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LASIK Laser Eye Surgery Frequently Asked Questions
Provided by Our Vision Correction Surgeons


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Am I a good candidate?


Schneider Vision Correction Centers offer complimentary, no obligation consultations. This is a series of diagnostic tests that determine that the eyes are healthy and that the vision correction is within acceptable corrective range for LASIK.

Because your eyes and your vision are as unique to you as your fingerprints and DNA, it is difficult to know if vision correction surgery would benefit you without a thorough examination. This is the next step in the evaluation process.

We like our patients to be at least 18 years of age, have healthy eyes, and have had stable vision over the past 12 months. Dr. Schneider evaluates each patient individually. He will define for you if you are a candidate, and the most appropriate technology to achieve the best possible results. As part of the evaluation process he will take the time to listen to you, so that he completely understands your visual needs and concerns.

Due to recent advances in technology, more patients are now candidates for vision corrections procedures. We are now able to correct problems that we were not able to correct just a few years ago.


Answer provided by Mark Schneider, MD of Corona, CA
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Guidelines for Quality Care and Treatment


The Key to Safe Surgery in Any Field of Medicine is an Informed Patient.

Take time to research the LASIK center you are considering for surgery.

Dr. Robert K. Maloney offers the following guidelines to quality care and treatment:
  • Find a doctor by getting referrals from other doctors or from patients who have had laser vision correction.
  • Don't be fooled by fancy advertisements about a particular laser center. Choose the doctor, not the laser center. Find out who will actually do your procedure, then ask about that doctor's qualifications (e.g., board certification, special training).
  • Choose a doctor who has done at least 5,000 LASIK surgeries. What a doctor doesn't know can hurt you.
  • Ask for information on your doctor's complication rates, during surgery. If your doctor won't tell you, find another one. For top surgeons, the figure is under 3 in 1,000.
  • Ask what measures are taken to prevent infection. Look for a center with a sterile or dust-free operating room. Make sure that disposable parts are not reused. Insist that your eye be thoroughly sterilized. Also insist that the surgical instruments be sterilized before your surgery to eliminate the risk of transmission of HIV or hepatitis.
  • Beware of advertisements pushing "low cost" surgery. Discount surgery is as good as a discount parachute. The potential savings are not worth the risk of receiving less than expert care!
  • Expect to see very well after LASIK, but don't expect to see perfectly. Each patient gets a slightly different result. The best surgeon in the world can't guarantee 20/20 vision. As with any surgery, results are as individual as each patient. Beware of any doctor who promises 20/20 vision.
  • If you feel like you're getting a hard sell, you probably are. Go elsewhere. You're not buying a car - this is real surgery.
  • Choose a doctor who is a fellow of the American Academy of Ophthalmology. Fellows must pass a rigorous board certification exam and conform to a strict code of ethics.
  • While you investigate, don't lose sight of the benefits: for most people a lifetime of bad vision can be cured in 5 minutes. LASIK surgery has improved the eyesight of millions of people around the world.



Answer provided by Robert K. Maloney, MD of Los Angeles, CA
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What Is LASIK?


LASIK is a minimally invasive surgical procedure that reduces and in most cases eliminates the dependency on vision assisted appliances such as glasses and contact lenses.

LASIK is an acronym for Laser-Assisted In Situ Keratomileusis and is a procedure that permanently changes the shape of the cornea, the clear covering of the front of the eye, using an excimer laser. A knife, called a microkeratome, is used to cut a flap in the cornea. The flap is folded back revealing the stroma or the middle section of the cornea. Pulses from a computer-controlled laser cut a portion of the stroma and the flap of the cornea is replaced. There are other techniques related to LASIK, some that do not involve cutting.

When is LASIK not for me?

If it jeopardizes your career. Some jobs prohibit certain refractive procedures. Be sure to check with your employer / professional society / military service before undergoing any procedure.

If cost is an issue. Many insurance companies do not cover LASIK. Please check with your provider. You may also apply for financing.

If you had a change in your vision prescription in the past year. This is referred to as refractive instability. Patients who are generally may qualify for refractive instability are:
  • In their early 20's and younger.
  • Diabetic and are susceptible to other diseases that lead to fluctuating hormones.
  • Are pregnant or breastfeeding.
  • On medications that cause fluctuations in vision.

If you have a disease or are on medications that may affect healing. Certain conditions, like autoimmune diseases such as lupus, rheumatoid arthritis, immunodeficiency states like HIV, diabetes, and some medications such as retinoic acid and steroids may prevent proper healing after a LASIK procedure.

