1 Consumer s Guide to LASIK A Community Service Project brought to you by Price Vision Group
2 Your Guide To A Successful LASIK Procedure The purpose of this educational guide is to help prospective patients make a more informed decision about improving their vision by reducing or eliminating their dependence on corrective eyewear through LASIK. The information presented in this guide is educational in nature and is not intended to serve as a substitute for medical advice, nor should it replace the informed consent process provided by doctors prior to patients having surgery. LASIK is actually an acronym for Laser Assisted In-Situ Keratomileusis. It has been deemed by the American Society of Cataract & Refractive Surgeons and the Eye Surgery Educational Council to be a safe and effective treatment for a wide range of common vision disorders, including myopia (nearsightedness), hyperopia (farsightedness), and astigmatism. During the past decade, LASIK has become the safest, most popular vision correction procedure ever developed. Since 1995, more than 10 million men and women worldwide have had their vision corrected through LASIK. Thanks to recent advancements, there has never been a better time to be considering LASIK than right now. Advances in LASIK Technology There are a number of laser manufacturers who have developed laser vision correction systems currently approved by the Food & Drug Administration (FDA) for laser vision correction in the United States. Many of the early laser manufacturers (VISX, Summit, LADARVision, Bausch & Lomb) have continually upgraded their lasers over the years. Many have now evolved into 4th and 5th generation status, but none were specifically designed for LASIK. Only one Excimer laser platform earned that exclusive right. The WaveLight Allegretto Wave Excimer Laser System was designed and developed in Germany by some of the world s leading eye surgeons, engineers and scientists. Because of its patented beam profile, eye tracking system and consistent results, the WaveLight Allegretto Wave Excimer Laser System is quickly becoming the laser of choice for many leading LASIK surgeons worldwide. The result? A new level of visual excellence impossible to achieve with either glasses or contact lenses. In clinical trials, the vast majority of patients achieved 20/20 vision or better 12 months following their Allegretto Wave LASIK procedure. Risk & Complications For the vast majority of patients, LASIK improves vision and reduces dependence on prescription eyewear. However, as in any surgical procedure, there are inherent risks, complications, and side effects that can occur. Therefore, it is essential that candidates considering the LASIK procedure be well informed on both the benefits and the risks.
3 Although extremely rare, potential risks include infection, over-correction, under-correction, flap complications, de-centered laser treatment and potential loss of best-corrected vision. Fortunately, advances in technology and surgical techniques have greatly reduced the risks associated with LASIK. Less than 1% of all LASIK patients experience complications, most of which are treatable. Determining the Ideal Candidate for LASIK The ideal candidate for LASIK should meet the following criteria: 1. Be at least 18 years of age. 2. Have a stable prescription for glasses or contacts for at least two years. 3. Have adequate corneal thickness and pupil size for the procedure. 4. Have naturally occurring myopia, hyperopia, and/or astigmatism. 5. Have no medical disease or vision impairment that could reduce the effectiveness of the procedure. 6. Be adequately informed of the benefits and risks of the procedure. 7. Have a desire to reduce their dependence on corrective eyewear. 8. Have reasonable expectations. Before choosing to have your LASIK procedure, be sure to discuss these criteria with your eye care professional. Conducting The Appropriate Pre-LASIK Testing To help ensure the best possible result from LASIK, all candidates should undergo extensive preoperative testing to rule out possible conditions that may affect your outcome. This special testing should include the following: 1. Wavefront Diagnostics using Wavefront aberrometry to measure the entire optical system of the eye, Wavefront technology identifies and measures imperfections in the eye many times more precisely than standard methods used for glasses or contacts; this is the ultimate determining factor for LASIK candidacy. 2. Corneal Topography a computerized topographical map that measures up to 7000 locations on the corneal surface for possible irregularities. Patients with ectasia (steepness in the lower part of the cornea) or keratoconus (bulging of the cornea) may not be considered ideal candidates. 3. Pachymetry technology that measures the thickness of the cornea to ensure adequate tissue is available for optimal results. 4. Pathology Exam a dilated examination by an eye doctor to check for cataracts, glaucoma, retinal diseases and/or tears or holes, diabetes, AIDS, or herpes simplex inflammation that could slow the healing or impair the results.
