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What is LASIK and how is it done?
What does the name of the LASIK procedure mean?
How long has LASIK been performed?
Is LASIK for me?
If I’m not eligible for LASIK, are there other options available to me?
I am happy with my contact lenses. Should I pursue having LASIK?
How much does LASIK cost?
Does insurance cover this surgery?
What results can I expect from LASIK?
Will my vision be as crisp after LASIK?
How long will it take before I can see well, and how long will it take before I have my best vision?
Will I need to wear glasses or bifocals once my eyes have healed?
After LASIK, how will my vision be at night or in low light?
Will my eyes be dry after LASIK?
Are the results achieved from LASIK permanent?
If I have LASIK and my vision changes later in life, can it be redone?
Does the LASIK procedure hurt?
How safe is the LASIK procedure?
Can I have both eyes done with LASIK at the same time?
If I have one eye done at a time, what will my vision be like in between the first and second surgeries?
How long will I be out of work after having LASIK?
Can I play sports after LASIK surgery?
Can I drive immediately after having LASIK?
Will my eyes look different after LASIK?
Is LASIK still considered investigational?
Why do I sometimes hear LASIK referred to as a practice of medicine procedure?
Is LASIK an off-label use of the excimer laser?
If LASIK if an off-label use on some lasers, why do ophthalmologists opt to do this procedure?


What is LASIK and how is it done?
LASIK (laser in-situ keratomileusis) eye surgery is a procedure that can correct nearsightedness (myopia), farsightedness (hyperopia), and astigmatism and so reduce or eliminate the need for glasses or contact lenses.

With LASIK, an excimer laser precisely and gently reshapes the front surface (cornea) of your eye to conform to your particular prescription. The laser is a computer controlled non-thermal beam of light that can be turned on or off at any moment. The procedure is virtually painless and is usually completed in less than 15 minutes.


What does the name of the LASIK procedure mean?
LASIK is the acronym for laser in-situ keratomileusis, sometimes referred to as laser assisted in-situ keratomileusis. The name refers to the use of a laser to reshape the cornea without invading the adjacent cell layers. In situ is Greek for in the natural or normal place. Medically, in situ means confined to the site of origin without invasion of neighboring tissues. Kerato is the Greek word for cornea and mileusis means to shape.


How long has LASIK been performed?
LASIK has been performed internationally for approximately 10 years. It was first performed in clinical trials in the United States in 1995. It is important to note that the major components of the procedure have a long history. Ophthalmologists have been reshaping the cornea for over 50 years, creating a protective layer of tissue for over 35 years, and using the excimer laser since
the 1980’s.


Is LASIK for me?
LASIK can benefit a great number of people with myopia, hyperopia, and astigmatism, but the procedure is not for everyone. We carefully screen patients who want LASIK to determine if the procedure is the appropriate treatment for their condition and lifestyle. A good candidate should have a strong desire to be less dependent on corrective lenses, have established realistic expectations, and understand the risks associated with the surgery.

There are also a number of factors the ophthalmologist will evaluate before he can determine if you are an eligible candidate for LASIK. Certain pre-existing conditions may render the procedure inadvisable and the doctor will not perform the surgery if you possess them.
   

If I’m not eligible for LASIK, are there other options available to me?
LASIK is only one type of refractive surgery available to our patients. Although you may not be eligible for LASIK, other procedures are available that can give you excellent vision as well. Simply call Eye City for a free consultation.


I am happy with my contact lenses. Should I pursue having LASIK?
Most surgeons agree that if you are comfortable wearing contact lenses and are not bothered by being dependent on them you should carefully evaluate the risks and benefits of LASIK.


How much does LASIK cost?
The price practices charge will vary, depending upon the conditions specific to the patient and location. Eye City makes every effort to make LASIK as affordable as possible to our patients and financing is available. Our complete LASIK package comes with one complete price.


Does insurance cover this surgery?
Although LASIK is not a cosmetic procedure, it is considered an elective surgery. Most policies in the U.S. insurance policies will not cover the procedure, nor will Medicare usually cover it. You should check with your insurance company to see if your policy offers partial or full coverage.