If you actively participate in contact and high impact sports. Boxing, wrestling, martial arts or other activities in which physical contact to the face and eyes are a normal occurrence

If you are under 18. Currently, the LASIK procedure is not recommended on persons under the age of 18.

Precautions

Some patients may experience different effects and have different safety concerns when undergoing LASIK. You should always consult with your doctor if you have a history of any of the following:
  • Herpes simplex or shingles involving the eye area.
  • Glaucoma, glaucoma suspect, or ocular hypertension.
  • Eye diseases, such as uveitis/iritis (inflammations of the eye).
  • Eye injuries or previous eye surgeries.
  • Keratoconus.

Other Risk Factors

Your doctor should screen you for the following conditions or indicators of risk:
  • Blepharitis. Inflammation of the eyelids with crusting of the eyelashes, that may increase the risk of infection or inflammation of the cornea after LASIK.
  • Large pupils. It is common for many people to have large pupils, younger patients and patients on certain medications may be particularly prone to having large pupils under dim lighting conditions. This can cause symptoms such as glare, halos, starbursts, and double vision after surgery. In some patients these symptoms may be overall detrimental; a patient may no longer be able to drive a car at night or in certain weather conditions.
  • Thin Corneas. The cornea is the thin clear covering of the eye that is over the iris; the colored part of the eye. LASIK changes the eye's focusing power by reshaping the cornea. Performing a refractive procedure on a cornea that is too thin may result in blinding complications.
  • Previous refractive surgery such as RK, PRK and LASIK. Additional LASIK may not be recommended. The decision to have additional LASIK must be made in consultation with your doctor after careful consideration of your unique situation.
  • Dry Eyes. LASIK can aggravate this condition.

What are the risks and how can I find the right doctor for me?
  • Some patients lose vision.
  • Some patients can develop glare, halos, or double vision that can greatly impair vision at night.
  • It is possible that full vision will not be restored. Some patients still need reading glasses or weak prescription lenses.
  • Some patients report severe cases of dry eyes after surgery.
  • Results generally depend on the severity of the eyesight. It is possible that a person with severe eyesight to not gain 20/20 vision after surgery.
  • Some farsighted patients may experience diminishing eyesight with age.
  • LASIK is a new technology. There is no long term data.

Additional Risks if you are considering the Following:
  • Monovision
    Monovision is a technique used to deal with presbyopia; when the eye gradually loses the ability to change focus from far to close up-usually a result of aging. The idea behind monovision is for the presbyopic patient to use one eye for viewing distances and the other eye for viewing close up. Since one eye is corrected for viewing far and the other eye is corrected for viewing close up, the two eyes no longer work in unison. The results are poor vision quality and decreased depth perception. Monovision is most noticeable in low light and tasks that require sharp vision. In most cases, you will need to wear glasses or contact lenses to fully correct both eyes for viewing far distances or close up when performing tasks that require a sharp eye, such as driving at night, operating machinery, or performing tasks that require sharp vision.

    Most patients have a hard time with having one eye blurred at all times. If you are considering monovision with LASIK, it is highly recommended that you go through a trial period with contact lenses to see if monovision can be tolerated. Different states also have specific requirements for driving with monovision.

    Another thing to consider is how much your presbyopia is expected to increase over time. Your doctor should be able to tell you when you can expect your monovision surgery to no longer be enough for you to see near-by objects effectively without the aid of glasses or contacts, or when a second surgery might be required to further correct your near vision.
  • Bilateral Simultaneous Treatment
    In most cases patients choose to have surgery on both eyes at the same time, however the practice of having surgery on both eyes is actually riskier.

    The advantage of having surgery on one eye at a time is to see how effective the surgery is on the eye and the resulting vision. Also by doing both eyes simultaneously there's a chance that vision in both eyes will be blurry during recovery and may not be able to see for a few days until both eyes heal.

Finding the Right Doctor
  • Compare.
    Always get a second opinion. Some doctors have more or less experience with newer and older technologies. The results from LASIK vary with every little detail, from the individual patient, to the doctor, to the procedure being performed and even the equipment being used.

Cost
  • Never compromise your health and well being over cost. This applies across the board with all medical related procedures. Eye surgery is permanent and irreversible.
  • No Guarantees. Be aware of false advertising, faulty promises or package deals. There are never any guarantees in medicine. Do your research.

What should I expect before, during, and after surgery?

