and replace bad glasses or contact lenses, but you
can't do that with a bad refractive surgery. Look for quality, service,
I've seen other doctors advertise LASIK at discount
prices. Why should I choose EyeSTAR LASIK Institute?
With some practices, a lower price for LASIK treatment comes at the
expense of patient care or surgical experience. In other words, you
get what you pay for. Our surgeons select our LASIK patients carefully
and provide them with the best care possible, from initial consultation
to post-procedure visits. Our surgeons' standards for success are higher
than most LASIK surgeons: more than 99% of our patients see 20/20 or
20/25 following LASIK. The industry standard for success is 20/40 or
How important is the choice of a doctor?
Your choice of doctor is a crucial decision. Not all doctors will meet
with you more than 5 minutes before the surgery and be willing to answer
ALL of your questions. This time is necessary to communicate the visual
goals of each patient and to establish trust and comfort. Since LASIK
operation is a corneal procedure, a cornea specialist is a smart choice.
Our surgeons are highly skilled and experienced cornea specialists.
Can both eyes be done at the same time?
virtually all cases, both eyes are done at the same time. But you may
elect to have one eye done at a time.
What kind of anesthesia is used during the treatment?
Numbing eye drops are used. Sometimes an oral medication is used to
help with relaxation. No needles or intravenous drugs are used.
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Can I see the 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 treatment. You will see a number of
lights, but the images will be blurred.
if I move my eye during treatment? What if I don't keep looking at the
to surgeon control, an extremely advanced eye tracker on our laser monitors
eye movements and compensates faster than the eye can move. This safety
feature is not present on all lasers. With any large deviations, the
surgeon or the eye tracker will simply stop the laser ablation and restart
the process when the eye is perfectly aligned. The laser is designed
to pick up where it left off. Although eye movement is a concern of
many patients, those who have experienced the LASIK laser vision correction
procedure rarely note a problem maintaining fixation throughout the
short laser ablation.
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What if I blink?
A small retaining device will be used to keep your lids open and prevent
blinking. There is no way you will be able to blink and hurt yourself
or your visual outcome.
Is the LASIK procedure painful?
Patients experience virtually no discomfort during the LASIK procedure.
No needles are used, as eye drop anesthesia is instilled directly onto
the eye prior to the procedure. EyeSTAR results indicate that,
post-procedure, we have never had a patient request pain medication.
Our patients tell us that they are so well prepared by our clinic's
staff before the procedure that any fear, anxiety and concerns were
gone! A mild sedative pill taken just before surgery soothes away any
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long will the LASIK procedure take?
operation takes about 4 to 5 minutes for an eye. The actual laser ablation
time is in terms of seconds.
my eyes be patched?
Your eyes will not be patched after the LASIK operation. You will wear
eye shields at bedtime for the first night after the procedure for protection.
Is there any pain after the LASIK procedure?
Most of our patients experience no pain or discomfort after the procedure.
Some have a little watering of the eyes and mild burning sensation.
One may have a mild to moderate foreign body sensation for a few hours
following surgery, but after about 3-4 hours, the eye normally feels
comfortable. Most people feel fine if they can take a nap soon after
soon after surgery will I see well?
Each patient is different. The eye drop medications cause some blurring,
also there is extra water within the cornea after the LASIK treatment,
but most patients notice a dramatic improvement even as they leave the
Will my eyes look different after LASIK operation?
No. Your eyes will look exactly the same.
What happens after the procedure ?
After your procedure, you will be encouraged to go home or to your hotel
and take a nap. You will wear sunglasses home. Avoid reading and watching
TV. If you rest for 1-2 hours at home after your LASIK laser vision
correction procedure, you will notice an immediate change in your vision.
Following surgery, for the first night, you will be asked to wear a
patch over your eyes at bedtime; so you don't inadvertently rub your
eyes while sleeping. You will be asked to use prescription eye drops
and artificial tears for several days, and will be encouraged to avoid
rubbing your eyes. Women are instructed not to wear mascara for two
days, ideally one week. LASIK patients should avoid water sports for
two weeks following the procedure to permit healing. You will be asked
to return for a check-up by your doctor the day after surgery. At that
visit, your doctor will check your vision, and monitor how your eyes
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Do I need to use eye drops after the procedure?
will use medicated eye drops for 1 week after your treatment, and artificial
tears are recommended up to 1 month.
What are the restrictions after Laser Vision Correction?