In many cases, the cost of the procedure can be covered by medical flex plans or medical cafeteria plans that allow pretax dollars to be set aside for medical expenses. You should check with your employer to see if your company offers this type of benefit.

It is possible that the cost of LASIK may be deducted from your US federal income taxes. You should check with your accountant to see if you can take LASIK as a deductible health expense.

If your insurance policy does cover LASIK, Eye City Vision Center accepts many insurance and discount plans. Financing is also available and can be set up online. Simply go to our Financing Options page to get started. Major credit cards are also accepted.


What results can I expect from LASIK?
LASIK improves the uncorrected vision (one’s vision without wearing corrective lenses) in most patients who have the procedure. Over 90% of patients with low to moderate myopia will achieve 20/40 vision, which is considered the minimum allowed by most states to drive without having to wear contacts or glasses. Over half of all patients can expect to achieve 20/20 vision or better. There are no guarantees that you will have perfect vision, and patients with high myopia (more than -7D) and high hyperopia (more than +4D) should have a different set of expectations. People who are most satisfied with the results of laser correction possess realistic expectations of what their vision will be like after surgery.


Will my vision be as crisp after LASIK?
Patients need to understand that 20/20 vision after LASIK might be different from 20/20 with corrective lenses. Some people describe the images they see post-operatively as not being as “crisp” as those seen through glasses.


How long will it take before I can see well, and how long will it take before I have my best vision?
Fast visual recovery characterizes this operation. Most patients achieve good vision the day of surgery and find that their eyes feel fairly normal within a day. However, vision can continue to improve, and your best vision can still take two to three months to occur. If necessary, adjustments to the surgery, called enhancements, can be done.  Patients who undergo hyperopic LASIK often need to wait longer to be able to see clearly. Typically, they are unable to see with intense clarity for one or two weeks, with best vision coming in several months post-operatively.


Will I need to wear glasses or bifocals once my eyes have healed?
Most patients who have LASIK do not need to wear glasses for their daily activities. However, patients may need to wear reading glasses if they are over the age of 40. This is caused by the normal aging of the eye, known as presbyopia. This condition occurs with or without LASIK. Some patients may need a minimal prescription for some activities. Those patients who currently have bifocals will still need reading glasses after the surgery unless they opt for a treatment plan called monovision, wherein one eye is corrected for distance and the other for near vision.


After LASIK, how will my vision be at night or in low light?
Most patients do not notice a change; however, some patients will notice glare, halos, or starbursts around objects in dim or low-light conditions. For the vast majority, these symptoms are temporary. However, others will continue to experience them for several months or longer. Although these symptoms do not necessarily interfere with visual acuity as it is measured by an eye chart, for some patients the experience can interfere with their activities.


Will my eyes be dry after LASIK?
Some patients who seek LASIK have underlying dry eye syndrome that has not been diagnosed. There appears to be a correlation between pre-operative dry eye syndrome and developing more pronounced dry eye symptoms post-operatively.  Therefore, many doctors test for dry eye prior to making a decision regarding eligibility.


Are the results achieved from LASIK permanent?
LASIK is a surgical procedure that permanently removes corneal tissue to reshape the eye in order to improve refraction. The physical results are permanent. However, you should be aware that eyes can still change with time, and LASIK does not affect a number of visual conditions associated with age. For example, LASIK does not prevent presbyopia or affect this condition once it does occur.


If I have LASIK and my vision changes later in life, can it be redone?
Depending on the cause, retreatment may be a viable solution to vision changes later in life, and other treatment options exist. You would need to see your ophthalmologist to determine the cause of the change and to determine which option is best for you.


Does the LASIK procedure hurt?
Patients are given a topical anesthetic (eye drops) to numb the eye, so they experience no pain during the procedure. When the surgeon applies the vacuum ring, the patient experiences a sensation of pressure just before his or her vision fades for a few seconds. The microkeratome–the instrument the surgeon uses to create the flap–and the laser do not cause any pain or discomfort. For several hours after the procedure, many patients describe a mild burning sensation, such as after opening the eyes while swimming in chlorinated water. Therefore, taking a nap for the first two to three hours after LASIK is encouraged.  After the first few hours, this uncomfortable feeling usually subsides.