What to expect before, during, and after surgery will varies from the individual and the doctor. This section is a compilation of patient information developed by manufacturers and healthcare professionals, but is not a replacement of the consultation that you will have with your doctor. Read this information thoroughly and make sure to discuss your expectations with your doctor.

Before Surgery
  • Make sure you have a consultation and evaluation with your doctor first.
  • It is recommended that you stop wearing contact lenses before your evaluation and switch to wearing your glasses full-time. Contact lenses can change the shape of your cornea for weeks after you have stopped using them depending on the type of contact lenses you wear. If your cornea does not assume its natural state before surgery it can lead to negative consequences; including inaccurate measurements and surgical plan, resulting in poor vision after surgery. These measurements, which determine how much corneal tissue to remove, may need to be repeated at least a week after your initial evaluation and before surgery to make sure they have not changed. This is especially true for those who wear RGP or hard lenses.
  • Soft contact lenses should not be worn 2 weeks before the initial evaluation.
  • Toric soft lenses or Rigid Gas Permeable (RGP) lenses should not be worn for at least 3 weeks before the initial evaluation.
  • Hard lenses should not be worn for at least 4 weeks before the initial evaluation.
  • You should tell your doctor:

    • about any current or past medical and eye conditions
    • about any medications being taken, including over-the-counter medications and any medications you may be allergic to
  • Your doctor should perform a thorough eye exam and discuss:

    • whether you are a good candidate
    • what the risks, benefits, and alternatives of the surgery are
    • what you should expect before, during, and after surgery
    • what your responsibilities will be before, during, and after surgery
  • During the consultation you should ask your doctor all the questions you feel you need to ask. Discuss the risks and benefits, review any informational literature provided by your doctor, and make sure all your questions are answered before signing anything.
  • You should never feel pressured by your doctor, family, friends, or anyone else to make a decision about having surgery. It is your health and well being. It is your decision.
  • The day before surgery, you should stop using creams, lotions, makeup, and perfumes. These products along with other debris on the eyelashes can increase the risk of infection during and after surgery.
  • Arrange for transportation to and from your surgery and your first follow-up visit. On the day of surgery, your doctor may give you medication that may impair your ability to drive and see clearly.

During Surgery
  • The surgery is generally no more than 30 minutes. The surgery takes place in a reclining chair in an exam room where the laser is housed.
  • Anesthetic eye drops will be placed in your eye and the area around your eye will be cleaned while the lid speculum holds your eyelids open. A ring is then placed on your eye and suction will be applied to the cornea. During suction your vision will dim and you may feel pressure and experience some discomfort. A cutting instrument called the microkeratome, is then attached to the suction ring and the doctor will cut a flap in your cornea.
  • Afterwards the microkeratome and the suction ring are removed. At this point you will experience fluctuating degrees of blurred vision during the rest of the procedure. The doctor will then lift the flap and fold it back on its hinge, and dry the exposed tissue.
  • Once the laser is positioned over the eye, you will be asked to stare at a light. The light is not the laser; it's to help you keep your eye fixed in one position so the laser can do its job. If you are unable to stare on a fixed point for no more than 60 seconds you may not be a good candidate for LASIK.
  • The pulse of the laser makes a ticking, or crackling sound. As the laser removes corneal tissue, you may experience a burning smell. Once the laser is done removing tissue the corneal flap is put back into place.
  • Your doctor should provide you with a shield to be placed over your eye at the end of the procedure as protection; since there are no stitches used to hold the flap in place. This shield should be worn at night especially to prevent rubbing or putting any kind of pressure on your eye during sleep. You don't want to accidentally hit or poke the flap while it's still healing.

After Surgery
  • Following the procedure you may experience burning, itching and discomfort as well as mild pain. Your eyes may tear or water and in most cases your vision will be a bit blurry. Remember not to rub your eye, you might move the corneal flap before it heals which will lead to further treatment. You may also experience sensitivity to light, see glare and halos around lights. However in most cases these symptoms improve a few days after surgery. If you work, you should plan on taking a few days off, the recovery time may impair tasks. If you experience severe pain or your vision gets worse, you should immediately see your doctor.
  • Your first visit to the doctor after surgery should be within the next 24 to 48 hours and at regular intervals afterwards for the next six months. At the first post operative visit your doctor will remove the eye shield, test your vision and examine your eye. At this time your doctor may give you one or more different kinds of eye drops to take home to help prevent infection and inflammation.
  • Your doctor will advise you to stay away from lotions, creams and make-up around the eye for a few weeks, along with continued scrubbing of your eyelashes. For continued safety, swimming, hot tubs and contact sports should be refrained from for a few months, it is very important to keep your eye safe from any kind of collision. Your doctor should be able to tell you when it is safe to resume these activities.
  • During the first few months after surgery, your vision may fluctuate. It may take up to anywhere between three to six months for your vision to stabilize after surgery. Glare, halos, difficulty driving at night, and other visual symptoms may also persist during this stabilization period.
  • Immediately contact your eye doctor if you develop any new, unusual or worsening symptoms at any point after surgery. Such symptoms could signal a problem that may lead to a loss of vision.

