Traditional LASIK Surgery
LASIK stands for Laser In-Situ Keratomileusis. It is a procedure used to correct or reduce moderate to high levels of myopia (near-sightedness), hyperopia (far-sightedness) and astigmatism (blurry vision not due to age).
LASIK is surgery to a very delicate part of the eye. In LASIK, the surgeon uses an excimer laser to sculpt and contour the cornea to achieve the desired effect. At Wills Laser Vision our experienced surgeons use a top-of-the-line XYZ laser with technology and engineering provided by the renowkned Wills Eye Hospital.
LASIK surgery is one of the most important advances in eye care. It uses advanced instruments to make the surgery fast, accurate and pain free. The surgery takes approximately 15 minutes and is conducted in our state-of-the-art, comfortable, convenient facility at the Wills Laser Vision Center at Princeton.
Here is a synopsis of the laser surgery procedure:
Here are some of the more common questions regarding traditional LASIK surgery:
Am I a good candidate for LASIK?
Millions of patients around the world, including thousands of patients in New Jersey who have come to Wills Laser Vision, have had LASIK done successfully and are enjoying crystal-clear vision without glasses or contact lenses as a result. If you've always wanted to live without the hassle and cost of contact lenses, or if you wear glasses and are constantly annoyed by them breaking, fogging up, getting dirty, causing discomfort, and so on, LASIK may definitely be right for you.
Having said that, LASIK is not for everyone.
- You should be at least 18 years old, since the vision of people younger than 18 usually continues to change.
- You should not be pregnant or nursing as these conditions might change the measured refraction of the eye.
- You should not be taking certain prescription drugs, such as Accutane or Oral Prednisone. During your initial consultation, your doctor will review all your medications and provide you detailed information.
- Your eyes must be healthy and your prescription stable.
- If you're myopic, you should postpone LASIK until your refraction has stabilized, as myopia may continue to increase in some patients until their mid- to late 20s.
- You should be in good general health. LASIK may not be recommended for patients with diabetes, rheumatoid arthritis, lupus, glaucoma, herpes infections of the eye, or cataracts. You should discuss this with your surgeon.
In addition, there are some whose corneas may not be suitable for traditional LASIK surgery. In those cases, surgery using IntraLase or Epi-LASIK may be preferable.
Weigh the risks and rewards. If you're happy wearing contacts or glasses, you may want to forego the surgery.
What should my expectations be about LASIK surgery?
This is one of the most important questions to consider before LASIK surgery. While statistics show that 92-98% of LASIK patients around the world are thrilled with the results of their surgery, a large number of those who reported dissatisfaction usually went in with incomplete or inaccurate expectations. Here are some facts about LASIK producted in cooperation with the American Academy of Opthalmology (AAO):
- LASIK cannot correct presbyopia. Presbyopia, or "aging eye" is a normal and expected consequence of the aging process which usually occurs around age 45 in which people are unable to focus on objects up close, usually requiring the use of reading glasses. So a patient whose myopia has been corrected by LASIK, for example, may still need to use reading glasses as he or she ages (as opposed to bifocals, which might be otherwise have been necessary). You can ask your doctor if you're a candidate for monovision--correcting one eye for distance vision and the other eye for near vision. If you can adjust to this correction, it may eliminate or reduce your need for reading glasses. In some instances, surgery on only one eye is required. If your doctor thinks you're a candidate, ask about the pros and cons.
- You may need additional surgery called "enhancements" to get the best possible vision after LASIK. While rare among patients at Wills Laser Vision, in some cases follow-up surgery may be required to adjust and improve vision.
- LASIK cannot guarantee 20/20 vision. No reputable doctor would promise that LASIK surgery will deliver 20/20 vision. In almost every case, LASIK surgery delivers improved vision that is frequently 20/20, but it is possible that a patient will need glasses for reading or night driving. At Wills Laser Vision at Princeton, we have achieved an excellent success rate with a low requirement for enhancement.
- LASIK surgery is too new to know if there are any long-term ill effects beyond twelve years after surgery. The first LASIK medical device was approved by the FDA in 1998, so there are still no long-term medical studies about LASIK.
What are risks and possible complications of LASIK?
Complications are relatively rare and almost always treatable. In fact, the surgeons at Wills Laser Vision at Princeton are often called upon to handle other surgeons' complications. As with any other surgery, there is always some risk, but understand that our surgeons feel their greatest responsibility is the patient's safety.
Although complications following LASIK at Wills Laser Vision at Princeton are rare, it is our responsibility to alert you to these possible risks. Your doctor will go through these and any other risks, possible complications, and potential side effects specfic to your individual case with you in detail prior to your surgery, including the pros and cons of having one or both eyes done on the same day (this is the "informed consent" process).
Generally speaking, some risks and possible complications include:
- Over- or under-correction. These problems can often be improved with glasses, contact lenses and enhancements.
- Corneal scarring, irregular astigmatism (permanent warping of the cornea), and an inability to wear contact lenses.
- Corneal infection.
