Frequently asked questions about LASIK and other eye laser procedures.
What is LASIK?
LASIK (laser in situ keratomileusis) is an outpatient surgical procedure used to treat nearsightedness, farsightedness, and astigmatism.
A laser is used to reshape the cornea, the glass-like part in the front of the eye. This improves the way the eye focuses light rays onto the retina, at the back of the eye, allowing for better vision without glasses or contact lenses.
Do I need LASIK?
If you answer "yes" to one or more of the following questions, then LASIK may be the solution that you have been looking for.
What happens before LASIK?
Your doctor will perform a comprehensive eye exam. This is not a routine eye exam, but a comprehensive, two-hour exam that will investigate the overall health of your eyes and determine whether you are a good candidate for LASIK treatment. Measurements and tests include:
Current prescription evaluation
Pupil size in low light
Presence of cataracts, glaucoma or another disease
How is LASIK done?
During the LASIK procedure, an excimer laser is used to reshape the cornea. The laser application itself lasts about thirty to ninety seconds.
First, your eye is numbed with a few anesthetic drops.An eyelid holder, called a speculum, is placed to keep eyes open and to prevent you from blinking.
A suction ring placed on your eye lifts and flattens the cornea and prevents your eye from moving. You may feel pressure from the eyelid holder and suction ring, similar to a finger pressed firmly on your eyelid.
A corneal flap is then created using a microkeratome blade or a laser.
The corneal flap is lifted and folded back.The excimer laser, which has been preprogrammed with measurements specifically for your eye, is then centered above your eye. You will look at a special target light while the laser sculpts the exposed corneal tissue. After the laser has reshaped your cornea, the flap is smoothed back to its original position.
What happens after LASIK?
It is normal for your eye to have a burning sensation or feel “scratchy.” This usually disappears in a few hours or when your eyes are closed. Plan on taking a nap or relaxing with your eyes closed for about 4 hours after the procedure.
You will be given eye drops to help the eye heal and to alleviate dryness.
You should be able to resume regular daily activities the day after your treatment.
Am I suitable for LASIK?
The limits of laser vision correction are different for each eye since every eye has a unique shape and corneal structure. The main determinants of these limits are the thickness of the cornea and pupil size. Besides these, the model of the laser, the treatment ablation contour, age, sex, climate and many minor parameters influence the outcome. Generally, you may be suitable if your eyes are within the following parameters:
Who is not suitable?
Those who may not be eligible to have eye laser treatment are patients:
with uncontrolled vascular disease
with autoimmune disease
who are immune-compromised or on drugs and/or therapy which suppress the immune system
with signs of keratoconus (excessive steeping of the cornea)
possibly with a previous history of keloid formation
Is LASIK safe?
Serious complications after LASIK are rare, and vision loss is very rare. Some people have dry eyes after LASIK. Eye drops or other treatments usually help, but some people can have this problem for a long time.
Other problems that sometimes happen after LASIK are hazy vision, trouble seeing at night, and seeing halos or starburst patterns around lights. These problems usually go away within six months after surgery.
The flap on the surface of the eye can be reopened if you hit your head or fall. People at risk of this kind of injury (such as boxers, skydivers, and racquetball players) should talk with their doctor about other options for vision correction.
How 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).
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.
If I'm not eligible for LASIK operation, are there any other options available for me?
LASIK 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.
I 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 astigmatism through the reshaping of the cornea with the laser.
Do I need a second procedure for my astigmatism to be treated?
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).
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.
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 age.
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.
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.
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 better.
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?
In virtually all cases, both eyes are done at the same 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.