How do I know if I am a candidate?
Most people who are in good health and are either nearsighted or farsighted or have astigmatism are candidates for some form of laser vision correction. In general, you should:
- be at least 18 years of age or older
- be in general good health
- have had stable vision for at least a year
- have no health issues affecting your eyes
Am I nearsighted or farsighted and can laser vision correction treat it?
As long as your prescription falls within FDA-approved limits, LASIK or another advanced refractive procedure can correct either nearsightedness or farsightedness. Being nearsighted, or myopic, means you cannot see things clearly in the distance. Nearsighted people need glasses to drive or to watch television, and some people with more extreme prescriptions may need glasses even to see the alarm clock in the morning.
If you are farsighted, or hyperopic, you may have trouble seeing things up close. Without glasses or contacts, reading, eating or even talking to friends can all be difficult.
I've heard so much about astigmatism. What is it? Does LASIK correct it?
Astigmatism refers to an asymmetric curvature of your cornea. A _normal_ cornea is round, like a basketball. If you have astigmatism, your cornea is shaped more like a football. Astigmatism can occur alone or in addition to either nearsightedness or farsightedness and can be corrected with LASIK.
Is there a vision correction procedure to help me get rid of my reading glasses?
As we age, our eyes lose the ability to focus on images up close. We continually move an image, such as a book or newspaper, farther and farther from our eyes in order to bring it into focus. This condition is called presbyopia. When presbyopia progresses to the point that our arms are not long enough, we need reading glasses or bifocals. CK is now being used to correct presbyopia. While it is not a cure, CK can reduce your dependence on reading glasses for an additional 5-10 years. LASIK may also be used to partially offset the effects of presbyopia through a technique called monovision.
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What is monovision?
Monovision is an option to help correct both your distance and near vision. The procedure corrects the focus of one eye for distance vision and the other eye for near vision. One eye will see things close up, the other eye will see things farther away, and the brain will integrate the visual information from both eyes and filter out any blur. It is similar hearing sound from stereo speakers. A different sound comes from each one, your brain combines the information to provide the entire range of sound. Monovision has been used successfully for over 20 years. _Blended Vision,_ created with the CK procedure, is similar to monovision and is being used to treat presbyopia. Many people who have been unable to tolerate monovision in the past have found Blended Vision to be a good choice for them.
What is Wavefront Custom LASIK?
Wavefront Custom LASIK is a highly customized laser vision correction technique that can correct your vision more accurately than ever before. Originally invented for NASA telescopes, Wavefront technology measures 217 different points on your eye, creating a 3-D Wavefront map of your eye. This information, as unique to you as your fingerprint, is transferred electronically to the laser, enabling the surgeon to adjust the laser and customize a solution for your unique visual requirements.
Who can benefit from Wavefront Custom LASIK?
Most people, including those with higher-order aberrations, can benefit from Wavefront Custom
LASIK. Until Wavefront was developed, those patients with a significant amount of higher-order aberration had less satisfactory results with LASIK than others. Over 90% of people who currently wear glasses or contact lenses for nearsightedness, farsightedness or astigmatism can now benefit from some form of laser vision correction. The best way to determine how a customized procedure may benefit you is to have a comprehensive eye evaluation and obtain a WavePrint map of your own individual visual fingerprint.
What is the difference between LASIK and PRK/LASEK?
LASIK (laser-assisted in situ keratomileusis) and advanced surface ablation procedures like PRK and LASEK are all laser vision correction techniques used to correct nearsightedness, farsightedness, and astigmatism. They each use a computer-controlled excimer laser to reshape the cornea, and each has excellent post-operative results.
LASIK involves the creation of a thin corneal flap and the use of the laser on the internal tissue of the cornea. The surgery takes only a few minutes per eye and is generally painless. Afterward, there is very little discomfort, and patients are often able to return to work the next day. Post-operative care typically involves at least three office visits.
Unlike LASIK, PRK and LASEK do not involve the creation of a flap. With PRK and LASEK, the epithelium (skin layer of the eye) is either removed (PRK) or moved gently aside (LASEK), and the laser operates on the surface of the cornea rather than internally. Again, surgery takes only minutes per eye and is generally painless. Post-operative recovery for PRK and LASEK, however, takes a little longer than recovery from LASIK. To assist healing after PRK/LASEK surgery, a clear bandage contact lens is placed over the cornea during the 3-5 days needed for the epithelium to re-grow. Additionally, LASEK/PRK patients typically use steroid drops for about a month, but may occasionally have to use them for up to three months, and there is somewhat more discomfort during the healing process.
There are some patients who prefer PRK/LASEK, as well as some medical conditions that make advanced surface ablation more suitable. Dr. Oster will help you determine which procedure is best for you.
What is IntraLase?
