The purpose of laser eye surgery is to reduce or eliminate ones dependence on glasses or contacts through the surgical correction of visual acuity. The most commonly performed laser surgery procedure is known as LASIK. The acronym LASIK stands for Laser Assisted in-situ Keratomileusis. The procedure involves the use of a delicate laser to permanently shape the cornea of the eye. For the majority of patients, the surgery will improve vision and reduce the need for corrective eyewear.
In the 1980s a laser known as the excimer laser was developed by the military, and subsequently altered to remove corneal tissue. Work with the excimer laser lead to the development of PRK, or photo-refractive keratectomy. PRK is the immediate precursor to LASIK. The first LASIK procedure in the U.S. took place in 1991, and is now responsible for the majority of laser eye surgery performed. While a huge number of PRK procedures were successfully performed, there are slightly differences in technique which make LASIK the preferred procedure over PRK. LASIK is a slightly more complex procedure than PRK and requires greater surgical skills. However, LASIK holds the promise of correcting more severe problems and there is a generally faster recovery period. In most circumstances, patients are able to see well enough after laser assisted surgery to drive home without glasses.
Laser eye surgery may be performed to correct many common vision problems, such as myopia (nearsightedness), hyperopia (farsightedness), astigmatism (blurred vision resulting from corneal irregularities), or a combination thereof. While most patients with these vision problems will benefit from laser eye surgery, not all are candidates. There are a number of parameters and conditions that must first be met before a patient is considered for laser eye surgery. Patients desiring this procedure will first receive a thorough vision screening by their ophthamologist to determine their eligibility for the procedure. There are likewise a number of lifestyle factors which make one a bad risk for laser vision correction.
While laser eye surgery has received FDA approval, as with any surgical procedure there are clinical risks involved. It is very important for anyone considering laser eye surgery to thoroughly discuss any possible complications with their physician before committing to the procedure.
Another area which must be considered with corrective laser eye surgery is cost. Lasik is considered by most insurance companies to be an elective procedure and may not be covered by your medical insurance. While many eye surgery practices may offer a payment plan for lasik surgery, it is important that the patients choice in a physician not be made on the basis of cost alone.
Contact Lenses
Many who are not candidates for laser eye surgery opt for contact lenses for vision correction. Contact lenses can offer correction for most of the same vision problems that can be addressed through surgical procedures, while still maintaining the cosmetic appeal of not wearing glasses. Lenses can be made for correction of nearsightedness, myopia, and astigmatism. In the case of those considering monovision surgery for presbyopia, contacts will often be prescribed for a period of time prior to surgery, or may be a more viable therapeutic alternative to surgery.
Contacts lenses generally fall into three categories. Corrective,which are used primarily to improve vision; cosmetic, which are designed primarily to improve the appearance of the eye; and therapeutic, which are often prescribed for non refractive eye disorders.
The original contact lenses were made of glass. Modern contact lenses are made of either a soft or slightly rigid material with a great number of variations available on the market. Your eye care practitioner will be able to advise you of the best options and type of lens available for your eye condition.
Contact lenses, being a medical device, require an eye examination and a prescription from a qualified optometrist or opthamologist. Prior to 2004, contact lens wearers could only purchase contacts from their eyecare practitioner. Newer legislation gives consumer the right to a copy of their prescription, and they are now free to purchase contact lenses from optical chains or online venues. The ability to shop for your contact lens needs can result in considerable savings to the consumer.
Regardless of where purchased, it is still important to see your eye care practitioner for proper fitting and regular eye examinations.
Contacts lenses generally fall into three categories. Corrective,which are used primarily to improve vision; cosmetic, which are designed primarily to improve the appearance of the eye; and therapeutic, which are often prescribed for non refractive eye disorders.
The original contact lenses were made of glass. Modern contact lenses are made of either a soft or slightly rigid material with a great number of variations available on the market. Your eye care practitioner will be able to advise you of the best options and type of lens available for your eye condition.
