| Common
Questions
About Refractive Surgery |
 |
 These
are some of the most common questions we are routinely
asked regarding refractive surgery. We hope that this
will help answer most of your questions but please
do not hesitate to ask your doctor or technician any
other questions you have.Our philosophy is "an informed
patient is a happy patient".
|
What
is Custom
Laser Vision Correction? |
|
Custom wavefront ablation is a modification
of conventional Laser Vision Correction. All
of the eye's unique visual errors are first
measured and then downloaded into the laser
for subsequent treatment with LASIK or PRK.
Laser vision correction has traditionally provided
the same type of correction as spectacles or
contact lenses by permanently treating myopia,
hyperopia,
and astigmatism.
Recent studies have revealed that additional
subtle visual errors (called "higher order
aberrations") limit eyesight and may contribute
to night glare and halos. Correcting these aberrations
may improve visual
outcomes after laser vision correction. The
Erdey Searcy Eye Group welcomes the opportunity to
discuss how individuals may benefit from this
technological step forward in refractive surgery.
To schedule a complimentary laser vision correction
evaluation, contact
us.
|
|
Am
I a good candidate? |
|
 Your
eyeglass or contact lens prescription, occupation,
leisure
activities,
age and personal expectations all help to determine
whether or not you are a good candidate for
vision correction surgery. General requirements
include the following: 18 years of age or older,
with no significant change in your glasses or
contact lens prescription for at least one year,
in good general health, and have good eye health
with no ocular diseases. You must have REALISTIC
EXPECTATIONS and understand that vision correction
procedures are not always perfect. To find out
if you are a suitable candidate, please
schedule a complementary consultation with the
Erdey Searcy Eye Group.
|
| How
does the expertise of the surgeon affect
my laser correction (LVC) result? |
|
| |
Laser
Vision Correction (LVC) is eye surgery!
Some people have the misconception that
since the laser is computer controlled,
the skill and experience of the surgeon
and staff is of negligible importance. This
could NOT be further from the truth. The
following factors significantly determine
how well you will see after your LVC procedure: |
-
The
quality of the pre-operative evaluation
process, conservative patient selection,
and meticulous monitoring during post-operative
eye healing. These must be individualized
for each patient.
-
The
training and expertise of your surgeon in
creating and replacing your cornea flap
and in applying the laser during your LVC
procedure.
Ask
if the surgeon has cornea/refractive fellowship
training (additional formal training, usually
a year or more, beyond a general ophthalmology
residency.not just a weekend laser course!) Ask
how much clinical research experience the surgeon
has in Laser Eye Surgery and what contributions
have they made in the field.
|
| Are
there risks with refractive surgery? |
|
There are risks with any surgical procedure. The
odds of encountering risks are small (less than
1%). Most adverse events are reversible with good
visual results. Serious irreversible sight-threatening
complications while possible are very rare. In
contrast, the odds of a sight-threatening corneal
infection eventually occurring in a contact lens
wearer (particularly if the contact lenses are
not removed at bedtime) are significantly greater.
|
| What
kind of results might I expect? |
|
 Although
the majority of our patients achieve 20/25 or
20/20 (considered perfect vision), there are no
guarantees. We continuously monitor our refractive
surgery outcomes. This allows us to regularly
refine our techniques, thereby improving your
chances of a successful result. The last 100 eyes
of our LASIK patients analyzed showed the following:
1. Nearly 100% achieve 20/40 vision (legal driving
in Ohio). Some patients may only need glasses
with a very subtle prescription, for use in low
illumination (night driving) to see distance objects
crisply.
2. Approximately 87% are within one line of 20/20
on an eye chart. This visual quality can be compared
to that of contact lenses and glasses. Patients
who achieve this level of vision after surgery
are independent of corrective lenses for distance
and near (assuming they are not over age 40 and
require reading glasses).