IntraLase (also known as IntraLASIK and All-Laser LASIK) is an interesting new procedure designed to make corneal flaps for LASIK surgery with a laser, rather than a microkeratome (blade). Current marketing for IntraLase claims that it is safer and produces better outcomes than a microkeratome, while there are other studies that do not support these claims. There are also documented surgeon reports of negative side effects and outcomes that are not commonly discussed by users or the manufacturer of this technology.
Although Dr. Oster is currently using this new technology, our safety and outcomes record with the Hansatome microkeratome is excellent.. In addition, potential disadvantages to IntraLase include longer surgery times, noticeably more patient discomfort, delayed visual recovery, and flaps that may not be as easy to lift if an enhancement is needed. Further, the use of IntraLase adds an extra cost of $400 or more to the LASIK procedure. Dr. Oster will advise you of your options and discuss which method of flap creation is best for you.
What is the difference between LASEK and PRK?
LASEK (laser epithelial keratomileusis) and PRK (photo-refractive keratectomy) are both advanced surface ablation procedures to correct vision by using the excimer laser to gently reshape the surface of the cornea. With PRK, the epithelium (skin layer of the eye) is fully removed and the laser is applied to the surface of the corneal tissue. During the LASEK procedure, the epithelial layer is lifted gently to the side and then replaced after the laser treatment. In each case, a clear bandage contact lens is placed over the cornea for 3 to 5 days to allow the epithelium to re-grow. Each procedure can be suitable for certain prescriptions and under certain conditions. Dr. Oster will help you decide which procedure is best for you.
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What are the risks?
As with any surgery, there are certain risks. Fortunately, however, the risks of laser vision eye surgery are low and patient satisfaction is high. The main risks include infection, overcorrection or undercorrection of your prescription, halos, a flap that shifts after surgery, and dry eyes.
- Infection - The risk of infection is VERY low, affecting only about 1 patient in 5000 procedures. Dr. Oster will prescribe antibiotic drops for use after surgery and monitor your eyes to ensure that there is no sign of infection.
- Overcorrection or undercorrection of your prescription - Since the cornea is living tissue and everyone's eyes are different, it is possible for your vision to be slightly overcorrected or undercorrected after surgery. If your eyes are over- or undercorrected, it is usually possible to do an enhancement to correct the remaining prescription.
- Halos - After surgery, patients may see a _halo_ of light around bright lights at night. For most patients, this occurs usually for the first week or two after surgery, but some patients continue to see halos longer. During your pre-operative evaluation, Dr. Oster will advise you of your risk for seeing halos long term.
- Shifting flap - It is possible that the flap created during LASIK may shift slightly immediately after surgery. This is most often a result of bumping or rubbing the eye early in the post-operative period. Twenty-four hours following surgery, the risk of the flap shifting decreases greatly. You should contact Dr. Oster if you experience any sort of eye injury within the first day or two after surgery.
- Dry eyes - The eyes are typically drier than normal for the first week or two following surgery, though some patients may experience dry eyes for a longer period of time. It is important to use lubricating drops frequently. If the eyes are uncomfortably dry for a prolonged period of time, Dr. Oster can prescribe other drops such as Restasis or suggest techniques that can help.
How long has laser vision correction surgery been performed?
The FDA approved the use of the excimer laser for laser eye surgery in 1996, although the microkeratome that creates the corneal flap has been used in other types of eye surgery since the late 1950s. Since the mid-1990s, LASIK has become increasingly popular with leading eye surgeons throughout the world. Over 9 million successful procedures have been performed to date.
What is the cost, and will my insurance cover it?
The cost of your LASIK procedure is determined at your eye evaluation. Most insurance plans consider LASIK to be elective surgery, but there are a few that offer some benefit that can save you money on the cost of the procedure. Your employer's flexible spending or cafeteria plan may also offer tax advantages for LASIK. We can help you understand your options and what questions to ask your benefits administrator. In addition, Grand Valley LASIK & Cataract offers several different payment options to help make LASIK fit your budget.
What is Dr. Oster's training and experience?
Dr. Oster has extensive training and experience in the latest refractive surgery techniques and has helped thousands of patients see better. He trained under Dr. Roger Steinert, one of the world's preeminent eye surgeons and past president of the American Society of Cataract and Refractive Surgery during his cornea and refractive fellowship at the Tuft’s University School of Medicine in Boston, MA.
What's the first step?
Schedule a FREE, no obligation LASIK eye evaluation. Dr. Oster and the staff at Grand Valley LASIK & Cataract can explain all of the refractive procedures available and help you determine the best option for you.
How long does the LASIK procedure take?
The procedure itself takes 5-10 minutes per eye, with the actual laser treatment time lasting less than one minute per eye. Patients are usually in the surgery suite for no more than 15 minutes and at the center for usually no longer than two hours.
What if I blink during the laser treatment?