LASIK Surgery Checklist (provided by the FDA)
  • Know what makes you a poor candidate
  • Career impact - does your job prohibit LASIK?
  • Cost - can you realistically afford this procedure?
  • Medical conditions - do you have an autoimmune disease or other major illness? Do you have a chronic illness that might slow or alter healing?
  • Eye conditions - do you have or have you ever had problems with your eyes other than needing glasses or contacts?
  • Medications - do you take steroids or other drugs that might prevent healing?
  • Stable refraction - has your prescription changed in the last year?
  • High or Low refractive error - do you use glasses/contacts only some of the time? Do you need an unusually strong prescription?
  • Pupil size - are your pupils extra large in dim conditions?
  • Corneal thickness - do you have thin corneas?
  • Tear production - do you have dry eyes?
  • Know all the risks and procedure limitations
  • Overtreatment or undertreatment - are you willing and able to have more than one surgery to get the desired result?
  • May still need reading glasses - do you have presbyopia?
  • Results may not be lasting - do you think this is the last correction you will ever need? Do you realize that long-term results are not known?
  • May permanently lose vision - do you know some patients may lose some vision or experience blindness?
  • Dry eyes-do you know that if you have dry eyes they could become worse, or if you don't have dry eyes before you could develop chronic dry eyes as a result of surgery?
  • Development of visual symptoms - do you know about glare, halos, starbursts, etc. and that night driving might be difficult?
  • Contrast sensitivity - do you know your vision could be significantly reduced in dim light conditions?
  • Bilateral treatment - do you know the additional risks of having both eyes treated at the same time?
  • Patient information - have you read the patient information booklet about the laser being used for your procedure?
  • Know how to find the right doctor
  • Experienced - how many eyes has your doctor performed LASIK surgery on with the same laser?
  • Equipment - does your doctor use an FDA-approved laser for the procedure you need? Does your doctor use each microkeratome blade only once?
  • Informative - is your doctor willing to spend the time to answer all your questions?
  • Long-term Care - does your doctor encourage follow-up and management of you as a patient? Your preop and postop care may be provided by a doctor other than the surgeon.
  • Be Comfortable - do you feel you know your doctor and are comfortable with an equal exchange of information?
  • Know preoperative, operative, and postoperative expectations
  • No contact lenses prior to evaluation and surgery - can you go for an extended period of time without wearing contact lenses?
  • Have a thorough exam - have you arranged not to drive or work after the exam?
  • Read and understand the informed consent - has your doctor given you an informed consent form to take home and answered all your questions?
  • No makeup before surgery - can you go 24-36 hours without makeup prior to surgery?
  • Arrange for transportation - can someone drive you home after surgery?
  • Plan to take a few days to recover - can you take time off to take it easy for a couple of days if necessary?
  • Expect not to see clearly for a few days - do you know you will not see clearly immediately?
  • Know sights, smells, sounds of surgery - has your doctor made you feel comfortable with the actual steps of the procedure?
  • Be prepared to take drops/medications- are you willing and able to put drops in your eyes at regular intervals?
  • Be prepared to wear an eye shield - do you know you need to protect the eye for a period of time after surgery to avoid injury?
  • Expect some pain/discomfort - do you know how much pain to expect?
  • Know when to seek help - do you understand what problems could occur and when to seek medical intervention?
  • Know when to expect your vision to stop changing - are you aware that final results could take months?
  • Make sure your refraction is stable before any further surgery - if you don't get the desired result, do you know not to have an enhancement until the prescription stops changing?



Answer provided by Elizabeth Miller, MD of Savannah, GA
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What if LASIK is not the best procedure for me?


