The doctors at Berks Family Eyecare have extensive experience in the pre-operative evaluation and post-operative care of LASIK and other vision correction procedures.
We will evaluate your eyes and discuss your visual goals to help determine if you are an appropriate candidate for LASIK, PRK or Cataract Refractive Technology. If you have appropriate goals and there are no contraindications for the procedure, we will recommend a pre-operative evaluation to determine suitability for refractive surgery. This evaluation includes:
- Counseling on refractive surgery options
- Eye dominancy testing
- Review of eye history and refractive stability
- Medical evaluation of the cornea and eye
- Current Refraction Status
If after the pre-operative evaluation, the decision is made to proceed with surgery, your information will be forwarded to the surgeon, a pre-surgery consult with a surgeon will be scheduled. Post-operative management will be provided by our doctors, and includes multiple visits over a period from the date of surgery to include medical evaluation and management of the vision and corneal healing. Evaluation of any additional needs such as reading glasses, sunglasses, or enhancement laser procedures is also included.
LASIK is currently the most popular vision-correcting or “refractive” surgery available. But there are other options as well. We will help you find the ideal solution for your problem and partner with the best surgeon to perform your procedure.
Introduction to LASIK
LASIK is the most commonly performed refractive surgery procedure. You may hear people calling it “LASIX,” but the correct name is LASIK, which is short for “laser-assisted in situ keratomileusis.”
Why is it so popular? LASIK has advantages over other vision correction procedures, including a relative lack of pain afterward and the fact that good vision usually is achieved by the very next day.
An instrument called a microkeratome is used in LASIK eye surgery to create a thin, circular flap in the cornea. Another, newer way of making the flap is with a laser.
The surgeon folds the hinged flap back out of the way, then removes some corneal tissue underneath using an excimer laser. The excimer laser uses a cool ultraviolet light beam to precisely remove (“ablate”) very tiny bits of tissue from the cornea to reshape it.
When the cornea is reshaped in the right way, it works better to focus light into the eye and onto the retina, providing clearer vision than before. The flap is then laid back in place, covering the area where the corneal tissue was removed.
Both nearsighted and farsighted people can benefit from the LASIK procedure. With nearsighted people, the goal is to flatten the too-steep cornea; with farsighted people, a steeper cornea is desired. Excimer lasers also can correct astigmatism by smoothing an irregular cornea into a more normal shape.
LASIK, short for laser-assisted in situ keratomileusis, is the most popular refractive surgery available today. Each year, more than one million LASIK procedures are performed in the United States.
LASIK has become the premier surgery for vision correction because it’s quick and painless, there is little or no discomfort after the procedure and vision recovery is rapid – some patients already see 20/20 the following day.
LASIK can correct nearsightedness, farsightedness and astigmatism. With a special technique called monovision, it can also reduce the need for reading glasses among patients over age 40 who wear bifocals.
Am I a good candidate for LASIK?
To be a good candidate for LASIK, you should be at least 18 years old, have healthy eyes, and have adequate corneal thickness since LASIK corrects your vision by removing tissue from your cornea to reshape your eye.
Chronic dry eye problems, corneal diseases and other abnormalities may disqualify you from having LASIK surgery. In order to know for sure if you are a good candidate, a comprehensive eye exam is required. For your convenience, we are happy to provide LASIK pre-operative exams and consultations at our office. Call us for details.
Important considerations when deciding whether or not to have LASIK are your expectations and your ability to accept a less-than-perfect outcome. LASIK can reduce your dependence on glasses and almost always gives you the ability to function well without the need for glasses or contact lenses. But there are no guarantees, and LASIK doesn’t always create perfect vision. In some cases, your vision after LASIK may be permanently less clear than it was with glasses before the procedure. You have to ask yourself if you’re willing to accept the risk of such an outcome before you decide to have LASIK surgery.
Remember: LASIK is an elective procedure, not a required one.
The LASIK procedure
LASIK is an ambulatory procedure. You walk in the surgery center, have the procedure and walk out again. The actual surgery usually takes less than 15 minutes for both eyes, but expect to be at the surgery center for an hour or more.
LASIK is a two-step procedure. In the first step, the surgeon creates a thin, hinged flap of tissue on your cornea with an instrument called a microkeratome or with a laser. This flap is folded back and the second step – the laser reshaping of your eye – begins. After the laser treatment, which usually takes less than a minute, the flap is repositioned and the surgeon moves on to your other eye.
What is wavefront LASIK?
Wavefront LASIK (also called wavefront-assisted, wavefront-guided or custom LASIK) means the laser treatment (or “ablation”) is determined by a computerized mapping of the power of your eye called wavefront analysis. Wavefront-guided procedures are more precise than ablations determined by using only an eyeglasses prescription, and they can correct subtle optical imperfections of the eye called “higher-order aberrations” that regular ablations can’t treat. Several studies show wavefront-guided ablations provide sharper vision than conventional, non-wavefront LASIK and may reduce the risk of nighttime glare and halos.
After LASIK surgery
After the procedure, your surgeon or an assistant will apply medicated eye drops and clear protective shields over your eyes. You can open your eyes and see well enough to walk without glasses, but you must have someone drive you home.
You will be expected to use medicated eye drops several times a day for a week or so to protect your eyes from infection and help them heal properly. You will also be told to use artificial tears frequently to keep your eyes moist and comfortable.
You should rest and not use your eyes much when you get home from surgery that day. You may also be more comfortable if the lights in your house are dimmed.
