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LASIK Laser Eye Surgery Frequently Asked Questions
Provided by LaserVue Eye Center


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What is LASIK?


LASIK, short for Laser Assisted In Situ Keratomileusis, is a 15-minute laser vision correction procedure, which reduces dependence on corrective lenses or eliminates the need for corrective lenses altogether, depending on patient-specific variables. In the procedure, the LASIK surgeon lifts a tiny flap of tissue on the surface of the eye in order to reshape the underlying cornea through use of a computer-guided excimer laser. The surgeon then repositions the flap of tissue over the reshaped cornea. LASIK is a surgical procedure that is capable of correcting a wide range of nearsightedness (myopia), farsightedness (hyperopia) and astigmatism.


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What is an excimer laser and how does it work?


The excimer laser produces a high-energy, cold, ultraviolet light beam in pulses and delivers the pulses to a surface of the eye's cornea. These pulses break the bond between molecules and tissue cells so that a controlled amount of tissue can literally be vaporized away to reshape the cornea -- one microscopic layer at a time. The excimer laser is computer controlled and programmed to custom treat each individual eye with a high degree of precision. For most cases, the thickness of the layer removed by the laser is less than the thickness of a human hair.


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What results can I expect from LASIK?


The goal of any refractive surgical procedure is to reduce or eliminate your dependence on corrective lenses ? so that you may freely enjoy activities without the encumbrance of glasses or contacts. Our commitment to you is that we will not perform laser vision correction on you or anyone we feel does not have a good possibility of achieving independence from glasses and contacts. There are three main variables that will influence vision results: a thorough pre-operative evaluation to determine whether you are a good candidate for LASIK, the experience of your LASIK surgeon/team, and the equipment utilized. To ensure the best outcomes, it is critical that you select your surgical team wisely. Honest evaluation, surgical experience, and state-of-the-art technology are crucial to the end result.


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What are the risks associated with LASIK?


As with any surgery, there are risks. Fortunately, however, the risks are low and the patient satisfaction rate is high. The informed consent will outline the risks more thoroughly before you decide to have the procedure. Potential risks may include the following:
  • Halos - Some patients will notice glare, halos or starburst around objects in low-light conditions. For the vast majority, these symptoms are temporary. However, others will continue to experience them for several months or longer. During your pre-operative evaluation, we will determine whether or not you are at high risk for seeing long-term halos.
  • Dry eyes - There is increased dryness of the eyes typically for several months following LASIK, though some patients may experience dryness for a longer period of time. It is important to use lubricating drops frequently. If the eyes remain dry for prolonged period, there are other drops or techniques that can help. Again, your pre-operative evaluation will help determine whether or not you are a candidate for experiencing dry eyes
  • Infection -This is an extremely rare occurrence, with a 1 in 2000-3000 chance (similar to any eye surgery). Fortunately, as the LASIK technique has developed over the years and proven to be of great benefit to millions of patients nationwide, firmly established protocols now exist which minimize dramatically the risk of infection.



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Is LASIK surgery right for me?


The best way to determine if you are a candidate for LASIK is by an individual evaluation by our doctors. At that time, we will verify whether you are a good candidate for LASIK and answer any questions you may have. We will encourage you to understand the procedure, the risks and benefits, and to harbor realistic expectations.

In general, a good LASIK candidate is at least 18 years old, has healthy corneas, and has maintained a stable eye prescription for the last 12 months. People with certain medical conditions or women who are pregnant or nursing may not be good candidates.

We believe that not everyone is a good candidate for LASIK eye surgery. When it comes to your eyes, being discriminating is appropriate. Only careful examination of your eyes and your individual case/needs will determine whether LASIK is right for you.


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How important is the choice of surgeon?