Contact lenses, being a medical device, require an eye examination and a prescription from a qualified optometrist or opthamologist. Prior to 2004, contact lens wearers could only purchase contacts from their eyecare practitioner. Newer legislation gives consumer the right to a copy of their prescription, and they are now free to purchase contact lenses from optical chains or online venues. The ability to shop for your contact lens needs can result in considerable savings to the consumer.
Regardless of where purchased, it is still important to see your eye care practitioner for proper fitting and regular eye examinations.
Monovision
Around the age 40 for many the eye will gradually lose the ability to accommodate, or change focus from distance vision to close up. This condition is known as presbyopia, and is the reason many require reading glasses or bifocals. A technique called monovision can correct one eye (the dominant one) for distance vision, while (if necessary) correcting the other for intermediate or near vision.
The main goal of monovision is reducing the patients need for corrective eyeware for for reading and close up activities. The technique relies a bit upon the brain to filter out the image from the eye which is not in clear focus.
Needless to say, monovision is not for everyone. It takes awhile to become accustomed to it, and approximately 6-8 weeks for the brain to adjust to each being at a different focus. Monovision may result in the loss of some degree of depth perception, and in some cases can cause reduced peripheral focus. Those with very active lifestyles may find monovision is not the right answer for them.
The monovision technique is accomplished through either contact lenses or refractive laser eye surgery such as LASIK. Many physicians will recommend that patients first try the contact lenses and evaluate the results before opting for the more permanent laser eye surgery.
The main goal of monovision is reducing the patients need for corrective eyeware for for reading and close up activities. The technique relies a bit upon the brain to filter out the image from the eye which is not in clear focus.
Needless to say, monovision is not for everyone. It takes awhile to become accustomed to it, and approximately 6-8 weeks for the brain to adjust to each being at a different focus. Monovision may result in the loss of some degree of depth perception, and in some cases can cause reduced peripheral focus. Those with very active lifestyles may find monovision is not the right answer for them.
The monovision technique is accomplished through either contact lenses or refractive laser eye surgery such as LASIK. Many physicians will recommend that patients first try the contact lenses and evaluate the results before opting for the more permanent laser eye surgery.
Epi-LASIK
Epi-LASIK is a variation of the more traditional LASIK and LASEK laser eye surgery procedures that attempts to combine the advantages of both. The purpose in its development was to minimize flap complications, promote faster healing, and better treat patients with very thin corneas.
Epi-LASIK (epipolis laser in situ keratomileusis) is similar in many respects to LASEK, in which an ultra thin flap is cut into the epithelium (outer layer of the cornea). The flap is then floated from the eye with a solution of alcohol. In epi-LASIK, a specially designed instrument called an epikeratome is used to both cut an ultra thin flap from the cornea as well as separate it. No alcohol is used in Epi-LASIK surgery, and it is believed that not using the potentially toxic alcohol solution may help promote faster healing.
After the flap is gently moved out of the way, the cornea is reshaped with the excimer laser as in traditional LASIK surgery. When the laser treatment is complete, the flap is gently replaced with a spatula-like instrument. A thin soft bandage contact lens will then be worn for several days to promote healing and lessen any discomfort.
Epi-LASIK offers an advantage to patients with very thin corneas, and it is believed that the recovery and healing process may be somewhat faster with this technique. The procedure in not suited for every patient. Based on your consultation, your eye surgeon will make the recommendation of which type of laser surgery is appropriate for you.
Epi-LASIK (epipolis laser in situ keratomileusis) is similar in many respects to LASEK, in which an ultra thin flap is cut into the epithelium (outer layer of the cornea). The flap is then floated from the eye with a solution of alcohol. In epi-LASIK, a specially designed instrument called an epikeratome is used to both cut an ultra thin flap from the cornea as well as separate it. No alcohol is used in Epi-LASIK surgery, and it is believed that not using the potentially toxic alcohol solution may help promote faster healing.
