101 LASIK FAQ

101+ LASIK Frequently Asked Questions

#1. What is LASIK?

LASIK (Laser-Assisted In-Situ Keratomileusis) is an FDA-approved refractive surgery that reduces your need for glasses or contact lenses. It has been refined over the last two decades to provide vision correction with a high level of precision.

2. For how long has the procedure LASIK been around?

LASIK with the creation of corneal flap as we know it was first introduced in 1991.

3. For how long has the use of excimer laser for laser vision correction been around?

The excimer laser has been used to perform surface ablation since 1985.

4. How long has refractive surgery been done on human eyes?

Incisional surgery in attempt to correct prescription of human eyes has been around since the 1800′s.

5. What conditions does LASIK treat?

LASIK can correct myopia (nearsightedness), hyperopia (farsightedness), and astigmatism. It can also be used to help presbyopia (difficulty with reading as we get older).

6. What kind of LASER is used for the LASIK treatment?

The laser used for LASIK, PRK, Epi-LASIK, and LASEK is called an excimer laser. The excimer laser is a kind of laser that does not penetrate the surface of the eye. The excimer laser breaks intra-cellular bonds and evaporates very small amounts of surface tissue at a time. Guided by a precise computer system, the excimer laser re-shapes the surface of the eye in a way that will focus light more precisely and make images more clear.

A different type of laser, called the femtosecond laser (explained bellow), is used to make the Intralase LASIK flap.

7. What is a LASIK “flap”?

During LASIK, a thin layer of tissue is created on the surface of the eye using an Intralase Excimer laser. This flap is about 110 to 140 microns thick. It is created using the femtosecond intralase laser. Subsequently the flap is lifted off the surface of the eye using a blunt instrument before the laser is applied. After the laser application is finished, the flap of tissue is placed on the surface of the eye where it was initially lifted.

8. How is a LASIK flap made?

A LASIK flap can be made by using a sharp blade called a microkeratome, or with the use of the femtosecond laser (blade-less LASIK).

9. Am I a good candidate for LASIK?

People who are near-sighted (myopic), farsighted (hyperopic), and astigmatic are all potential candidates for LASIK.  Certain individuals with very thin corneas or with corneal ecstasia (called keratoconus) are not good candidates for LASIK. People with severe dry eyes are not good candidates for LASIK. Certain systemic diseases (such as diabetes) and certain infectious conditions (such as HSV1 infection) can also make some individuals not good candidates for LASIK. Every eye is unique, however, and only a qualified surgeon, after careful examination, can detemine if each indivisual is a good LASIK candidate. The San Diego Laser-Vision Eye Center San Diego LASIK surgeons believe in conducting a very thorough, comprehensive eye examination prior to your surgery to determine if you are a good LASIK candidate.

#10. What if I am not a good candidate for LASIK? Are there other options for correcting my vision?

Yes. Many patients who are not good LASIK candidates, are in fact good candidates for surface treatments (such as PRK, LASEK, and Epi-LASIK) or intraocular contact lens implantation (ICL). Please look at the sections for PRK and ICL on this website for more information. However, there are some patients who may not be a good candidate for any of the procedures for vision correction.

11. What if I have had previous corneal surgery such as RK(radial keratotomy) or corneal transplantation? Can I still have LASIK?

Some patients who have had RK or corneal transplant can be candidates for laser vision correction. However, this needs to be examined on a case-by-case basis by an experienced surgeon. Having had prior RK or corneal transplant makes LASIK more challenging and some patients may no longer be candidates for laser vision correction after having had these procedures. 

12. What laser machines are used to perform the LASIK?

The femtosecond laser by AMO (advanced medical optics) is used to create a corneal flap. Some of the leading technologies for the laser treatment are the AMO Star laser and the Allegretto laser. There are also a few other laser machines that can be used to perform LASIK.

13. Are there any sharp, cutting instruments used for LASIK?

With the advent of the Intralase femtosecond laser, LASIK can be done without the use of any sharp instruments. This precise laser can create a plane of separation with bubbles in the cornea that creates a thin surface flap without the use of any sharp blades or sharp instruments. There are still some centers that use the microkeratome (a very sharp blade) in order to create the corneal flap for LASIK.