No swimming for at least 3 days, ideally 2 weeks and no knuckle-rubbing
eye rub for two weeks. As always, avoid getting soap or water directly
into your eyes. Obviously, after Laser Vision Correction you will be
on an antibiotic and soothing drops for one week. Showering with water
in the face, shampooing hair, eyes closed is fine. Eye make up in 2
days but, preferably, a week. Common sense things.
Otherwise, enjoy your new vision to the max!
can I drive after the LASIK treatment?
should not drive the day of the treatment. After that, you may drive
when you feel confident that your visual acuity and eye comfort allow
you to drive safely. Almost all of our patients are able to drive the
next day. They achieve a vision equal or better than driving license
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How soon can I use eye makeup?
You may resume wearing eye makeup starting 2 days, preferably a week
after your treatment. We strongly recommend that you purchase new eye
makeup, specifically mascara, to avoid potential infection following
How soon after the treatment can I exercise?
Non-contact sports can be resumed as soon as you feel capable. Eye protection
is recommended for racquet sports or rough sports where there is a risk
of being hit in the eye.
soon can I swim?
You should stay out of swimming pools for at least 3 days, ideally 2
weeks after your treatment, and rivers, lakes, hot tubs, sea and oceans
for one month following your treatment.
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can I go back to work?
Most of our patients have good enough vision and are comfortable enough
to return to work and drive the next day. An additional day or two is
rarely required before returning to work. Healing can vary however from
person to person so it is a good idea to maintain some flexibility in
your work schedule immediately after your LASIK procedure. If you can,
we recommend that you take it easy for a couple of days.
Will I need glasses or contact lenses after the
The goal of refractive surgery is to reduce your dependence on glasses
and/or contact lenses, but seldom LASIK patients may benefit from reading
glasses or distance glasses when they desire perfect near or distance
long will it take before I can see well, and how long will it take before
I have my best vision?
visual recovery characterizes this operation. Most patients achieve
good vision the day of surgery and find that their eyes feel fairly
normal within a day. Right after the procedure you see as if looking
behind water. In about 4 hours the vision will be clearer. While your
eyes are healing, it is normal for your vision to go back and forth
between clear and blurry phases for several weeks. However, vision can
continue to improve, and best vision can still take two to three months
to occur, particularly with higher prescriptions. If necessary, adjustments
to the surgery called enhancements can be done. Patients who undergo
hyperopic LASIK often need to wait longer to able to see clearly. Typically,
they are unable to see with intense clarity for one or two weeks, with
best vision coming in several months post-operatively.
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Will I see 20/20 after my procedure?
Your corrected vision following LASIK operation depends on the strength
of your prescription as well as other individual factors. As with any
surgical procedure the results are not guaranteed. However, all of our
patients without any preexisting eye disease such as lazy eye, retinal
diseases etc. see 20/40 or better (enough to pass a driver's exam) without
correction. More than 99% of our patients achieve 20/20 or 20/25 vision.
Approximately 0.5% of our patients require an enhancement to achieve
results can I expect from LASIK?
Numerous studies have been published about the subject. Even the most
pessimistic studies state that at least 90% of all the LASIK patients
achieve a vision equal or better than driving license requirements.
All of our existing LASIK patients (without any preexisting eye disease
such as lazy eye, retinal diseases etc.) see far better than these requirements.
Is the effect of LASIK treatment permanent?
Yes. Following an initial healing period of three to six months, the
effect of the treatment is life-long. Rarely, a minimal regression might
my vision be corrected forever?
People often ask how long the benefits of their procedure will last.
The first nearsighted patient's eye ever treated with laser vision correction
was in the United States in 1987. That patient achieved 20/20 vision
following treatment and is still 20/20 more than a decade later. Today,
most experts around the world are confident that they will discover
no long-term problems with laser vision correction. Based on the excellent
results seen to date, laser vision correction has become the most commonly
performed refractive procedure in the world.
hear that some nearsightedness comes back after awhile? Is that correct?
People with high prescriptions who had PRK, the older laser treatment
method might experience regression after the procedure. With LASIK treatment,
this does not happen after the eye stabilizes, i.e. after 6 months.
EyeSTAR surgeons take this initial regression into consideration when
they enter the data to the laser's computer so that our patients have an
I am still nearsighted after the procedure, can I be treated again?
is possible to have an enhancement after the initial procedure if the
doctor deems it necessary and beneficial to the patient. Should an enhancement
be necessary, it will be performed at no charge to the patient after
six months following the procedure. Sometimes for very high prescriptions
our surgeons purposefully divide the treatment into two sessions. Our
retreatment rate is extremely low, approximately 0.5% compared to other
internationally famous centers which usually range from 3% to 33%.
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Is there a guarantee that I will not have to wear
glasses or contact lenses again?
