Learning Center
Questions and Answers
What is laser vision surgery?
Surgery done with a laser, most often an excimer laser, to remove corneal tissue in order to reshape the surface of the eye to bring it into better focus and reduce or eliminate the need of corrective glasses or contact lenses.
What’s the difference between Lasik & PRK
The difference between PRK and LASIK is the location on the eye that the laser treatment is applied. In PRK, the laser pulses are delivered to the surface of the cornea, whereas, in LASIK a corneal flap is created and the laser treatment is placed beneath this flap. Patients undergoing the LASIK form of treatment recover quicker, which has always made it the more popular form of laser treatment.
Are Lasik and PRK safe?
Both PRK and LASIK have been found to be safe and effective by the FDA. For more information, please refer to these
official Visx Patient Information documents:
What are implants?
Implants are lenses, smaller than a dime, that are made of various materials, purified plastics, silicone, and synthetic combinations, that can be placed inside the eye to either replace the natural lens (cataract removal) or correct nearsightedness, farsightedness, etc.
How does laser surgery differ from RK & implant surgery?
RK was a procedure employing surgical micro-knives to make small incisions in the cornea to induce a shape change. There was no removal of tissue in the RK procedure. RK was less accurate and had a smaller treatment range than either laser or implants. Lasik uses an excimer laser to directly alter the shape of the cornea by removing tissue, and implants are lenses placed inside the eye to alter the power of the eye.
How do I know if I’m a candidate?
If you are 21 years old or older, feel that your glasses or contact lenses prescription is not changing significantly anymore, and have no serious medical or eye conditions, you may likely be a candidate for some form of vision correction surgery. There are still factors that may disqualify you for surgery. Our consultation and evaluation process is designed to complete the process of determining your candidacy for one of the various treatment modalities we employ. The best thing is to call our office and speak to one of our technicians/counselors for more information.
What is the current minimum age for having Lasik?
The labeling of the Visx excimer laser system that we use states that patients should be 21 years or older to have PRK or Lasik. If a patient is good candidate with the exception of age, the surgery may be performed as an “
off–label” procedure.
How long do I have to have my contacts out before my exam and surgery and why?
It is important for your eyes to return to their most normal shape and healthy condition. FDA guidelines indicate that all soft contact lens wearers should be out of their contacts at least two weeks prior to their exam and surgery, and hard and gas perm lens wearers should be out at least three weeks. These are minimums and depending on how out of shape your eyes are it could take much longer.
If I start the process today, how soon can I have surgery, and what do I do first?
If you don’t wear contact lenses, have no medical or eye problems, you may be able to complete the consultation,
complete examination and surgery within a period of one week, perhaps slightly less in ideal circumstances. You start
by scheduling either a consultation or a combination consultation and comprehensive examination. Otherwise, the main
factor is the period of time required to stabilize the eyes after contact lens use. See the
above answer
about contact lens removal.
Can I do both eyes at once?
Yes you can, if you wish. Most of our patients prefer this simultaneous treatment, however, there can be circumstances in which one eye at a time may be preferable. There are some surgeons that prefer the one eye at a time treatment, but most surgeons do not. It is, however, more common that surface laser procedures (PRK, LASEK) may be performed one eye at a time.
How long does it take?
For the advanced IntraLasik procedure, you will be at the office for about one hour and fifteen minutes. In terms of the actual surgery time, it takes approximately 8–10 minutes to create two corneal flaps with the Intralase device, and another 15 minutes to reshape the cornea with the Visx excimer laser system. Surface laser procedures take shorter time, usually about 45–60 minutes. When we begin with the phakic lens implant procedures we expect them to take approximately the same as IntraLasik.
Does the surgery hurt?
There is little to no discomfort with the Lasik procedure. Your eyes are numbed prior to surgery with anesthetic eye drops. You will feel a small lid support holding your eye open during the procedure, and there is a short period in the flap creation part of the Lasik procedure where there is a pressure sensation that most patients report this as “uncomfortable”, but not painful.
What happens on the day of the surgery?
- We ask that you arrive promptly at the time you are scheduled.
- Please wear comfortable clothing.
- Abstain from wearing makeup, perfume, fragrant body lotions, cologne or after–shave, since vapors from these scents may interfere with the delivery of the laser beam.
- Avoid drinking any products containing caffeine, as you need to go home and sleep after the procedure.
- You will need to arrange for transportation. We recommend you have someone you know assist you in getting you home safely.
- Expect to be at the Center for approximately one hour and fifteen minutes.
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In The Preoperative Area
- Upon arrival, you will be escorted to the preoperative area where the nurse on duty will greet you and take care of you.
- You will be asked to read and sign the consent for surgery form. Should you have any questions, be sure to ask the attending nurse prior to signing.
