- When can I return to work?
- Is there any pain?
- Will I need glasses after surgery?
- I’m over age 45 and usually take my glasses off to read. Will I need reading glasses after laser vision correction?
- What if my uncorrected vision isn’t 20/20 after surgery?
- Am I a good candidate for laser vision correction?
- How much does it cost?
- I am confused by the long list of laser vision correction techniques. What do all these acronyms mean? Can you clear up the alphabet soup?
- Which is better, iLASIK or surface ablation?
- Why should I have my laser vision correction with Dr. Foote?
- What are the risks associated with laser vision correction?
1. When can I return to work?
Patients undergoing iLASIK or Intacs placement can usually return to work in one to two days. Patients having surface treatments (epiLASIK, LASEK) usually require three to five days due to a slightly longer healing process. An individual’s experience may vary however depending upon your body’s healing process and the type of work to which you are returning.
2. Is there any pain?
Patients having iLASIK may experience a pressure sensation during flap creation that can be uncomfortable for some. There is no pain during the laser procedure itself for patients having iLASIK or surface treatments. In the days following the procedure patients undergoing iLASIK or surface treatment can experience some discomfort, foreign body sensation or mild to moderate pain.
These symptoms are usually well tolerated by most patients and can, when needed, be treated with eye drops or oral analgesics. The symptoms can last longer for patients having surface treatments. Most patients report minimal if any pain with the procedure.
3. Will I need glasses after surgery?
All patients who have laser vision correction to improve their distance vision will have to wear reading glasses after age 44 to 45. It is normal for a healthy eye with good uncorrected distance vision to lose near vision with age. Laser vision correction can improve your near-sightedness, far-sightedness and astigmatism but unfortunately it does not stop aging!
So whether you’re 35 when you have laser vision correction or 50, don’t expect that you’ll be the lucky one to miss out on the need for reading glasses after your mid-40s.
4. I’m over age 45 and usually take my glasses off to read. Will I need reading glasses after laser vision correction?
Yes. There are some options to patients over age 45 including custom monovision treatment which may lessen the need for reading glasses. However loss of up-close vision is a natural aging process for all of us and is unavoidable.
Any near-sighted patient who is more than 45 years old who values his or her near vision more than far vision should probably reconsider proceeding with the laser vision correction for distance only.
5. What if my uncorrected vision isn’t 20/20 after surgery?
Some patients can become very fixated on numbers after surgery thinking that if they don’t see 20/15 or 20/10 that their surgery was a failure or that if they are 20/25 or 20/30 that there was a problem. It is important to understand that not everyone will have 20/20 uncorrected vision in both eyes after surgery.
Instead it is much better to remember the purpose of having laser vision correction is to reduce dependency on glasses and/or contacts. Provided that a patient’s uncorrected vision is better than 20/40, about 2% of patients having laser vision correction will need to have an enhancement usually due to a small under or over correction caused by the laser.
6. Am I a good candidate for laser vision correction?
This can only be determined by a thorough eye exam and specialized testing for patients considering laser vision correction. Some patients cannot be safely treated and should not have laser vision correction. This includes patients with extreme amounts near-sightedness, far-sightedness or astigmatism.
Patients with some types of autoimmune disorders similarly may not be candidates for laser vision correction due to greater risks of inflammation or scarring with surgery. Anyone who is pregnant or considering pregnancy should wait for six months post-partum and/or breast-feeding. There may be other reasons preventing someone from having laser vision correction which may be discovered during the exam.
7. How much does it cost?
Our laser vision correction coordinator will go over with you in greater detail the cost of surgery, the financing options available to you, as well as what is included with your treatment in consultation with you. There is no charge for this consultation.
8. I am confused by the long list of laser vision correction techniques. What do all these acronyms mean? Can you clear up the alphabet soup?
As laser vision correction has evolved many techniques have been developed to perform the surgery. The expanding number of names, usually acronyms, can become confusing and seem a bit overwhelming.