After the flap is gently moved out of the way, the cornea is reshaped with the excimer laser as in traditional LASIK surgery. When the laser treatment is complete, the flap is gently replaced with a spatula-like instrument. A thin soft bandage contact lens will then be worn for several days to promote healing and lessen any discomfort.
Epi-LASIK offers an advantage to patients with very thin corneas, and it is believed that the recovery and healing process may be somewhat faster with this technique. The procedure in not suited for every patient. Based on your consultation, your eye surgeon will make the recommendation of which type of laser surgery is appropriate for you.
LASEK Eye Surgery
LASEK is a somewhat newer variation of laser eye surgery that combines techniques from the more popular LASIK and PRK procedures. The acronym LASEK stands for laser epithelial keratomileusis. Its use is primarily geared for patients whose corneas are too thin or too flat for the more conventional LASIK procedure.
As opposed to LASIK, in LASEK eye surgery the outer layer of the eye is not cut with the microkeratome cutting tool to produce a flap. Instead, after the eye is numbed with eyedrops, a diluted alcohol solution is applied that allows softening of the epithelial or outer surface of the cornea. It can then be peeled back, and the eye is reshaped with the excimer laser as in more traditional forms of laser eye surgery. After the surgery, the epithelial flap is placed back on the eye and usually a soft contact lens is then appled to protect and promote healing.
The LASEK procedure avoids any possible complications with making the flap utilized in LASIK surgery. The major disadvantages are that vision recovery and healing are somewhat slower than in LASIK, but generally faster than PRK.
While LASEK eye surgery is a good alternative for some patients, the procedure is fairly new, and is not for everybody. Your eye surgeon will be able to determine if your eye surgery may best be accomplished with LASEK, or with other laser treatment.
As opposed to LASIK, in LASEK eye surgery the outer layer of the eye is not cut with the microkeratome cutting tool to produce a flap. Instead, after the eye is numbed with eyedrops, a diluted alcohol solution is applied that allows softening of the epithelial or outer surface of the cornea. It can then be peeled back, and the eye is reshaped with the excimer laser as in more traditional forms of laser eye surgery. After the surgery, the epithelial flap is placed back on the eye and usually a soft contact lens is then appled to protect and promote healing.
The LASEK procedure avoids any possible complications with making the flap utilized in LASIK surgery. The major disadvantages are that vision recovery and healing are somewhat slower than in LASIK, but generally faster than PRK.
While LASEK eye surgery is a good alternative for some patients, the procedure is fairly new, and is not for everybody. Your eye surgeon will be able to determine if your eye surgery may best be accomplished with LASEK, or with other laser treatment.
Laser Eye Surgery Cost
Laser eye surgery, while not cosmetic in nature, is still regarded as an elective procedure, meaning the patient has chosen to have the procedure performed. Most insurance companies in the U.S. and Canada will not cover the cost of surgery. While cost should certainly not be the deciding factor in choosing a laser eye surgeon, it does however remain a factor in your decision.
Contact your medical insurance provider first for information regarding their coverage of costs. As a general rule, most will not provide coverage. However, it always pays to ask first rather than just assuming this is the case. Also check with your employee benefits administrator to see if your company has any arrangements with a given laser eye surgery center for a discounted price. Beyond that, credit cards and cash are accepted by virtually all lasik practices.
It is worth repeating to state again that it is never wise to choose a surgeon based on cost alone. Better you should find the best surgical care possible and if need be finance the cost of the procedure. Many of the larger LASIK centers such as LasikPlus will offer financing for Lasik through third party financing companies and frequently offer incentives such as free initial exams.
The actual cost of the procedure can vary greatly for a variety of reasons. Surgical practices in large metropolitan areas have a much greater overhead than those in smaller cities and thus must pass some of that cost on to their patients. Keep in mind that the surgical practice is also paying rent, employee salaries, and the cost of laser equipment and supplies. Another big factor in determining the cost is the condition of your eyes and the actual surgical procedure that must be performed. The more complex the laser eye surgery, the higher the cost. Custom LASIK which involves using special technology to map aberrations in the eye will generally cost more than traditional laser eye surgery. Some surgeons will add this as an additional charge while others will include it in a global package type fee.
