Laser Vision Correction

Q. What is Laser Vision Correction?

A. Laser Vision Correction (LVC) uses a computer-controlled laser to precisely re-shape the cornea (the front surface of the eye) so that light will focus properly on the retina (the back of the eye). Laser Assisted in-Situ Keratomileusis (LASIK) and Photo Refractive Keratectomy (PRK) are the main types of Laser Vision Correction. Your optometrist can discuss advantages and disadvantages of each procedure. LASIK is the most commonly performed LVC today.

Q. What is Lasik?

A. LASIK, or Laser Assisted in Situ Keratomileusis, involves reshaping the cornea of the eye. To correct nearsightedness the curvature is flattened; to correct farsightedness, the curvature is increased. Techniques that reduce astigmatism reshape the cornea producing a more evenly curved surface.

Q. Are there different types of laser systems?

A. The lasers systems used in vision correction today are incredibly precise surgical instruments capable of delivering tissue removal to 1/50th thickness of human hair. There are different types of laser equipment. Some systems follows eye movement with a laser radar tracker, others with a video or "active" tracker, and still others don't use a tracking system at all. The width of the laser beam varies considerably from system to system as well.

These technological differences do matter, because they can affect what happens during the procedure. More importantly, they can affect the vision you will have for the rest of your life. Your doctors Sacramento Contact Lenses and Optometry have affiliated only with the most technologically advanced laser facilities staffed with the highly skilled refractive surgeons.

Q. What are the most important factors for successful Laser Vision Correction?

A. Contrary to what many patients believe, the success of the laser procedure is largely determined not by the state of the art of the laser, nor the skill of the surgeon, nor the precision of measurements, although each of the above factors does contribute to the success of the outcome.

The most important factors in the success of the laser correction are:

Assessing the reasons for undergoing laser procedure – if you are very happy with your current vision correction by either glasses or contact lenses, you are much more likely to be satisfied with nothing less than perfection from your laser vision correction Adjusting your expectations – if you expect more than can or will be delivered by LVC, you will be disappointed Understanding what the LVC can and cannot deliver – being informed on the limitations of the currently performed LVC, such as inability to preserve or restore focusing ability as one ages, and inability to deliver the same degree of accuracy of correction as with glasses or contact lenses The healing process – ultimately the optical result of LVC largely depends on individual's corneal healing, something that the best of doctors cannot either predict or control, and that accounts for most of the variability of outcomes among patients and, sometimes, even for the difference in outcomes between the two eyes of the same patient

Discussing all of these factors with your doctors at our practice will lead to a more satisfactory result and may save you from the disappointment.

Q. How do I know if I'm a candidate for LVC?

A. Most patients who are nearsighted, farsighted or have astigmatism can be treated with one of the laser techniques. There are some general medical and eye conditions for which LVC is contraindicated. In addition, even a healthy eye may have certain characteristics, such as larger pupil size or thinner cornea that may lead to complications or undesirable effects. Discussing your reasons and expectations with your doctor and having a thorough eye examination that includes some tests specific to LVC is the best way to ascertain the suitability of LVC for you.

Q. Are there risks associated with LVC?

A. Contrary to what you may have been led to believe by the advertising blitz, LVC is a serious surgical procedure and, thus, has certain inherent surgical risks. In addition to the surgical risks, there is a risk that your vision may not be corrected as well with LASIK, as it is currently corrected with your glasses or contact lenses. Other complications may include loss of best-corrected visual acuity, reduced contrast sensitivity, halos at night, glare, dry eyes, and infection. This is not a complete list of possible side effects and complications. It is very important to discuss the potential risks with your doctor prior to consenting to surgery.

You can minimize the risks of the LVC by seeking out the best pre-operative assessment and advice on whether you are a candidate for the LVC. Your doctors at Sacramento Contact Lenses and Optometry, who have followed your eyes, vision and medical history for years, and are familiar with your unique visual needs and demands, are in the best position to advise you on the suitability of LVC in your particular case. The skilled and experienced surgeon in a sterile, professional setting, and the most advanced equipment will also maximize the chances for a successful outcome. Your postoperative care with your optometrist is critical for early diagnosis and treatment of complications so you can maintain good vision. It is very important to follow your doctor's postoperative instructions completely.

