Laser Vision Correction (LVC) is one of the most exciting technological advances in the history of eye care. It is performed with an excimer laser, which produces a “cool” ultraviolet laser light that gently reshapes the cornea. Both LASIK and PRK utilize an excimer laser to perform Laser Vision Correction.
During PRK (Photo Refractive Keratectomy), Physicians Eye Care and Laser Center surgeons gently alter the cornea's outer layer through a series of ultra precise pulses, which changes the way you see. The treatment takes only a few minutes and anesthetic drops are used to ensure that the treatment is completely painless. PRK is performed for nearsightedness, farsightedness, and astigmatism.
During LASIK (Laser Assisted In-Situ Keratomileusis) Physicians Eye Care and Laser Center surgeons lift a flap of the cornea with a special instrument called a keratome. Then the laser beam is directed with precision control to reshape the cornea. The flap is then returned for more controlled healing and more rapid vision stabilization, with little or no discomfort. LASIK is performed for nearsightedness, farsightedness, and astigmatism.
Determining whether PRK or LASIK, or any other procedure such as RK (Radial Keratotomy), ICL (Intraocular Contact Lens), Corneal Ring, or clear lens extraction, is right for you is a decision best made by you in consultation with one of our surgeons. There is no cost for the initial consultation and there is absolutely no obligation.
Physicians Eye Care and Laser Center is always looking for the newest innovative technology while making sure the patients' safety and best interests come first. In this respect, Dr. Wexler continues to evaluate new laser technology (wavefront analysis and custom ablation) in order to provide quality service you can clearly see. With CusomVue corneal ablation, your vision becomes unique as WaveScan technology provides a “fingerprint” map of your eye. At Physicians Eye Care and Laser Center there are always ongoing laser and CustomVue updates.
At Physicians Eye Care and Laser Center we use the VISX StarS4 with ActiveTrak and iris registration. This is a 7-beam variable spot laser with eye tracking. The VISX Star53 is FDA approved for the correction of nearsightedness, farsightedness, astigmatism, and mixed astigmatism. By coupling the StarS4 excimer laser and WaveScan Wavefront system, CustomVue treatments are performed. This allows a tailored procedure for each eye. This technique of measuring is 25 times more precise, which translates to a higher level of precision and accuracy, allowing patients to achieve the full potential of their vision.
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Since 1982, more than two million Laser Vision Correction treatments have been performed. From all of the data available to date, there have been no significant long term problems. Laser Vision Correction is considered to be very safe. Though extremely rare, as in any medical procedure, there may be some side effects associated with excimer laser treatment. During a consultation, these will be explained by a Physicians Eye Care and Laser Center surgeon who will be performing your procedure.
Risks of PRK And Lasik Include
- Overcorrection and Undercorrection: This is a normal part of healing; however, in rare instances if it persists, a follow-up procedure can be performed to remedy this problem at no charge to you. This is called an "enhancement." At Physicians Eye Care and Laser Center, our enhancement rate is less than 3 percent, far less than the national average.
- Regression: Over time, if undercorrection occurs, it too can be corrected with an additional procedure. The overwhelming majority of individuals require only one procedure.
- Night Glare: The most common problem, which usually improves within the first few months.
- Infection: Although very rare, corneal scarring can occur from a severe infection. All patients receive antibiotic eye drops both before and after surgery.
- Corneal Haze: A scar or cloudy cornea that may affect vision.
- Loss of best corrected vision. Although rare, this may be permanent.
- Contrast Sensitivity Loss: Can occur but is usually well tolerated.
- Dry Eye: A very common occurrence. Treated successfully with tears, tear duct plugs and time in the overwhelming majority of individuals.
Risks of Lasik Only from Corneal Flap Creation Include
- Loss of the flap.
- Penetration into the eye.
- Infection or growth of cells under the flap.
- Wrinkling, swelling, or dislocation of the flap.
Laser Vision Correction may end your dependence upon glasses or contact lenses. Laser Vision Correction does not always create 20/20 or better vision. It cannot correct presbyopia or aging of the eyes that normally occurs around age 40 and may require the use of reading glasses. The cosmetic, recreation, and psychological aspects are all positives.
If the idea of reducing or eliminating your dependence on glasses or contacts is appealing to you, then Laser Vision Correction may be worth your consideration.