14. What is myopia?

Commonly known as “nearsightedness,” myopia is a condition that causes people to not see far objects very well. Myopia is a condition that usually starts in childhood, but can start at any age. Nearsighted individuals can see the near objects better than objects far away. Nearsightedness can often be improved with LASIK. The diagram bellow demonstrates that myopic or near-sighted eyes focus light at a point in front of the retina (which is the eye’s equivalent of the film of a camera).

15. How is myopia improved with LASIK?

 A myopic eye is an eye that has too much power and thus bends light too strongly, focusing the image in front of the retina rather than exactly on it. Retina is equivalent to the film of a camera that takes a picture and sends the picture to the brain. In order to treat myopia, the power of the eye to bend light needs to be decresed. The excimer laser flattens the surface of nearsighted eye in order to decrease its power and thus allowing it to focus light better.

16. What is hyperopia?

Commonly known as “farsightedness,” hyperopia is a condition that blurs vision in the distance as well as the near. Farsighted people, usually, see the far objects better than the near objects. With hyperopia, the focus point of light in the eye is at a point behind the retina as can be seen in the diagram bellow.

17. How is hyperopia treated with LASIK?

Eyes with hyperopia have too little power for bending light. For this reason, they focus the image behind the retina (as depicted in the picture above.) In order to improve vision for farsighted (hyperopic) eyes, the eye’s power of bending light needs to be increased. This is done by using laser to increase the steepness of the surface of the eye, thereby increasing its ability to bend light.

18. Does LASIK improve far-sightedness?

Yes, LASIK improves hyperopia (farsightedness). However, results are best with low to moderate levels of hyperopia. Hyperopic or farsighted people will be initially blurry in the distance as the laser initially has to over-correct and make them slightly nearsighted. This over-correction normally improves over the next 12 months after surgery.

19. What is astigmatism?

Astigmatism is a condition that causes blurred vision in both the near and distance. Astigmatic eyes have a power curve that is steeper (or more powerful) in one direction compared to the other, similarly to how a football has a steeper radius of curvature in one direction compared to the other. Conversely an eye without astigmatism has similar power in all directions, similar to a tennis ball having the same curvature in all directions. Astigmatic eyes, as depicted bellow have multiple focus points causing blurred vision. LASIK can improve astigmatism as well as myopia and hyperopia above.

LASIK Question #20. Does LASIK improve astigmatism?

Yes. Astigmatic prescription of most eyes can be improved with LASIK.

21. How is astigmatism treated with LASIK?

Astigmatism causes different parts of the surface of the eye to have different powers, and thus blurring the image. To simplify this notion, astigmatic eyes can be compared to footballs that have more curvature in one direction compared to the other. The LASIK laser can re-shape the power on the surface of the eye from more of a football shaped to a basketball-shaped shape allowing improved focusing of the light.

22. Does the power-curve on the surface of each specific eye look exactly like a football or a basketball?

No. Most eyes have what is called higher-order-aberrations. The surface power of the many eyes looks more like the surface of mars as compared to the smooth surface of a ball. For this reason the new Custom Wavefront technology allows us to correct vision at about 200 specific points on the surface of the eye.

23. How are higher-order-aberrations treated?

Higher-order-aberrations are treated using Wave-scan technology and CustomVue technology as described bellow. Make sure to ask your LASIK surgeon about custom LASIK correction prior to your surgery.

24. How long does the LASIK procedure take?

The LASIK procedure, on average, takes about ten minutes to complete.  However, you need to allow some time for getting into the office, signing in, and doing the other preoperative arrangements before your LASIK.

25. Does LASIK hurt?

LASIK is usually a painless procedure. However, during the treatment, you will feel some pressure on the eyelids. In addition, for a few days you may have the feeling of slight burning or having something in the eye.

26. Will I have to take any eye-drops prior to my LASIK surgery?

Your surgeon will usually ask you to take some antibiotic eye drops 2 to 4 days prior to your surgery day. He or she may occasionally ask you to take anti-inflammatory eye-drops or eye-drops for dryness prior to you LASIK.

27. Do I get any relaxing medications prior to LASIK?

It is usually not necessary to take any relaxing medications prior to LASIK. However, for those patients who do not have any medical contraindications to relaxing medications, and who may be unusually nervous, a small dose can be given.

28. Is LASIK done for both eyes at the same time?

Usually LASIK is done for both eyes at the same time. However, it can be done one eye at a time as needed.

