WHAT YOU SHOULD KNOW ABOUT
LASER EYE SURGERY
Eye surgery to improve vision has been around for a long time. Results of early, "state of the art" techniques varied significantly depending on the surgeon's skill and limitations of the procedures. One such technique, radial keratotomy, was very popular during the 1980's. However, the advent and refinement of Laser Refractive Surgery over the past ten years, has dramatically revolutionized surgical vision correction. Much of the uncertainty and risk associated with earlier procedures have been minimized or eliminated. The U.S. Food and Drug Administration, officially recognizing their safety and effectiveness, has approved the VISX S4 eye-tracking laser, the implantable contact lense, the Wavefront treatment, as well as Lasek and PRK proceedures for various types of refractive surgery.
Most people who use eyeglasses or contact lenses to correct their vision are familiar with the terms myopia (nearsightedness), hyperopia (farsightedness), astigmatism (irregular focusing of light), and presbyopia (loss of ability to focus on small print usually after age 40). They are also aware of the numerous inconveniences, annoyances, limitations, expenses, and frustrations of using these visual aides. The newest Laser refractive surgical equipment, combined with highly skilled eye surgeons specializing in the newest refractive procedures, can help these people improve their vision by correcting almost any refractive error. For those individuals with very high or uncommon vision problems, there are other very new investigational procedures that are proving to be highly successful when Laser surgery is not appropriate. There are also the Custom-Cap procedure and Therapeutic Wavefront-guided lasik. Both of these are available at Maloney Vision Institute and often used to correct problems with other proceedures done elsewhere. So if you have had Lasik elsewhere and are unhappy with the results, there is new hope for help.
Currently, the most commonly performed Laser refractive procedures are PRK (Photorefractive Keratectomy) and LASIK (Laser Assisted In-Situ Keratomileusis) primarily used to correct myopia and astigmatism. However, the very latest techniques involve these and variations of these procedures to correct hyperopia, hyperopia with astigmatism and presbyopia. Patients frequently ask questions about Laser surgery after being told they are good candidates for Laser vision correction, or, sometimes after they have been inappropriately advised that they are not good candidates for Laser surgery.
ANSWERS TO FREQUENTLY ASKED QUESTIONS
Laser eye surgery does not hurt.
During the procedure patients may feel some pressure on their eyes. There is some post-op discomfort which varies depending on the type of surgery performed. PRK tends to involve more post-op discomfort than LASIK.
Post-op "20/20" vision is never guaranteed.
However, well over 90% of patients attain driving vision or better with many seeing equal to or better than pre-op vision with glasses or contact lenses. There are no reported long-term adverse effects. The surgical alteration of pre-existing refractive error is generally considered permanent. The cornea tissue is normally a very stable and is unlikely to change significantly post-surgically.
The biggest risk, although rare, is infection.
Should an infection arise, it can be effectively treated in most cases with antibiotics. Both procedures, LASIK and PRK, utilize antibiotic and anti-inflammatory post-op eye drops to minimize potential complications.
Both eyes can be corrected at the same time.
However, some surgeons recommend separate surgeries depending on the selected procedure or technique.
Most patients note improved vision immediately post-op, can safely drive the day after surgery and usually return to work within 2-3 days.
Normal post-op protocol calls for several check-up visits to be certain of proper healing, no infection, and monitoring vision stability. It is normal for the vision to vary for several weeks or months post-op as the eye heals. Occasionally, patients require a light eyeglass prescription for better near reading or night vision while healing. People over 40 often require reading glasses unless they have a modified type of Laser correction resulting in "monovision" where one eye is more in focus for near objects and the other one is set more in focus for distant objects. Monovision does not work for everyone but success can be anticipated during pre-op testing.
Who should do the Laser surgery on my eyes?
This is the most important question to ask yourself. The answer most thoughtful patients arrive at is to go to a highly skilled surgeon specializing in Laser Refractive Surgery who has extensive experience, a long running successful track record and is trusted and respected by his/her patients and professional colleagues.
The second most important question to decide on involves co-management.
Co-management is usually done with an Optometrist. A qualified co-managing optometrist has obtained the necessary training, experience and skills to perform pre-op evaluation and testing and knowledge and expertise necessary to quickly detect, manage and/or refer back to the surgeon should there be any post-op problems or complications. Successful co-management provides the patient with closer, one on one care not always attainable with a busy refractive surgeon. The co-managing optometrist collaborates closely with the surgeon, pre- and post-op. Dr. Gordon goes one step further and offers to accompany all his patients to their surgeries upon request and provides them with 24 hour phone access to answer questions or concerns.
Dr. Gordon has been successfully co-managing laser patients since 1996 with several prominent ophthalmologists highly skilled in refractive surgery, including Dr. Robert Maloney, former head of UCLA's Refractive Surgery Center, now of Maloney Vision Institute. Not all optometrists co-manage or have embraced laser vision correction: Many optometrists do not co-manage laser patients. Some simply refer interested patient to surgeons and end their involvement. Others do not believe laser vision correction is safe or appropriate. Some fear loss of business. Unfortunately, many patients have been advised not to pursue their interest in laser vision correction or have been given advice based on incorrect or outdated information. Although not all patients are good candidates for laser surgery, do not be discouraged until you consult with someone specializing in the field.
We have available several sources of information on all current forms of Laser Surgery including booklets, CDs, DVDs and VHS tapes. If you are interested and need more information, please call our office and speak to Dr. Gordon. He can set an appointment for you to come in simply to learn more before you make any decision.
FEEL FREE TO EMAIL QUESTIONS OR
DR. DAVID W. GORDON,