The following day, you should be seeing well enough to drive and can resume most activities. Be careful, however, not to rub your eyes until your eye doctor tells you it is safe to do so.
Usually, you will be asked to return to the surgery center the following day so your surgeon or another eye doctor at the center can check your vision and make sure your eyes appear as they should. At this visit, you typically will be given additional instructions about using eye drops and artificial tears, and you will be able to ask the doctor any questions you have.
From this point forward (and sometimes for this “day one” visit as well), your post-operative care may be performed by an eye doctor other than your LASIK surgeon. When your post-operative care is provided by a doctor other than your surgeon or another doctor at the surgery center, it’s called co-management. We are happy to provide post-operative care for you at our office through a co-management agreement with your surgeon. Call our office for details.
What if my vision is still blurry after LASIK?
Though most patients see quite clearly in a matter of days after LASIK, it can take several months before your eyes are completely stable. Until then, improvements in your vision can still occur. But if several months pass and your vision is still blurred, see your LASIK surgeon. Usually a second LASIK surgery (called an enhancement) can sharpen your eyesight further.
If for some reason an enhancement is not indicated or desired, eyeglasses or contact lenses may help. We will be happy to examine your eyes and discuss the different options with you.
Eyewear after LASIK
Keep in mind that, even if your vision seems perfect after LASIK, you still need eyewear.
When outdoors, it’s important to protect your eyes from the sun’s harmful rays with sunglasses that provide 100% UV protection. If you play sports when wearing sunglasses, make sure the lenses have polycarbonate lenses for extra protection. And any time you’re working with power tools or doing anything else when an eye injury is possible, you should wear safety glasses with polycarbonate lenses.
If you’re over 40 (or soon will be), it’s likely you’ll need reading glasses after LASIK. Also, many LASIK patients can benefit from a pair of prescription eyeglasses for night driving. Though these lenses may have only a mild prescription, they often can make your vision sharper for added safety and comfort.
Eye care after LASIK
And don’t forget to continue to have routine eye exams after LASIK. Even if your vision is perfect, you still need to have your eyes checked for glaucoma and other potential problems on a regular basis. Routine exams also help you make sure your vision stays stable after LASIK. We are happy to serve all your eyewear and eye care needs after your LASIK surgery.
LASIK Risks and Complications
LASIK – Laser-Assisted In Situ Keratomileusis -is the most common refractive eye surgery today. As of 2011, over 11 million LASIK procedures have been performed in the United States and as of 2009 over 28 million have been performed worldwide.
LASIK, often referred to as laser eye surgery or laser vision correction, is a type of refractive surgery for the correction of myopia, hyperopia, and astigmatism. LASIK surgery is performed by an ophthalmologist who uses a laser or microkeratome to reshape the eye’s cornea in order to improve visual acuity. For most patients, LASIK provides a permanent alternative to eyeglasses or contact lenses.
LASIK is most similar to another surgical corrective procedure, photorefractive keratectomy (PRK), and both represent advances over radial keratotomy in the surgical treatment of refractive errors of vision. For patients with moderate to high myopia or thin corneas which cannot be treated with LASIK and PRK, the phakic intraocular lens is an alternative.
LASIK is the premier surgery for vision correction. It is quick, almost painless and there is little or no discomfort after the procedure. Vision recovery is rapid – patients report seeing 20/20 within 24 hours.
LASIK corrects nearsightedness, farsightedness and even astigmatism. With a technique called mono-vision, it can reduce the need for reading glasses among patients over age 40 who wear bifocals.
LASIK – Criteria for Success
Is laser eye surgery for everyone? Below are some guidelines to help you decide if LASIK is a good choice for you.
- Vision stability: Young adults often experience annual changes in their prescription for eyeglasses or contact lenses. A 12-month period of maintaining the same prescription is highly recommended prior to LASIK. Otherwise there is a considerable risk of requiring repeated LASIK surgery in the future.
- Healthy Eyes: Problems, diseases or conditions related to your eyes could cause increased risks to both the actual surgery and the healing process. If you have a condition that can be treated such as dry eyes, pink eye (conjunctivitis) or any eye injury speak to your doctor. It is probably best to wait until the condition is resolved to schedule your LASIK surgery. Conditions like cataracts, glaucoma, and other more serious conditions may disqualify you from LASIK altogether.
- Age: 18 is the minimum age of consent for LASIK. Younger patients may be able to get special exemptions based on certain circumstances.
Vision prescription range: A very high degree of myopia may require removal of too much corneal tissue. This may exclude your candidacy for LASIK or make another refractive surgery a better option. For example, many surgeons conclude that a phakic IOL procedure provides better results and possesses less risk than LASIK for nearsighted prescriptions higher than -9.00 diopters.
- Pregnancy: Normal hormonal changes of pregnancy may cause swelling of the cornea which can alter vision. Dry eye is also common during pregnancy. Additionally, medications (antibiotics or steroids) which are administered for LASIK could cause risk to the embryo or nursing infant. It is recommended to delay LASIK for several months after childbirth until the eyes stabilize and risks are reduced.
- Systemic and autoimmune diseases such as rheumatoid arthritis, type 1 diabetes, HIV or AIDS may disqualify or delay candidacy for LASIK. If your body has trouble healing, your cornea may not heal properly after LASIK surgery. Opinions vary among professionals as far as which diseases automatically disqualify and which ones pose acceptable risks. Discuss this in depth with your doctor if applicable.