So what is the average cost of Lasik surgery? Costs can and will vary considerably, however a ballpark average is about $2000 - $2500 per eye, depending upon where you have it done. Your surgeon should be able to give an exact figure for the cost of your laser eye surgery procedure after an initial assessment of your medical condition is made. The fee should cover your preoperative treatment, the actual procedure, and postoperative care.
Contact your medical insurance provider first for information regarding their coverage of costs. As a general rule, most will not provide coverage. However, it always pays to ask first rather than just assuming this is the case. Also check with your employee benefits administrator to see if your company has any arrangements with a given laser eye surgery center for a discounted price. Beyond that, credit cards and cash are accepted by virtually all lasik practices.
It is worth repeating to state again that it is never wise to choose a surgeon based on cost alone. Better you should find the best surgical care possible and if need be finance the cost of the procedure. Many of the larger LASIK centers such as LasikPlus will offer financing for Lasik through third party financing companies and frequently offer incentives such as free initial exams.
The actual cost of the procedure can vary greatly for a variety of reasons. Surgical practices in large metropolitan areas have a much greater overhead than those in smaller cities and thus must pass some of that cost on to their patients. Keep in mind that the surgical practice is also paying rent, employee salaries, and the cost of laser equipment and supplies. Another big factor in determining the cost is the condition of your eyes and the actual surgical procedure that must be performed. The more complex the laser eye surgery, the higher the cost. Custom LASIK which involves using special technology to map aberrations in the eye will generally cost more than traditional laser eye surgery. Some surgeons will add this as an additional charge while others will include it in a global package type fee.
So what is the average cost of Lasik surgery? Costs can and will vary considerably, however a ballpark average is about $2000 - $2500 per eye, depending upon where you have it done. Your surgeon should be able to give an exact figure for the cost of your laser eye surgery procedure after an initial assessment of your medical condition is made. The fee should cover your preoperative treatment, the actual procedure, and postoperative care.
Laser Eye Surgery Complications
The vast majority of patients who undergo laser eye surgery are quite pleased with the results of their surgery. However, as with any medical or surgical procedure, there is a certain degree of risk involved, and possible complications cannot be discounted. The risk of possible complications versus the benefits of laser eye surgery should be carefully weighed by the patient prior to committing to the procedure. A few of the possible complications are briefly addressed below:
- Under or over treatment. The possibility that you may require additional treatments or that you may still require glasses or contacts after your surgery. It is important to understand that only a certain percentage of patients will actually achieve 20/20 vision without glasses or contacts.
- Possibility of infection or delayed healing. There is a slight chance of corneal infection which is slightly higher with PRK than LASIK.
- Loss of vision. As a result of treatment some patients may lose lines of vision on the vision chart that cannot be corrected by any further surgical treatment or glasses.
- Debilitating visual symptoms. Some patients develop halos, glare, double vision, or difficulties seeing at night or in low contrast light.
- Severe dry eye syndrome. This can be uncomfortable condition as well as impair visual acuity. It may become a permanent condition, and can require the use of intensive eye drop therapy.
- Results of laser eye surgery may not always be as good as hoped in patients with large refractive errors. The possibility of requiring contacts or glasses even after laser eye surgery exists.
- Results may also diminish with age, particularly with patients who are farsighted (hyperopia)
Its is important to keep in mind that LASIK in particular is a relatively new eye laser surgery technology. Long term data regarding complications, risk, safety, and effectiveness simply do not exist. The possibility of complications should be discussed thoroughly with your surgeon during your initial consultation.
- Under or over treatment. The possibility that you may require additional treatments or that you may still require glasses or contacts after your surgery. It is important to understand that only a certain percentage of patients will actually achieve 20/20 vision without glasses or contacts.
- Possibility of infection or delayed healing. There is a slight chance of corneal infection which is slightly higher with PRK than LASIK.
