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LASIK Laser Eye Surgery Frequently Asked Questions
Provided by Dr. Mark Schneider


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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.


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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.


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Do I need time off work?


Following LASIK, most patients return to work the day after the procedure. With PRK, the recovery time may be a little longer.


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Will it hurt?


There is no pain during any of the laser vision correction procedures since anesthetic drops numb the eyes. A relaxation pill is also given prior to the procedure to help relieve anxiety. The only discomfort that may be experienced is a slight pressure sensation lasting about 20 seconds, while the Intralase laser creates the corneal flap. After LASIK you might experience slight irritation, a burning sensation, or increased tearing for 2 to 4 hours. We encourage our patients to rest or sleep during this period of time. If needed, an over the counter pain reliever should be all that is needed to relieve this discomfort. PRK patients may experience more post-operative discomfort for 3 to 5 days following the procedure.


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What about night time side effects?


You have probably heard stories about patients having trouble with driving at night after refractive surgery. Night time side effects may include halos around lights, glare or starbursts. Most of these resolve over the first few weeks as the eye heals. In some cases they may be caused by over correction, under correction, or residual astigmatism. If this is the case and the side effects do not resolve on their own, a "touch up" or enhancement may be recommended.

Another possible cause of night time side effects is the pupil size. In the dark, the pupil expands to let in more light. If a patient has a large pupil, the pupil may expand to a size larger than the treatment area. The light coming in through the peripheral cornea beyond the treatment area will be out of focus. However, today's improved laser technology has expanded the treatment area to go beyond most large sized pupils. Patients who at one time were not candidates because of pupil size, are now able to have laser vision correction with less risk of glare and halos.


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Has anyone ever gone blind because of LASIK?


Approximately 1.5 million people a year in the United States choose to undergo the LASIK procedure. We know of no recorded incidence of anyone losing their eyesight due to this procedure.


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Is laser vision correction safe?


There are possible risks with any surgical procedure. Serious complications with LASIK or PRK are very rare today. Many of the risks and complications associated with this procedure can be reduced or eliminated with careful patient screening and thorough pre-operative testing using the latest diagnostic technology. This pre-screening combined with a highly experienced surgeon and staff dramatically increases your chances for success.

After laser vision correction you may experience some mild temporary side effects. These most often diminish in a few days to a few weeks. If, after a thorough exam, we decide that you are a good candidate for laser vision correction, you will be given additional information about the procedure and what you can expect based on your specific treatment. This will help you to make an informed decision about whether to proceed.


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Will laser vision correction give me 20/20 vision?


The goal of any refractive surgical procedure is to reduce your dependence on glasses and contacts.

If you have correctable 20/20 vision with your glasses or contacts, you have the potential to achieve 20/20 with laser vision correction.


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Do you treat one eye at a time?


In most cases both eyes are treated the same day. In some circumstances, or certain procedures, we will treat one eye at a time.


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What can I expect on the day of my procedure ?


Arrival

The total time in our facility will be approximately 1 hour or less. You will need someone to drive you home. Our center has a comfortable viewing area. Friends and family are invited to watch the procedure if they are interested in doing so.

You will be offered an oral sedating medication. Dr. Schneider then meets with every patient prior to the procedure to answer any last minute questions and recheck your measurements personally. He believes that your surgeon should have the primary role in customizing your treatment plan, and that it should not be left up to other doctors or technicians.

The laser suite

You will be escorted to the laser suite. You will be asked to lie on a comfortable reclined chair/bed. Several anesthetic eye drops will be used to numb the eyes. Dr. Schneider will talk you through each and every step.

The first step in the reshaping of the eye is the creation of the corneal flap. This is accomplished with the Intralase laser. This is the only true blade free technique. Dr. Schneider uses it exclusively because of the superior results and safety it provides. You will feel a slight pressure sensation as the special focusing devise positions the eye. This portion of the procedure lasts 20 seconds. The pressure is usually described as "slightly uncomfortable". At the end of the 20 second period, the focusing device is removed and the corneal flap is created. You will feel nothing for the remainder of the procedure.

Reshaping the cornea

Dr. Schneider will carefully position the bed so that your eye is precisely aligned under the microscope and aiming beam of the laser. In order to prevent blinking, a simple device is used to keep the eyelids open. There will be no discomfort during this second step. You will be directed to look at a red focusing light. The laser's eye tracking system will follow any tiny movements of the eye.

As the laser reshapes your eye, you will hear a loud snapping sound generated by the laser, but you will feel nothing. Most laser applications last less than 30 seconds. At the end of the treatment, the corneal flap will be carefully replaced in perfect position.

After LASIK

When you leave the office, you should go home and rest. It is unlikely that you will have much discomfort after surgery, but there may be mild irritation or scratchy feeling that can last 4 to 6 hours. The relaxing medication given to you at the office will help you to relax in order to sleep through this phase.

You will be given prescription eye drops to use. It is important that you follow the eye drop instructions exactly as instructed.

Visual recovery

LASIK surgery affords rapid visual recovery. It is likely that you will be able to drive by the day after the procedure. Most patients return to work the next day. The vision will be clear, but not as clear as it is going to be after the next few weeks. Everyone heals at a different rate. Complete recovery of vision and stability typically occurs after about 3 months. The final outcome may be achieved sooner for some than others, longer in high levels of myopia and hyperopia.


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What are some common vision problems?


Certain vision problems, such as nearsightedness, farsightedness, astigmatism, and presbyopia are called "refractive" because they relate to the eye's ability or inability to properly bend, or refract, light rays entering the eye. The proper refraction of light onto the retina creates "normal" vision.