During your examination, we gather important information regarding the health of your eye, including various measurements regarding your prescription, your pupil size and the shape and thickness of your cornea. Our goal is to help you select the procedure which will have the highest chance of getting you to your goal of clear vision without glasses, while at the same time having the least risk possible of any complications.

Some patients have corneas that are thinner than average, and, depending on the amount of correction needed in these cases, a LASIK procedure could be riskier than in a patient with a cornea of normal thickness. With LASIK, a flap is created and lifted aside, and the laser is used to sculpt the exposed corneal bed, which is usually 130-180 microns deeper into the cornea from the surface.

The laser sculpts the cornea by vaporizing corneal tissue. So, the laser will make the cornea thinner than it was. If the thickness of the corneal bed is reduced too much with LASIK, a complication known as "ectasia" can occur, which is a destabilization of the cornea, causing high levels of nearsightedness, astigmatism and possibly cornea irregular curvatures to result. This is something which needs to be avoided. The amount of corneal tissue vaporized with the laser depends on the degree of correction being attempted, and the treatment zone diameter programmed into the laser. Bigger treatment zones are helpful in reducing nighttime side effects, but they do go deeper into the cornea.

Patients with thinner corneas might be better off with a procedure other than LASIK. A procedure which does not create a flap would give us more cornea to work with, to enable a more complete correction and/or a bigger treatment zone diameter. There are surface treatments available, known as LASEK or PRK. These techniques are extremely similar. They involve removing the very surface layer of the cornea, known as epithelium (usually about 50 microns thick), then lasering the exposed corneal bed. This way, the laser is not vaporizing tissue as deep in the cornea as with LASIK, and the risk of ectasia is lowered. With LASEK, a form of alcohol is applied to the cornea, which loosens (and kills) the surface epithelium. After the laser part of the procedure, the layer of dead and dying epithelial cells is replaced over the treated area to act as a bandage, and a contact lens is placed over that. Much of the healing involves the regeneration of new epithelium cells, over the course of a week. With PRK, no alcohol is used, and the surface epithelial cells are removed with a soft brush. After the laser treatment, as with LASEK, a disposable contact lens is placed on the eye, without replacing the damaged epithelial cells. New epithelium regenerates naturally, over two to three days. Both techniques are effective, however I have found that the alcohol used with LASEK causes significant inflammation and delayed recovery of vision. In other words, patients seem to see and recover more quickly with PRK, without trying to salvage the surface epithelium cells.


Answer provided by Gary Kawesch, MD of San Jose, CA
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How do I know if I'm a good candidate for laser vision correction of nearsightedness, farsightedness, and/or astigmatism?


The great majority of all nearsighted, farsighted, and astigmatic Americans are potential candidates for the treatment. Typically, patients who are at least 21 years of age and have nearsightedness, farsightedness, or astigmatism. However, only our eye doctors, who are specially trained in laser correction of nearsightedness, farsightedness, and/or astigmatism can evaluate your suitability for the treatment.


Answer provided by Jack T. Holladay, MD, MSEE, FACS of Bellaire, TX
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What are my options when it comes to vision correction surgery?


Dougherty Laser Vision offers an exceptionally wide range of vision correction options including LASIK, Implantable Contact Lenses (ICLs) and Intraocular Lenses (IOLs) to treat most common vision problems. Our experience and breadth of service ensure that you receive the most appropriate, customized treatment for your unique vision correction needs.


Answer provided by Paul J. Dougherty, MD of Los Angeles, CA
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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.


Answer provided by LaserVue Eye Center of San Francisco, CA
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How does LASIK LASER Vision Correction work?


LASIK is an advanced laser procedure that can reshape the surface of your eye, the cornea, to reduce or eliminate nearsightedness, farsightedness, and astigmatism. This enables the vast majority of patients to see to drive, work, swim, play sports or just see the alarm clock in the morning!


Answer provided by Srini Mutyala, MD of Weston, FL
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Cataract Surgery


About Cataracts

A cataract is a cloudy area in the lens in the front of the eye, which is normally clear. There is no pain associated with the condition but there are other symptoms, including:
  • Blurred/hazy vision
  • Spots in front of the eye(s)
  • Sensitivity to glare
  • A feeling of "film" over the eye(s)

Risk factors for developing cataracts include being over 55 years old, eye injury or disease, a family history of cataracts, smoking or use of certain medications.

For people who are significantly affected by cataracts, lens replacement surgery may be recommended. During cataract replacement, the most common surgical procedure in the country, the lens is removed and replaced with an artificial one called an intraocular lens or IOL.