- You will be given a mild sedative to relax you, followed by a series of antibiotic eye drops, prior to entering the laser suite. Anesthetic drops to numb the cornea are instilled just prior to entering the laser suite.
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In The Operating Room
- Laser vision correction is performed in a two main steps. Flap creation with the Intralase will take approximately ten minutes for two eyes. You will then be escorted back to your recliner chair to rest for approximately 10-15 minutes as the small bubbles developed by this process dissipate.
- The treatment laser (Visx) is programmed with your correction before you even enter the second laser room.
- After you enter the second laser room, it will take a few minutes to prepare and position you properly under the microscope.
- The procedure itself will take no more than 10–15 minutes.
- Immediately after Surgery
- We ask that you go directly home and sleep. The healing begins while you are sleeping. It is best to go to sleep while your eye(s) are still numb.
- You will be given medications and eye drops to take home, along with postoperative instructions.
- A follow-up appointment will be scheduled for the very next day. This visit will be brief in nature, but very important. At that time, the doctor will verify that the flaps are healing well and measure your vision.
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What Is Normal After Surgery?
- Tearing, burning, and foreign body sensations are normal and are usually gone by the following morning.
- A few patients may be light sensitive following surgery, and if so, this should go away several days to a week or two. Sunglasses may be worn to ease the discomfort if needed.
- Some initial soreness may occur due to the suction ring. This also should quickly diminish.
When can I resume driving?
Since 99% of our Lasik patients will be at least 20/40 or better (legal driving vision) without their glasses the morning after surgery, most patients can resume normal activities the day after surgery. Occasionally, a patient may be somewhat light sensitive or still feeling the effects of the medications used the day before. Also, don’t forget to change your drivers license status.
PRK and Lasek patients may have a somewhat more delayed recovery, especially if both eyes are done at the same time, as it generally takes longer to regain sharp vision.
When can I go back to work?
Depending upon the nature of your job you can often return the day after surgery. Most patients prefer surgery on a Thursday or a Friday to have the weekend to recover, although it is usually not really necessary. You will need to protect your eyes from injury or rubbing. If you work in an environment that causes eye irritation it may be necessary to wear eye protection and use you eye lubricants liberally.
When can I resume wearing makeup?
We feel it is best that patients should refrain from makeup use for about two weeks. It is the rubbing action required to remove the makeup that concerns us, not putting the makeup on. Other facial makeup is fine, but not those items involving eye rubbing to remove.
How many checkups do I need after surgery?
The typically postoperative follow-up regimen is as follows:
- First day after surgery
- One month after surgery
- Three months after surgery
- Six months after surgery
- One year after surgery
What if it doesn’t work as well as it should?
While laser treatments are highly accurate when fired into plastic testing plates, plastic doesn’t heal and change shape afterwards, as some patients do. There is always the possibility that the initial treatment will not adequately correct the refractive error. This most is apparent immediately, is not usually of such a magnitude that it requires glasses correction, but needs to stabilize before being addressed by an enhancement procedure. This stabilization period is typically three months for nearsighted patients and six months for farsighted patients. This explains why 75% of all retreatment procedures occur within a three to six month period postop.
A few patients we do well initially but slowly change over a longer period of time as their personal healing may affect the result. We will wait until this stops and, again, perform an enhancement as needed (99% of all retreatments occur within the one year period).
What if my vision changes years later? Can I have it again?
If the vision changes slowly over many years, this is related to changes in the eye that are unrelated to the original laser treatment, but instead, reflect ongoing structural shape changes biologically programmed into the eye, or some other medical condition affecting the eye. These can, where safe and appropriate, also be addressed by the retreatment process even if many years later.
I’ve heard that your eyes get dry after the surgery.
Yes, temporarily. Laser vision correction causes a transient decrease in tear production that results in dry eye symptoms. This problem can generally be alleviated by the use of artificial tears until the eye begins to produce an adequate quantity of tears on its own. If there are particular dry eye concerns found during your preoperative examination, steps can be taken to minimize the effects of the dryness.
I’ve heard that Lasik makes your near vision worse?
If you are under the age of 40, you should not experience any trouble seeing up close after surgery for some time. However, due to the natural aging of the eye, around age 40, people usually have trouble seeing up close and must resort to store–bought magnifying glasses to read small print.
This reduction of near vision will develop eventually regardless of whether or not you undergo laser eye surgery. If you do not have surgery, nearsighed patients will need to wear reading glasses over their contacts or go into bifocals. If you already need reading glasses prior to surgery, your dependence upon them will remain and may even be increased as a result of your distance vision being improved.
Monovision is one option for patients over 40 who would like to see up close and far away. With monovision, one eye is treated for distance and the other eye is treated for near vision.
