Individuals who are in good general health, i.e. without medical conditions such as rheumatoid arthritis, lupus or other connective tissue disorders. Individuals with immune disorders may not be candidates, though patients with well-controlled diabetes can often still have the procedure. Prior to surgery, a thorough medical history is taken and potential medical contraindications are discussed in detail.
The eyes must also be in good health. A history of herpes keratitis, keratoconus or severe dry eye syndrome most often is disqualifying. However, the San Diego is a dry region and we commonly treat patients with moderate dryness. Significant cataracts are a contraindication to laser vision correction, though patients with mild cataracts or glaucoma can often still have surgery. A stable eyeglass prescription is another prerequisite. LASIK eye surgery is a purely an elective procedure and therefore is not intended for individuals who just use glasses for reading or are happy with wearing glasses or contacts.
There are two common medications that are disqualifying. The first is the acne medication Accutane (isotretinoin). The second is the heart medication Cordarone (amiodarone). It is essential to provide us a a complete and accurate medical history, especially if you have ever taken one of these medications, as they must be discontinued for a long time in order to proceed with laser vision correction.
The absolute minimum age for any laser vision correction procedure is 18, although we take a safer approach of waiting until the FDA recommended age of 21. For younger patients, it is essential to document that the eyeglass prescription is stable before contemplating laser eye surgery. For this reason we often times will postpone surgery until the patient is in their mid-20s to ensure the best long-term results. As long as the eyes are healthy and the candidate is in good general health (see above), there is no maximum age.
No. Pregnancy and nursing often cause fluctuating vision, so accurate measurements cannot be obtained during this period of time. Additionally, medications and eye drops carry a theoretical risk to the baby, and there is no reason to take any unnecessary risk with an elective procedure such as LASIK or PRK. After the baby is born and normal menstrual cycles have resumed, laser vision correction can be pursued.
This a great question and one that is frequently asked. Bear in mind that conditions such as nearsightedness, farsightedness and astigmatism are an inherited condistion of the eye, where the eye is too long, too short or is not curved properly. Once your visual condition is corrected with the laser(LASIK or PRK), then that inherited condition is permanently fixed. As the average patient(let's say 28 years old) is no longer growing, then there is no reason for the eye to grow more, and certainly no reason for it to shrink or change shape. All of this is said with the assumption that the patient remains healthy. Conditions like new onset diabetes can change a patients vision, but that should be understood up front.
As a patient ages, the visual result of LASIK(or PRK) will remain in place and the only change that will occur is sometime after age 45 or so, the natural decline in reading ability, which will require the use of reading glasses or returning to your surgeon for a near procedure. Another change that happens is that with age some people develop cataracts and their vision declines secondary to this condition.
Most patients who have LASIK (a flap procedure) are typically comfortable, see clearly, and are able to drive and work the next morning. Recovery takes longer for patients who have PRK (a flapless procedure). There may be a three to five day period that the eyes are scratchy and watery. Medication for discomfort is sometimes prescribed. The initial healing perios is typically down time for the patient. The vision is usually good enough to get by, but patience is needed as the vision gradually reaches its full potential over a period of several weeks.
Dryness is common for the first few months after receiving laser vision correction surgery. It is more noticiable with flap procedures, such as LASIK and IntraLASIK, as opposed to flapless procedures such as PRK. During the first month, lubricating drops such as Systane are frequently used throughout the day. Dryness usually lessens during the second or third month, with less frequent drop usage. Transient night glare and halos are possible for two to three weeks after surgery. A small percentage of patients require an enhancement or fine-tuning procedure a few months after the original procedure.
With any flap procedure, inflammation underneath a LASIK or IntraLASIK flap is not unusual and is commonly treated with anti-inflammatory drops or rinsing underneath the flap. On occasion, small striae (microscopic wrinkles) develop from flap trauma the first night after the procedure. These are removed by lifting, smoothing and resetting the flap. Epithelial ingrowth (migration of the surface epithelial layer of the cornea underneath the flap) is uncommon with primary treatments, but more common after retreatments. It is treated by lifting the flap and clearing out the epithelium, though this is rarely needed.
Some PRK eyes take longer than 3 to 5 days for the initial healing to finish. Therefore, the eye can remain scratchy, watery and uncomfortable for longer than expected. In the past, corneal haze (opacification of the surface of the cornea) was common with PRK, but with modern techniques significant haze is rare.
There are no serious side effects that are common in LASIK or other laser vision correction procedures. Dryness is the most common side effect. For the first few months after receiving laser vision correction surgery dryness of the eyes may be noticed. It is more noticiable with flap procedures, such as LASIK and IntraLASIK, as opposed to flapless procedures such as PRK. During the first month, lubricating drops such as Systane are frequently used throughout the day. Dryness usually lessens during the second or third month, with less frequent drop usage. Transient night glare and halos are possible for two to three weeks after surgery. A small percentage of patients require an enhancement or fine-tuning procedure a few months after the original procedure.
With any flap procedure, inflammation underneath a LASIK or IntraLASIK flap is not unusual and is commonly treated with anti-inflammatory drops or rinsing underneath the flap. On occasion, small striae (microscopic wrinkles) develop from flap trauma the first night after the procedure. These are removed by lifting, smoothing and resetting the flap. Epithelial ingrowth (migration of the surface epithelial layer of the cornea underneath the flap) is uncommon with primary treatments, but more common after retreatments. It is treated by lifting the flap and clearing out the epithelium, though this is rarely needed.
Some PRK eyes take longer than 3 to 5 days for the initial healing to finish. Therefore, the eye can remain scratchy, watery and uncomfortable for longer than expected. In the past, corneal haze (opacification of the surface of the cornea) was common with PRK, but with modern techniques significant haze is rare.
A very small percentage of patients need an enhancement procedure to fine-tune their vision. Enhancements are typically performed three to six months after the primary procedure. Eye Center of La Jolla enhancements are provided at no additional charge, as long as they are performed within one year of the primary procedure. Enhancements often cost extra at other centers.
If you are over 45 and have perfect distance vision in both eyes, then you will eventually need reading glasses to see up close. This is true regardless of whether your vision is naturally clear at a distance, has been laser corrected for distance or is corrected for distance with contact lenses.
There is generally no significant pain during a flapless procedure such as PRK. With LASIK, there is a strong pressure sensation during creation of the flap, but again generally no pain.
From start to finish these procedures usually take less than 30 minutes to perform. Most of the time is spent preparing for the procedure. The actual procedure time is quite brief. Flap creation takes less than a minute and laser treatment usually takes about 1 minute.
Yes. The standard of care is to treat both eyes at once. We are more than willing to treat one eye at a time, if that is your preference. Remember we are very conservative. Just bear in mind that your eyes may feel out of balance between treatments.
No. You must have someone you know and trust drive you home. Since you will receive a sedative, we cannot even release you to take a taxi or bus.
You don't need to stop your contacts prior to your initial consultation, though if you are pretty sure that you want to pursue treatment, doing so will allow you to have your procedure sooner. However, once a decision is made to pursue treatment, contact lenses must be stopped in order to obtain the most precise measurements and achieve the best possible vision. The official FDA recommendation is that daily wear contacts be held for two weeks, toric or extended (overnight wear) lenses for three weeks, and RGP or hard lenses a minimum of one month.
The Lasik MD website has a great article about this shameful bait and switch tactic: The Secrets of $299 LASIK.
No. Custom wavefront-guided LASIK technology has now been available for over five years. Though there may be incremental improvements in wavefront technology, there are no new breakthrough technologies around the corner.
