Is LASIK right for me?
Some things to look for when choosing a LASIK practice.
LASIK surgery is elective in nature and on a very important and delicate organ, the eye. As such it is imperative that both you and your doctor firmly feel that the potential benefits outweigh the risks. It's also important as you're evaluating different providers that you understand the process and know what's important to look for.
A good candidate for LASIK has a prescription for glasses or contacts that has been basically stable for at least a year, and has healthy, disease-free corneas. Certain types of patients are not candidates for LASIK surgery at all. While there is no maximum age for LASIK, the minimum age for consideration is 18 as vision must be stable before considering surgery (eyes, like your height, will grow to a point and then stay about the same for the rest of your life). For safety reasons, women who are pregnant, people with poorly controlled diabetes, severe autoimmune disorders, or a history of ocular herpes would also not be considered candidates for LASIK.
Asssuming you are a good candidate for LASIK, there are certain things you should look for in a LASIK provider to ensure that risk is minimal and you have the very highest probability for success.
Be Sure your LASIK Practice Offers Expert Medical Screening and Consultation
When you come to Wills Laser Vision, our technicians will run a series of advanced diagnostic tests, measuring your refractive error, current vision prescription and best corrected vision. Your outer eye is checked for infections and eye abnormalities. Your pupils are measured and your eyes are checked for glaucoma. Your eyes may be dialated and examined for cataracts and retinal diseases. The results of these tests will be given to your doctor, who will determine whether you are a perfect candidate from a safety point-of-view.
One of the more important things the doctor will look to see is that your cornea is strong, rigid and clear and that re-shaping the cornea at the micron level will leave it as strong, rigid, and clear. The intent of LASIK surgery is simply to change the curvature of the cornea (which in turn changes the focus point of your eyes). The cornea is essentially a strong, clear flexible dome (similar to a mini watch cover) covered by a thin translucent lining (similar to Saran Wrap). In LASIK surgery, the goal is to re-shape the surface of the clear dome (just as a surgeon sculpts cartilage when reshaping the nose) and expect that it'll maintain a constant shape throughout life.
The laser does this all at the micron level (a micron is 1/25,000th of an inch--that's very precise).
It's critical at this stage that your doctor has the expertise and the experience to be able to make an accurate and thorough diagnosis and to foresee and forestall any issues before they happen.
Look for the Most Advanced Technology
LASIK consists of two stages. At the first stage, the surgeon gains access to the cornea ("the dome") by lifting off the translucent lining ("Saran Wrap") together with a thin layer of the dome surface. That creates the LASIK "flap". While many traditional LASIK surgeons use a vibrating razor blaze to create this flap, advanced LASIK practices will do this using a blade-free laser system. Specifically, this involves a femto-second laser, which is the fastest and most precise technology used in all of medicine. There have been five generations of refinement of blade-free systems. Wills Laser Vision currently uses what is considered the best in the field, the FemtoSecond 200, a laser which creates 1.3 million micron-sized overlapping bubbles in a plane in the cornea ('the dome") in about six seconds. This far surpasses any other blade-free system available in speed and precision. Blade-free and the FemtoSecond 200 represent the highest standard of care available from a safety perspective.
In the second stage, after the LASIK flap is created, the dome underneath it must be scuplted. In our office, we use the Wavelight Allegretto Eye-Q 400. This laser scupts with sub-micron pulses and is controlled by a tracking device, called the "Perfect Pulse System" that is the fastest and most accurate in the field. The tracker re-aligns the laser to your pupil 400 times a second. So be assured, if you or your eyes move a bit during the procedure the laser follows your eyes with utter precision. If your line of sight moves one degree over, the tracker tells the laser to move over one degree, and then the tracker double-checks its position before the laser fires. If you move too far, the tracker turns the laser off without harm; the doctor will simple re-center the tracker and the laser will pick up exactly where it left off.
By working so fast, the laser applies many, many little light delicate pulses which makes the sculpting process more accurate and more precise. When evaluating LASIK practices, look very carefully at the technologies they use. Older technologies used in other centers employ lasers and trackers that may work 10 times slower, resulting in laser hits that are much more coarse. In fact, with older lasers (which are still used by many other LASIK centers in New Jersey), while there was an improvement, nearly 10% of patients had to come back for re-treatment or enhancement. The technologies at Wills Laser Vision have enabled us to lower that rate to less than 1%.
