Laser
Vision Correction (LVC)
If you are considering Laser Vision
Correction,
check out the information below by clicking on the graphic
of choice.
Laser Vision Correction
FAQs
1. How will Dr. Blaze be involved in
the Laser Vision Correction (LVC) process?
2. Am I a good
candidate?
3. What
kind of outcome can I expect?
4.
Will my vision
be corrected forever?
5. Is
laser vision correction covered by insurance
or flexible benefits programs?
6.
Will the procedure hurt?
7.
What will my
recovery
be like?
8.
What are the risks?
1. How will Dr. Blaze be involved in
the LVC process?
Dr. Blaze will be involved by determining
whether you are a candidate or not for Laser Vision Correction (LVC).
He will also do all pre- and post-op care. Typically Dr. Blaze
will be there the day of your surgery to assist. Then he will see
you at his office the day after. Post-operative follow-up visits
will include 1 week, 1 month, 3 months, 6 months, and 12 months after
surgery. From there, Dr. Blaze will monitor medications and assure
proper healing.
Dr. Blaze works with a few top LVC
Surgeons and Laser Centers who have proven themselves through quality
outcomes and who practice responsible medicine.
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2. Am I a good
candidate?
Yes, if
you're at least 21 years old, in good general health, and have good eye
health with no diseases such as cataracts or glaucoma. Laser vision
correction can treat a wide range of nearsightedness
, farsightedness,
and astigmatism.
Dr. Blaze will review your history and
prescription during a complimentary consultation to determine your
candidacy. He will explain what to expect so that you can make an
informed decision. Most patients are good candidates, but some are
not candidates for the procedure, and others are candidates but with
higher risk. Dr. Blazes optometric opinion about laser surgery
will help you make a more balanced decision, with realistic
expectations.
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3.
What kind of outcome can I expect?
While LVC has proven successful in reducing
dependence on glasses and contact lenses, the degree of improvement will
vary among individuals. Individual healing responses and the
degree of prescription are the most important variables.
We do not promise 20/20 vision,
however, more than 85% of laser
patients with mild to moderate prescriptions do achieve 20/20 vision or
are within 1 to 2 lines of 20/20 vision on an eye chart. This level of
accuracy will allow you to drive or play sports without the need for
correction.
Re-treatment procedures are
needed about 5% to 10% of the time, and are usually performed after a
minimum of three months of healing and when stability is achieved.
The most common need for re-treatment occurs in those who have very high
prescriptions.
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4.
Will my vision be
corrected forever?
The most common questions
about LVC are "Will LVC stop my eyes from changing in the
future?" and "What do long-term studies show about the
effectiveness of LVC?" There is no guarantee that your eyes
will stop changing in the future. That is it is best to wait for
relative stability before proceeding with other correction. In addition,
since 1987, many clinical studies have analyzed
the long-term effects of the excimer laser on the cornea. Every study
performed so far has shown that there are no long-term
negative effects of the laser on the eye's integrity or strength.
Today,
most experts around the world are confident that they will discover no
long-term problems with laser vision correction. They also believe,
based on the excellent results seen to date, that laser vision
correction will become the most commonly performed refractive procedure
in the world. This is why Dr. Blaze believes he can help offer you three
options with confidence: Contact lenses, spectacles, or LVC.
However, it is important that you consider your prescription when making
your decision on which option is best for you.
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5.
Is
laser vision correction covered by insurance or flexible benefits
programs?
Most
insurance companies do not cover laser vision correction, but we
encourage you to check with your provider. In the U.S., if your
company has a flexible benefits program, you can usually use this for
laser vision correction.
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6.
Will the procedure hurt?
The LASIK
procedure is basically painless. Anesthetic drops are used to numb the eye just before surgery begins.
The microkeratome ring creates pressure on your eye and will dim your
vision temporarily. After your procedure, your eye may feel a foreign body sensation or
irritation for a few hours. You will be given drops for your eyes to
counteract the potential dryness you may experience for several days
following the surgery.
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7.
What will my recovery be
like?
Most LASIK
patients usually see reasonably well the day following their procedure and
may be able to resume most of their normal activities, but
patients with higher prescriptions may recover more slowly. It is
important to stay out of direct sunlight without UV protection,
sunglasses and jacuzzi orpods for the first few weeks.
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8.
What are the risks?
It is important to note that the chance
of having a serious vision-threatening complication is much less than
1%.
In general, most of the risks following
the LASIK and PRK procedures are the same. However, while LASIK does
offer a faster and easier visual recovery, it also has specific risks
due to the creation of the corneal
flap.
Refractive Complications:
Refractive problems that may be
encountered include too much correction, too little correction, a
prescription imbalance between eyes, aggravation of muscle imbalance
problems or a loss of effect from regression. LASIK may result in
overcorrections and undercorrections due to the variability in patient
healing patterns and other surgical variables, leaving patients
nearsighted, farsighted, or with astigmatism. This may or may not
require patients to wear spectacles, contact lenses or undergo further
surgery.
Incidence of significant overcorrection: 1 in 100
Incidence of significant undercorrection: varies with prescription
Infection
This is probably the greatest risk during the first 48 to 72 hours
following the procedure. You will receive antibiotic drops, both before
and after the procedure, to help prevent an infection. Most minor
infections are treated and quickly eliminated.
Incidence of serious infection: 1 in 5000 for LASIK, 1 in 1000
for PRK
Post-Treatment Haze
Healing haze is the term for the collagen protein that develops on the
surface of your eye following the procedure. Almost everyone develops
trace degrees of haze, only seen at high magnification by a trained
observer.
It is invisible to the naked eye and very
rarely affects your vision. Most patients are not even aware that they
have haze. Although treatable in most cases, haze usually clears
gradually over many months following the procedure.