Cataract Surgery

We perform a minimally invasive, no-stitch cataract surgery called phacoemulsification ("phaco") surgery. First, the eye is numbed with anesthetic eyedrops. Then a tiny incision is made in the eye to make room for a small ultrasonic probe. This probe breaks up, or emulsifies, the cloudy lens into tiny pieces.

After the cloudy lens has been removed, a new artificial lens is implanted in the eye. With the recent advance of foldable IOLs (intraocular lenses), artificial lenses can be implanted through the same small incision from the phaco procedure. The doctors at Capital Eye have been pioneers in the development of techniques and equipment that have resulted in the increased safety and comfort of the procedure. We are always evaluating new technology and adopting techniques that will improve our outcomes and benefit our patients.


Answer provided by William L. Gonzalez, M.D. of Bowie, MD
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What is ophthalmology?


Ophthalmology is the branch of medicine dealing with the prevention, diagnosis, and medical and surgical treatment of eye diseases, disorders, and injuries.


Answer provided by Mitchell Shultz, M.D. of Northridge, CA
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Why Do LASIK Costs Vary So Widely?


There are different types of LASIK from which you can choose. Like selecting options on a new car or home, you have several alternatives for your LASIK procedure. There is 1) conventional LASIK, 2) CustomVue LASIK, 3) conventional IntraLASIK, or 4) CustomVue IntraLASIK.


Answer provided by Jamie M. Monroe, MD of Orem, UT
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What is LASIK?


LASIK is the advanced laser procedure used to treat nearsightedness, farsightedness and astigmatism. A small protective flap is made on the surface of the cornea. The flap is then lifted and an Excimer laser is used to reshape the cornea under the flap after which the flap is put back into place, where it self seals.


Answer provided by Sanford L. Moretsky, D.O. of Phoenix, AZ
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What is Wavefront treatment?


Wavefront is a laser treatment developed to make the LASIK procedure even more effective. Wavefront allows for a complete, personalized measurement of the entire visual system, including the eye's shape, lens shape, corneal shape, depth of the eye, and the most accurate identification possible of anatomic anomalies that could cause vision conditions such as impaired night vision or presence of halos. Thanks to wavefront, a highly accurate, FDA-approved laser can correct all or most vision problems with one treatment, whereas traditional LASIK is more limited in the number of errors it can simultaneously correct. If you live in Seattle, Washington; Portland, Oregon; Boise, Idaho; Spokane, Washington; Billings, Montana, Alaska or anywhere in the Pacific Northwest and are interested in learning more about wavefront LASIK laser eye surgery, contact us today.


Answer provided by Mark Walker, MD of Renton, WA
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About the Eye and Vision


In the emmetropic eye, the patient sees perfectly or 20/20. The light rays are focused exactly onto the retina for a clear view of objects.

Myopic Eye

In the nearsighted (myopic) eye, objects appear out of focus because the focal point of the eye is located in front of the retina. Because of this, properly focused light rays cannot reach the retina, resulting in blurred vision. With refractive LASIK surgery at our practice in Bayside, Queens, our LASIK surgeon utilizes a laser to reshape the eye so that the rays will diverge onto the retina. PRK can also accomplish this adjustment, however LASIK surgery is ideal. Both PRK and LASIK require use of a laser, however LASIK is performed under a protective flap. With PRK, the outer cells of the eye are scraped off prior to vision correction, leading to an increased risk of vision haze and months of eye drops. The LASIK treated eye usually requires drops for only about four days after the procedure and provides almost immediate visual recovery. The excimer laser can also be used to treat astigmatism, or irregular curvature of the cornea.

Astigmatic Eye

In the farsighted (hyperopic) eye, the ideal focal point for light is located behind the retina and light rays cannot converge enough to focus on the proper area of the eye. Using the excimer laser under the protective flap of LASIK, our surgeons are able to alter the shape of the eye so that light rays converge perfectly onto the retina, resulting in clear vision.


Answer provided by Barry Drucker, MD of Bayside, NY
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What is LASIK?


LASIK is a procedure for nearsightedness (myopia), farsightedness (hyperopia) and astigmatism. It has become the procedure of choice for almost all levels of refractive error when performed by an expert surgeon. An excimer laser reshapes the partially-exposed central cornea under a thin corneal flap. The flap is then replaced over the cornea without the need for sutures.


Answer provided by Edward E. Manche, MD of Palo Alto, CA
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How do I know if I am a candidate?


