Laser Vision Correction

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1 Patient s Guide To Laser Vision Correction lasikworld.com

2 A Brief History of Laser Vision Correction (LVC) After years of testing and procedures being performed in counties around the world, the excimer laser (a highly-precise, cool laser) was approved in the US by the Food and Drug Administration (FDA) in 1995 for use in vision correction. It was originally approved for use in PRK (see below). Later, in 1998, it was approved for use in the LASIK procedure (below). Since that time, there have been over 15 million laser vision correction procedures performed in the US alone. Even today, there continues to be technological and procedural advances to improve the predictability of outcomes, patient candidacy, recovery and experience. What does LVC Correct? Laser vision correction is a procedure used to correct the vision of patients who have been diagnosed with the following: Near-sightedness (Myopia) - Able to see clearly when objects are near, but not farther away. Far-sightedness (Hyperopia) - Patients can see clearly in the distance, but not when objects are closer. Astigmatism - Blurry or fuzzy vision caused when the cornea, normally round in shape, is shaped more like a football. Many patients may have a combination of these issues (ex. near-sightedness with astigmatism). These can also be treated with laser vision correction surgery. How Does LVC/LASIK Work? Clear vision is created when light enters your eye and the cornea (located in the front, outer portion of your eye) bends, or refracts the light to focus on a single point that is located on your retina (located at the back of your eye). When the curvature of your cornea does not allow a single focal point on the retina, you will experience vision problems. These issues can be treated through laser vision correction surgery. Laser vision correction is a procedure used to re-shape the cornea so that it can correctly concentrate light to a single focal point on your retina.

3 Near-sightedness (Myopia) - This is caused when the cornea is too steeply curved causing light to focus at a point in front of the retina. To correct this, a cool laser is used to remove a microscopic amount of tissue located at the center of the cornea, making it slightly flatter so light focuses precisely on the retina. The amount of tissue removed is typically less than the width of a human hair. Far-sightedness (Hyperopia) - This is caused when the shape of the cornea is too flat causing the light to focus at a point behind the retina. To correct this, the laser is applied to areas surrounding the center portion of the cornea, making it more steeply curved and allowing light to now focus precisely on the retina. Astigmatism - This is blurry vision caused when the cornea (which in normal vision is round and shaped more like a baseball), has an asymmetrical shape, more like a football. Another analogy is comparing a ping pong ball to an egg. This causes light to focus on more than one focal point, causing blurry vision. Our highlyprecise laser can be used to reshape the front of your cornea so that it is more symmetrical and reduce the blurring effect caused by astigmatism. PRK In 1995, the FDA approved the excimer laser for use in performing PRK for laser vision correction surgery. PRK is an alternative to LASIK for performing laser vision correction and a good choice for many people who have been told they may not be an ideal candidate for LASIK. PRK is performed using the same excimer laser that was later approved for use when performing LASIK, and is also able to correct nearsightedness, farsightedness, and astigmatism. In the PRK procedure, our surgeon uses an instrument to remove the outer surface cells of the cornea to access the underlying stromal layer, where the treatment must be performed. The surgeon then uses our Alcon WaveLight EX500 laser to apply your specific treatment to your cornea. Unlike LASIK, PRK does not require our surgeons to create a flap on the corneal surface. There are differences in the recovery period between LASIK versus PRK. LASIK recovery is typically quite rapid and most patients return to work the following day. PRK requires more time to heal due to a much larger area of the front (epithelial layer) of the cornea that must replace itself as compared to the small rim that must heal around the flap made during LASIK. The discomfort associated with PRK recovery has been over exaggerated. New post-operative medications and special bandage contact lenses are quite effective in treating the potential discomfort experienced by some PRK patients. Your visual outcome will be the same regardless of whether PRK or LASIK is performed.

4 LASIK In 1999, the excimer laser was approved by the FDA for use in the laser vision correction procedure commonly known as LASIK. In the LASIK procedure, rather than applying the laser to the outer surface of your cornea as in PRK, your surgeon creates a hinged flap on the front surface of your cornea with our Ziemer Z4 laser. We do not use a blade to make the flap as do many providers. The flap is then gently lifted back and it is the underlying corneal tissue that is treated with the laser. Once the laser correctly shapes the cornea, the flap is laid back into place, acting much like a natural bandage, which adheres quickly like velcro. Because there is almost no treated cornea tissue exposed to the elements, the recovery is much quicker and more comfortable for the patient. It also reduces the potential for infections during recovery. Blade-free, All-laser LASIK The process and technology used to create the hinged flap used in the LASIK is a critical part of the procedure. Earlier technology utilized a mechanical device called a microkeratome that uses a blade to create the corneal flap. Many providers still use this method mainly due to cost concerns. The femtosecond laser is the latest technology available and allows for more precise creation of the flap and eliminates the need for a blade. In fact, some patients that were earlier dismissed as candidates for LASIK due to cornel thickness may now be a candidate with this advanced technology. According to studies published by the American Academy of Ophthalmology, blade-free, all-laser LASIK offers some notable advantages*: 1. Reduced incidence of flap complications like buttonholes, free caps, irregular incisions, etc. 2. Greater surgeon control over flap diameter and thickness, side cut angle, hinge position and length 3. Increased precision with improved flap safety and better thickness predictability 4. Capability of cutting thinner flaps to accommodate thin corneas and high refractive errors 5. Absence of moving parts 6. Stronger flap adherence 7. Decreased incidence of epithelial ingrowth 8. Lesser incidence of dry eyes (*