- Loss of vision. As a result of treatment some patients may lose lines of vision on the vision chart that cannot be corrected by any further surgical treatment or glasses.
- Debilitating visual symptoms. Some patients develop halos, glare, double vision, or difficulties seeing at night or in low contrast light.
- Severe dry eye syndrome. This can be uncomfortable condition as well as impair visual acuity. It may become a permanent condition, and can require the use of intensive eye drop therapy.
- Results of laser eye surgery may not always be as good as hoped in patients with large refractive errors. The possibility of requiring contacts or glasses even after laser eye surgery exists.
- Results may also diminish with age, particularly with patients who are farsighted (hyperopia)
Its is important to keep in mind that LASIK in particular is a relatively new eye laser surgery technology. Long term data regarding complications, risk, safety, and effectiveness simply do not exist. The possibility of complications should be discussed thoroughly with your surgeon during your initial consultation.
Laser Eye Surgery LASIK vs. PRK
While LASIK is the most commonly performed laser eye surgery procedure, for a variety of reasons not all patients may be ideal candidates for this type of surgery. Photo Refractive Keratectomy , or PRK, may in some cases be the best option to correct for some patients whose corneal thickness and curvature will not allow them to have LASIK.
Prior to the introduction and subsequent popularity of LASIK, PRK was the most common refractive eye surgery procedure. Both LASIK and PRK share similarities in that the excimer laser is utilized to sculpt and reshape the cornea of the eye in accordance with the patients medical needs. Both techniques are used in the correction of nearsightedness, farsightedness, and astigmatism. There are, however, a few differences in the two procedures.
LASIK procedures require a small flap to be cut with a special tool on the exterior of the cornea. The computer controlled excimer laser then is used to reshape the corneal tissue under the flap. The flap is then replaced over the cornea. In PRK, the excimer laser is used to remove tissue and reshape the cornea directly on the surface, or epithelial layer, of the eye. A protective soft contact lens is placed over the eye for 3-5 days to allow the epithelial surface to heal.
A major difference in the two procedures is the recovery period, which is considerably shorter for LASIK than for PRK. Likewise, vision improvement with PRK is more of a gradual process than take from a few days to a few months, whereas LASIK patients tend to experience the benefits of their surgery in a much shorter time.
The end result for both procedures is an improvement in vision, and only a thorough examination and consultation with a qualified opthamologist can determine which is right for you.
Prior to the introduction and subsequent popularity of LASIK, PRK was the most common refractive eye surgery procedure. Both LASIK and PRK share similarities in that the excimer laser is utilized to sculpt and reshape the cornea of the eye in accordance with the patients medical needs. Both techniques are used in the correction of nearsightedness, farsightedness, and astigmatism. There are, however, a few differences in the two procedures.
LASIK procedures require a small flap to be cut with a special tool on the exterior of the cornea. The computer controlled excimer laser then is used to reshape the corneal tissue under the flap. The flap is then replaced over the cornea. In PRK, the excimer laser is used to remove tissue and reshape the cornea directly on the surface, or epithelial layer, of the eye. A protective soft contact lens is placed over the eye for 3-5 days to allow the epithelial surface to heal.
A major difference in the two procedures is the recovery period, which is considerably shorter for LASIK than for PRK. Likewise, vision improvement with PRK is more of a gradual process than take from a few days to a few months, whereas LASIK patients tend to experience the benefits of their surgery in a much shorter time.
The end result for both procedures is an improvement in vision, and only a thorough examination and consultation with a qualified opthamologist can determine which is right for you.
Laser Eye Surgery Procedure
Laser eye surgery is by far the most technologically advanced method available of restoring poor vision. LASIK, or Laser Assisted in-situ Keratomileusis is the most common laser eye surgery procedure performed, with thousands of successful procedures performed since its inception. Prior to actually being scheduled for laser eye surgery, your surgeon will perform a very comprehensive eye examination and will give you ample opportunity to ask questions and address concerns.