There are no guarantees in any part of medicine. We can give outcome
percentages, rather good or bad, but as a rule, people under 7 diopters
of myopia who have LASIK will have a 99% chance of success and will
have less than a 0.5% probability for enhancement.
What happens if I don't achieve my full correction?
Although the vast majority of our patients will achieve excellent vision
without glasses or contacts, a few will have a small residual refractive
error, leaving them still slightly nearsighted or farsighted. Most of
these patients can see fine for most of their daily activities, and
use a thin pair of glasses for such tasks as nighttime driving. If you
like this residual refractive error corrected, an enhancement laser
procedure can be performed after six months. The enhancement rate in our
practice is 0.5%. Our doctors will weigh the probable benefits,
patient expectations, and potential risks when determining whether an
enhancement is appropriate.
Typically, patients considered for an enhancement procedure should have
at least 1.00 diopter of residual hyperopia, myopia or astigmatism or
unaided vision of 20/40 or worse. Enhancement procedures should only
be performed once adequate corneal healing and stability is achieved.
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If I don't get full correction, can I be retreated?
Correction may be fine-tuned with retreatment, known as enhancement,
and is generally performed after the first six months. With an enhancement,
the flap is simply lifted back to allow the laser beam to remove a little
more tissue. Then the flap is gently smoothed back into place again.
Although retreatment may further improve your ability to see, perfect
vision is still impossible to guarantee.
Will I pay for the retreatment?
At EyeSTAR LASIK Institute, any re-treatments necessary will be 'free'
for five years following the initial treatment.
If I have LASIK and my vision changes later in
life, can it be redone?
on the cause, retreatment may be 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.
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necessary, can I wear contact lenses after LASIK?
These procedures do not modify the cornea in a way that would prevent
contact lens wear. However, many patients elect to have refractive surgery
because they were unable to wear contact lenses. In this case, you can
expect to have problems after the surgery just like you did before it.
If you didn't have problems with contact lenses before, you can wear
contact lenses including cosmetic contacts if you wish to.
I have cataract surgery or any other eye surgeries in the future?
you can. If you had LASIK operation before, there are some differences
in the calculation of intraocular lens power. Your surgeon should take
that into consideration before your cataract operation, phacoemulsification
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What outcome can I expect after surgery?
Although no results can be guaranteed, our goal is to correct you to
between 20/10 (more than 20/20) and 20/40 (legal driving vision) without
glasses or contacts. At EyeSTAR LASIK Institute, we are meticulous in
tracking our outcomes and analyzing them statistically. This attention
to detail allows us to create reproducible, excellent outcomes. Our
patients are very happy. Because people heal differently, outcomes can
vary so it is important that your expectations are reasonable, and this
will be discussed with
you during your consultation. If you are over 40 years old, you may
need to wear reading glasses afterwards, as presbyopia naturally occurs
in this age group or you may choose to have monovision.
In general, how are the LASIK results?
It changes from center to center. In general, 95% of LASIK patients
achieve 20/40 vision or better and 85% achieve 20/20 or 20/25 vision.
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How are your LASIK results?
Our results are far better than this. EyeSTAR's results are significantly
better than the industry average: more than 99% of EyeSTAR's patients
achieve 20/20 or 20/25 vision. In the US, the industry average is that
95% of LASIK patients achieve 20/40 vision or better. EyeSTAR's outcomes are exceptional because of
our dedication, experience and attention
to detail. EyeSTAR LASIK Institute Istanbul is dedicated to
the perfection of laser vision correction.
I go blind?
has ever gone blind from this procedure to our knowledge.
How safe is laser treatment?
safety of LASIK operation is one of the main reasons it has become so
popular. Severe complications are extremely rare. The complication rate
and the infection rate from LASIK are much less than those with contact
The laser has been in widespread use for the treatment of myopia (nearsightedness)
and astigmatism over 15 years. Millions of successful procedures have
been performed around the world.
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performed by the proper surgeon, LASIK treatments are extremely safe.
Although no procedure is without risks, these risks are minimal. The
complication rate is much lower when the treatment is performed
by corneal specialists who are very experienced in LASIK, as our
surgeons are. Here is what
the TIME magazine (November 1,1999) has stated: "Estimates of post-LASIK
complication rates range from less than 1% of patients of corneal specialists
to as high as 5% of patients of less experienced ophthalmologists".
When you are interviewing doctors and you ask about their complication
rates and you hear the answer "none", walk away. Quoting Dr.
Machat: "If doctors say they have never had a complication, they
either don't do surgery or they are lying."
