Archive for October, 2006

Lasik surgery is an amazing advancement in eye care that helps improve the vision of those who suffer from visual difficulties. With this cutting edge procedure, the patient remains awake and alert throughout the entire process. The Surgeon cuts a flap into the cornea using either a special type of blade or a special type of laser. The surgeon leaves a hinge on one side of this flap so it can be pulled back and replaced later.
While the flap is pulled back, the surgeon reshapes the middle portion of the cornea, which is called the stroma. He accomplishes this by using an excimer laser to vaporize unnecessary tissue without damaging areas that need to be left untouched.
The Results
For most Lasik patients their vision is improved almost immediately after the procedure is completed. For other patients, the vision shows gradual improvement over a period of a few days or weeks.
Most people gain 20/20 vision, or even better than 20/20, after undergoing the Lasik procedure. Some people, however, achieve 20/40 or worse. 20/40 is still quite good, and most states consider this level of vision to be good enough for driving a car, but it is less than ideal. In addition, these patients might still find it necessary to wear glasses or contacts in order to feel comfortable with their vision. Their prescription, however, will be much lower.
In addition, some Lasik patients experience regression after the procedure takes place. This means that their vision gradually worsens. If this happens, the surgeon can often perform an enhancement or touch up surgery to improve vision again.
Presbyopia
Even for those patients whose vision is improved perfectly by Lasik surgery, it might still be necessary to get reading glasses or bifocals after reaching the 40’s. This is due to presbyopia, which begins to occur between the ages of 38 and 42. If this occurs, distance vision generally remains crisp, but it becomes more difficult to see things up close. Those suffering from presbyopia also often need to hold reading material at arms length to see if not wearing glasses or develop headaches when doing work close up.
Presbyopia is part of the eye’s natural aging process that can be corrected with glasses. With presbyopia, the eye loses its ability to change focus in order to see nearby objects. This condition is often thought of as farsightedness, but the two are actually very different. Presbyopia occurs when the lens within the eye loses its flexibility. Farsightedness, on the other hand, is the result of a misshapen eyeball. This causes light to bend incorrectly after entering the eye.
Currently, farsightedness can be corrected with Lasik surgery because it simply requires altering the shape of the cornea. Presbyopia, on the other hand, cannot be corrected by Lasik surgery. Researchers, however, are studying ways to correct presbyopia with surgery, as well.
Astigmatism
Irregular astigmatism can also occur as a result of Lasik surgery. This occurs when the corneal surface is not made sufficiently smooth during surgery, which is the result of failing to center the laser correction properly. Irregular astigmatism can lead to visual blurring, double vision, and ghost images. It may take glasses or contact lenses to correct this problem, though it can also often be rectified through an additional surgery.
The Bottom Line
When undergoing Lasik surgery, it is important that expectations are not set too high. A patient who expects to have perfect vision after the procedure can potentially be highly disappointed, as the procedure does not have perfect results 100% of the time. In addition, complications from the surgery, though rare, can actually cause site to be worse afterward.
Furthermore, regression does occur in some Lasik eye surgery patients. If this occurs, it might be necessary to return to glasses once more. Or, another surgery may correct this problem.
Finally, it is necessary to remember that certain forms of eyesight are a natural part of the aging process. Therefore, although perfect results may occur from the surgery, it might still be necessary to wear reading glasses. This is especially true for older adults who undergo the Lasik procedure and are, therefore, already going through the process of presbyopia. In addition, patients who do attain perfect vision may begin to have difficulties with their vision because of presbyopia.

