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LASIK Laser Eye Surgery Frequently Asked Questions
Provided by Dr. James Kao


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What is LASIK?


LASIK, or laser in-situ assisted keratomileusis, is an outpatient procedure that uses a cool laser beam of ultraviolet light to reshape the cornea, the clear outer covering of the eye. The laser removes microscopic layers of tissue to change the curvature of the cornea and correct common vision errors such as nearsightedness, farsightedness and astigmatism.


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What can LASIK do for me?


Millions of people have been enjoying the benefits of laser vision correction since the early 1990s. You can expect to improve your vision and enjoy an active lifestyle without relying on glasses or contact lenses. LASIK is very successful in helping people gain freedom from corrective eyewear; however, the degree of improvement in vision may vary among individuals. Most people with mild to moderate prescriptions can achieve 20/20 vision or within one to two lines of 20/20 vision on an eye chart. Ask your surgeon about your specific prescription.


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Am I a good candidate for LASIK?


If you are 18 years of age or older, you may be a good candidate for LASIK as long as your overall medical status and the health of your eye is satisfactory. You should also have vision errors (nearsightedness, farsightedness or astigmatism) that fall within the FDA-approved range and have had a stable prescription for the past 18-24 months. You would not be a good candidate if you have cataracts that have not been treated, a vision condition called keratoconus (an abnormal thinning of the cornea) or any ocular disease that is not controlled. For a complete list of contraindications, please speak with a patient counselor.


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Is All-Laser LASIK different from Traditional LASIK?


To understand the difference between All-Laser LASIK and traditional LASIK, you first have to understand that laser vision correction is a two-step process. The first step involves creating a small flap on the surface of the cornea. To do this, traditional LASIK uses a mechanical surgical blade called a microkeratome. All-Laser LASIK uses the IntraLase laser. All-Laser LASIK is sometimes called blade-free LASIK or IntraLASIK. The IntraLase laser creates a corneal flap that has a more consistent thickness. A corneal flap made with a microkeratome can vary from 140 to 250 microns, whereas the IntraLase laser can create a 100-micron flap every single time to within +/- 10 microns. Additionally, IntraLASIK eliminates the possible complications of the microkeratome blade, making it a safer, blade-free LASIK procedure with a faster healing time.


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What is the second step of the LASIK process?


After the corneal flap is temporarily moved aside, the surgeon uses an excimer laser to reshape the cornea based on the patient’s prescription. Once the reshaping is complete, the surgeon moves the corneal flap back into place and the flap begins healing immediately without stitches.


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Is All-Laser LASIK safer than traditional LASIK?


Clinical studies show that All-Laser LASIK is safer than traditional LASIK, with reduced risk of flap complications and infection. It is also more precise and accurate. The IntraLase has a long wavelength, which allows cool laser energy to pass safely through the top layer of the cornea, and a short pulse, which delivers short bursts of energy close together for a smooth, precise separation of tissue, rather than a cut. With IntraLase, there is a lower incidence of corneal abrasion than with the microkeratome, along with reduced potential for persistent striae (wrinkles) that can obscure vision, and reduced problems with the growth of corneal epithelium under the flap. It also eliminates the risk of infection from use of the blade.


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Is All-Laser vision correction the same as All-Laser LASIK?


No, PRK, is an earlier form of laser vision correction that does not require a corneal flap, and can technically be called all-laser vision correction. But, only LASIK using the IntraLase FS laser is the blade-free, All-Laser LASIK that offers superior results with improved safety and reduced potential for complications.


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What is CustomVue® All-Laser LASIK?


CustomVue All-Laser LASIK is a laser vision correction procedure that is tailored for your specific vision care needsÑit is a customized approach to LASIK using the revolutionary WaveFront mapping diagnostic system, and the IntraLase laser to create the corneal flap.


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What is WaveFront mapping?


WaveFront mapping is a diagnostic tool that allows the surgeon to obtain a detailed three-dimensional map of your entire optical system. WaveFront mapping measures the curve of the cornea, how light is distorted as it reaches the retina, and both lower- and higher-order aberrations or vision errors.


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Can you explain lower- and higher-order aberrations?


Glasses, contacts and traditional LASIK correct lower-order aberrations-nearsightedness, farsightedness and astigmatism. However, they do not correct higher-order aberrations, which are irregularities unique to your particular eye, just as your fingerprint. Higher-order aberrations could not be detected and mapped prior to WaveFront technology, so they remained uncorrected. Now, correcting these irregularities enhances patient satisfaction, reduces the potential for problems with night vision and provides even sharper visual acuity.


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What type of WaveFront system does LASIK Today use?


At LASIK Today, we use CustomVue by VISX. Wavefront LASIK is used to extract digital information of your eye and the WaveFront map of your eye is transferred directly to the excimer laser used to correct your vision. This allows for the most precise and accurate shaping of the cornea.


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What kind of results can I expect?


The goal of LASIK is to reduce or eliminate your dependence on glasses or contact lenses. Using CustomVue All-Laser LASIK technology, 95 percent of patients achieve 20/20 vision, and some patients even achieve 20/15 vision. However, even with the best technology and skilled surgeons, we cannot guarantee perfect vision; the results may vary among individuals.