Myopia (nearsightedness)

Myopia occurs when the eye is too long in relation to the curvature of the cornea. It causes the light rays entering the eye to focus in front of the retina. The term "nearsightedness" means that you can see objects that are near to you more clearly than distant objects.

Hyperopia (farsightedness)

Hyperopia occurs when your eye is too short in relation to the curvature of the cornea. Light rays entering your eye focus behind the retina, producing a blurred image. Some farsighted patients can use their focusing muscles
to pull the image forward into focus. But others who cannot, need glasses for distance as well as reading glasses.

Astigmatism

Many patients with myopia and hyperopia have some degree of astigmatism, or an oval shape to their cornea. The cornea is shaped more like a football than a basketball.
This causes light entering the eye to focus at multiple points within the eye, causing blurred and sometimes double vision.

Presbyopia

Presbyopia is part of the normal aging process. This occurs when the lens of the eye loses the flexibility that allowed it to change shape and bring near objects into focus. Everyone will experience the effects of presbyopia, usually between the ages of 40 and 50.

Mild myopia will counteract presbyopia for a period of time. This is why a patient in this age group may remove their glasses and be able to read. When laser vision correction eliminates the myopia, glasses are needed for fine print and small objects to correct the presbyopia. This is usually in the form of single vision reading glasses, bifocals, or progressive addition lenses. An option for some presbyopic patients is monovision.

Monovision has been used for years among contact lens wearers and is adaptable for some people choosing laser vision correction. With this technique, the dominant eye (the one in which one would focus a camera) is generally corrected for distance vision and the non-dominant eye is focused primarily for close vision. The brain learns how to integrate the different visual information and soon learns which image to select for a given visual distance. It doesn't necessarily mean eliminating glasses forever. Patients may still choose to fine-tune their vision for fine print or night vision following surgery. New surgical options to treat presbyopia are being researched.


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What is IntraLASIK?


Currently the most popular laser vision correction procedure in North America is LASIK (laser-in-situ-keratomileusis). LASIK uses an excimer laser to change the curvature of the cornea (the clear front surface or "window" of the eye). This procedure has quickly become the procedure of choice for most patients because they recover quickly and have fewer side effects than with other methods of vision correction.

LASIK involves two steps. The first is the creation of a hinged flap of thin corneal tissue. IntraLASIK (derived from the combined use of the IntraLase laser and excimer laser in the LASIK procedure) has elevated the first step of the procedure to a new level of safety and precision. The flap is created with a femtosecond laser rather than a mechanical microkeratome with a metal blade. The advantages that the IntraLASIK, All-laser approach provide include, more safety and predictability, more accurate flap thickness, more precise positioning of the flap, and much lower probability of flap complications.

Next, the flap is lifted and the underlying corneal tissue is reshaped with conventional excimer laser ablation or wave-front guided custom technology. The surgeon then replaces the corneal flap over the treated area where it bonds securely without the need for stitches. Most patients experience very little, if any, discomfort during or after the procedure. Functional vision returns very rapidly. Most patients are able to see well enough to drive without glasses the day after the surgery. Most patients elect to have IntraLASIK performed on both eyes the same day.

Recent studies have shown IntraLASIK to be more favorable than LASIK with a mechanical microkeratome in providing vision with better contrast sensitivity.


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What is an Implantable Collamer Lens?


This is an artificial lens that is implanted inside the eye without removing the eye's natural lens. They can be a viable alternative for those who are too nearsighted or farsighted for laser vision correction, or who have thin or irregularly shaped corneas.


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What is PRK?


This procedure offers some advantages over LASIK for patients who have thin corneas or certain corneal irregularities. Instead of creating a flap of tissue, the surgeon gently removes the surface cells of the cornea, the epithelium. The underlying tissue is then treated with the excimer laser, reshaping the cornea to eliminate nearsightedness, farsightedness, and astigmatism. A protective soft contact lens is placed on the cornea to make the eye more comfortable while it heals. The disadvantages of PRK may include more discomfort than LASIK, longer healing time, and the possibility of corneal haze.


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What are INTACS?


INTACS are acrylic, micro-thin corneal inserts that are implanted by gently separating some of the layers of the cornea. They are a safe and effective, removable alternative for the correction of mild nearsightedness and astigmatism. They are most commonly used to treat keratoconus, a progressive thinning condition of the cornea. By reshaping and giving support to the cornea INTACS may improve functional vision when glasses and contacts no longer provide suitable vision.


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What is Clear Lens Extraction?


This outpatient surgical procedure is usually reserved for patients with amounts of nearsightedness and farsightedness beyond the FDA approved treatment parameters for laser vision correction. It involves the removal of the clear, noncataractous natural lens of the eye as a refractive procedure with or without the replacement of an intraocular lens implant. Clear Lens Extraction, also called Refractive Lensectomy or Refractive Lens Exchange has a slightly increased risk of complications because it is an intraocular procedure, but is a very stable procedure and an excellent alternative for select patients.


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What is ReSTOR?


This intraocular implant lens is used to replace the natural lens of the eye when it is removed due to a cataract, or as with a Clear Lens Extraction. Unlike traditional monofocal intraocular lenses, ReSTOR can provide patients a full range of vision - near through distance - and greatly reduce the dependence on reading glasses or bifocals by allowing the eye to focus at different distances.


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What is NearVision CK?


NearVision CK is a procedure for the treatment of presbyopia (the loss of the ability to focus at near). It may offer patients who have difficulty seeing small print, the opportunity to read again with less dependence on reading glasses or bifocals. CK uses the controlled release of radio frequency energy placed in spots around the periphery of the cornea. This steepens the cornea in farsighted patients, improving their near vision.


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Mark Schneider, MD
Schneider Vision Correction Centers

Office Address:

1124 S. Main St.
Suite 102
Corona, CA 92882
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