For patients who are not good Blade-Free LASIK candidates other refractive surgery options exist, including LASEK (PRK with mini flap) and PRK (PhotoRefractive Keratectomy) where no flap is created but the same surface reshaping laser is used (one laser instead of two). PRK is the "mother" of all laser refractive procedures. It is an option for patients who have thinner corneas, corneal scars or abnormalities or who have a high risk for repeated "bodily contact" injuries (professional or amateur boxers, etc.) The end visual results are as good as Blade-Free LASIK but the recovery is longer and less comfortable, which is why the majority of patients who are good Blade-Free LASIK candidates are electing that procedure over other refractive surgery options. To learn if you are a good LASIK candidate please contact us for a personal complementary consultation at 609-924-9200.
Look for Skilled, Caring Surgeons
While the technology at Wills Laser Vision is the best in the area, at the end of the day the lasers are just tools. They must be used with great care and caution. The surgeon has to set everything up just right, much like a pilot setting up a sophisticated plane. The right tools in the right hands can work wonders.
The surgeons of the Princeton Eye Group are among the most highly trained and renowned in New Jersey and the entire tri-state area. Each has studied in the world's foremost medical schools and hospitals. Their work is known worldwide and they've received multiple awards. But more importantly, every day we get wonderful comments from happy patients who are thrilled not just with the results of their LASIK surgery, but also for the way the doctors help them understand the process, care for their well-being, and communicate clearly and patiently every step of the way.
Understand The Risks and Constraints of LASIK
On our Is LASIK Safe page, we talk about some of the short-term and long-term risks of LASIK surgery in general and ways Wills Laser Vision mitigates much of that risk. Ultimately, the decision is yours as to weighing the risks versus the benefits. We've aimed to be very open and straightforward on this Web site to help you make an informed decision, and if you choose to come to Wills for a free LASIK consultation, our doctors and staff will go into much greater detail and answer any questions you have.
One common misconception of LASIK is that it can eliminate the need for reading glasses as you get older. While LASIK can correct myopia, hyperopia, and astigmatism and eliminate the need for glasses for these conditions, it cannot correct presbyopia. However, there is a LASIK option called "blended vision" that minimizes the need for reading glasses for patients who choose to do it. Here, the doctor can make a full correction in a patient's dominant eye and for the other eye trade off a little distance acuity for a little near focusing ability. Some older patients prefer this because they won’t need reading glasses for "every little thing"--they can read their watches, cell phones, and so on for "on the go" or "navigational" vision and only need reading glasses for long term reading. Blended vision is not for everybody, so the doctor will enable patients to "preview" the results of the LASIK outcome prior to surgery using trial lenses before making a decision.
Understand The Benefits of LASIK
As for the benefits of LASIK, there's no better authority on this than our own patients.
The phrase we hear most from our patients is "life changing". One thing we never tire of hearing is the excitement in patient's voices the first time they do something as simple as waking up in the morning to a crystal-clear vision or driving a car without glasses within 24 hours of their surgery. Unlike other kinds of surgery, LASIK is associated with very little pain and no bandages or stitches are required after LASIK.
Many of our younger patients who are active in sports and physical activities love the fact that they can swim, play tennis, run, and participate in virtually every active activity without worrying about losing their contacts or breaking their glasses.
Other patients tell us that they love the freedom they now feel by getting away from contacts and glasses. All of us who have worn glasses have stories about losing our glasses and being stranded without them, or losing contacts and having to search endlessly for them, or falling asleep with our glasses on and destroying them, or dealing with the daily hassle of putting contacts in and taking them out. Patients who have had LASIK tell us they feel liberated without having to worry about any of those things.
Of course, the decision to have LASIK is yours alone. But in making that decision, make sure that you find a practice that uses the latest and most advanced technology for precision and safety, as well as a doctor who will work with you personally, helping you understand the process, answer all your questions, put your mind at ease, and perform your procedure with world-class expertise. For information about the LASIK process, visit our page on 100% Blade-Free LASIK.