In laser vision correction, complications rarely occur. But, when they do, they are usually related to the surgeon's experience and technique. Complications appear to be greatly reduced by the surgeon's experience, training, and meticulous attention to detail. Error rates that are less than one percent with a skilled LASIK surgeon can rise rapidly in less experienced hands. LaserVue surgeons have helped train many LASIK surgeons and co-managing doctors through proctoring, lectures and seminars. Additionally, LaserVue surgeons have designed several innovative LASIK instruments and a popular LASIK surgical nomogram. Because of our vast experience, hundreds of doctors, surgeons and other health care workers have trusted their eyes to Drs. Bansal and Singh. We routinely are asked to provide second opinions for LASIK complications experienced by patients from other providers. Both Dr. Bansal and Dr. Singh have performed many thousands of LASIK procedures.

It is crucial to select your surgeon wisely. Our goal at LaserVue is to communicate clearly to our patients what they can expect during their laser experience, and what their results are likely to be. We pledge to you, always, our honest evaluation and complete dedication.


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Isn't all laser vision correction the same?


No. Many of the discount LASIK centers want you to believe that LASIK should be purchased like a commodity and that surgeon experience, laser and diagnostic technology, and follow-up care do not matter. Laser vision correction will affect the way you see for the rest of your life. You should make your decision to have laser vision carefully, not quickly. We encourage you to visit other laser centers and compare them to us. Our website provides detailed information about our surgeons, our laser technology, our advanced diagnostic technology, and what you should expect for the money you spend.


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Can I have both eyes done at once?


Absolutely. We perform LASIK on both eyes on the same day in the overwhelming majority of our patients. There are pros and cons to this approach but most people would like to minimize any postoperative discomfort and time off from work.


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Is LASIK painful?


The procedure is painless. Your eye is anesthetized with numbing eyedrops. You will be awake and comfortable throughout the procedure. Most people experience 4-6 hours of mild irritation after their LASIK procedure and can return to work the next day.


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Will my eyes look different after LASIK?


No. Your eyes will look exactly the same.


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Will I need reading glasses?


Most normally sighted patients require readers in their mid-forties. This is caused by the normal weakening of the focusing muscles of the eye known as presbyopia, which usually starts around the age of 40 ? 45. This condition occurs with or without LASIK. Those patients who currently have bifocals will still need reading glasses after the surgery unless they opt for a treatment plan called monovision, wherein one eye is corrected for distance and the other for near vision.


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What is monovision?


If you are presbyopic, monovision is an option to help correct both your distance and near vision. The monovision procedure corrects the focus of one eye for distance vision and the other eye for near vision. Monovision is a compromise of both distance and near vision. Depth perception is also affected. For people with high visual demands like sports or constant near work (i.e., reading), we recommend full distance correction with glasses for near vision. A trial period with contact lenses or glasses may help determine if monovision would be a good option for you.


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Will my vision remain stable long after the procedure?


The vision correction is permanent. However, your vision may change naturally with time and LASIK does not affect visual conditions that may develop with age. Also, LASIK does not prevent presbyopia and the eventual need for reading glasses. Depending on the cause, retreatment may be a viable solution to later vision changes, and other treatment options also exist.


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Do I need to have my contacts out prior to my initial exam?


Yes. We recommend that you discontinue soft contact lens wear at least 3 days before your initial exam. For soft toric and gas permeable/rigid contact lenses, we recommend that you discontinue wear for a minimum of 3 weeks prior to your initial exam. However, prior to your procedure, we recommend you discontinue soft lens wear 1-2 weeks and a minimum of 3-4 weeks for soft toric/gas permeable lenses.


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How much should I pay for laser vision correction?


The cost of vision correction varies among practices, based on surgeon experience, technology, and what the center includes in the fee. We are not the least expensive provider. We have invested heavily in staff training and technology. Our advanced laser and diagnostic technology are second to none. This investment is extremely important to surgical results and our patients tell us they can see the difference. We encourage you to visit other laser centers and compare.

It's only natural to want to get the best price, but remember, quality, personal service, attention to detail and results are extremely important when it comes to your eyes. Your vision is one of your most important assets.


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Will my insurance cover LASIK surgery?


LASIK is an elective procedure, which means that the surgery is optional. As a result, only a few insurance companies pay for all or part of vision correction procedures - you can check with your plan administrator, or we will be happy to make a copy of your insurance card and check coverage for you. In some cases, the fees can be covered by medical flex/cafeteria plans that allow pretax dollars to be set aside - please ask your employer if they offer this type of benefit. Vision correction also may be tax deductible as a medical expense (check with your financial advisor).

