Frequently Asked LASIK Questions
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- Who is a good candidate for LASIK?
- Good general health is necessary for laser vision correction. As such, Phoenix / Scottsdale LASIK surgery patients with rheumatoid arthritis, lupus and other connective tissue disorders are often non-candidates, though patients with well-controlled diabetes can often still have surgery. Prior to surgery, we take a thorough medical history and discuss potential medical contraindications in detail.
As expected, the eyes must also be in good health. A history of herpes keratitis, keratoconus or severe dry eye syndrome is often disqualifying. However, the Arizona desert is dry and we commonly treat patients with moderate dryness. Significant cataracts are a contraindication to laser vision correction, though patients with mild cataracts or glaucoma can often still have surgery. A stable eyeglass prescription is another prerequisite.
There are two medications that are disqualifying. The first is the acne medication Accutane (isotretinoin). The second is the heart medication Cordarone (amiodarone). It is essential to tell us if you have ever taken one of these medications, as they must be discontinued for a long time in order to proceed with laser vision correction.
- What are the age limits for LASIK?
- The absolute minimum age for any laser vision correction procedure is 18, and as long as the eyes are healthy, there is no maximum age. For younger patients, it is essential to document that the eyeglass prescription is stable prior to contemplating surgery. Often, deferring surgery until the patient is in his or her early 20s is advisable to ensure the best long-term results.
- Can I have LASIK if I am pregnant or nursing?
- No. Pregnancy and nursing often cause fluctuating vision, so accurate measurements cannot be obtained. Furthermore, oral medications and eye drops carry a theoretical risk to the baby, and there is no reason to take this risk with an elective procedure. Once the baby is born and normal menstrual cycles have resumed, laser vision correction can be pursued.
- Is LASIK permanent? What are the long-term results?
- It is difficult to study long-term results, because patients often move away or are otherwise lost to follow-up. However, over the last 15 years, several million people have undergone laser vision correction. If the results only lasted a short while, word would be out by now and the procedure would have lost favor with the public. The longest formal study of laser vision correction that we are aware of is now ten years out, and the vast majority of patients are still enjoying good vision.
- How quickly will I recover?
- Most patients who have a flap procedure such as LASIK or IntraLASIK are comfortable, see clearly, and are able to drive and work the next morning. However, recovery takes longer for patients who have a flapless procedure such as PRK. There is a three to five day period that the eyes are scratchy and watery. Medication for discomfort is sometimes needed. This initial healing phase is typically down time for the patient. The vision is usually good enough to get by, but patience is required as the vision gradually reaches its full potential over a period of several weeks.
- What are the common risks of LASIK and other vision correction procedures?
- Dryness is common for the first few months after laser vision correction. It is more pronounced with flap procedures, such as LASIK and IntraLASIK, versus flapless PRK. During the first month, lubricating drops such as Systane are often needed throughout the day. Dryness typically lessens by the second or third month, with only occasional drop usage thereafter. Transient night glare and halos are typically present for two to three weeks after surgery. A small percentage of patients require a retreatment (also known as an enhancement or fine-tuning procedure) a few months after the original procedure.
With flap procedures, inflammation underneath a LASIK or IntraLASIK flap is not uncommon and is treated with anti-inflammatory drops or rinsing underneath the flap. Occasionally, small striae (microscopic wrinkles) develop from flap trauma the first night after the procedure. These are removed by lifting, smoothing and resetting the flap. Epithelial ingrowth (migration of the surface epithelial layer of the cornea underneath the flap) is uncommon with primary treatments, but more common after retreatments. It is treated by lifting the flap and clearing out the epithelium, though this is rarely necessary.
With flapless procedures, some PRK eyes take longer than 3 to 5 days for the initial healing to finish. Therefore, the eye can remain scratchy, watery and uncomfortable for longer than expected. In the past, corneal haze (opacification of the surface of the cornea) was common with PRK, but with modern techniques significant haze is rare.
There are no serious side effects that are common, as for obvious reasons, no one would have surgery.
- What if time passes and my vision is not clear?
- A small percentage of patients need an enhancement procedure to fine-tune their vision. Enhancements are typically performed three to six months after the primary procedure. At Q Vision, enhancements are provided at no additional charge, as long as they are performed within one year of the primary procedure. Enhancements often cost extra at other centers.
- Will I need reading glasses after LASIK?
- If you are over 40 and have perfect distance vision in both eyes, then you will need reading glasses to see up close. This is true regardless of whether your vision is naturally clear at a distance, has been laser corrected for distance or is corrected for distance with contact lenses. Patients who wear glasses for distance vision will either have to take off their distance glasses to see up close or wear bifocal lenses. For those patients who wish to maximize their freedom from reading glasses, monovision is often the preferred option.
- What is monovision?
- Monovision involves correcting one eye fully for distance while leaving the other eye more blurry at distance but better up-close. For many patients, the brain is able to take the clear distance picture from one eye and the clear up-close picture from the other eye and create a full range of vision. The compromise is that the distance vision is not quite as clear as it would be if both eyes were corrected for distance.
- Is the actual procedure painful?
- There is generally no significant pain during a flapless procedure such as PRK. With LASIK, there is a strong pressure sensation during creation of the flap, but again generally no pain. The pressure sensation is less intense with an Intralase flap.
- How long does the actual procedure take?
- From in the laser suite to out of the laser suite usually takes 17 to 18 minutes. Most of the time is spent preparing for the procedure (cleaning around the eyes, positioning, applying sterile drapes) and following a "preflight checklist" of calibrating, checking and double-checking the laser. The actual procedure time is quite brief. Flap creation takes 30 to 45 seconds and laser treatment usually lasts 20 to 40 seconds.
- Can I have both eyes treated at once?
- Yes. The standard of care is to treat both eyes at once. However, we are more than willing to treat one eye at a time, if that is your preference. Just keep in mind that your eyes may feel out of balance in between treatments.
- Can I drive home from my procedure?
- No. You must have someone you know and trust drive you home. Since you will receive a sedative, we cannot even release you to take a taxi or bus.
- Do I have to stop wearing my contacts prior to LASIK?
- You don't need to stop your contacts prior to your initial consultation, though if you are pretty sure that you want to pursue treatment, doing so will allow you to have your procedure sooner. However, once a decision is made to pursue treatment, contact lenses must be stopped in order to obtain the most precise measurements and achieve the best possible vision. The official FDA recommendation is that daily wear contacts be held for two weeks, toric or extended (overnight wear) lenses for three weeks, and RGP or hard lenses a minimum of one month.
- I live far away. Is there a convenient way for me to have LASIK at Q Vision?
- Q Vision has treated patients from Florida to Alaska and as far away as England, Japan and Germany. We commonly treat patients from Tucson, Prescott, Flagstaff and Phoenix metropolitan locations that are some distance from our Scottsdale laser suite. We can often work together with your primary eye doctor to reduce the number of times you need to travel to Scottsdale. In fact, many patients travel to Arizona and visit a LASIK and cataracts Scottsdale surgeon for their procedure and next day checkup, and the rest of their visits are conveniently close to home with their local eye doctor.
- I've seen the LASIK for $299 ads. What's the catch?
- Again, the Lasik MD website has a great article: The Secrets of $299 LASIK.
- Is there anything better than LASIK on the horizon?
- In short, no. For many years the answer to this question was custom wavefront-guided LASIK, but this technology has now been available for over five years. Though we expect incremental improvements in wavefront technology to continue, there are no new breakthrough technologies around the corner.
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