Incidence of serious haze: 1 in 1000 for LASIK, 1 in 100 for PRK
Regression
Regression refers to the tendency of the eye to bounce back somewhat
towards your original prescription following Laser Vision Correction. If
your vision regresses, you may require an enhancement procedure or a
thin pair of glasses. In most cases, the regression
experienced is minimal and is accounted for when planning your
procedure. In some cases, glasses for night driving may be all that is
required by a patient who experiences regression.
It is essential that you
understand as much as possible about the risks associated with the
excimer laser procedure. The risk of having a serious vision-threatening
complication is much less than 1%, however, the excimer laser procedure,
like all surgical procedures, has limitations and risks.
Night Glare
Even before having Laser Vision Correction, many people experience poor
night vision or night glare (haloes, starbursting) when wearing glasses
or contact lenses. Night glare is common immediately following the
procedure and will typically last for three or four months. By the time
both your eyes are treated or six months have passed, your night glare
tends to decrease and you should be back to where you began. However,
you may still require glasses for driving at night.
Incidence of significant glare: 1 in 50
Post-Treatment
Discomfort
You should have very little, if any, pain during the laser procedure
itself. With new techniques, a relatively small number of patients
experience significant discomfort following the procedure, which can
usually be eased with medication. Most patients experience some
irritation, sensitivity to light, and watering or swelling of their eyes
for a few days following the procedure.
Incidence: 1 in 50 for LASIK, 1 in 10 for PRK
Loss of Best
Corrected Vision
A small number of patients experience a slight loss of visual sharpness
or crispness following Laser Vision Correction (compared to when they
were wearing glasses before the procedure). In these cases, one or
2 lines (20/20 or 20/25) on the bottom of the chart are not
readable. In some cases, the sharpness returns over a period of
six to 12 months. This means that after the procedure, even with
glasses or contact lenses, you may not be able to see as clearly as you
did prior to the procedure.
Incidence: 1 in 100
LASIK
Flap Complications
While only about 1% of patients have complications with their LASIK
procedure, even fewer experience a serious flap related complication.
This may result in loss of best corrected vision.
Incidence: 1 in 500
Corneal
Flap Complications
The primary benefits of LASIK are related
to the creation of the protective corneal flap. The corneal flap
must be of clinically adequate quality, thickness and size to proceed
with laser treatment. Corneal flap complications range in severity
from those that simply require the procedure to be postponed by 3 to 6
months, to those that create permanent corneal irregularities resulting
in blurred vision. The rarest and most severe LASIK complication
is that of corneal perforation which has been reported several dozen
times worldwide. Corneal flap complications that occur after the
LASIK procedure during the recovery period include displacement and
wrinkling of the corneal flap and epithelial in-growth.
Corneal flap problems
include but are not limited to:
 |
Corneal flaps of
inadequate size, typically too short, preventing laser
treatment, and requiring the LASIK procedure to be repeated in
3-6 months. Typically no serious visual disturbance
although glare and shadowing may occasionally be produced. |
|
Corneal flaps of
inadequate thickness, may or may not be adequate for laser
treatment, and may result in the procedure being stopped and
repeated after 3-6 months. A thin corneal flap may
result in a slow visual recovery over weeks to months and
possibly permanently blurred vision with or without laser
treatment. |
|
Corneal flaps of
inadequate quality or smoothness include a variety of corneal
flap problems which may produce serious permanent corneal
irregularities and significant visual blurring. Corneal
flap irregularities may be produced because of inadequate
suction pressure, inadequate orbital size, inadequate patient
cooperation, malfunction or problems with the microkeratome,
blade or suction apparatus. |
|
Corneal flaps are
routinely hinged either nasally or superiorly beneath the
upper eyelid. A corneal hinge is not required for a good
visual result, but a hinged corneal flap is more secure and
typically heals faster and more smoothly. It is possible
depending upon the corneal shape, the suction ring alignment
and the microkeratome, that a free corneal cap may be produced
which is not hinged to the cornea. Although the laser
treatment can still be performed, if any irregularities in
flap quality or thickness are noted, the corneal disc is
immediately replaced and allowed to heal. If the free
corneal cap is of excellent quality then the procedure is
completed, but special care must be taken during the first
24-48 hours not to displace or lose the corneal cap.
Loss of the corneal cap may result in scarring, and permanent
corneal irregularity and the need for more invasive surgery. |
|
Corneal flap
displacement, partial or complete, occurs during the early
post-operative period, typically during the first 12-24 hours,
but may occur days to weeks later with trauma. Care
should be taken to protect the eyes from trauma, as well as
avoiding rubbing the eyes or forcefully closing the eyes
during the first week following LASIK. Partial
displacement of the corneal flap may result in corneal striae
or wrinkles, which blurs vision both qualitatively and
quantitatively. Most corneal striae are treatable but
some may be resistant to treatment especially in highly
nearsighted patients. Complete displacement of the
corneal flap is often painful and requires urgent
replacement. There is a higher risk of epithelial
in-growth and infection with corneal flap displacement. |
Epithelial
In-growth
Epithelial in-growth occurs
during the first
month following LASIK and is more likely to occur in patients with an
abnormal or weakly adherent protective layer, for which age is a
factor. Epithelial in-growth is produced when epithelial surface
cells grow underneath the corneal flap during the healing of the corneal
flap incision. Epithelial in-growth is more common with any trauma
or breakdown of the epithelium, which is more common in LASIK
enhancement procedures and long-term contact lens wearers.
Treatment of this condition involves lifting the flap and clearing the
cells away. Although most small areas of epithelial in-growth need
only be monitored, untreated large areas of epithelial in-growth may
distort vision and may actually damage the flap integrity if severe and
progressive.