If you do not have insurance coverage, we do offer affordable payment plans. It is easy to apply online and receive credit approval before you schedule an appointment.


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Should I be nervous about the procedure?


Eyes and vision are very precious. It is perfectly natural to be nervous about having the procedure. Much of this comes from fear of the unknown. Drs. Bansal and Singh and their staff spend a great deal of time describing exactly what's involved in the procedure and what sounds and sights you will experience. We will "walk you through the process" to make you as comfortable as possible.

It's always wise not to rush into something you know very little about, especially when it comes to something as precious as your vision. We encourage you to bring friends or family members with you to your laser vision evaluation so that we can educate them, as well as you, and answer any questions they might have. It may be comforting to know that LaserVue surgeons televise on closed-circuit monitors your surgical procedure for your loved one to view ?live?. We are very proud of our surgical techniques and protocol.


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What is an advanced technology intraocular lens (IOL)?


The advanced technology IOL is a new, state-of-the-art type of intraocular lens that can provide a full range of vision, from near to distance, in most patients. The procedure for removing the natural lens and implanting the advanced technology IOL is the same that's been used for years in cataract surgery, but the result is a full range of vision, significantly reducing or eliminating the need for glasses or contact lenses.


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What makes advanced technology IOLs different from ordinary intraocular lenses?


Unlike an ordinary IOL, the advanced technology IOL can focus on objects near and far. The Crystalens? is designed to be focused by the eye's natural muscle; the ReSTOR? and ReZoom lens have special surface design that brings near and distant objects into focus without muscle assistance. All are intended to provide patients a fuller range of vision, reducing the need for corrective lenses. With ordinary IOLs, most people MUST rely on glasses or contact lenses for middle and near vision.


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Do advanced technology IOLs provide 20/20 vision for both reading and distance?


Advanced technology IOLs were created to provide a fuller range of vision, near to distance. Nearly everyone will find their uncorrected vision significantly better after surgery, but some will not see 20/20 through the full range of vision.

Pre-existing ocular and physiological factors may prevent full range 20/20 vision. Your doctor will advise you of any conditions which may affect the outcome of your individual surgery.

In a two-year FDA clinical study, 92 percent of participants with Crystalens? in both eyes achieved 20/25 or better distance vision, 96 percent achieved 20/20 at arm's length (middle vision), and 73 percent achieved 20/25 near vision without glasses or contact lenses.

To apply the study results to real life, 98 percent of participants were able to pass driver's license eye exam, read newspapers and phone books. All of them could read a computer screen, dashboard instruments, and supermarket price stickers; all the female participants could apply makeup.

In FDA clinical studies of ReSTOR?, 80 percent of participants with the ReSTOR lens in both eyes did not use glasses or contact lenses after the procedure; 84 percent achieved 20/25 or better distance vision and 20/30 or better near vision and could read small stock quotes in a newspaper.


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How do advanced technology IOLs affect middle vision for tasks such as working on the computer? How does it compare to trifocals?


Advanced technology IOLs will greatly enhance middle vision, roughly arm's length, used for tasks such as using a computer, viewing dashboard instruments, or reading supermarket price stickers.

For many patients, there is no comparison to the hassle of trifocals. No matter the distance, near, middle, or far, your advanced technology IOLs can put your view in focus without the annoyance of tilting your head to see more clearly.


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How do advanced technology IOLs affect low-light vision?


Since the lens implant procedure replaces the cloudy natural lens with a crystal-clear IOL, the transmission of light to the retina should be enhanced. However, low-light vision is influenced by other factors, including the health of the eye in general and of the retina in particular. With time, it is normal for low-light vision to decrease. Adequate lighting is always beneficial, especially when reading.


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Am I a good candidate for advanced technology IOL vision enhancement?


Only an experienced eye doctor can evaluate your vision care needs and recommend a customized course of treatment.