Most people who are in good health and are either nearsighted or farsighted or have astigmatism are candidates for some form of laser vision correction. In general, you should:
  • be at least 18 years of age or older
  • have had stable vision for at least a year
  • have no health issues affecting your eyes
  • be in general good health



Answer provided by Arun C. Gulani, M.D., M.S. of Jacksonville, FL
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What is refractive surgery?


Refractive surgery is an outpatient procedure that corrects vision problems such as nearsightedness (myopia), farsightedness (hyperopia) and astigmatism The surgery restores the eye's normal curvature and its ability to bring images into focus.


Answer provided by Ernest W. Kornmehl, MD, FACS of Wellesley, MA
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Advanced Surface Ablation


Advanced Surface Ablation is a relatively new laser vision procedure that has additional safety features over LASIK making it an ideal alternative for some patients. Instead of cutting a flap on the front of the cornea, the surface skin cells (epithelium) are loosened with a diluted alcohol solution and removed. The corneal surface is then treated with the laser and covered with a bandage contact lens.

ASA removes tissue within the cornea to treat low to high levels of nearsightedness, farsightedness and astigmatism.

ASA is a better choice for those who is for those who:
  • want to reduce or eliminate their dependence on glasses or contacts
    are over 18 years of age
  • have had a stable eye prescription for at least one year
  • have no health issues affecting their eyes
  • have wide pupils
  • have corneas too thin for LASIK
  • want to avoid LASIK flap complications
  • who want to minimize dry eye problems after surgery
  • who cannot have LASIK because of eye pressure problems (glaucoma)
  • who cannot have LASIK because of corneal dystrophy problems
  • who do not want LASIK because it requires a microkeratome
The margin of safety with ASA may be greater than that with LASIK as the need for a microkeratome is eliminated, so there's no risk of flap complications. You do not need to worry about rubbing your eye or bumping it after surgery and having the LASIK flap slip or wrinkle, because there is no flap. The nerve endings that control tear secretion are not cut, so there is less of a problem with dry eye after surgery.


Answer provided by Daniel Ritacca, MD of Vernon Hills, IL
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I can see clearly; why do I need an eye exam?


A complete eye exam is more than just updating your prescription for glasses or contacts. Your eye examination by an ophthalmologist consists of a series of tests to assess the overall health of your eyes. Your doctor also checks for eye conditions such as glaucoma, cataract, diabetes, hypertension, retinal detachments, etc.


Answer provided by Shobha Tandon, MD of Union City, CA
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Am I a good candidate for laser vision correction?


We recommend you come in for an evaluation. You will be thoroughly educated during your complete exam. We will test your present glasses, check your present prescription, and help you decide which refractive procedure will offer you the greatest benefit.


Answer provided by John J. Teahan of Albuquerque, NM
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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.


Answer provided by James J. Kao, DO, PC of Pasadena, CA
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What are the odds of eliminating my glasses?


Overall, 99% of patients will see well enough without glasses to pass the DMV eye test (20/40), 90% will have 20/25 or better vision without glasses, and 84% will have 20/20 or better vision without glasses. The results are even better with the Custom technology: 99% have 20/25 or better uncorrected vision, and 96% have 20/20 or better vision without glasses or contacts. The general rule is: more accurate results will be obtained in people who require less treatment.


Answer provided by Andrew I. Caster, MD, FACS of Beverly Hills, CA
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How long does the procedure take?


The total time you are at our center is usually less than 1 hour. The procedure itself usually takes about 5 minutes per eye.


Answer provided by Mark Schneider, MD of Corona, CA
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Questions and Concerns


The field of corrective eye surgery is constantly being refined. If you have any questions or concerns, ask a qualified professional eye surgeon your questions.

If there are any concerns you have which have not been addressed, or if you would like to make an appointment for a consultation, please click here to send an email to Dr. Maloney.


Answer provided by Robert K. Maloney, MD of Los Angeles, CA
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What Is Custom LASIK or Wavefront LASIK?


Custom LASIK is also known as Wavefront LASIK or more precisely Wavefront Guided LASIK. It reshapes the cornea by using three dimensional measurements of how your eye processes images to guide the laser. This provides a precise and individualized vision experience that would be otherwise impossible to achieve with traditional LASIK.

The FDA has very strict guidelines to follow in order to qualify for custom Wavefront LASIK. Factoring in the different available lasers and the thickness of your cornea, you could be considered a candidate even if you have myopia, hyperopia and astigmatism.

