LASIK FAQs Answered
Are there any health benefits to laser eye surgery, aside from vision improvements?
Yes. The main health benefits have to do with no longer wearing contact lenses and eliminating the risks that are associated with contact lens wear. Even with perfect use of daily contact lenses (which allow more oxygen to permeate to the cornea than weeklies or biweeklies), taking them out each night and placing new ones the following day, the cornea does not get all the oxygen it requires, and over time, there are small blood vessels that grow around the periphery of the cornea. Additionally, LASIK eliminates the risk of infections that result from contact lens wear.
Are laser eye surgery improvements permanent?
LASIK surgery IS permanent, with a few exceptions. There is a chance that the prescription and correction can regress, and the vision regresses slightly back to what it was before. It won’t go back to the full original prescription but it can change by a little. This can be corrected again if needed. Additionally, if LASIK is done to correct the distance vision, by the time we reach our mid to late 40s, our lens accommodation starts to decline, and a person would need to start to wear reading glasses, even if LASIK had corrected the distance vision originally.
Why is laser eye surgery a better option than glasses or contacts?
Laser eye surgery is better than contacts because it improves quality of life and decreases the risk of chronic contact lens wear. Without contacts or glasses, there is no hassle of needing to travel with an extra case or extra contact lens solution. Additionally, patients who are very active or play sports find that it is difficult to get the right prescription for example for scuba diving mask, ski mask, and find it challenging to wear glasses while playing basketball or running. Recently, glasses have become particularly bothersome because the humid breath from masks fogs up the glasses. Finally, getting rid of contacts eliminates the risk of corneal infection, scarring, and blood vessel growth over a long period of time.
Does insurance cover LASIK, and if so, when?
Usually not, but I just had a patient whose medical, not vision, insurance did cover LASIK. Depends on the patient’s specific plan and benefits but definitely worth calling and finding out. Either way, using a HSA (Health Savings Account) to pay for LASIK is a great idea because it is funds set aside pre-tax.
What should someone expect during an initial LASIK consult?
You should be out of your contact lenses for a certain period of time before the consult. In the initial consultation, your prescription will be measured several times, first before drops and then after dilating drops. An image of your cornea will be done, called a topography. Your eye history, and your family’s eye history will be asked about .
What are some questions the patient should ask during this consult and why?
– You should discuss your goals and your lifestyle. Do you want your distance or near vision corrected? (If you are over age 45)
– You should ask about other types of refractive correction (such as PRK). Even if you are not a candidate for LASIK, you could still be a candidate for PRK.
– You should ask about your surgeons experience with LASIK
– You should ask about any restrictions afterwards (sports, swimming, work, etc.)
– You should ask about touch- ups and what the policy is if the prescription changes in 1, 5, or 10 years
What is the minimum age for LASIK patients? Is there an age limit for getting LASIK? What’s the recommended age for LASIK surgery?
There is no accepted minimum age or age limit, but your prescription can no longer be changing. This is typically around 21/22. There is no upper limit, however after age 45, you will need to account for someone needing reading glasses as well. This can be done with “mono-vision”- one eye for distance, one eye for near..
What are some qualifications required of patients to be approved for LASIK surgery?
To qualify for LASIK, you must not have any other eye diseases (such as cataract, glaucoma, corneal scar, macular degeneration). Your prescription has to be within a certain limit, and your cornea has to be a certain level of thickness. Also, you cannot be pregnant or nursing, you cannot have certain viral diseases in the eye (such as shingles), and if you have diseases such as Diabetes or Rheumatoid Arthritis, they have to be under control.
What anesthesia is used for LASIK?
Since this is not true surgery, no IV anesthesia is required. You will have numbing eye drops, as well as an oral relaxing medication beforehand, such as Xanax/ Ativan.
Can you feel LASIK eye surgery?
You will feel your eye open and see lights and hear sounds. There is no pain and no discomfort during the procedure.
Is there a recovery time after LASIK surgery?How long is this recovery time?
Recovery time is typically 1 day. Most patients go back to their day to day activities including work, home, school, and play the very next day. The only exception to this is contact sports and swimming. You will be on drops for 2 weeks, and you will sleep with goggles over your eyes for several days.
“LASIK and Presbyopia: What You Should Know”
In Presbyopic patients, the lens can no longer accommodate, and a patient cannot see both up close and at far. If a patient’s goal is to get rid of glasses both at distance and at near, I perform “mono-vision” or “mini mono-vision” which means that I correct the dominant eye for distance and intentionally under-correct the non-dominant eye for near or almost near. This minimizes the need for glasses at all distances. If a presbyopic patient does not care about wearing glasses at a particular distance, then I will correct the distance vision and the patient will still need to wear reading glasses.
“LASIK and Glaucoma: What You Should Know”
Since LASIK is not a surgery inside the eye, it does not affect the optic nerve, and it does not increase nor decrease your baseline risk for developing glaucoma. The intraocular pressure does increase significantly for about 30 seconds during the procedure, but this does not increase your risk for developing glaucoma. However, after LASIK, the cornea is thinner, and the intraocular pressure is a number that is assessed in context of your corneal thickness as well. That is to say, a pressure of 20mmHg is normal in an average corneal thickness of 540 microns, but that same pressure may be considered high in a cornea whose thickness is 490 microns.
“LASIK and Amblyopia (Lazy Eye): What You Should Know”
LASIK cannot correct the vision in a lazy eye. The best corrected visual acuity (BCVA) in an amblyopic eye will remain the same. It makes sense to perform LASIK in that eye if it means not needing to wear contacts or glasses to achieve the BCVA, but it will not improve the BCVA.
What is each condition and how can LASIK improve it? Are there any potential side effects?
Myopia – near sightedness – A patient is myopic, or near-sighted, because the eyeball is too long, or the cornea is too steep, and the light rays focus in front fo the retina. The patient can see well at near without correction, but cannot see at distance without correction. LASIK corrects this by flattening the cornea, causing the light rays to focus on the retina, and the patient to see at distance and at near without correction.
Hyperopia (far sightedness) is the opposite. A patient is hyperopic when the eyeball is too short or the cornea is too flat. In this case, LASIK flattens the periphery of the cornea and makes the center steeper.
Some side effects include regression to the original prescription, topical infection or inflammation, and dry eyes. Some specific side effects for LASIK include diffuse lamellar keratitis, and epithelial ingrowth, both flap-related complications. Some specific side effects for PRK include post-operative haze.
Presbyopia- LASIK cannot correct the ability of the lens to accommodate to see both at distance or near, so correcting the eye for mono vision is a great option for patients who are presbyopic and desire not to wear correction for both distant and near.