The degree of improvement may vary from individual
to individual depending upon the severity of their
original eyeglass prescription. This quality of
vision generally allows patients to participate
in sports, drive, swim, watch TV, movies, and
see the alarm clock without glasses or contacts
following refractive surgery.
|
| Is
LASIK performed on both eyes at the same
time? |
|
The
practice of performing LASIK on both eyes at
the same time is popular because of patient
convenience (fewer office visits) and more rapid
restoration of optical balance between the two
eyes. In fact, the vast majority of our patients
choose this option. However, there are a few
patients who simply prefer to have one eye done
at a time, and there are also some clinical
circumstances in which we may advise you to
have one eye done at a time.
The decision to perform LASIK on one or both
eyes at the same time is made on an individual
basis during your consultation.
The reasons to have LASIK on ONE eye at a time
may include:
- ACCURACY:
The healing process and visual recovery in
the first eye is monitored and this information
may be used to make subtle modifications to
the treatment plan for the second eye.
- SAFETY:
Both eyes would not simultaneously be subjected
to certain surgical risks such as infection,
retina damage, or other adverse reactions
which, although very rare, could lead to significant
loss of vision in both eyes.
- VISUAL
RECOVERY:
Although the vast majority of LASIK patients
experience a rapid recovery in their vision,
the recovery can at times be delayed. Please
realize that even a temporary loss of vision
quality in both eyes is extremely disruptive.
If the eyes are operated on separately, you
can function with the fellow eye while the
first eye fully recovers. This is especially
 true
if you are able to wear a contact lens in
the untreated eye.
- SATISFACTION:
You will be given the opportunity (before
proceeding to the second eye) to determine
whether the LASIK procedure has produced satisfactory
visual results without loss of vision quality
or other uncommon undesirable side effects
such as glare, ghost images, or increased
light sensitivity. If you are over age 40,
you will have an opportunity to experience
the change in your close vision. This could
influence your decision on whether or not
to fully correct your other eye to maintain
some degree of close vision without the need
for glasses (monovision).
After you and your surgeon are satisfied with
the results of the first eye, we will proceed
with LASIK on the second- eye usually one
to two weeks later. To maintain balanced vision,
a contact lens is often used in the untreated
eye until the second eye is treated.
|
| Is
refractive surgery a permanent procedure? |
|
Yes. The benefits of your procedure are permanent.
The few patients that require an enhancement procedure
will typically do so within the first several
months following the procedure, not years later.
|
| Will
the procedure need to be repeated (enhancement)? |
|
 Occasionally,
fine-tuning the original surgical procedure to
obtain best visual outcome is necessary. If necessary,
an enhancement is usually performed 3 months following
the original procedure after the eye has stabilized.*
If we determine an enhancement is necessary during
the first year following a procedure performed
at the Erdey Searcy Eye Group, you will receive it at
no additional charge from the Erdey Searcy Eye Group
(occasionally there is a minimal fee from the
laser facility). That is our "Best Vision Commitment".
*Our LASIK enhancement rate is approximately 4%.
This compares to published rates of as high as
43%.
|
| I
am a diabetic. Can I still have refractive
surgery? |
|
 Patients
who have good control of their blood sugar with
no systemic or ocular diabetic complications are
generally suitable candidates.
|
| I
have dry eyes. Will this affect the procedure? |
|
 It
can in some instances. The decision to operate
when this condition exists can only be made after
a comprehensive eye exam. It is not uncommon for
us to treat your dry
eyes before the refractive procedure.
|
| Do
I need to remove my contact lenses prior
to the examination? |
|
 Yes,
contact lenses can cause "molding" of the cornea.
Before surgery we need to take precise measurements
of the corneal shape without the influence of
contact lenses. The cornea needs to return to
its natural shape prior to the examination and
surgery to achieve the most accurate results.
- Hard/Gas
Permeable Lenses:Remove
lenses at least 3 weeks before your visit
-
Soft Lenses: Remove at least 3 days before
your visit.
|
| Once
I've decided to proceed with refractive
surgery, what is the procedure? |
|
A complete eye examination is first performed.