Refractive Surgery

The irregularities in the way your eye processes images are used to guide the laser in the custom shaping of the corneal surface. The irregularities are measured by creating a three dimensional map from the way your eye focuses light.

Prior to Custom or Wavefront LASIK, ordinary defects like myopia, hyperopia and astigmatism were corrected with glasses, contacts or traditional LASIK. However, irregularities associated with the eyes' perceived vision such as glare, halos and poor vision at night could not be addressed

What Are The Benefits of Wavefront-Guided Custom LASIK?

Many of the concerns surrounding LASIK are the post LASIK complications that may occur, such as glare, halos and difficulty seeing at night, which is why Wavefront technology is cutting-edge. It not only has the potential to improve your vision based on the standard 20/20 chart, but has the potential to improve the fine details and better contrast.

Lower-order aberrations or small defects such as myopia, hyperopia and astigmatism can determine how much you can see. These defects can be treated with traditional LASIK.

Higher-order aberrations or a measure of visual distortions more severe than normal vision problems that cause decreased vision at night, glare, shadows and halos cannot be treated with traditional LASIK and are sometimes a side effect of traditional LASIK. Thus the amount of higher-order aberrations determines how well you see. Wavefront LASIK can address these higher-order aberrations.

Wavefront LASIK has the advantage of offering a higher quality of vision and not just a measure of how much you can see. On top of being able to achieve 20/20 or better vision, there is a reduced chance of losing visual quality such as contrast sensitivity, vision at night and distorted vision effects such as halos and glares.

Wavefront LASIK is also ideal for those who have had vision correction procedures done already and have since lost the corrected vision, from previous LASIK, PRK and RK procedures.

How Does Wavefront LASIK Work?

The Wavefront laser safely emits a light into the eye where it maps out a visual pattern of your lower and higher-order aberrations. This pattern is displayed as a three dimensional map, known as a Wavefront map. This map allows the surgeon to customize the LASIK procedure to the unique pattern that is associated with your eye, giving you a customized procedure.

Where can I get Wavefront-Guided Custom LASIK?

Although the cost of traditional LASIK procedures has gone down significantly over the years, Wavefront Guided Custom LASIK is still more expensive than traditional LASIK. Fortunately more and more practices are offering Wavefront or Custom LASIK.

Currently Wavefront LASIK cannot address high myopia and presbyopia; the eyes' inability to focus between different vision planes, such as far, middle and near.

Wavefront LASIK isn't the end all be all procedure. Remember to discuss all procedures and vision related issues with a doctor to determine if you are a candidate for Wavefront or any other LASIK procedure.


Answer provided by Elizabeth Miller, MD of Savannah, GA
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Can I wear contact lenses after surgery if I want to?


It is very uncommon that someone would want or need to wear contacts after surgery. Most patients do not need any correction, and those who do usually just need part-time correction for things like night driving. Rarely will someone want to wear contacts versus glasses for activities like this. If full-time glasses or contacts is needed after surgery, usually a retreatment can be done to improve the vision and reduce the need for use of glasses. In the rare case that someone wants to wear contacts after surgery, usually they can without any trouble (assuring they could wear contacts prior to surgery). There is always the outside possibility that a contact would not fit well, but this is rare.


Answer provided by Gary Kawesch, MD of San Jose, CA
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How long does the treatment take? How long will my recovery be?


The laser treatment itself takes about 15-40 seconds, based on the degree of correction necessary. Typically, you'll notice improvement in your sight in 3-5 days following the treatment, and you can usually go back to work the next day. Recovery varies based on each individual's own healing time. In most cases, both eyes will be corrected during the same visit to our facility.


Answer provided by Jack T. Holladay, MD, MSEE, FACS of Bellaire, TX
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Who can benefit from vision correction surgery?


People with most common vision disorders can be treated effectively by one or more of the above mentioned procedures. Common disorders include myopia (nearsightedness), hyperopia (farsightedness), presbyopia (age-related trouble focusing) and astigmatism.


Answer provided by Paul J. Dougherty, MD of Los Angeles, CA
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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.


Answer provided by LaserVue Eye Center of San Francisco, CA
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Does it hurt?


No, with anesthetic eye drops your procedure should be quite comfortable. Once you return home after LASIK, it is normal for some patients to experience irritation, light sensitivity, or watery eyes similar to the feeling if you had left your contacts in too long. Most symptoms are controlled with Tylenol or Advil.


Answer provided by Srini Mutyala, MD of Weston, FL
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