Q. How is LASIK performed?

A. Your eyes are numbed using "eye drop" anesthesia, an eyelid holder is placed between your eyelids to prevent you from blinking.

Next, and instrument known as a microkeratome makes an incision into the cornea, creating a flap of the cornea, which is gently folded back. During this process you may feel a little pressure and the microscope light will momentarily fade away.

Then, you will be asked to look at a focusing light. At this point the laser tracks your eye movement while the small spot laser beam precisely reshapes the cornea by removing a certain amount of corneal tissue in a matter of seconds.

The flap is then laid back into place where it adheres like a decal, without sutures.

An advantage to LASIK is that the surface cells of the cornea remain intact. This allows for faster stabilization of good vision and enhanced comfort. After LASIK, some patients report a slight discomfort that usually goes away after 24 to 72 hours.

Q. How long will the procedure actually take?

A. The Excimer Laser corrects most prescriptions in less than a minute. In order to allow adequate time for preoperative preparation and postoperative examination, expect to spend approximately 90 minutes at the surgical laser facility.

Q. Does it hurt?

A. LVC is not painful since anesthetizing eye drops are used during the procedure. After surgery, most patients experience little or no discomfort. Your eyes may feel scratchy, watery or dry, and your vision will be foggy at first. These symptoms are temporary and are not a problem for most patients. These symptoms usually disappear within 2-3 days.

Q. When will I be able to return to work?

A. Many patients can return to near normal activities several days after the procedure. Your optometrist will advise you of any activities you should avoid during the immediate postoperative period. Usually, patients have functional vision and can return to work within one week.

Q. Can both eyes be treated at the same time?

A. Due to the advanced technology used to perform LVC, both eyes are usually treated at the same visit, one right after the other.

Q. Do the results last?

A. LVC is considered to be a permanent procedure. However, eyes may and do change with age. Regression, which is the return of nearsightedness or farsightedness is possible, and may require either re-treatment or wearing spectacles or contact lenses. In addition, it will not prevent any age related conditions such as presbyopia (age related diminution of focusing necessitating reading glasses) or cataracts. They would need to be treated in the usual manner.

Q. How much does LVC cost?

A. The fee will depend upon your specific vision needs and type of procedure you select. The fee includes your pre-operative consultation and care, the surgery itself, and your postoperative care at 1 day, 1 week, 1 month, 6 months (or more often if needed). Many laser facilities have arranged group rates with some employer and insurance groups. By contacting them, we can determine which insurance or group program may apply.

Q. Does insurance cover Laser Vision Correction?

A. Some insurance companies have added Laser Vision Correction to their benefits. We can contact the laser center on your behalf to see if yours does.

Q. How do I find the right surgeon and the right laser center?

A. Ask your expert in vision care — your optometrist! Your doctors at Sacramento Contact Lenses continually monitor the capabilities of the regional surgeons and the quality of laser facilities in order to provide the best referrals to you. Unlike majority of eye care providers, our doctors have absolutely no financial interest in any of the laser centers, so they can provide you with the unbiased opinion. Our doctors have only your interest in mind when advising you on the suitability of the LVC for you, or referring you to a specific surgeon or a laser center.

Q. I've seen Laser Vision Correction advertised for a lot less.

A. Remember, LVC is a complex surgical procedure that should only be performed by experienced professionals in vision care, providing the necessary preoperative time to comprehensively measure your suitability and required correction. There should be numerous follow-up appointments over the course of a year to monitor your healing process. There should be secondary treatments included, should the first fall short of the planned outcome. You should have a team checking and double-checking the treatment process. Would you price shop for a parachute?

Q. I've heard about nighttime vision problems after LVC. Will this affect me?

A. Glare, halos and ghosting are not uncommon side affects of many laser procedures, which may become more noticeable at night. Certain characteristics of the patients' eyes, the pupil size most prominently amongst them, determine the likelihood of these complications after the surgery. The latest equipment and protocols can substantially reduce the occurrence of these symptoms. Every set of eyes is different, as is each and every treatment. A consultation with your doctor may help determine the likelihood of your night vision being affected.