Most people in good general health are good candidates for advanced technology IOLs. Some patients may require an enhancement procedure by laser vision correction or other technology to achieve the best result. Those with uncontrolled diabetes, chronic infections, and certain other health problems should not have lens replacement surgery until these conditions are under control.


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Will the doctor implant advanced technology IOLs in both eyes at the same time?


For the best result, advanced technology IOLs should be implanted in both eyes. Cataracts normally develop in both eyes at the same time. In the instance of only one clouded lens, only that lens needs to be replaced. For the typical patient, although both lenses need replacement, most surgeons prefer not to do them at the same time.

The normal procedure is to replace the lens that is most clouded first. The interval between surgeries depends on the healing of the first eye and the vision results; two to four weeks is typical.


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How long does the procedure last? Is it painful?


The actual implanting of the advanced technology IOL takes about 20 minutes; the whole visit to the surgical center usually takes less than two hours.

The patient arrives about an hour before the procedure and is given medication to induce relaxation and eye drops to anesthetize the eye and dilate the pupil.

During the procedure, the old lens is removed and the new lens implant inserted through a tiny incision. There is a sensation of pressure on the eye, but little or no pain.

After surgery, more eye drops are applied to prevent infection, and decrease inflammation. A protective patch is usually placed over the eye. Once home, the patient should rest and avoid any strenuous activities. The doctor will examine the eye the next day and advise the patient on the appropriate course of recovery, which will include continuing eye drops for a few weeks and avoiding strain on the eye until it is thoroughly healed.

Be sure to arrange for some one to drive you home after the procedure.


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What is the likelihood of complications, and what might they be?


Advanced technology IOLs are revolutionary, because, unlike ordinary IOLs, they provide multifocal vision. The standard cataract surgical procedure is performed on more than a million eyes each year, and has proven extremely safe; however, there is always a chance of complication with even the most routine surgery.

Most complications, such as minor infections, inflammation, and irritation, are temporary and easily treated. Serious sight-threatening complications, such as serious infection, hemorrhaging, or retinal detachment, are extremely rare. Complications are more likely in patients with diabetes and high blood pressure, and those who suffer from chronic inflammation and infections. About 98 percent of cataract surgery patients experience no complications and more than 95 percent achieve improved vision.

As with all surgical procedures, the eye doctor will perform a thorough examination and provide a complete evaluation of expected results and possible complications.


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How soon does vision improve after surgery?


Distance vision will usually be very good within a few days to a week after surgery. Return of near vision may take longer, as it usually requires more time to adapt to the multifocality of the lens.

Although results vary from patient to patient, most achieve excellent near and distance vision, and very good middle vision. Some patients still require glasses or contact lenses with a mild prescription for optimal vision in extreme situations. Some patients achieve better vision improvement than others, but virtually all will see better with lens replacement than without.

Implant surgery is intended to correct deficiencies in the eye's lens, and will not help with vision problems related to other parts of the eye, such as floaters, flashes, or visual field loss.

This information is general and not intended to apply completely and specifically to any individual patient.

The long-term safety and effectiveness of this lens has not been established.


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Will lens implant surgery cause glare, night driving problems, and light sensitivity?


Glare, night driving problems, and light sensitivity can occur with both traditional and advanced technology lens implants. Night vision problems are usually much less severe than before cataract surgery. These phenomena are usually temporary and diminish as the brain and eyes adjust.

Light sensitivity is usually temporary. The crystal-clear material of the advanced technology IOL nearly always permits more light to pass through than the natural lens it replaces, so that some patients might have to adjust to seeing vivid colors and brighter lights than before surgery.

All intraocular lenses can produce glare, light flares, or a halo effect at night, since the pupil is open wider and allows light to reflect off the edge of the implant. Your doctor, through medication or night driving glasses, can usually compensate for these problems.


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How soon after lens implant surgery will I be able to resume normal activities?


Most patients require only a few days to resume normal activities, with some limitations and adjustments. Some sensitivity to touch and bright lights should not deter most patients from driving and returning to work.

Patients are given medications to prevent infection and control inflammation. A protective shield is advisable while sleeping, and sunglasses can provide protection during the day.