- "Loss of best corrected visual acuity" - that is, you would not be able to see as well after surgery, even with glasses or contacts, as you did with glasses or contacts before surgery.
- A decrease in contrast sensitivity, "crispness," or sharpness. This means that even though you may have 20/20 vision, objects may appear fuzzy or grayish.
- Problems with night driving that may require glasses.
- Flap problems, including: irregular flaps, incomplete flaps, flaps cut off entirely, and ingrowth of cells under the flap.
The following side effects are possible, but usually disappear over time. In rare situations, they may be permanent.
- Discomfort or pain
- Hazy or blurry vision
- Haloes or starbursts around lights
- Light sensitivity
- Small pink or red patches on the white of the eye
Describe the LASIK eye surgery procedure in detail.
Here's what to expect before, during, and after LASIK surgery:
You'll need a complete eye examination. Take your eye prescription records with you to the exams and leave your contact lenses out as directed by our LASIK coordinators.
Our doctors will:
- Dilate your pupils to fine-tune your prescription.
- Examine your eyes to make sure they're healthy. This includes a glaucoma test and a retina exam.
- Take the following measurements:
- The curvature of your cornea and your pupils. You may be rejected if your pupils are too large.
- The topography of your eyes to make sure you don't have an irregular astigmatism or a cone-shaped cornea - a condition called Keratoconus.
- The pachymetry - or thickness - of your cornea. You need to have enough tissue left after your corneas have been cut and reshaped.
If you intend to proceed with surgery you will be asked to sign an informed consent form after a thorough discussion of the risks, benefits, alternative options and possible complications. Review the form carefully. Don't sign until you understand everything in the form. If your doctor doesn't think LASIK is right for you, you might consider getting a second opinion; however, if the opinion is the same, believe it.
If you qualify for surgery, your doctor may tell you to stop wearing your contact lenses for a while before the surgery is scheduled because contacts can temporarily change the shape of the cornea. Your cornea should be in its natural shape the day of surgery. Your doctor also may tell you to stop wearing makeup, lotions or perfume for a few days before surgery. These products can interfere with the laser treatment or increase the risk of infection after surgery.
LASIK is an outpatient surgical procedure. The only anesthetic is an eye drop that numbs the surface of the eye. The surgery takes 10 to 15 minutes for each eye. Sometimes, both eyes are done during the same procedure; but sometimes, surgeons wait to see the result of the first eye before doing the second eye.
The Surgical Procedure: A special device cuts a hinged flap of thin corneal tissue off the outer layer of the eyeball (cornea) and the flap is lifted out of the way. The laser reshapes the underlying corneal tissue, and the surgeon replaces the flap, which quickly adheres to the eyeball. There are no stitches. Plastic goggles are placed over the eye to protect the flap.
Healing is relatively fast, but you may want to take a day off after the surgery. Be aware that:
- You may experience a mild burning or sensation for a few hours after surgery. Do not rub your eye(s).
- Your vision probably will be blurry the day of surgery, but it will improve considerably by the next day when you return for a follow-up exam.
- If you experience aggravating or unusual side effects, report them to your doctor immediately.
- Do not drive until your vision has improved enough to safely do so. 98% of patients drive without glasses the next day.
- Avoid swimming, hot tubs and whirlpools for two weeks after surgery.
How much does LASIK surgery cost?
Visit our Financial Information page for details on what you might expect for LASIK surgery, as well as financing options. When judging price among any eye care professional, consider the amount of expert care dedicated to each patient. In the case of Wills Laser Vision, our pricing covers in-depth consultation with the patient prior to surgery, the surgery itself, all medications, post-operative care, and any necessary enhancements for one year.
How long does LASIK surgery take?
LASIK surgery itself takes very little time - generally 15 minutes. Your stay will be approximately 1-1/2 to 2 hours on the day of your surgery. You should plan on relaxing the day of your surgery, and save time the next day for a follow-up visit.
What is the best technology for LASIK?
Although the results from LASIK are largely surgeon-dependent, your results also depend on the equipment used. Wills Laser Vision at Princeton is equipped with the most advanced technology, including the newest generation of IntraLase 100% Blade-free LASIK, and a state-of-the-art excimer laser and microkeratomes. For optimal results, we calibrate our VISX WaveScan S4 laser system prior to each patient treatment and sterilize our equipment prior to each use. At Wills Laser Vision quality is our main concern. We do not cut corners.
Are there alternatives to LASIK?
Other Refractive Procedures exist which may in some cases be more suitable for patients than LASIK. The surgeons of The Princeton Eye Group have extensive experience in the whole armanentarium of refractive procedures and will recommend them when appropriate. Here are some of the procedures:
- Photorefractive Keratectomy (PRK) is a laser procedure used to reduce myopia, hyperopia and astigmatism without creating a corneal flap.
- Phototherapeutic Keratectom (PTK) is a laser procedure used to treat various ocular disorders by removing tissue from the cornea.
- Astigmatic Keratotomy (AK) is an incisional procedure to reduce astigmatism.
- Intrastromal Corneal Rings are clear, thin, polymer inlays placed on the eye to correct low myopia only.