A small restraining device is used to keep your eyelids open during the procedure and prevent blinking. You will not be able to blink and affect the outcome of the procedure.
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Am I awake during the procedure?
Yes. All you need to do is relax and focus on the red light. Our VISX STAR4 excimer laser will track and compensate for any eye movements during the surgery. Dr. Oster will talk to you throughout the procedure so that you know what to expect. You may elect to take a mild, oral sedative before surgery to help you relax.
What if I don't keep looking at the red target light?
The procedure is performed using a VISX STAR4 ActiveTrak eye tracking laser. This advanced system will track any small eye movements and automatically make any needed laser adjustments. Dr. Oster is in full control of the laser at all times during the procedure. The laser will not fire if your eye movements take you outside the treatment zone.
Is the LASIK procedure painful?
Patients experience virtually no discomfort during LASIK, and eye drop anesthesia to numb the eye is administered prior to the procedure. If you experience post-operative discomfort, you may use Tylenol or ibuprofen during the first day or two after the procedure.
Can I have both eyes treated at the same time? Do I have to?
Dr. Oster performs bilateral (both eyes) procedures on the majority of his LASIK patients because he believes it is safe, and patients prefer the convenience. Because the LASIK procedure affords a rapid visual recovery, you can comfortably enjoy the convenience of having both eyes treated at the same time. However, it is always an option to have each eye treated on a different day.
How much time do I need to take off from work?
On the day of the procedure, you will be at the laser center for about two hours. After surgery, we recommend that you go home and rest, keeping your eyes closed as much as possible. Most patients do not require medication for pain. Sleeping or listening to the radio or a book-on-tape is a good way to pass the time. Watching TV or going out to dinner is not recommended. On the day following surgery, most patients are able to return to work and other normal activities.
What kind of results can I expect?
Many people notice an immediate improvement in their vision when they sit up after surgery, although there will be an initial haziness that should clear by the next morning. The vast majority of Dr. Oster's LASIK patients see 20/40 or better the day after surgery. Often patients drive themselves to their first post-operative visit. Dr. Oster has an enhancement rate of only 2.1% and has one of the lowest complication rates of any surgeon throughout Colorado. Of course, your individual results may vary depending upon your presurgical prescription and the condition of your eyes. Dr. Oster can provide more information regarding your potential outcome after he examines your eyes.
What precautions do I have to take after surgery?
You will be given plastic shields to wear over your eyes immediately after surgery and for the seven nights following surgery to protect your eyes while sleeping. For the first month, care should be taken to not touch your eyes for any reason, and patients should avoid getting sweat, dust, or smoke in their eyes. It is also better to avoid swimming for two weeks, but with care, there is usually no problem with showers.
Are there any visual side effects?
Most visual side effects from LASIK are usually temporary. The most common ones are a _ghosting_ or lighter second image around the edge or border of objects, nighttime halos (a rim of light around bright lights at night), mild fluctuations of vision, and light sensitivity. These effects can last anywhere from days to weeks and, in some cases, may last for months. There is also a possible decrease in your ability to see well in low contrast situations, such as driving at night. Dr. Oster will discuss the possibility of these visual side effects in more detail after he examines your eyes.
What is an enhancement and will I need one?
There is no guarantee of 20/20 vision following LASIK or any of the other vision correction procedures. It is possible, however, to have enhancement surgery if Dr. Oster feels that it is medically safe and will improve your vision. An enhancement is a second LASIK procedure, used to fine-tune vision not corrected in the original surgery. The healing time after the enhancement is the same as after the first surgery. Since everyone's eyes heal differently, no one can predict a patient's outcome with 100% accuracy. Generally, the worse your vision was before treatment, the greater the chance that you will need an enhancement. Enhancements are done no sooner than 9 to 12 months following the original surgery, allowing time for the eye to heal and the vision to stabilize. On average, approximately 2% of patients need an enhancement.
All of our laser vision correction patients are eligible for the Grand Valley LASIK & Cataract Enhancement Policy whereby enhancements may be performed at no charge at our center if the enhancements are performed within 2 years of the initial procedure and are medically advisable. Enhancements performed beyond this year may be performed at the center’s actual cost.
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Will I need to have this surgery repeated in the future?
The vision achieved with LASIK is generally the vision you will have for the rest of your life. The correction achieved with LASIK is long lasting and very little vision change has been seen after years of patient follow-up in clinical studies. Cataracts or other eye health-related problems may occur later in life, but are not caused by or directly related to LASIK.
LASIK does not, however, prevent presbyopia, the age-related condition that makes people need reading glasses.
Will I ever have to wear glasses again?
Since 98% of Custom LASIK patients see 20/20 or better, very few choose to wear glasses again. Those who do, generally use them only in certain circumstances such as driving at night or in the rain. For most people in their 40s, though, whether they have had LASIK or not, reading glasses may be necessary.