Additional tests may include corneal topography
(a computer generated mapping of your corneal
curvature), corneal pachymetry (an ultrasonic
measurement of your corneal thickness), and an
A-Scan (an ultrasonic measurement of the length
of your eye). Sometimes this is done in our office,
but it can also be done by many of our referring
optometrists or ophthalmologists. Once all necessary
information is gathered, you and your surgeon
will determine the best procedure for you. Our
surgery coordinator will schedule your surgery
time for you.
|
| What
will the procedure be like? |
|
Refractive surgery is a brief, outpatient procedure.
Although you are awake and alert, anesthetic eye
drops are applied so there is typically no discomfort.
A lid speculum is used to gently hold open your
eyelids so you cannot blink during the procedure.
During LASIK, a thin flap of corneal tissue is
made with a very precise instrument. It takes
less than a minute for the actual application
of the laser light. The surgeon will demonstrate
the laser beam to you before it is actually applied
to your eye. Once you are finished, you will be
given your eye drops and final instructions before
going home. LASIK patients generally experience
no significant discomfort after surgery! Although
most patients resume normal activity immediately
without restrictions, some prefer to relax for
the remainder of the surgery day. You will usually
be seen in the office the next day.
|
| Can
I drive home after the procedure? |
|
 No.
You will need a responsible adult to accompany
you on the day of your surgery.
|
| Follow
up care? |
|
 After
your surgery, you will be asked to adhere to a
series of examinations to ensure that your eye
is healing as expected and to measure your visual
progress. You may have your follow-up care with
the Erdey Searcy Eye Group or with your comanaging optometrist.
A typical schedule includes the following visits:
one (1) day, one (1) week, three (3) months, 12
months, then annually thereafter.
|
| What
is comanagement? |
|
Optometrists and ophthalmologists residing within
and outside of our region refer many patients
to us. Patients benefit by having their care shared
by two specialists, one of whom is likely to be
both familiar with the patient's history and conveniently
located. These doctors have been trained in the
pre- and post- surgical care of refractive surgery
patients and work closely with us to provide you
with the highest quality eye care available. Usually
a pre-operative evaluation will be performed in
their office. Patients are then referred to the
Erdey Searcy Eye Group for surgical consultation and
the procedure. Shortly afterwards, you may return
to their care for the remainder of the postoperative
period.
|
| What
are some of the side effects of refractive
surgery? |
|
Some patients experience fluctuation in their
vision for the first few days following refractive
surgery. Other common side effects that usually
dissipate with time are: slightly scratchy sensation
or dryness, increased tearing and light sensitivity,
tender eyelids or mild eyelid swelling, sensitivity
to smoke, and halos, ghosting, or starburst effects
around objects or lights. Using your prescribed
eye medications and artificial tear drops will
soothe your eyes during the immediate postoperative
period.
|
| After
refractive surgery, will I still need reading
glasses as I get older? (Watch
video here) |
|
Presbyopia (the need for bifocals) occurs as a
natural aging process of the crystalline
lens inside the eye (located behind the
pupil). After age 40, the ability of the crystalline
lens to instantly change shape in order to focus
light rays on the retina
for near vision tasks starts to decline. This
decline is gradual through age 50 at which time
there is generally a total dependence on bifocals
or reading glasses. Refractive surgery changes
the cornea curvature, and thus does not affect
the natural aging process of the eye's crystalline
lens. Therefore, you will more than likely still
need to use reading glasses as you get older.
If you are approaching or are in the presbyopic
age range (above age 40), you and your doctor
may decide to "tailor" the surgery (leave some
residual near-sighted ability in your non-dominant
eye) to allow some independence from reading glasses.
This is called monovision. You may be familiar
with this arrangement if you are over age 40 and
have worn contact lenses set up for monovision.
|
| What
is Monovision? |
|
The use of one eye for distance vision and one
eye for near vision is referred to as monovision
and is one of the options to consider as part
of your refractive surgery decision if you are
over age 40. Monovision has been used successfully
for over 20 years with contact lens correction
and with various types of refractive surgery.
By correcting one eye to focus for distance and
one eye to focus for near, the vision part of
our brain tends to suppress or filter out the
image from the eye that is not in clear focus.