Your examination will include a glaucoma test, retina exam, and careful measurements of a number of areas of your eyes. Your surgeon will discuss the procedure with you and inform you of any possible risks or complications. You will then be asked to sign an informed consent form. Be sure you completely understand the form before signing. Your physician will also advise you of anything you need to do before the procedure, such as not wearing contacts or make-up for a period of time.
The LASIK procedure itself is an outpatient surgical procedure, which is usually performed in the physicians office or surgical center. The surface of the eye will be numbed with anesthetic eyedrops. In the procedure itself, a very thin flap is made to the outer layer of the eyeball with an instrument called a microkeratome. The flap is then moved out of the way .The excimer laser is then used to remove a very thin layer of tissue beneath the flap to reshape the cornea. The amount and intensity of laser energy required for correction of your specific problem is pre-programmed into the lasers computer. After the cornea is reshaped, the flap is placed back over the cornea where it will adhere to the eyeball. The entire surgical procedure should take an average ten to fifteen minutes to complete.
Healing after a laser eye surgery procedure is fairly rapid. There will likely be some blurry vision on the day of the surgery and you may experience a mild burning sensation for a few hours after the procedure. Your doctor may give you prescription eye drops to keep your eyes moist and prevent infection. A follow up visit will usually be scheduled within 24-48 hours after the procedure, and then at regular intervals for the first 6 months after surgery.
Your examination will include a glaucoma test, retina exam, and careful measurements of a number of areas of your eyes. Your surgeon will discuss the procedure with you and inform you of any possible risks or complications. You will then be asked to sign an informed consent form. Be sure you completely understand the form before signing. Your physician will also advise you of anything you need to do before the procedure, such as not wearing contacts or make-up for a period of time.
The LASIK procedure itself is an outpatient surgical procedure, which is usually performed in the physicians office or surgical center. The surface of the eye will be numbed with anesthetic eyedrops. In the procedure itself, a very thin flap is made to the outer layer of the eyeball with an instrument called a microkeratome. The flap is then moved out of the way .The excimer laser is then used to remove a very thin layer of tissue beneath the flap to reshape the cornea. The amount and intensity of laser energy required for correction of your specific problem is pre-programmed into the lasers computer. After the cornea is reshaped, the flap is placed back over the cornea where it will adhere to the eyeball. The entire surgical procedure should take an average ten to fifteen minutes to complete.
Healing after a laser eye surgery procedure is fairly rapid. There will likely be some blurry vision on the day of the surgery and you may experience a mild burning sensation for a few hours after the procedure. Your doctor may give you prescription eye drops to keep your eyes moist and prevent infection. A follow up visit will usually be scheduled within 24-48 hours after the procedure, and then at regular intervals for the first 6 months after surgery.
IntraLasik
Routine Lasik eye surgery generally involves two basic steps; creating a flap in the cornea, and reshaping the cornea with the excimer laser. In Lasik the corneal flap is traditionally cut with a mechanical microkeratome blade.
The primary difference in traditional Lasik and IntraLasik is in the method of cutting the corneal flap. IntraLasik (also know as "All Laser Lasik") utilizes a computer programmed femtosecond laser microkeratome as opposed to a mechanical microkeratome blade to create the corneal flap.
Utilizing IntraLasik software, the flap is cut with an infrared laser to an exact pre-programmed depth and position. The laser does not alter the corneal curvature, affect the prescription, or cause damage too surrounding tissue.
The obvious huge advantage to IntraLasik is the predictability and precision of the corneal flap cut. This translates into a much lower possibility of flap related complications such as corneal abrasion, thin flap, thick flap, partial flap, incorrect diameter, or buttonhole flaps. Some recent studies have also suggested that Intralasik provides better vision contrast sensitivity.
Minor possible disadvantages of IntraLasik include temporary eye redness, increased corneal edema, and photosensitivity. Al of these issues generally resolve during the healing period.