For several days after surgery, patients should avoid any heavy lifting or straining the can increase pressure in the eye. Rubbing or pushing of the eye and any situation that could result in being hit in the eye are also to be avoided.

Careful showering and shampooing are permitted, as long as no soap or shampoo touches the eye. Any makeup around the eye should be avoided for several weeks. Public swimming pools, hot tubs, and other potential sources of bacterial contamination should also be avoided.

When in doubt, the patient should consult the doctor for guidelines regarding post-surgical activities.


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Do the Multifocal lens require an adjustment period?


Yes. For most people there is a period of weeks when your brain is learning to "see" up close and at a distance with the new lens. This adjustment period is usually complete within 10 to 12 weeks. Also, like all multifocal lenses, some people report halos or glare around lights. Again, for most people this diminishes over time. For some, it becomes less troublesome but never completely goes away. Most people report that the ability to see near and far outweighs any visual side effects associated with the lens.


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How often do I need to have my eyes checked after surgery?


Your doctor will check your eyes the day after surgery, and, depending on your particular case, about one week, at four weeks, and again after about three to six months later. After that, annual eye exams are recommended, unless a specific problem develops.


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Can I go to any eye doctor for check-ups after the surgery?


The surgeon or a member of his or her team should perform the checkup on the day after surgery. The surgeon may approve subsequent checkups with another doctor, after a consultation with that doctor to ensure familiarity with your case and appropriate care.


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Will I have to have cataract surgery again?


In cataract surgery, natural lenses are removed and replaced with artificial lenses, which are not subject to deterioration and should last a lifetime.

Some patients experience subsequent clouding of the membrane which holds the lens, called the capsule. The normal treatment for this is a capsulotomy, in which a laser beam is used to create a hole through the membrane, allowing a clear path for light. It is a quick and painless procedure.


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What happens if my eye is injured some time in the future?


The presence of an advanced technology IOL does not make the eye more susceptible to damage from trauma. Most injuries affect the cornea, the clear front portion of the eye, or the retina, the light sensing lining on the rear of the eye. If anything, the lens implant eliminates the chance of cataract due to eye trauma.


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Does the presence of an advanced technology IOL rule out other eye surgery?


The advanced technology IOL takes the place of a natural lens in the capsular bag. Once healing is complete, usually about three months, other eye surgery will be unaffected by the presence of advanced technology IOL; it will be no different from surgery with a natural lens present.

Surgery on or around the eye should also be avoided until the implant procedure is well healed; this includes Botox?, plastic surgery, or procedures performed on the surface of the eye. A doctor performing any procedure near the eye should be notified of a patient's eye surgery history.


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Does lens implantation have any effect on chronic red and irritated eyes or headaches from eyestrain?


Red, irritated eyes and eyestrain are often caused by inappropriately wearing contact lenses and or dry eye syndrome. Implantation of advanced technology IOLs may help the situation, if it reduces or eliminates the need for contact lenses.

These symptoms can be caused by several other factors, including allergies; consulting a doctor is recommended.


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Will security eye scanning still work after advanced technology lens implantation?


Security scanners usually read patterns on the iris or retina, and should not be affected by the presence of an advanced technology IOL or standard IOL.


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Is advanced technology IOL implantation covered by insurance?


Most private insurance covers the cataract surgical procedure and the anesthesia, but may cover only a portion of the cost of an advanced technology IOL, since it costs more and is considered non-standard.

Patients should consult with both the doctor and the insurance carrier to determine their best alternatives.


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How can I be sure an advanced technology IOL implant surgeon is qualified?


Most advanced technology IOL surgeons have been thoroughly trained, and have experience in performing standared cataract surgery, applying the same techniques used to implant the advanced technology IOL.

Starting the search for an implant surgeon on the internet can save a lot of time and travel, but, once the field has been narrowed, a face-to-face consultation with the surgeons is best to facilitate meaningful dialogue. Asking questions and building a good rapport with your surgeon is always beneficial and more comforting.

Direct contact with patients who have had advanced technology IOL implant surgery is also very informative.


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LaserVue Eye Center

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1700 California Street #280
San Francisco, CA 94109
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