Generally laser vision correction is done in one of two ways. The laser is reshaping the cornea making it more or less steep and the reshaping can be done on the surface (PRK, LASEK, epiLASIK) or in the middle of the cornea underneath a thin flap (LASIK, iLASIK, intra-LASIK).
In surface treatments a thin layer of corneal “skin” cells (the corneal epithelium) must be removed before reshaping the cornea. With PRK (photorefractive keratectomy) the first technique of laser vision correction developed, the skin cells are vaporized by the laser. LASEK (name?), a later development uses alcohol to dislodge the the skin cells as a sheet. epiLASIK uses a plastic separator with a mechanical device to remove the cells also as a sheet. The epithelium may be replaced immediately after surgery but if not will re-grow in three to five days.
LASIK (laser assisted in situ keratomileusis) traditionally uses a mechanical device (also called a microkeratome) with a sharp blade to cut a partial thickness flap. The Excimer laser then re-contours the corneal surface underneath the flap. The flap is gently put back into place and heels with minimal scarring. All laser LASIK, iLASIK or intra-LASIK use a second entirely separate laser (a femtosecond laser) to create the flap. Despite improvements made to bladed mechanical microkeratomes, all laser LASIK is gradually replacing the mechanical devices due to improved safety, reliability and greater flexibility (more customizable for the patient). iLASIK is a proprietary name for an integrated platform combining the Intralase femtosecond laser with the VISX Star S4 IR Excimer laser. (Both sold by parent company AMO — advanced medical optics).
Finally SBK (sub Bowman keratomileusis) is a variant of iLASIK or intra-LASIK that creates very thin flaps. The advantages to this technique include the comfort and faster healing process of LASIK with the greater residual corneal strength of surface treatments.
9. Which is better, iLASIK or surface ablation?
iLASIK and surface ablation are both good procedures with excellent visual outcomes and long-term stability. iLASIK has the advantage of faster visual recovery and improved patient comfort. Surface ablation has the advantage of improved corneal tensile strength postoperatively and avoids the potential for complications related to the flap.
Which technique is best suited to an individual however depends upon a number of factors including corneal thickness, corneal curvature, work and recreational activities as well as other factors which may only be discovered on a complete eye examination. Your doctor will discuss these issues with you in greater length at the time of your consultation.
10. Why should I have my laser vision correction with Dr. Foote?
We have the newest, most up-to-date lasers and laser vision correction equipment in El Paso.
We can provide the widest array of treatment options.
All of our lasers are permanently located on site and are not leased from a company that transports the lasers from city to city.
Laser vision correction was part of Dr. Foote’s training during residency.
We take a conservative approach and consider patient safety our top priority.
11. What are the risks associated with laser vision correction?
It is normal for patients undergoing eye surgery for any reason whether cataract surgery, laser vision surgery or corneal transplantation among others to experience dry eye syndrome after surgery. For most patients the symptoms are brief lasting several weeks but often can last several months. Occasionally some patients may have long-term dry eye syndrome. This is particularly problematic for us here in El Paso given our arid climate. Fortunately most patients’ symptoms resolve however some patients can experience long-term dry eye syndrome which may require use of artificial tears or other medicated eyedrops.
It is not uncommon for some patients to experience halo and glare after laser vision correction. Studies indicate that fewer patients report problems with halo and glare after surgery than prior to surgery. However some patients may have more halo and glare after surgery while others may have less.
Under-correction or over-correction after surgery is probably the most frequent problem encountered after laser vision correction. The over- or under-correction is significant enough to require an enhancement in approximately 2% of patients.
Rare but serious complications can include infection, corneal ectasia (a progressive weakening and bowing of the cornea) or unmasking of keratoconus (a rare corneal condition causing a misshapen cornea). Other complications though rare can occur. Your physician will discuss these with you further at the time of your consultation.