If paying for Laser Vision Correction is an issue, financing plans are available. At Physicians Eye Care and Laser Center, we have different financial plans available to allow you to pick what is best for you. We even have a plan with zero percent interest. You may also pay for laser vision correction with a flexible spending plan, if provided by your employer. Don't let cost prevent you from seeing the world clearly.
Frequently Asked Questions
- Am I a good candidate?(show answer)
- Many people are good candidates for laser vision correction. Laser vision correction may be performed for the correction of myopia for -1.00 to -16.00 and for the correction of astigmatism from zero to +5.00 diopters. Farsightedness can be corrected up to +6.00 diopters with a small amount of astigmatism.
- What kind of results can I expect?(show answer)
- 98% of our patients see 20/40 one week after laser vision correction; 92% of our patients see 20/20.
- Will my vision be corrected forever?(show answer)
- 12-year studies done in Canada, England, France, and Germany indicate no long-term side effect and very little change in your vision. There is every reason to believe that your vision will remain good. If you happen to develop an unrelated eye problem your vision may change.
- What does the cost of the procedure cover?(show answer)
- The cost of the procedure covers all of the pre-op evaluation including: corneal topography and a full ophthalmologic examination; the laser vision correction; one year's post-op care; and if needed, additional laser vision correction during that year.
- Is it covered by insurance or flexible benefits programs?(show answer)
- A flexible benefits programs is a wonderful way to pay for your procedure with pre-tax dollars. Some insurance companies may cover part or all of the procedure.
- Who will my doctors be and what will they do?(show answer)
- We will be your eye doctors. We will supervise and actively participate in your eye evaluation. We will perform the laser surgery. We will personally care for you during the post-op period.
- What is my eye doctor's (if the physicians at PECC are not the regular eye doctors) role?(show answer)
- Physicians Eye Care and Laser Center will co-manage your care with your optometrist, who will do all your post-operative examination. However, we will be in direct contact with your optometrist to optimize your visual outcome and see you when needed.
- Will the procedure hurt?(show answer)
- To insure that laser vision correction is a painless experience, at the beginning of the procedure anesthetic drops are used. Most patients feel eye pressure, however with our experienced surgical team, patients are quickly reassured.
- Are there any risks?(show answer)
- As with any surgical procedure there are risks. There are several and are generally minor. (Please see Risks and Benefits for more detail.)
- What's the difference between LASIK and PRK?(show answer)
- With LASIK a thin flap of the top layer of your cornea is created. The laser is performed on the next layer down. The flap is then put back in place. LASIK has become the procedure of choice because of its reliability and lack of discomfort and quick healing. PRK involves vaporizing the top layer of your cornea, then performing laser on the next laser, healing takes 3-5 days. PRK may be an option for patients whose corneas are too thin for LASIK. (Please see Laser Vision Correction for more detail.)
- What is LASEK?(show answer)
- LASEK is Laser-Assisted Epithelial Keratomileusis. Like LASIK, a flap is lifted, but this is only the epithelium. Then the excimer laser treatment is applied and the flap replaced. For the most part, LASEK is painless and vision rapidly returns. However, clinical results are guarded and there are some questions about healing and scar formation.
- What is Intralase?(show answer)
- Intralase is a blade-free technique to perform the first step in LASIK, creating a corneal flap. At Physicians Eye Care and Laser Center almost all patients elect to have a microkeratome perform the first step, as it has been time and result proven. However, Intralase is available if desired.
- What will my recovery be like?(show answer)
- With LASIK recovery is rapid with a dramatic improvement in your vision within 4 hours of the laser surgery. Overnight your vision becomes even better. Most people return to work the next day with no glasses or contacts. Vision will continue to improve over weeks and months.
- Why should I choose this practice for my surgery?(show answer)
- You should choose our practice because we achieve superior outcomes in laser vision correction. We continually study and are up to date in the latest and best technology. We have a passionate commitment to superior results while providing quality personal care to our patients. The surgeons at Physicians Eye Care and Laser Center also are the doctors directly involved in your care. We provide global services and do not offer partial services. It's a commitment you can clearly see.
- Is this procedure FDA-approved?(show answer)
- The excimer laser usage and the LASIK procedure itself are approved by the FDA.
- What is involved in physician training for this procedure?(show answer)
- In order to become a laser and LASIK surgeon we must go through rigorous courses involving a series of lectures as well as practice sessions utilizing animal practice tissue. Following this, each of us has been proctored by a certified supervisor or surgeon. We are highly experienced surgeons. We are now surgical supervisors. We teach and proctor surgeons how to perform these procedures.