5 What If I Have Presbyopia (need reading glasses)? The ability to focus at different distances is a physical process referred to as accommodation. In cases where patients need reading glasses in order to focus on near objects (Presbyopia), this is caused when muscles in your eye lose their ability to flex your lens (located underneath the cornea). This flexing of the lens allows you to change your focus to closer objects. As part of the aging process (typically starting around age 40+), your lens stiffens and loses its flexibility. The result is presbyopia. Since the underlying problem with presbyopia is a declining physical issue and not a refractive issue (due to the shape of your cornea), LASIK cannot reverse this process, but may provide a vision correction option Monovision. Patient s Guide to Laser Vision Correction Monovision Many patients may start experiencing signs of presbyopia, but still need vision correction for distance or astigmatism. Previous to laser vision correction surgery, bifocals were the common solution. Today, laser vision correction can provide a solution that is more convenient to your lifestyle. Monovision laser vision correction is a procedure that treats one eye for distance vision and the other for near vision. For most patients, monovision is an effective solution that allows you to enjoy clearer vision both near and far. In cases where patients are in their 40 s, or even 50 s, and still pre-presbyopic (able to see close objects clearly without reading glasses), monovision treatment could consist of correcting just one eye for distance correction. If you are considering this option, we will fit you with monovision contacts so that you can experience your world with this type of vision in order to make the best decision possible without being rushed or pressured.

6 LASIK vs. Cataract Surgery As patients reach their late 50s or 60s, they will start noticing cloudy or blurred vision where even new glasses cannot provide crisp, clear vision. In most cases, these patients are experiencing the early signs of a cataract. As we age, the lens of our eye not only becomes more stiff (see presbyopia), but starts to become increasingly cloudy. This blocks light from focusing directly on your retina, causing blurred vision. The treatment for a cataract is a common surgery that replaces the old, cloudy lens with a clear, artificial lens (intraocular lens, or IOL). In some cases, you may also be a candidate for a more advanced lens that provides focal properties to enhance your vision without glasses or contacts. You will need to discuss these options with your surgeon. Cataract surgery is performed on an out-patient basis and takes only minutes to perform. Since cataracts are caused by the clouding of your lens and not a refractive error caused by your cornea, LASIK/laser vision correction surgery is not a viable treatment for cataracts. Cataract Surgery After LVC Since cataract surgery (replacing the lens of your eye) and laser vision correction (correcting the curvature of the cornea of your eye) are two different types of surgeries on two different parts of your eye, it is possible, and even common, for laser vision correction patients to later have cataract surgery performed. To ensure the most predictable visual outcome for your cataract surgery, it is important to provide your cataract surgeon with detailed input about your eyes and vision before and after your laser vision correction surgery. If you are not satisfied with your vision after cataract surgery, it may also be possible to perform corrective LVC/LASIK surgery after cataract surgery. In addition, if you have vision correction needs prior to your cataract surgery, there are more advanced vision-correcting IOL lenses (referred to multi-focal lenses) that can be used to improve your vision without LASIK or other laser vision correction procedures. You should consult your cataract surgeon to discuss your needs and options in more detail.

7 Should I Consider LVC? Laser vision correction procedures, like LASIK, have provided millions of patients the benefits of clearer vision without relying on glasses and contacts, but every patient needs to take a number of items into considerations to determine if it is right for your specific needs and situation. These items should be discussed with your eye care provider to help you make well-informed decisions. First, you and your surgeon should fully understand your primary motivations for having vision correction surgery. Some reasons for having laser vision correction surgery may include: Convenience Appearance Issues with contact lenses Outdoor activities, sports Career or work-related benefits You and your surgeon will also need to determine your current eye condition, if you are a candidate, and if vision correction surgery is the best solution to meet your specific vision needs and goals. Some considerations may include: Type of refractive error (Nearsighted/Farsighted) Astigmatism? Current vision prescription Changes in vision prescriptions in the past year or two Healthy cornea Other eye or medical conditions Age Work or lifestyle considerations Financial considerations Potential risks and complications Ready To Take The Next Step? If you are ready to take the next step to having LASIK or some other vision correction surgery, start by investing the necessary time to consider your options. Keep in mind, vision correction surgery still comes with some inherent risks, and outcomes can vary based on the providers, their screening and treatment processes, as well as the technology they use. Use this LASIK Patient Checklist to ensure you make educated decisions regarding your vision correction choices.

8 LASIK Patient Checklist Your Checklist - How To Compare LASIK Providers Consultation Process: Provided quality information throughout the process Provided a very thorough examination Met with the surgeon who will perform my surgery The surgeon is a board-certified ophthalmologist The surgeon has extensive experience I had a highly positive consultation experience Sevice and Technology: Surgeon actually helped with my examine and discussed my case in detail Surgeon will also provide follow-up exams Practice performs Custom LASIK treatment for Every patient Offers the most advanced diagnosis and examination technology (Pentacam) Offers the latest Blade-free, All-laser LASIK treatment Offers the latest laser technology for laser vision correction treatment Trust and Credibility: Discussed the 20/20 Vision or Your Money-Back program Discussed costs and affordable payment options Checked their patients reviews and ratings Checked surgical outcomes and results For An Extensive List of Questions To Ask:

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