In order to decrease the risk of complication, we at the EyeSTAR LASIK
Institute, Istanbul, Turkey take many steps that go far beyond the minimum
standards of most laser centers. Our laser is calibrated before every
single procedure to ensure the most accurate results, whereas many laser
centers only calibrate the laser every six patients, or even just once
per day. We monitor and control the temperature and humidity in our
laser room strictly, which improves the accuracy of our results.
Reputable centers like ours use one microkeratome blade per patient
to avoid infection and potential flap complications from a damaged or
progressively dulled blade. The risk of both problems increases significantly
the more times the blade is used. Low-cost providers usually cut costs
by using blades multiple times. Some centers don't even sterilize them
between patients. At such discount centers, there is even the risk of
contagious diseases such as hepatitis or AIDS.
One of the more important steps to avoid complication is in the rigorous
testing of our patients. After the brief initial screening exam and
prior to undergoing a procedure, we will perform a most thorough evaluation;
some important measurements will be performed two or more times, and
will be further repeated if necessary.
At the EyeSTAR LASIK Institute, we will only perform LASIK operation
on you if we believe that we can obtain a very good result.
By far the most common complication is under-correction or over-correction.
In the case of an under-correction or over-correction, the vision will
be dramatically better, but a small amount of focusing error still remains.
Further laser treatment, known as an "enhancement" or a "touch-up",
can then be used to improve the vision further by decreasing the remaining
nearsightedness, farsightedness, or astigmatism. There is no additional
fee for "enhancement" procedures, which are performed on only
0.5% of our patients.
Some excimer laser patients will experience optical aberrations during
the initial healing phases, including glare, halos at night, or ghost
images. This will disappear within several weeks. Careful attention
to detail in centration and calibration of the laser, as well as measurement
of pupil size, substantially lessens the incidence of optical aberrations.
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are the most common side effects?
The most common side effects of LASIK operation are: fluctuating vision
(which only lasts for the first few weeks), night glare (which typically
lasts for the first few weeks), and dry eye (which only lasts for the
first few weeks).
What are the risks involved with LASIK?
risks include ablation and flap problems. Ablation problems are usually
correctable with the newer laser nomograms. Flap problems have traditionally
been the most common type of problems experienced with LASIK surgery.
The latest generation of microkeratomes has reduced this risk significantly.
The Hansatome which we use, developed by Chiron Vision and the Moria
M2 have been shown in recent studies to be the safest available microkeratomes.
Serious complications, though rare, include induced astigmatism, scarring,
and infection. Most complications can be corrected through eye drops
or a repeat procedure.
What is the most feared risk associated with LASIK?
most feared risk following LASIK treatment is infection which we prevent
using antibiotic eye drops for a few days. The risk of infection with
contact lenses is 20 times more than that of LASIK. None of our patients
have had any infections.
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there any long term risks?
No! Over the first 15 years that this laser has been performed, there
have been no progressive or long term changes that would lead one to
believe that there would be any changes in the next 10 or 20 years.
I become nearsighted again?
The treatment changes the corneal shape. If your prescription is stable
before the laser, it should remain so after the treatment. There may
be some regression within the first 6 months after LASIK. This is taken
into consideration when we enter your data to the laser's computer.
If there is a small residual refractive error and if you would like
this residual refractive error corrected, an enhancement laser procedure
can be performed after six months. The enhancement rate in our practice
is 0.5%. Our surgeons will weigh the probable benefits, patient expectations,
and potential risks when determining whether an enhancement is appropriate.
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Would an eye surgeon ever have this performed?
In fact many already have! For example, Dr. Stephen Brint, who was the
first to perform LASIK in the United States had LASIK treatment himself
in 1997. Studies show that the more doctors, especially eye doctors,
know about laser vision correction, the more likely they are to have
it performed on themselves. More than half of the high-volume refractive
surgeons who once depended on corrective lenses have had vision correction
surgery after seeing the great results they achieved for their patients
day in and day out.
LASIK is also a procedure that most would recommend to their spouses
or friends. This is the best indication of what eye specialists feel
about the procedure. Our surgeons have performed the procedure on
family and other doctor friends.
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Are all excimer lasers the same?
Absolutely not! EyeSTAR uses the best and most advanced lasers.
Other cheaper lasers, which are commonly used by discount laser centers,
are much less expensive to purchase and use, but do not produce the
same level of vision. Also, the maintenance and calibration of the laser
are very important in obtaining the optimal treatment result (we calibrate
the laser before every treatment -- many centers only calibrate the
laser between every 4 treatments, or even just once each day).
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