- What are the implications of pupil size in this procedure?(show answer)
- Pupil size is usually not a significant factor in this procedure. There are some people whose pupils normally enlarge a great deal at night. If the pupil size exceeds the size of the lasik flap and laser treatment, some halos and glare may occur. Interestingly, many of our former contact lens patients on whom we have performed LASIK note that glare was greater at night with their contacts on than it is following LASIK. When glare or halos do occur they tend to disappear over a several week period of time. With CustomVue Laser correction, the risk of glare has dramatically decreased.
- What is CustomVue?(show answer)
- With WaveScan technology your vision becomes unique as a personal map of your eye is provided to the surgeons at Physicians Eye Care and Laser Center. The CustomVue procedure can then be performed which allows for a tailored procedure for each eye. This technique is 25 times more precise which translates to a higher level of precision and accuracy, allowing patients to achieve the full potential of their vision.
- Is it possible to have a cornea that is too thin to recommend LASIK?(show answer)
- It is possible to have a cornea that is too thin for this procedure. People with a corneal thinning problem called keratoconus, are not candidates for this procedure. Some very, very nearsighted people may also have thin corneas. We routinely measure corneal thickness pre-operatively to make sure you are a candidate for this procedure. If you cannot have LASIK because of a thin cornea, there may be other procedures for you. (Please see About the Eye for more detail.)
- What percentage of patients needs enhancements done after the first treatment (and is there an extra cost)?(show answer)
- In our experienced hands, very few patients need enhancements performed. If additional laser needs to be done there is no extra cost to the patient. Enhancements are performed if the patient's desired correction is not achieved. Enhancements may also be done if the patient has previously requested monovision (that is one eye set for near and the other for far) and the patient does not like monovision. Our enhancement rate is less than 3%, well below the national average.
- How many LASIK procedures has the doctor performed?(show answer)
- We have performed thousands of LASIK and laser procedures.
- Is a new blade used with each patient?(show answer)
- A new keratome blade is used with each patient, and the laser is tested between eyes.
- What percentage of patients have flap complications?(show answer)
- Flap complications are extremely rare. Our percentage of flap complications is less than 0.1%.
- What percentage of patients have infections?(show answer)
- There is always a chance that an infection can occur. National studies are one in 30,000. We use a treatment protocol involving the use of an antibiotic before, during and after the laser procedure. To date we have had no infections.
- What specific machines are used for the laser surgery?(show answer)
- We use the VISX excimer STAR4 laser with ActiveTrac and iris registration to perform LASIK and PRK. The VISX laser is the most used laser in the U.S.
- Does the doctor prescribe preservative free eye drops?(show answer)
- Some of the eye drops we prescribe are preservative free.
- If the patient experiences significant regression, can contacts be worn again?(show answer)
- If the patient experiences significant regression contact lenses may be worn again. If medically safe, an enhancement may be performed. We have not yet had a patient who needed to wear contact lenses again.
- What does the surgery cost?(show answer)
- Laser vision correction is affordable and cost effective. Many payment plans are available. (Please see Cost for more detail.)
- Is there any benefit to doing one eye at a time?(show answer)
- Studies show the success rate and complication rate is the same whether one eye or both are done at the same visit. Our policy is if a complication occurs in the 1st eye, we do not proceed with the 2nd eye at that time. The standard of care in the U.S. is to perform bilateral simultaneous surgery. However, for some patients with specific needs, and in consultation with the surgeon, one eye may be done at a time.
- What things would disqualify someone from having this surgery?(show answer)
- A number of conditions have been identified that would disqualify someone from the laser vision correction eye surgery. These include collagen vascular diseases such as rheumatoid arthritis, lupus, and autoimmune deficiencies. Pregnancy and post-pregnancy breast-feeding is a contraindication to surgery. Corneal diseases that cause thinning or lesions involving the inside of the cornea are also contraindications to surgery. There are also relative contraindications to surgery. They include diabetes and glaucoma. The surgeons at Physicians Eye Care and Laser Center will be able to determine if laser vision correction is in your best interest or not.
- How soon after surgery will the patient be able to see?(show answer)
- About one hour after the surgery your vision has improved a great deal and it keeps getting better and better. In a few hours, T.V. viewing and light reading are possible. Patients are able to drive the next day.