While IntraLasik is an option for most who are seeking laser eye corrective surgery, it may be a requirement for some individuals whose pre existing medical conditions require the greater precision offered with IntraLasik.
The primary difference in traditional Lasik and IntraLasik is in the method of cutting the corneal flap. IntraLasik (also know as "All Laser Lasik") utilizes a computer programmed femtosecond laser microkeratome as opposed to a mechanical microkeratome blade to create the corneal flap.
Utilizing IntraLasik software, the flap is cut with an infrared laser to an exact pre-programmed depth and position. The laser does not alter the corneal curvature, affect the prescription, or cause damage too surrounding tissue.
The obvious huge advantage to IntraLasik is the predictability and precision of the corneal flap cut. This translates into a much lower possibility of flap related complications such as corneal abrasion, thin flap, thick flap, partial flap, incorrect diameter, or buttonhole flaps. Some recent studies have also suggested that Intralasik provides better vision contrast sensitivity.
Minor possible disadvantages of IntraLasik include temporary eye redness, increased corneal edema, and photosensitivity. Al of these issues generally resolve during the healing period.
While IntraLasik is an option for most who are seeking laser eye corrective surgery, it may be a requirement for some individuals whose pre existing medical conditions require the greater precision offered with IntraLasik.
Laser Eye Surgery Candidates
LASIK eye surgery, while one of the most frequently performed voluntary surgical procedures today, is still not for everybody. There are a few indications for individuals that may preclude them from being a good candidate for laser eye surgery. Only after a thorough eye examination and consultation can you be absolutely sure your are a good candidate for laser eye surgery. Your surgeon will be the final word in you as a candidate. A few things that will be considered when determining if laser eye surgery is for you are:
- Your age. You must be at least 18 years old (21 for some lasers), The reason behind this is that the vision of people under the age of 18 is still changing.
- If you are pregnant or nursing. This may temporarily change the measured refraction of the eye.
- Good general health. Laser eye surgery may not be recommended for patients with diabetes, rheumatoid arthritis, lupus, glaucoma, herpes infections of the eye, or cataracts. Likewise, patients being treated with medications such as steroids or immuno-suppressants, which can prevent healing, or are suffering from auto-immune diseases that can slow healing.
- You should not be taking certain prescription drugs. (your surgeon will advise which during your consultation)
- Your eyes must be healthy and your prescription stable. Ideally there should not have been need for a prescription change within the past 2 years.
Another aspect to carefully consider is your overall expectation of laser eye surgery. Laser eye surgery, while having a relatively high degree of patient satisfaction, may not always result in perfect vision every time for every patient. Retreatment, or enhancement surgery is not unusual and may be necessary for months following the initial procedure. The possibility of complications is yet another factor that must be carefully considered. All of these factor should be thoroughly discussed with your physician during your consultation. This is known as the "informed consent" process.
Quite simply, you should not go into this without a full and realistic knowledge of what the outcome may be, and be comfortable with this knowledge. Carefully judge the risk versus the rewards. If you find that you are content with wearing glasses or contacts, you may want to forego laser eye surgery.
- Your age. You must be at least 18 years old (21 for some lasers), The reason behind this is that the vision of people under the age of 18 is still changing.
- If you are pregnant or nursing. This may temporarily change the measured refraction of the eye.
- Good general health. Laser eye surgery may not be recommended for patients with diabetes, rheumatoid arthritis, lupus, glaucoma, herpes infections of the eye, or cataracts. Likewise, patients being treated with medications such as steroids or immuno-suppressants, which can prevent healing, or are suffering from auto-immune diseases that can slow healing.
- You should not be taking certain prescription drugs. (your surgeon will advise which during your consultation)
- Your eyes must be healthy and your prescription stable. Ideally there should not have been need for a prescription change within the past 2 years.
Another aspect to carefully consider is your overall expectation of laser eye surgery. Laser eye surgery, while having a relatively high degree of patient satisfaction, may not always result in perfect vision every time for every patient. Retreatment, or enhancement surgery is not unusual and may be necessary for months following the initial procedure. The possibility of complications is yet another factor that must be carefully considered. All of these factor should be thoroughly discussed with your physician during your consultation. This is known as the "informed consent" process.