29. What if my eyes itch after LASIK, is it ok to rub them?

It is very crucial for at least the first 24-48 hours after LASIK to avoid touching or manipulating the eyes at all. This is done in order to avoid moving the LASIK flap. If the LASIK flap is moved or wrinkled, it may be necessary for your surgeon to lift the flap and replace it on the cornea. If you have some feeling of itching or discomfort, you can try closing the eyes or placing a preservative-free artificial tear drop in the eyes. This can usually alleviate the symptoms of itching. It is also advised to avoid rubbing of the eyes for at least two weeks after surgery and only very gentle rubbing in the first few months after surgery.

LASIK Question #30. When is it ok to exercise after LASIK?

We recommend no contact sports or sports that can result in the eye being hit for at least 2 weeks. After that protective goggles need to be worn for the first month for any contact sports. Non-contact gentle exercise (not swimming) can be played as soon as 2 days after surgery. Again, it is better to wear sunglasses or protective goggles for the first 2 weeks after surgery.

31. How long after LASIK surgery is it ok to swim?

We recommend that you do not do any swimming for at least 2 weeks after surgery.

32. Will my eyes be patched after LASIK?

We recommend hard eye-patches to sleep with at night. Durign the daytime, you will have protective goggles.

33. Are there any stitches in LASIK?

LASIK is usually stitch-free. However, very rarely can it become necessary to place a stitch during LASIK. This would most likely be removed in the future by your surgeon.

34. When does the doctor see me again after my LASIK surgery?

Your surgeon will see you one day after and typically at one week and one months after your surgery. However, this can change on a case-by-case basis. It is possible that you will need to be seen more frequently.

35. What will I see during the LASIK treatment?

You will be trying your best to look at a blinking light in front of you. Your vision will be blurry and you may see a few flickers of light during the actual treatment.

36. Will my vision go dark at any point during the LASIK treatment?

It is possible that during the creation of the corneal flap, your vision will go dark for a few seconds. This darkness will improve after the succion device is removed from your eye.

37. How can I help the healing after LASIK?

Keeping the eyes closed as often as possible for about 6 hours after LASIK is helpful for healing after surgery.

38. How long does it take for my vision to improve after LASIK?

LASIK patients usually see improvement in vision within a few hours and are often able to return to normal activities within a day or two. However, healing and visual recovery can potentially take longer for some individuals.

39. Will my eye get red or blood-shut after LASIK?

After LASIK, there is usually some redness that is normal. This is due to the placement of the succion device that allows your surgeon to make a precise LASIK flap. This redness will improve over the ensuing few weeks after your LASIK.

LASIK Question #40. How long after LASIK can I go to work?

If your work does not expose your eyes to dirt or potential manipulation, and also it is not physical, you can usually go back to work within 1 to 2 days of having LASIK. If there is any possibility of dirt in the eye, we recommend at least one week off. If the work is physical and there is any possibility of eye manipulation, we recommend at least 2 weeks off. However, each case is unique and we recommend that you follow the special individualized LASIK directions given to you by your San Diego Laser-Vision Eye Center LASIK surgeon.

41. What about showers after LASIK?

Your surgeon will advise you more specifically, but it is better not take a shower for about 2 days after surgery. For the first 1 to 2 weeks after surgery, it is recommended to keep any water or soap out of direct contact with the eye.

42. Can I drive after LASIK?

We advise that you do not drive for at least one day after LASIK. After that, most individuals should be ok to drive as long as their vision is good enough for driving.

43. How long after LASIK can I start putting on make-up?

It is usually ok to put on make-up about 1-2 wks after LASIK. It is recommended to buy new makeup for around the eye to decrease the risk of infection.

44. What is Custom LASIK?

CustomVue™, Custom LASIK, or Wavefront-Guided LASIK can now be  used to treat imperfections in vision more precisely than with standard methods used for glasses and contact lenses. The Wave-scan technology measures the visual imperfections on the surface of the eye at 200 individual points. Treating each of these 200 points individually creates a personalized vision correction that is customized for each specific eye. This treatment can potentially provide vision better than ever achieved with glasses or contact lenses. Previously to the devolopment of this technology, standard laser vision correction could at best achieve the level of clarity offered by glasses. Today, prior to having a laser vision correction, all patients should ask their surgeons if they provide Custom LASIK.

45. How good are the outcomes after Custom LASIK? What percentage of people get 20/20 vision afterwards?

One year after the CustomVue™ LASIK procedure, a clinical study showed that 100% of patients could pass a driving test, 98% could see 20/20 or better, and 70% could see 20/16 or better.