New technologies are becoming available that will try to solve this age–old problem and restore reading vision as well as distance vision in patients as they age.
I’ve heard that Lasik makes your night vision worse
For many people, glare and halos are a fact of life regardless of whether or not they have had laser vision correction. Scientific studies on the cause of glare, halo and overall night vision issues are confusing. Some believe pupil size is critical in the issue of night disturbances, while some do not. Night vision problems are, most likely, related to multiple factors, one of which is what’s called higher–order aberrations. We feel that the main thing that we can do to prevent the increase in night vision problems is to minimize the increase of these higher–order aberrations during surgery. In the flap making step of LASIK, the use of the Intralase to produce a more precise flap helps in reducing the induction of aberrations. During the main laser treatment, the use of the wavefront–guided CustomVue system helps to insure that we are inducing as few of these aberrations as possible.
Another point to keep in mind concerning night vision problems is that greater degrees of refractive error (nearsightedness, farsightedness, and
astigmatism) require more treatment and thus may lend to a greater chance of inducing unwanted aberrations. Each patient must be assessed individually and these issues are addressed in your evaluation.
How many vision correction surgeries has Dr. Hale personally performed?
Dr. Hale has been a board certified Ophthalmologist for 25 years and 20 of those years have been spent performing refractive surgeries including Radial Keratotomy (RK),
Astigmatic Keratotomy (AK), Automated Lamellar Keratoplasty (ALK), and now, the procedures of choice: LASIK, LASEK, and PRK.
The estimated number of refractive procedures Dr. Hale has performed over the past 20 years exceeds the 15,000 mark. LASIK cases performed by Dr. Hale are estimated at about 12,000 (Dec. 2003). While the high number of cases Dr. Hale has performed is reassuring to the patient, equally valuable is his comprehensive experience in all refractive procedures.
Will I be 20/20 after the surgery?
No surgeon can guarantee the outcome of a surgical procedure beforehand. However, our rate of success is extremely high, as evidenced by the fact that we are one of the only centers in the nation to publish our exact success rates online:
For a general review of our results, please see the
Success Rates page in our
Statistics section.
To see our actual results for your exact prescription, please see the
Results Calculator in our
Statistics section.
What about these $299 Lasik ads? What’s that about?
There was purposeful price confusion interjected into the LASIK arena a number of years ago by discounting
organizations hoping to attract patients with a “too good to be true” low price. Once you were
in the door and had given up your credit card number, you would suddenly find the actual price to be much higher.
Often patients found themselves in too deep to get out without a fight and decided to just go through with it.
Please visit our
“Other Providers” page and learn more
about the various organizations that make laser vision correction services available to the public.
Why have you switched to the Intralase to make flaps after all these years of using a different method?
Time marches on and so does technology. When we starting creating flaps in 1992 (before lasers and LASIK), we used
what we thought was the best keratome (instrument used to cut corneal flaps) available at the time, it was also the
only unit available to us at the time. In 1998, a new, improved model keratome was introduced by the same manufacturer.
While it still worked on the same basic principle, an oscillating blade, we tried it and immediately saw the advantages
of the new modifications. To our satisfaction, we put aside our old, trusted keratome and proceeded with the more modern one.
In 2002, we saw the introduction of a revolutionary new way to create corneal flaps, the Intralase. Using infrared light pulses,
we could create a flap without a metal blade. However, we were not easily convinced as the early results were not clearly superior
to what we were currently providing. As this device was tested and improved, it became clear that it was superior to any other
existing method for the creation of a corneal flap. Therefore, in the summer of 2004, after attending a major medical meeting at
which scientific papers were presented that documented the superiority of this method, Hale Vision invested in this new technology.
We have since been thrilled with our results and couldn’t imagine going back to the “old days” of the mechanical
microkeratome, even though there is nothing wrong with the older technology, and it is still widely used today. We do, however, feel
that the day is radiply approaching when all LASIK will be performed with an Intralase-like device. For further information on Intralase
see our “
Technology” page or visit the
Intralase website.
What are the risks and potential complications associated with laser vision correction?
We have listed the most common concerns elsewhere on this website. Please
our LASIK Book for a general discussion of these issues and the
Success Rates page of our
Statistics section for our actual numbers.
Prior to surgery, you will be given an Informed Consent document that lists the risks and possible complications of your procedure comprehensively. We also advise that you download and read the
Patients Information Booklet from
Visx.
May I speak with any of the patients on whom you've done this procedure?
Definitely. We have a long list of past patients who have offered their phone numbers to anyone considering surgery. In fact, we have such a collection of patients that we can often connect you with past patients who are of similar prescription, age, or who enjoy the same recreational activities, such as golf or tennis.
Sharing the Vision
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