Laser Vision Correction procedures are used to correct vision problems of nearsightedness, farsightedness and astigmatism. These problems occur when the eye is not able to bring images to proper focus inside the eye. Refractive surgery or laser vision correction are general terms that commonly refer to two different procedures: photo-refractive keratectomy (PRK) or LASIK. LASIK has recently become the preferred corrective procedure for most cases of vision correction.
In LASIK a small, thin flap is made on the corneal surface and is reflected back. The laser then reshapes the exposed corneal tissue by removing an amount less than one-third the thickness of a human hair. The flap is replaced and adheres after several minutes without any sutures. LASIK corrects myopia (near-sightedness), hyperopia (far-sightedness), and astigmatism (irregular corneal curvature). There is little or no discomfort. The visual recovery is usually less than 24 hours but the vision can fluctuate slightly for a week or two. Both eyes can be done at the same time. Many people can go back to work the next day. LASIK is currently Dr. Weiss’ preferred technique for most patients.
Myopia is nearsightedness. Myopia is a refractive error in which close objects are seen clearly but distant objects are blurred.
Hyperopia is farsightedness. Hyperopia is a refractive error in which distant objects are seen more sharply than near objects, however, usually neither is in sharp focus, especially after forty years of age.
Astigmatism is a condition that occurs when the cornea has several curvatures causing the eye to have more than one point of focus. The curvatures bend light differently and the result is blurred or distorted vision.
Presbyopia is a normal condition caused by aging that occurs in everyone and is first noticed between 35-45 years of age. At birth the focusing lens inside the eye is soft and flexible and as we age the lens gradually hardens and becomes resistant to changes in shape. Since the older lens cannot change shape as easily as it once did, the eye gradually loses its focusing ability, resulting in blurred reading or near vision. Once present, presbyopia slowly progresses throughout
The ideal candidates for laser vision correction should:
- be at least 18 years or older,
- have relatively stable vision for at least one year before laser vision correction,
- have healthy eyes,
- have a refractive error within the ranges of treatment,
- and be free of eye conditions that would preclude laser vision correction.
There are risks associated with all surgical procedures. When laser vision correction is performed by an experienced surgeon risk is minimal. Although very safe (about the same as the risk associated with extended-wear contact lenses), all patients should be well informed of the safety record and common side effects of surgery.
Success depends on the individual’s expectations. Patients that are good candidates for laser vision correction have a better than 95% chance of becoming independent of glasses and contact lenses for most (or all) of their activities. Results depend on the amount of refractive error you have. The lower the degree of refractive error, the higher the success rate will be.
You should avoid driving until your vision stabilizes. With LASIK, many patients can drive safely the day following the procedure.
You can wear make up right after surgery, however, we recommend that you avoid wearing mascara for at least one to two weeks while the cornea is healing. Particulate matter such as mascara can increase the chance of infection after laser vision correction surgery.
You are instructed to look straight up into the light on the microscope or the blinking red fixation light of the laser immediately above the eye. You should feel no discomfort. Most patients are surprised when the doctor informs them that he has finished.
Strenuous activities should be avoided for at least 2 weeks, especially contact sports.
Swimming should be avoided for 1-3 weeks after the laser vision correction procedure.
You should wait at least one month before snorkeling or scuba diving.
A few companies and insurance plans will sometimes cover laser vision correction. You should check with your insurance carrier or employer prior to your initial evaluation.
No. Only by examining your eyes under high magnification can anyone tell that you have had laser vision correction.
Yes. Cataract, glaucoma and retinal surgeries can all be performed following laser vision correction.
The excimer laser produces a high energy ultraviolet laser light beam. This laser is able to break the molecules in the tissue cells of the cornea. The laser is so precise that it can remove tissue 1/4 of a micron a time (one micron is one twenty-five thousandths of an inch). This precisely vaporizes and remove microscopic layers of tissue to reshape the corneal surface.
In most cases, yes. Once the healing period has completed, the results of laser vision correction are permanent.
Initially after surgery it is common to experience light sensitivity, starbursts around light and / or halos at night, however, these will diminish as the cornea heals. You should wear sunglasses with ultraviolet protection following surgery.
One to two million Americans and additional million around the world have had laser vision correction to improve their vision.
The eyes are numbed with eye drops so there will be very little discomfort during surgery. You may feel some minimal pressure.
You are given a mild sedative prior to surgery to help you relax, but you are awake during surgery and able to understand Dr. Weiss’ instructions.
The day following surgery most patients experience little or no pain, but some may have mild to moderate discomfort. You will be given eye drops and pain medication that will relieve any discomfort. Your eyes will be watery and scratchy for a few days after surgery.
In most cases, patients can go back to work one to four days after surgery.
Results have shown that the majority of patients do not have to wear glasses or contact lenses for distance vision after laser vision correction. The small percentage of patients who still require corrective lenses usually are much less reliant upon them or need them only for certain visual tasks. However, this procedure does not completely eliminate the need for reading glasses. In some cases, glasses may be needed for the best possible vision.
Most patients under the age of 40 will not need glasses for reading following laser vision correction. Nearly all patients entering their 40’s will require glasses or bifocals for reading because of presbyopia. This is also true for patients that have had laser vision correction (unless they were corrected for monovision).
Monovision is a method for correcting vision so that one eye can see distance and the other can see near. This can potentially eliminate the need for both reading glasses and distance glasses in presbyopic patients for most situations. More information on Monovision
An enhancement is an additional surgery intended to “fine-tune” the results of the original procedure.
Yes, your can take a bath or shower the same day your have laser vision correction. However, you will need to be very careful not to get soap or water in your eyes.
Yes. The FDA has approved the laser for hyperopic correction with small amounts of astigmatism. For PRK with the VISX laser, the use of the rotary epithelial brush that Dr. Weiss co-developed with South African ophthalmologist Percy Amoils, is mandated by the FDA. However, Dr. Weiss’ currently preferred technique for far-sightedness is hyperopic LASIK, which does not require this invention, and has a much shorter recovery time.
PRK was developed in the United States in 1983. The first excimer laser photo-refractive keratectomy procedure was performed in 1987 in Berlin, Germany. Shortly thereafter, LASIK combined PRK with a previously performed technique called ALK. Since then, millions of PRK and LASIK procedures have been performed worldwide.
The risks of Lasik surgery are minimal. Potential risks associated with LASIK include:/p>
Initial overcorrection (farsightedness). This is a part of the normal post-operative course. The eye generally stabilized within three months; however, some patients may remain overcorrected.
Undercorrection. Significant undercorrection may need an enhancement procedure or corrective lenses for sharp vision.
Light sensitivity. Some eyes are sensitive to light following LASIK. This usually diminishes and disappears as the eye heals completely. Some patients may experience a halo effect around bright lights at night, similar to wearing contact lenses.
Persistent corneal haze. Possible with PRK, very rare with LASIK.
Infection. This is very rare and it can usually be treated with antibiotic drops. In the rare event that the infection results in corneal scarring, an enhancement is usually needed. In extreme cases a corneal transplant may be required.
Decreased best-corrected visual acuity. This also rarely occurs. It can usually be corrected with an enhancement or contact lenses, although fitting and wearing contact lenses may be difficult following laser vision correction.
No. Because the excimer laser only removes microns of the corneal thickness. It leaves the strength of the eye virtually unchanged.
As with all eye surgery, the risk is extremely rare. The risk of extreme complications from laser vision correction is about the same as the risk of loss of sight due to the use of extended wear contact lenses. Nonetheless, laser vision correction should be taken quite seriously and patients should be aware of all the common side effects and possible complications.
You may go in an airplane at any time following laser vision correction.