Laser Vision Correction is one of the most exciting procedures that we offer. Worldwide over two million Laser Vision Correction procedures have been performed, and last year in the United States there were nearly 900,000 procedures performed. For millions of people who are nearsighted, farsighted, and/or have astigmatism, Laser Vision Correction is a procedure which may eliminate or reduce the need to wear glasses or contact lenses.

Excimer Laser Vision Correction is a state-of-the-art technology in which a computer controlled cool laser reshapes the surface of the cornea. The Excimer Laser has been used since 1989 to treat nearsightedness. Lasik has been performed internationally for 10 years and clinical trials were begun in the United States in 1991. The FDA approved the excimer laser to treat nearsightedness in 1995.

The Procedure

The Excimer Laser is used to perform two types of vision correction procedures: PRK and LASIK.

Photorefractive Keratectomy can be used to treat low to moderate myopia. In this procedure, topical anesthesia is instilled. Then a lid speculum is placed in the eye to hold the lids open. The corneal epithelial layer is removed. At this point the patient fixates on a light and in less than 60 seconds, depending on the refraction, the Excimer Laser reshapes the surface of the cornea.

Custom Lasik is now an available option. The VISX Star S4™ Variable Spot Scanning™ Laser with ActiveTrak® utilizes the most advanced technology in vision correction surgery. In addition to corneal topography and thickness, a wave scan analysis is performed which will be used to individualize the laser treatment.

Expectations
It is important to have realistic expectations for the procedure. Not all patients undergoing Lasik will have perfect vision. Many will see 20/20 and a few will see even better than that after their initial procedure. The vast majority (90%) of low to moderate myopic patients will see well enough to legally drive. However, some may require corrective lenses to sharpen their vision for certain activities. Also, patients in their forties or older may have more difficulty with their near vision, as Lasik only corrects for distance vision. It does not reverse presbyopia nor eliminate the need for bifocals. One option, however, is monovision in which one eye is corrected for distance and the other is corrected for near. If this option seems appealing to you, you should discuss this with your ophthalmologist.

Risks and Complications  As with any surgical procedure there are risks. Every individual patient should weigh the potential benefits which Lasik can provide to the likelihood of experiencing a complication. Patients may develop corneal haze after the procedure. It is usually something the ophthalmologist sees after surgery and may or may not affect the patient's vision. Corneal haze usually resolves with time. However, some patients may describe glare or haze especially at night. This is somewhat related to the depth and size of the ablation, and may be more of a factor in younger patients whose pupils dilate more.

Intra-operative complications may also occur. These are usually related to the creation of the corneal flap with the keratome. The flap may be too thin or a completely free flap may be created. The occurrence of these complications is decreasing, especially with the current generation of keratomes that are used. The frequency of these complications in recent studies was less than 2%. In these instances, the flap is replaced to its natural position. It is allowed to heal for three months and the procedure can again be performed. As with any surgical procedure, there is a very small risk of a post-operative infection. There may be other postoperative complications; however, a recent study reported an overall postoperative complication rate of 2.6%.

Risks and Complications

Q How do I know if I am a candidate for Retractive Surgery?

A: You must have a complete eye exam by Doctor VanderLugt who will tell you if you are a candidate based on your eye health and refractive error.

Q Can I have both eyes operated on the same day?

A: With PRK you must wait about a month between eyes. However, Lasik is commonly performed on both eyes on the same day.

Q How long will the procedure take?

A: PRK will take about 10-15 minutes for one eye. Lasik, which can be done bilaterally, will take about 20-30 minutes for both eyes.

Q How soon after the procedure can I return to work?

A: It depends on your occupation, but PRK patients may wish to wait 4-5 days. Many Lasik patients choose to return in 1-2 days.

Q How soon after the procedure can I wear makeup?

A: You should wait a week before using eye makeup.

Q How long must I wait afterwards to play sports?

A: It depends somewhat on the activity, but generally we recommend about a week. We also strongly recommend wearing sports goggles for certain sports.

Q Do insurance companies pay for this procedure?

A: In the United States most insurance plans consider this an elective/cosmetic surgery and do not cover the procedure. Some vision insurance plans are working to add this as a benefit. In some cases you can use your medical flex plan and pay for it with pretax money. You should check with your insurance plan to see if your policy covers any portion of the procedure.