46. How is night vision after Custom LASIK?

In the same clinical study above, it was shown that four times as many people were satisfied with their night vision after the procedure as compared to their night vision before with glasses or contact lenses. However, usually after LASIK for higher corrections, there are some haloes around lights. These haloes usually improve a few months after LASIK.

46. Are expensive LASIK centers better?

LASIK is a procedure that is highly variable between different centers. In addition, the price of LASIK can be very different among different centers.  Not every high-price LASIK center is a good quality one. However, there are a number of low-price “LASIK-mills” that do not use the best technology and do not provide the best service. They spend minimal time on each patient and the subtleties of each patient’s eye. At the San Diego Laser-Vision Eye Center, we believe in providing premium quality LASIK by top-notch surgeons. We believe that providing anything less than the best technology and service is not doing justice to our patients. We also believe in providing premium LASIK for a fair price.

47. What are the options for LASIK financing?

The payment options include cash, financing, and the use of expense accounts. Some vision plans can help pay for LASIK as well. Approval for 100 percent financing is usually possible. In addition, the cost of buying glasses and/or contact lenses over-time often adds up to the cost of the payments made for LASIK.

48. Is LASIK hard to afford?

The cost of buying glasses and contact lenses over time for most people can quickly add up to more than the cost of LASIK. Considering all the financing options available, today LASIK is affordable for a large number of individuals that are interested in being free of glasses and contacts.

49. How important is the choice of doctor for my LASIK?

The choice of your surgeon is absolutely crucial. Make sure that your surgeon is an experienced ophthalmic surgeon educated in a reputable university. Also, make sure that your surgeon spends adequate time explaining LASIK to you, personally performs your LASIK workup, and confirm all measurements. A surgeon without a reputable university education that does not spend sufficient time planning your personalized procedure will be unlikely to obtain optimal results for your LASIK procedure.

LASIK Question #50. What is pupil tracking?

Pupil tracking makes is possible to perform a truly customized LASIK treatment. With custom LASIK, it is important that the LASER treatment follows the small movements of the eye during surgery. For this reason, pupil tracking uses an infrared camera is used to track the movements of the eye every few milliseconds and adjust treatment according to the specific position of the eyeball at any given time.

51. What if there is a sudden large movement during my LASIK procedure?

If there is a sudden large movement during your procedure that the pupillary tracking system can not adjust for (the rare event of an earthquake for instance), the Visx LASIK machine is designed to simply stop and save the treatment plan. After conditions are stable again without movement and the infrared camera is able to track the eye again, the computer can usually re-start the treatment from where it was stopped.

52. What if I blink during the procedure?

There is a small device that will keep your eyes open during LASIK. You will not be able to blink usually during your LASIK surgery. However, if you squeeze your eyes very hard or move your head, procedure may be halted.

53. What is iris-registration?

Iris registration is a LASIK technology that adjusts the LASER treatment to the torsional movement of the eyeball. This technology involves capturing an image of the iris (the blue/green/brown/hazel colored part of the eye) and matching this picture to the picture of the eyeball under the LASER device. Usually when patient go from the standing or seated position to the laying down position, there is a subtle torsional movement of the eyeball. In earlier LASIK technologies, it was not possible to adjust the treatment to this subtle torsional movement of the eye. With iris registration it is possible to adjust the LASIK treatment not only according to the movement of the eye in the x and y direction, but also according to the torsional movements of the eye. This technology helps provide a more precise treatment. Prior to having LASIK scheduled, please be sure to ask if a LASIK center offers iris-registration.

x54. How long does the effect of LASIK last?

Usually, a patient’s vision is improved for years after LASIK. A majority of patient do not have any need for glasses to see the distance for years. However, similarly to a normal eye without LASIK, the prescription of the human eye can change naturally after LASIK. Usually these changes are much smaller than the original prescription.

55. How can change of prescription after my LASIK be prevented?

It is very important that your LASIK surgeon measures your prescription very carefully prior to having your LASIK and to make sure that it has been stable preferably over the last few years. An eye which has not had a stable prescription prior to the LASIK procedure is usually one that will continue to change afterwards. In those cases, a prudent doctor would recommend observation of your eye until your prescription stabilizes prior to doing the LASIK procedure. It is also prudent to avoid surgeons that will not enquire about your prescription stability over the last few years prior to recommending LASIK. While a stable prescription before surgery will not guarantee stability after LASIK, it is a very important precaution to take.