4 5. Pupilometry Testing measures the size of your pupil in maximum darkness to anticipate halos, starbursts, glare, and ghosting from an abnormal pupil size or shape. 6. Slit Lamp Exam basic examination by an eye doctor to check the general health of the eye and check for irregularities in the cornea. 7. Schirmer Tearing Test a test to detect possible dry eye syndrome, which can be exacerbated by LASIK surgery. 8. Refraction testing to determine level of nearsightedness, farsightedness, and astigmatism under both non-dilated and dilated conditions. 9. Vision Goal the patient s desired outcome is defined based on accumulated information about his or her visual system. Be certain to ask your LASIK surgeon if all of the testing mentioned here will be included in your preoperative work-up prior to LASIK. Finding The Right Surgeon Your results from LASIK will be directly related to the overall experience of the surgeons and staff within a practice. To achieve optimal results from your LASIK procedure, seek a surgeon who has completed fellowship training in LASIK and is a corneal specialist. Your surgeon should also be an active member of the American Society of Cataract and Refractive Surgery and be certified & trained on the latest laser technology. It is also important to select a LASIK practice with a proven history of refractive surgery and one who understands the intricacies of laser vision correction. A practice should also carefully monitor its surgical outcomes (LASIK results) and make those available for patients. According to a study conducted by the American Society of Cataract and Refractive Surgery, the level of intraoperative complications for experienced surgeons is less than 1% compared to a complication rate of 4.5% of less-experienced surgeons. Continuity of postoperative care and surgeon availability following LASIK is also critical for optimal results. Prior to undergoing the LASIK procedure, determine who provides your pre- and postoperative care,
5 how much specific experience your surgeon or co-managing optometrist has, and where he or she has received training. Making LASIK Safer One of the major obstacles preventing most patients from enjoying the benefits of LASIK is their fear of the procedure. Statistics involving thousands of patients indicate that the more understanding and working knowledge a patient has of LASIK, the more capable he or she becomes in making an informed and educated decision regarding vision correction. This includes helping them overcome their basic fear of the procedure. Fortunately, new technology now available in Indianapolis is helping patients reduce their fear and anxiety of LASIK. LASIK involves making a thin protective flap in the cornea, then reshaping the inner tissue using an Excimer laser. Traditionally, this protective flap was created using a hand-held mechanical instrument called a microkeratome which contains a metal blade that slices into the cornea. Although relatively safe, the microkeratome can produce a rough and irregular corneal surface that can affect the quality of vision. To eliminate the potential problems caused by a bladed cut, femtosecond lasers have added a tremendous level of safety and accuracy to flap creation with over a million procedures performed to date. The Alcon FS200 femtosecond laser represents the next level of excellence in flap creation. Using its ultra-fast, tightly focused, low energy laser beam, microscopic bubbles are created at a precise, programmed depth within the cornea. This causes the layers of the cornea to separate thereby creating a LASIK flap of the desired thickness, size, orientation and location, unique to each patient s needs. The bubbles created by the laser disappear soon after the flap is lifted, creating a smoother surface and allowing the LASIK procedure to be performed. This tremendous level of control and customization makes LASIK safer, speeds visual recovery, makes patients more comfortable, and contributes to better visual outcomes.
6 The Right Operating Environment Factors such as humidity levels and room temperature in a laser environment can affect LASIK results. Therefore, it is critical to ensure your procedure is performed in a controlled, medically-clean environment, where conditions such as humidity, air quality, and temperature are closely monitored and maintained. Best results will be achieved in dedicated laser suites with proper air exchange and controls that have been designed specifically for LASIK and the type of laser technology in the laser center. Take your vision to the next level
7 Results You Can Expect From LASIK After LASIK surgery, the majority of patients with low to moderate levels of nearsightedness, farsightedness, and astigmatism achieve 20/20 vision or better. This level of vision enables patients to pass the vision portion of their driver s license test without glasses or contacts and enables them to perform most of their normal daily activities. Many patients but not all achieve 20/20 or their visual goal, depending in part on their preoperative, bestcorrected visual acuity. The majority of LASIK patients report the quality of their vision after LASIK to be better than they saw previously with their glasses or contacts. Your postoperative goal will be determined by your age and the general health of your eyes. Patients with high to severe levels of nearsightedness, farsightedness, and astigmatism can still benefit greatly from LASIK, but they should discuss their special circumstances with the surgeon. If you do not achieve optimal results, a follow-up procedure or enhancement can be performed to further improve vision. Ask your surgeon if he or she maintains an active database of outcomes analysis. Postoperative Management and Fees Final results from LASIK depend not only on the qualifications of the surgeon and the technology he or she uses to perform the procedure, but also on the patient following all pre- and post-op instruction and steps. This includes the postoperative management instruction that patients receive from the surgeon, technical staff, and/or co-managing doctor during the weeks and months following the procedure. Because fees for LASIK vary greatly from center to center, it is important to discuss postoperative costs with the surgeon performing your procedure. Patients should ensure that at least one full year of postoperative exams and follow-up visits are included in the global fee charged for the procedure. Some centers charge patients according to their level of refractive error to help make LASIK seem more affordable. Be sure to go over specific costs with your surgeon prior to undergoing the procedure.
8 Reputation and Research Choosing a LASIK center with a proven reputation for leading-edge technology and uncompromised patient care will further enhance the overall LASIK experience. Unfortunately, many corporate and discount LASIK centers today frequently change surgical teams and surgeons, making it difficult to maintain the highest standards and continuity in quality patient care. Surgeons who are involved in ongoing research and development are continually exposed to the latest breakthroughs in technology and surgical techniques long before the average surgeon. For optimal LASIK results, have your procedure performed at a comprehensive eye care facility with an experienced refractive surgical team dedicated to research, technology, and complete patient satisfaction. In addition, ophthalmologists who provide full service surgical and general eye care can handle your needs now and into the future. Choosing such a surgical team gives you access to the most upto-date techniques and medical advances available today. A Community Service Brought To You By: During the past 25 years, Price Vision Group has helped to set the standard in the field of vision correction and is today recognized as one of Indianapolis most trusted names in ophthalmology. Our fellowship-trained, board-certified surgeon has more than twenty years of surgical and clinical experience and is dedicated to helping you enjoy a lifetime of the best possible vision. Our founding surgeon, Dr. Francis Price Jr., received the Senior Achievement Award from the American Academy Ophthalmology in 2006 for his significant contributions to his profession through educating others, as well as serving in leadership roles. Dr. Price has also been named an Indiana Hero by the Indiana Pacers for his exceptional contributions to the Indianapolis community and the state of Indiana. Price Vision Group was the first center in Indianapolis to offer patients the unsurpassed safety of IntraLase and the personalized precision of the Allegretto Wave Eye-Q Excimer Laser system. Our dedication to leading edge technology is surpassed only by our commitment to personal quality care N. Meridian Street, Suite 106 Indianapolis, IN 46260
Laser-assisted in-situ keratomileusis (LASIK) versus photorefractive keratectomy (PRK) for myopia (Review) Shortt AJ, Allan BDS, Evans JR This is a reprint of a Cochrane review, prepared and maintained
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