Quite simply, you should not go into this without a full and realistic knowledge of what the outcome may be, and be comfortable with this knowledge. Carefully judge the risk versus the rewards. If you find that you are content with wearing glasses or contacts, you may want to forego laser eye surgery.
Questions for Your Surgeon
Your vision is of extreme importance, and as such it is very important that are perfectly comfortable with the surgeon performing your laser eye surgery. Just as your surgeon will be asking you a number of questions to assess you as a candidate for laser eye surgery, you also should have the opportunity to ask any questions regarding your surgeons qualifications. Do not be afraid that any question is "too stupid" or might offend someone. Again, this is your vision, and you have every right to know the qualifications of the individual performing your surgery. Below are a few sample questions you may consider, (as well as a few suggested answers), during your consultation:
- In the past year (12 months) how many refractive surgeries have you performed? (250+)
- How long have you been practicing laser eye surgery? (3 years +)
- Are you certified by the American Board of Ophthalmology, American Board of Eye Surgery, and the Council for Refractive Surgery Quality Assurance? (ABO does not provide procedure specific certification, ABES has peer reviewed certification for LASIK and RK, and CRSQA is a non-profit group that evaluates doctors on actual patient outcomes)
- What will my vision be like for the first few weeks after surgery? (if your surgeon says "perfect" or anything of that nature, it may be time to head for the door). The reality is that its not unusual for minor fluctuations in your eyesight for months following your surgery. Your surgeon should be fully prepared to explain these to you.
- What is your percentage of successful malpractice claims? (This can be a tough one to ask. Most surgeons will have some either settled or pending litigation. Your interest is in the percentages - you are looking for not more than 1 in every 500 surgeries resulting in malpractice claims. If you are wary of asking, this information is usually available through an internet search)
- What percentage of your patients continue to experience complications six months after surgery? (A response of "very few', or "not many" may be cause fro alarm - look for specifics)
- What is involved in the post surgical care?
Also consider asking questions regarding your lifestyle after surgery. When will I be able to use the computer? Will this affect my participation in certain sports? Any concerns, no matter how seemingly trivial, should be addressed.
This page is a jumping of point to get you thinking about questions you might ask. A few days before your consultation with your surgeon write down your questions and concerns, and be sure and take them with you on your appointment.
- In the past year (12 months) how many refractive surgeries have you performed? (250+)
- How long have you been practicing laser eye surgery? (3 years +)
- Are you certified by the American Board of Ophthalmology, American Board of Eye Surgery, and the Council for Refractive Surgery Quality Assurance? (ABO does not provide procedure specific certification, ABES has peer reviewed certification for LASIK and RK, and CRSQA is a non-profit group that evaluates doctors on actual patient outcomes)
- What will my vision be like for the first few weeks after surgery? (if your surgeon says "perfect" or anything of that nature, it may be time to head for the door). The reality is that its not unusual for minor fluctuations in your eyesight for months following your surgery. Your surgeon should be fully prepared to explain these to you.
- What is your percentage of successful malpractice claims? (This can be a tough one to ask. Most surgeons will have some either settled or pending litigation. Your interest is in the percentages - you are looking for not more than 1 in every 500 surgeries resulting in malpractice claims. If you are wary of asking, this information is usually available through an internet search)
- What percentage of your patients continue to experience complications six months after surgery? (A response of "very few', or "not many" may be cause fro alarm - look for specifics)
- What is involved in the post surgical care?
Also consider asking questions regarding your lifestyle after surgery. When will I be able to use the computer? Will this affect my participation in certain sports? Any concerns, no matter how seemingly trivial, should be addressed.
This page is a jumping of point to get you thinking about questions you might ask. A few days before your consultation with your surgeon write down your questions and concerns, and be sure and take them with you on your appointment.
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