How safe is the LASIK procedure?
According to several large studies, there is approximately a 2% intra-operative and 3-5% post-operative complication rate.  Most of these complications do not result in loss of two or more lines of best corrected visual acuity or interfere with vision long term. The rate of severe complications should be substantially less than 1%. It is important for patients to understand that LASIK is surgery, and a small incidence of complications is to be expected.


Can I have both eyes done with LASIK at the same time?
You can have bilateral simultaneous LASIK (both eyes done at the same time). In fact, the practice is common. However, in some circumstances, surgeons or patients will determine that it is best to wait between eyes in order to evaluate the results.  Hyperopic LASIK patients do not experience the extremely fast visual recovery that myopic patients do. Therefore, some surgeons prefer to operate on their eyes separately. Patients should discuss their options with
their ophthalmologist.


If I have one eye done at a time, what will my vision be like in between the first and second surgeries?
There are a number of different options to help patients deal with their vision between procedures. Some patients who do not have bilateral surgery will begin wearing a contact lens in the eye that has not undergone surgery. This practice gives them an opportunity to use their two eyes simultaneously. However, the contact lens will need to be removed at least three days prior to the second surgery. Others function by using the operated eye immediately without use of a contact lens in the opposite eye.  This solution may work for nearsighted patients with a moderate refractive error (less than six diopters). A patient with a refractive error above six diopters who does not wear a contact lens may be unable to use both eyes together due to the large difference in refractive error between the eyes. Removing one lens from a pair of glasses is usually not useful. Doing so could cause double vision and eye strain.


How long will I be out of work after having LASIK?
It depends on your occupation. Certain jobs that require intense clarity of vision (dentistry and surgery, for example) may be difficult to perform for one or two days. Most patients can return to work the next day, assuming their vision is adequate for their job. However, some people may feel fatigued for a day or so following surgery.


Can I play sports after LASIK surgery?
You can resume most normal activities immediately after surgery. However, for at least two weeks you will need to avoid activities that would cause perspiration to run into the eyes. You should wear safety glasses while playing contact sports whether or not you have had surgery. But if you do not routinely wear safety glasses, your surgeon may recommend wearing them for at least one month after LASIK. You will also need to avoid such activities as contact sports and swimming for several weeks. It is important to talk specifically with your doctor about limitations on activities after LASIK.


Can I drive immediately after having LASIK?
Patients may experience some discomfort and/or blurred vision for a few hours after surgery. And most patients receive a sedative prior to surgery. Therefore, you cannot drive home after undergoing the procedure, and you should plan not to drive for at least twenty-four hours.


Will my eyes look different after LASIK?
No, your eyes will look exactly the same.



Is LASIK still considered investigational?
No. LASIK has been performed outside of the United States for approximately ten years and in United States clinical trials with excellent results since 1995. It is now the most commonly performed refractive procedure in the United States.  Long-term studies indicate that LASIK is safe and effective. The US FDA provides a complete listing of the approval status of excimer lasers in the United States on their website.


Why do I sometimes hear LASIK referred to as a practice of medicine procedure?
The FDA approves drugs and devices, not specific surgeries. However, the FDA evaluates the safety and efficacy of a device within the context of studies that have been done on a particular procedure, like PRK or LASIK. US FDA approved excimer lasers in the United States earned approval based on PRK and/or LASIK data. On those lasers that have earned approval based on PRK data alone, LASIK is permitted as a practice of medicine.


Is LASIK an off-label use of the excimer laser?
Except on four commercial lasers and three practices’ proprietary systems, LASIK is performed off-label in the United States.  LASIK for treatment of hyperopia has been approved for two commercial laser systems and is off-label on all other United States lasers. The use of devices during a procedure deemed a practice-of-medicine is called an “off-label” use of these devices. Because the approved lasers and microkeratomes have proven safe and effective in other procedures, ophthalmologists can use them off-label if they feel it is in their patients’ best interest to do so.


If LASIK if an off-label use on some lasers, why do ophthalmologists opt to do this procedure?
LASIK has significant advantages over other methods for many patients. The safety and accuracy of LASIK equals or exceeds that of PRK. Because of the wide range of correction and the rapid visual recovery associated with LASIK, many surgeons offer this procedure as a treatment option.