56. Will I need reading glasses after LASIK?

Usually, as long as you are under 40 you can be free of glasses after LASIK for distance and near. However, some time in the 40′s, even people with excellent distance vision will need reading glasses. This is called presbyopia. LASIK does not correct presbyopia. However, another option called monovision LASIK, can be used to help people see well in the distance and near past their 40s.

57. What is monovision?

Monovisionis a type of vision correction that sets one eye (your dominant eye usually) for the distance, and the other for near. This allows many individuals to be able to function well past their 40s without wearing any glasses for the distance or for the near. Monovision can be done with contact lenses or with LASIK.

58. What is modified monovision?

Modified monovision is a type of monovision that makes the non-dominant eye only slightly near-sighted. Modified monovision is for individuals that prefer to have their two eyes’ prescription not very much different from one another. Also, these people’s lifestyle may have a higher demand for intermediate vision as compared to very near vision.

59. Is LASIK safe for people who play contact sports or have physical jobs?

It is important to avoid intense physical activity in the few weeks after having LASIK. However, after a few months, intra-cellular bonds attach the LASIK flap to the surface of the eye. Many professional athletes and military personnell have had LASIK and can safely perform their physical duties. There is a slight possibility of flap dislocation after LASIK due to activity, however, there have been very few such cases reported. If you have concerns about having a LASIK flap due to having a physical job or lifestyle, PRK, Epi-LASIK, or LASEK may be good choices for you. These procedures do not create a corneal stromal flap and so there is no possibility of flap dislocation after healing from these procedures.

LASIK Question #60. What is Epi-LASIK?

Like LASEK, Epi-LASIK is a newer variation of the PRK. Epi-LASIK lifts a very thin epithelial layer off the surface of the cornea prior to the application of the laser for LASIK. After the laser treatment, the epithelial flap is placed back on the cornea, covered by a bandage contact lens and allowed to heal over the next week. This epithelial flap is much thinner than the LASIK flap and usually heals without a trace.

61. How is Epi-LASIK different from LASIK?

Epi-LASIK makes a much more superficial flap compared to LASIK. After the Epi-LASIK, the elevated epithelial flap heals almost exactly as it was before the procedure. LASIK flaps however, can be identified on the eye even years after having had the original LASIK done. Unlike LASIK which is very comfortable and usually heals within a day giving quick, excellent visual results; Epi-LASIK can cause some discomfort for about one week. Also visual improvement with Epi-LASIK can take up to 1 to 6 months.

62. Why should I choose LASEK or Epi-LASIK and not PRK?

The Epi-LASIK procedure and LASEK were both developed in order to decrease the discomfort involved in healing after the PRK. The thinking behind them was that if, instead of removing the epithelial corneal cells, we replaced them on the corneal surface, they would heal more quickly and cause less discomfort. In practice, however, these removed epithelial cells do not always re-attach and at times detach a few days after surgery. While some surgeons subjectively report getting less discomfort with Epi-LASIK and LASEK as compared to PRK, we have noticed that the healing time and discomfort with both surgeries is most frequently manageable and not significantly different from each other.

63. Why should I choose Epi-LASIK and not LASIK?

There are some patients who  have corneas that are not suitable for LASIK. These patients may have evidence of corneal abnormalities, or may have corneas that are too thin for creating a LASIK flap. In addition, for patients who have mild dry eyes, often LASIK is not as suitable compared to Epi-LASIK, LASEK or PRK.

64. What are some complications of LASIK?

LASIK, in good hands, is a very safe procedure with very low complication rates. However, it is a surgery and for any surgery there are some possible complications. Some of the more common complications of  LASIK include undercorrection, overcorrection, regression, irregular flap, flap wrinkling, dry eye syndrome, glare and haloes with lights, diffuse lamellar keratitis (DLK), central island, infection, and corneal perforation.

65. What is an under-correction of LASIK?

An under-correction is when your prescription is not fully corrected by the LASIK procedure. For instance after correcting your nearsightedness, you may still be somewhat near-sighted.

66. What is an over-correction of LASIK?

An over-correction is when an eye may have had more correction for its prescription by LASIK than needed. For example, an eye that was near-sighted, may be left far-sighter after LASIK.

67. Is it normal for me to be over-corrected after hyperopic (farsighted) LASIK?

Yes. As a matter of fact, you should be somewhat near-sighted the day after your hyperopic (farsighted) LASIK correction. This will usually normalize over the next 3 to 9 months. Farsighted people are over-corrected by the machine initially because they are expected to undergo regression towards their original prescription over the ensuing months.