One critical factor after your Lasik procedure is the healing of the hinged corneal flap that is created to allow the laser to reshape the inner corneal surface. What is required is the eventual healing and re-bonding of the flap to the outer surface of the cornea. This is a great area of concern for most patients as they picture their corneal flap ‘flapping in the breeze.’ It’s comforting to realize, however that even complete corneal transplants ultimately heal, such is the healing power of the eye.
The normal healing period for the post-Lasik patient is six-months, by that time, in the vast majority of cases, any problems you were having with your vision will have disappeared or dissipated to the nearly unnoticeable stage. Some things do take longer however. Complete healing of the corneal flap may take up to two-years, but the fact that it is not completely healed should not be a concern nor should it cause a vision problem.
After your Lasik procedure you will most likely be scheduled for a minimum of five follow-up visits — the first one will be within 24-hours of your surgery. It is very important that you make it to all of these appointments so that your healing process can be monitored and any adjustments can be made to your post-op treatment.
You will, in most cases be required to use eye drops for the first two-to-four weeks after your procedure. These will help alleviate any discomfort you feel in your eyes during this initial healing period. Some discomfort (not pain) is normal as are:
” Watery eyes and a runny nose
” Sensitivity to bright light
” Redness and minor swelling of the eye
” A dry feeling in your eyes
” Slightly blurred vision
Other post-op tips are:
” You might need to take an OTC medicine that does NOT contain aspirin, like Tylenol or Advil, for minor discomfort.
” Make an effort to protect your eyes from bright light or sunlight (sunglasses) and water.
” Rest your eyes as much as possible and try to get some extra sleep for at least the first two or three days after your procedure.
” You will be given a mask (an eye shield) to wear — use it for the first two-hours after your procedure and then while you sleep for the next three-or-four days.
” Avoid all water sports and water related activities (hot tubs, whirlpools, swimming, etc.) for the first two weeks.
” Don’t go scuba diving for at least six weeks.
Complications. Your risk of complications after Lasik surgery and the possible need for touch-up surgery depends on a number of factors. One such factor is the state of your pre-operative vision; the worse your eyes were going into a Lasik procedure that greater the chance that a) you will not be completely satisfied with the results and b) your surgery will result in some complications. As an example, if you needed reading glasses before your surgery, you may still need them post-op and if you had a small amount of astigmatism before your results might not seem be satisfactory. Touch-up surgery is not highly unusual and it is usually covered by the cost of the Lasik treatment program but it’s still an additional surgery that it would be nice not to have.
One guarantee about surgery is that there are no guarantees. Fact of the matter is everyone heals differently, some of us are lucky enough to have amazing healing powers while some of us are rather slow getting our health back after a sickness or a surgery.
A thorough pre-op evaluation and complete honesty between the perspective patient and the Lasik counselor can eliminate problems for both parties. Not everyone should have Lasik! Some of the determining factors that should eliminate a perspective Lasik patient are:
” Refractive instability indicated by requiring a new vision prescription within the year prior to your evaluation.
” Age! Someone who is between 19 and 24 years old is a bad risk for a trouble-free Lasik procedure.
” If you are pregnant or breast feeding any unnecessary surgery is unwise.
” If you have a disease such as HIV, herpes, diabetes eye surgery could lead to disastrous results.
” Eye conditions such as large pupils and thin corneas also spell trouble.

The cost of Lasik vision correction can be a deciding factor for many people who depend on corrective lenses everyday. Lasik eye surgery can be quite expensive and for many, this is cost-prohibitive. Most insurance companies do not pay for Lasik surgery because it is considered elective. There are ways however, to pay for Lasik, even for those who are on a budget.
For people who wear corrective lenses, the idea of Lasik vision correction is very appealing. The technique used during a Lasik procedure is highly precise and customized for each patient. The result of improved eyesight is usually immediate. While Lasik often does not completely eliminate the need for glasses or contacts, it can greatly enhance eyesight. Most insurance companies do not pay for Lasik. There are many employers that offer expanded vision insurance the help cover the cost of Lasik procedures. Some companies also have agreements with certain Lasik centers to offer their employees a reduced rate on Lasik.
There are many different payment options for people who do not have expanded vision plans. Most Lasik surgery centers offer some sort of payment or finance options. There are ways for people who want Lasik to easily find ways to pay for their procedures. When choosing a Lasik surgeon it is often tempting to go with the one that charges less for the procedure. This may not be a good idea, however, as this surgeon may have considerably less experience or may not use the latest technology. It is always wise to choose a Lasik doctor that has the most experience for the type of procedure that you need. This will ensure that you have the best possible outcome from your Lasik procedure.
Another important factor you should consider when choosing a Lasik doctor is the fee that is charged if you need a second surgery, also called enhancement. The cost of the second procedure varies from doctor to doctor. Many people end up needing this second surgery. Some Lasik doctors do not charge a fee if the enhancement surgery is done within a certain time frame from the initial surgery. Some will charge a small fee. Others may charge a full price, so it is important to ask this before choosing a Lasik doctor.
It is also important when considering Lasik surgery to see what is included in the price that the doctor gives you for your procedure. Find out if all parts of the procedure is covered in the cost, including any follow up appointments, initial testing, medications and eye drops you may need, and second surgeries. This can make a big difference when you are trying to pay for your Lasik procedure on a tight budget. Most Lasik doctors do included all of this in their price, but it is always a good idea to ask so you are not surprised with any last minute expenses.
Look for Lasik centers that offer finance options: This is often the easiest way to pay for a Lasik procedure when you are on a budget. Most Lasik surgeons do offer some sort of financing or payment options that fit the needs of most people. Also, many Lasik surgeons can recommend a local or national back that can provide low monthly payment places. They might also allow patients to pay for their surgery procedure in installments.
See if your employer offers flex-spending accounts: Sometimes employers offer their employees flexible spending accounts that can be spent on procedures such as Lasik. Flex spending accounts, also sometimes called cafeteria plans can be used for Lasik. This is when a portion of the money you earn goes into an account to be used for medical expenses or other discretionary items that your insurance may not cover. Often, this money can be used to pay for co-payments or procedures. If you have an account such as this, you may be able to use the money to help pay for your Lasik eye vision correction. This can help reduce or completely pay for your procedures depending on how much money you have in your flex account.
Check to see if your Lasik procedure can be deducted from your income tax: Sometimes people are eligible to deduct the cost of their Lasik vision surgery off of their United States federal income tax as a health claim. Before deciding to go this route to help with the cost of your Lasik procedure, you should always seek advice from your tax accountant. Your tax accountant will be able to tell you whether or not you are eligible for this tax deduction.