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What’s the difference between LASIK and PRK?


PRK is generally considered the forerunner to LASIK. PRK involves the use of a laser on the surface of the eye without creating a corneal flap. It takes longer to heal when compared to LASIK. LASIK is usually considered the treatment of choice because it offers less discomfort, faster recovery of vision, and less risk of corneal scarring. It also offers a wider range of corrections.


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Does LASIK hurt?


Anesthetic drops are used to numb the eye before surgery. You may feel pressure, but little or no discomfort. You may also receive a mild sedative to help you relax and to alleviate any anxiety. After the procedure, your eyes may feel mildly irritated for a few hours, but this is temporary and can be relieved by keeping the eyes closed for several hours. You will be given eye drops to take care of any dryness you may experience in the first few days after surgery.


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How long does the procedure take?


LASIK is an outpatient procedure that takes less than 10 minutes. You can expect to stay at the center for approximately one and a half to two hours the day of your procedure for testing, pre-operative care and so you can rest before you go home.


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Will I see better immediately?


Most patients will notice a marked improvement in vision immediately with a steady increase in visual acuity during the 24 hours following the procedure. Most patients are able to drive to their one-day postoperative appointment. Vision will continue to improve during the next one to two months. The speed of recovery may vary among individuals, although most can return to work and resume all normal activities within a few days. Ask your patient counselor about the specifics of post-operative care.


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What are the risks and side effects?


LASIK has been performed since the early 1990s and millions of people are happy with the results. However, as with any surgical procedure, there is some risk. Fortunately with LASIK, the degree of risk is very low and the potential of vision-reducing complications is less than one percent. Any risks and possible side effects are fully discussed prior to the procedure. The best way to prevent LASIK complications is to select a surgeon with extensive experience and skill performing laser vision correction. You can be confident in selecting LASIK Today for your vision correction, knowing that your surgeon will be a highly respected and knowledgeable LASIK professional.


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What if I’m not satisfied with the results?


Occasionally, an enhancement may be required to help you achieve your best-corrected vision (BCV). If your eye is under-corrected or over-corrected, additional treatment, called enhancement surgery, can be scheduled within a few months. Depending on your vision correction plan, enhancements may or may not be included in the price of your procedure.


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Can I have LASIK on both eyes at the same time?


Both eyes are usually operated on during the same sitting. This is called bilateral surgery. Bilateral surgery restores balanced vision immediately, which is a benefit if you cannot wear a contact lens in the eye that has not yet been corrected.


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How long will the results last?


The results of laser vision correction are designed to be permanent. You may need an enhancement to help you achieve your best-corrected vision, but the changes to your eye after LASIK are meant to last a lifetime. Any vision change in the future may be related to presbyopia (over 40 vision) or other eye conditions, such as cataracts.


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What is monovision?


Some patients may request that the surgeon treat one eye for near vision and the other eye for distance vision. This type of blended vision is called monovision. Not everyone is comfortable with this type of procedure. Talk with your doctor about whether or not you would be a candidate for correcting monovision.


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Will LASIK prevent me from getting cataracts or glaucoma?


LASIK has no effect on whether you will develop an eye disease such as cataracts and glaucoma, and it will not interfere with treatment, including cataract surgery.


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Is LASIK affordable?


LASIK Today offers affordable vision correction procedures based on the type of procedure best suited to your vision care needs. Remember, LASIK is an investment that will pay off with greatly reduced dependence on glasses and contacts. You may no longer have the cost of maintaining your contact lenses and glasses, leading to significant savings over time.


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Does CustomVue LASIK laser eye surgery cost more than traditional LASIK?


At LASIK Today we offer several vision packages that take into consideration both the your laser eye surgery cost budget and your prescription. The Value Package offers Traditional, low budget LASIK performed with the VISX Star S4 Excimer Laser and a microkeratome. The Select Package features WaveFront Custom LASIK performed with the VISX Star S4 Excimer Laser System with Iris Registration and microkeratome. The Premium Package offers WaveFront Custom LASIK performed with the VISX Star S4 Excimer Laser with Iris Registration and the all-laser, blade-free IntraLase FS.


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What are my payment options?


At LASIK Today, we offer several affordable payment plans, ranging from interest-free to long-term extended payment plans. You will find the application process simple with quick approval. We also accept most major credit cards. Some patients take advantage of this option because their credit card reward program offers airline miles or points toward merchandise. You might want to compare your credit card’s interest rates with our financing options. LASIK might also qualify as a tax deduction, depending on your circumstances. Check with a tax professional.


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Is LASIK covered by insurance?


Most of the time, LASIK is considered an elective procedure. However, you should check with your insurance company to find out they provide coverage for LASIK vision correction.


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Will my Flex Plan pay for LASIK?


A company-sponsored flex plan or Medical Spending Account is an excellent way to pay for LASIK. Flex dollars are deducted from your paycheck before taxes, which allows you to pay for health expense with pre-tax dollars. Check with your employer to determine your companyÕs flex plan rules and regulations.


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James J. Kao, DO, PC


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