68. What is regression of LASIK?

Regression means that a patient that has been initially corrected properly by LASIK, over the next few months or years, may move towards his or her old prescription. This is more common for farsighted indivisuals (hyperopes).

69. Can over-corrections, under-corrections, and regression be treated?

Yes. They can be treated using a LASIK touch-up procedure as described elsewehere in this website. However, sufficient time should be allowed for healing and stabilization of the prescription.

LASIK Question #70. What is an irregular LASIK flap?

Infrequently, the LASIK procedure can result in the formation of an irregular LASIK flap. The occurrence of the irregular LASIK flap is more frequent with the microkeratome blade. The irregular LASIK flap is one that has an irregular shape or size. Currently with the advent of Intralase femtosecont blade-free LASIK flap technology, the occurence of the irregular LASIK flap is very infrequent.

71. How do you manage irregular LASIK flaps?

A decision is made by your surgeon during your LASIK surgery as to whether or not it is ok to proceed with surgery despite an irregular LASIK flap. Some irregularities are mild and will not interfere with the surgical outcome. However, if there is an irregularity that is concerning, then your surgeon will abort the LASIK surgery and try to place the corneal flap back on the eye to heal. A treament likely will be possible in these cases in the future with PRK.

72. What is a flap wrinkle?

When the LASIK flap is placed back on the eye, there are sometimes a few microscopic wrinkles (called micro-strea) that do not effect vision. These wrinkles are not signficant. However, sometimes thes wrinkeles may be more significant or cause blurred vision. In those cases, your surgeon may choose to re-lift your LASIK flap, smoothen, and place it back on the eye.

73. Will I have glare and haloes after LASIK?

Glare and haloes can be experienced by anyone without glasses, with glasses, or with contact lenses. Glare is more frequent in patients who have had LASIK treatment zones that can be smaller than the size of their pupil at times. When light hits the untreated zones, it can scatter and cause more glare and haloes. With today’s latest technologies and wider available treatment zones as well as custom LASIK, problems with glare and haloes are uncommon. It is normal to have some glare and haloes initially after LASIK, however, these usually improve within the first 3 months.

74. What is a central island?

Central island is an irregularity in the surface of the eye more commonly caused by older genearation “broad beam” lasers. It consists of an irregularly elevated central cornea after LASIK which resembles an island. The newer lasers use “scanning” or “tracking” systems making this complication very infrequent.  This irregularity can usually be treated with a LASIK touch-up.

75. How will dry eyes affect LASIK and vise versa?

Severe dryness is a contraindication for LASIK. However, patients with mild to moderate dryness can do well with LASIK. Your eyes will be more dry than usual after having LASIK, but for most people this will improve within a year after surgery. It is possible, however, that after having LASIK your eyes will be more dry permanently and need ongoing treatment for dryness.

76. Which type of LASIK is better for dry eyes?

The surface treatments such as PRK, Epi-LASIK, and LASEK will do better with dryness as compared to LASIK. This is because there is no corneal stromal flap made with these procedures. It is thought that making of the corneal stromal flap for LASIK can affect surface corneal nerves and exacerbate dryness. However, severely dry eyes are not good candidates for PRK, LASEK, or Epi-LASIK.

77. How do you treat dry eyes after LASIK?

The treatment for dry eyes after LASIK can include any of the following methods. Preservative-free artificial tears can be used few times a day. Another option is the use of punctal plugs. These plugs close one of the two drains of tears thus keeping eyes better lubricated. Also, Restasis is a medication that is used frequently after LASIK. Restasis is thought to increase the baseline tear production of the eyes.

78. What is DLK (Diffuse Lamellar Keratitis)?

DLK is an infrequent complication of LASIK that causes inflammation in the interphase of the LASIK flap and the eye. It is not known what causes this condition; however, it can cause blurred vision within the first six days after LASIK surgery. If treated promptly with steroid medications, DLK often resolves quickly. However, very infrequently, DLK can cause scarring on the surface of the eye that is visually obstructing. With close follow-up after surgery, a great majority of DLK cases can be recognized and treated with excellent surgical outcomes.