The eye that is not in focus usually does not
bother the patient.
One of the best ways to define monovision in the
context of refractive surgery is that you can
aim to have each eye corrected to focus at any
distance you choose. How well it will see at other
distances depends upon how old you are. For example,
if you are 30 and we correct each eye to excellent
distance vision, then you will have good vision
at almost any distance because, due to your young
age, your eyes will be able to accommodate (adjust
focus) for near vision tasks. If, on the other
hand, you are over 40 and we correct each eye
to excellent distance vision, you will not see
well at a typical reading distance and will need
reading or near vision glasses. This change in
accommodation (focusing ability) will generally
begin to be noticed around age 40 and will usually
become significantly worse over the next few years
(presbyopia). This loss of ability to change your
focusing distance from far to near (presbyopia)
will occur whether or not you have refractive
surgery. At any age, if you have the vision in
one eye corrected to focus for near tasks such
as reading, you will not see clearly with this
eye for distance.
As a general rule, however, we suggest against
monovision if you are under age 35 for two reasons:
1) It will be a number of years before you will
notice any benefit
2) It is very possible that there could be a better
(or at least as good) surgical way to help presbyopia
by the time it becomes a problem for you.
We also generally recommend against monovision
at any age for people who may need to see above
average for tasks at a particular distance, such
as pilots, race car drivers, anyone who drives
for a living (especially at night), and avid tennis
players (especially for night playing).
We create monovision using the laser such that
the dominant eye focuses at distance and the non-dominant
eye focuses at near. The brain typically adjusts
to each eye being focused at a different distance
within 6-8 weeks. You do not need to consciously
make any adjustments.
There is no right or wrong answer to the question
of whether to have monovision. We hope that this
information is helpful in making this decision.
|
| Can
I still wear contact lenses after the surgery? |
|
In
most cases, if you could wear contact lenses before
surgery you should be able to wear them after
surgery. Because the shape of your cornea has
been altered, you will need to have an optometrist
fit you with new lenses. Fortunately, the need
to wear contact lenses after refractive surgery
is rare.
|
| Can
I swim or scuba dive? |
|
 Refractive
surgery has created a whole new world for water
sports enthusiasts who previously had to wear
goggles or masks with corrective lenses or were
afraid of losing their contact lenses in the water.
However, you should avoid water sports or pressure
exerted from diving at excessive depths for several
weeks following the surgery to allow your cornea
to fully heal.
|
| Can
I lose my civilian pilot's license after
I have this surgery? |
|
No. The FAA has approved these procedures for
all classes of pilots and air traffic controllers.
However, rules are constantly changing. If this
applies to you, please check with the appropriate
agency to verify their requirements before having
this procedure. NOTE: Military aviation has their
own guidelines!
|
| What
does the fee include? |
|
 Our
fee includes the surgery, post-operative kit containing
medications and sunglasses, follow up care for
1 year, and any enhancement treatments if necessary
during the first 12 months. There are easy payment
plans available. An Erdey Searcy Eye Group financial
counselor can review all of your options with
you. Please contact
us and our patient counselor will be happy
to talk with you.
|
| Does
insurance or flexible spending programs
cover refractive surgery? |
|
 *Insurance
companies generally consider refractive surgery
"cosmetic" and do NOT cover the cost. However,
we advise all patients to check with their insurance
provider to be sure.
* A surgical procedure may be tax deductible depending
on your filing status. Check with your accountant.
* If your company has a flexible benefits program,
refractive surgery can often be included.
*Payment plans
provided at about $70.00 /month for both eyes.
|
| How
do your savings with Laser Vision Correction
compare to glasses and contacts over time? |
|
Over a 15-year period, the one-time fee for laser
vision correction is less than the cost of corrective
lenses.
*Price may vary **based on treatment of two eyes
|
| How
do I know that refractive surgery is right
for me? |
|
Although we will provide information and guidance,
only you can answer that question. You need to
ask yourself why you want the surgery and if your
visual expectations realistic.
|
|
Refractive
surgery includes procedures to correct nearsightedness