79. What is a LASIK flap-lift?

A flap-lift is when your LASIK surgeon decides, for any reason, to lift your LASIK flap, irrigate some fluid underneath it and place it back on your eye. Your eye will be prepped in a sterile fashion similarly to the initial surgery. Some anesthetic drops will be placed on your eye. Then, underneath the microscope, your surgeon will use a blunt instrument to lift your LASIK flap, irrigate some fluid underneath it, and to place it back in place on the eye in order to heal. The LASIK flap-lift is usually painless and recovery similar to the original LASIK.

LASIK Question #80 Why should I need a LASIK flap-lift?

A LASIK flap-lift may is most often done if there are some wrinkles on the LASIK flap, if the LASIK flap has been misplaced after surgery (usually due to rubbing or manipulation of the eyes), or if there are some deposits underneath the LASIK flap that your surgeon may want to clean or culture.

81. Can I get a corneal perforation after LASIK?

There are no cases reported of a corneal perforation when all-laser femtosecont LASIK is performed without a blade. However, with the microkeratome sharp blade, there is a remote possibility of malfunction, leading to a corneal perforation that may need to be repaired by your surgeon.

82. What is a LASIK enhancement or touch-up?

A LASIK touch-up or enhancement is a refinement of a LASIK procedure that has been performed in the past. Over the next few years after having LASIK, it is possible that your eye can undergo microscopic changes that can make you dependent on glasses or contact lenses again. This prescription is usually much smaller than your original prescription. Usually this small prescription can be treated using a LASIK enhancement.

83. What kinds of LASIK touch-ups or enhancements are there?

LASIK enhancement can be done by lifting your old LASIK flap and applying LASER underneath it where laser had been applied before. It can be done by cutting another flap. Or, it can be done in the form of a surface treatment such as PRK, LASEK, or Epi-LASIK.

84. What type of LASIK enhancement do you recommend?

At the San Diego Laser-Vision Eye Center, we recommend surface treatment with PRK, LASEK, or Epi-LASIK for LASIK enhancement. This is because disturbing the old LASIK flap has been associated with an incidence of epithelial-ingrowth underneath the flap. We belive that despite the longer recovery time and some discomfort, the surface LASIK enhancement or touch-up is the more prudent way to do a LASIK enhancement.

85. What are the risks of LASIK Touch-ups?

Similar to any ocular procedure, there is a small risk of infection. In addition, there is a small risk of LASIK flap dislocation. One of the most common problems with LASIK enhancements is epithelial ingrowth that involves corneal epithelial cells growing underneath the LASIK flap. However, the risks of flap dislocation and epithelial ingrowth are minimal if the enhamcement is done with a PRK and thus without moving the original flap.

86. How many LASIK touch-ups can I have?

It is most preferable to have the fewest possible LASIK touch-ups, however, there is no absolute limit that applies to everyone. Some people may have too thin of a cornea, or other eye issues after their LASIK that may make further enhancements unsafe for them.

87. Can I have LASIK if I have keratoconus?

No. Keratoconus and other corneal ectasias are contraindications for LASIK. One of the most important things that your doctor needs to do prior to your LASIK is to rule out the possibility of you having even very early keratoconus or corneal ectasia. Having LASIK can potentially worsen and complicate the course of these corneal diseases.

88. How does my doctor determine if I have keratoconus or corneal ectasia?

Your doctor will determine if you have keratoconus or corneal ectasia by performing a very careful examination of your eye with a microscope. He or she will also assess very carefully your corneal thickness as well as the steepness of the front and back of your cornea using very advanced imaging technologies.

89. Can I have LASIK if I have diabetes?

Diabetes can cause very serious eye problems. Also it can slow healing and make patients more prone to infections after the procedure. In addition, fluctuating blood sugars can make your prescription fluctuate, making it difficult to correct vision with glasses, contacts, or LASIK. At the San Diego Laser-Vision Eye Center we only consider patients with excellent blood sugar control and no other eye complications from diabetes mellitus potential LASIK candidates. Every case, however, will need to be discussed with a surgeon and evaluated individually.

LASIK Question #90. Can I have LASIK if I have a history of herpetic eye disease?

A history of herpetic eye disease is often a contraindication to LASIK. Herpetic eye infections can potentially recur and cause irreversible visual loss after LASIK. It is extremely important to speak to your surgeon about having a history of herpetic eye disease during your LASIK evaluation. Deciding whether or not you are a good LASIK candidate with a history of ocular herpes infection is best made by a well-informed, experienced clinician and on a case-to-case basis.

91. What is the risk of infection after LASIK?

Infectious keratitis or corneal ulceration is an infrequent but very important complication of LASIK. Some previous studies on LASIK have reported rates of less than 1 out of 2500 cases (less than 0.05 percent).

92. Is infectious keratitis after LASIK a treatable condition?

Infectious keratitis is a very dangerous and potentially vision threatening complication of LASIK. However, most cases of infectious keratitis can be treated using topical antibiotics. After the resolution of the infection, however, there may be scarring that interferes with visual acuity. With the advent of newer antiobiotic eyedrops, it is expected that the current rates of infection will be lower than those reported in the older studies quoted above. With strict following of the post-operative antibiotic eyedrop regimen and avoding contaminants, the risk of infection after LASIK can be reduced to extremely low rates.

93. Can I have other ocular procedures such as cataract surgery after having had LASIK?

Yes. It is possible to have other ocular procedures after having had LASIK. In the common case of cataract surgery, your surgeon will have to take into account the fact that you have had LASIK in the preoperative calculations.

94. Would eye-surgeons have LASIK themselves?

Yes, and man eye surgeons have had laser vision correction. This is because, in the right hands, LASIK is a very safe procedure. As a matter of fact our surgeons have much more frequently seen vision-threatening complications of wearing contact lenses as compared to post-LASIK patients. It is for this reason that many ocular surgeons who do not wish to wear glasses choose laser vision correction over contact lenses.

95. What technologies should I ask about from a LASIK center?

Ask about femtosecondlaser (Intralase), Iris registration, Wavescan guided LASIK (Custom LASIK), Pupillary tracking, and Visx Star S4 or Allegretto LASIK machines. We recommend that you make sure any center that gives you a price for LASIK uses ALL of the above technologies.

96. Why is it so important to ask specifically for the technologies above before my LASIK?

Because a lot of LASIK centers simply do not spend the money required to keep up with the latest and best technologies. They may offer the exact same price as another location without offering up-to-date technology. Also they may compromise the quality of your treatment by using outdated technology but offering you a slightly cheaper price.

97. What are some qualities of a great LASIK surgeon?

Qualities of a great LASIK surgeon are similar to those of a great doctor. Your LASIK surgeon should not sound like a salesman or quickly send you to sales-agents . Your surgeon should have a great resume, a great training, great surgical experience, great bedside manner, and great patience in listening to you and answering all your questions.

98. What should I watch out for in a LASIK provider?

Watch out for extremely sales-oriented centers that try to go through as many patients as possible. As mentioned above, specifically demand the latest technologies. Also, ask if your surgeon will be around after the surgery to see you in case there are any issues. Many “LASIK-mill” type practices fly in surgeons that will perform your surgery and take a flight away to another state the next day. Naturally, they will be unavailable to address any issues with your surgery.

99. Can my optometrist help with my LASIK?

Absolutely. Your optometrist can recommend an excellent surgeon for your LASIK procedure and also can help with the pre-operative workup and your follow-ups after surgery.

LASIK Question #100. What if my surgeon says bad things about other surgeons in the vicinity?

This is an ominous sign that you may not be speaking to the most ethical surgeon. Similar to other professions, collegial surgeons are usually the best and most ethical ones. A great surgeon and doctor will have no desire to speak negatively about a colleague.

101. What if my surgeon constantly brags about his resume?

You should ceratainly check the qualifications of your surgeon. However, just like other doctors, a LASIK surgeon that speaks more about him or herself than you is one that is focused more on him or herself as compared to your eyes and our LASIK outcome.

102. Is there a minimum age for LASIK?

There is no absolute minimum age for LASIK. As a matter of fact LASIK has been used in the treatment of very young people with serious visual problems that can cause long term vision loss. However, for most people, it is wise to at least wait until the age of 18. If you are 18 or 19 years old and intersted in having LASIK, we recommend that you make sure your eye prescription has been very stable over the last 3 years at least. Once you are past the age of 20, 1 to 2 years of stability of prescription is usually sufficient.

103. Is it possible to do a multifocal LASIK for distance and near vision?

Yes, however, this technology is very new and its future complications and shortcomings, as well as long term results are still unknown.

104. What is CK? Is it a type of LASIK?

CK or conductive keratoplasty is not a type of LASIK. It is a technique of vision correction that has been used with mixed results. It re-shapes the surface of the eye by heating the cornea at specific points. However, results with CK have been variable and very likely to change over time.

 

 

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