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Laser Corrective Surgery In New York City

Did you know? You can have LASIK for nearsightedness, farsightedness, astigmatism and if
you wear reading glasses?

"I strongly recommend Dr. Rapoport if you are considering LASIK, or if you are simply in need of a great eye doctor."

MJ / New York


Why LASIK Eye Surgery?

LASIK, or Laser in-situ keratomileusis, and PRK, or Photorefractive Keratectomy, are non-invasive laser procedures that change the shape of your cornea to correct your vision to enable you not need glasses or contacts any more for vision correction. Both bladeless LASIK and PRK use advanced technology to provide 20/20 vision without glasses and contacts and are performed at a LASIK center.

What Is a LASIK Eye Surgery?

When light rays travel through your eye- they go through the clear cornea, lens and focus onto the retina and are then transmitted into neuro-electrical signals which are then sent to the brain. If you are nearsighted or “myopic,” your cornea is too steep and/or your eyeball is too long, and the light rays focus in front of the retina. If you are farsighted, or “hyperopic,” your cornea is too flat and/or your eyeball is too short and the light rays focus behind the retina. The goal of advanced technology laser vision correction – of LASIK (and PRK) – is to resurface the front of the cornea to make it flatter in the case of myopia, and steeper in the case of hyperopia, to enable the light rays to focus perfectly onto the retina and for you to see without glasses or contacts correction.
In bladeless LASIK, or Laser in-situ keratomileusis, a flap is created by a femtosecond laser, the flap is then lifted, the excimer laser resurfaces the corneal layer underneath, and the flap is put back down. The top layer, or epithelium is not removed during this procedure, and thus there is no discomfort in the few days after the procedure. The post op course is very short and most patients go back to their day to day lives the next day. We assume that the Lasik procedure will be stable for at least 20 years. 

Am I a qualified candidate for LASIK Eye Surgery?

There are certain criteria that you are required to meet in order to qualify for LASIK:
  • Over age 18, preferably older than 21 so that your prescription is stable
  • Stable prescription for over a year
  • A glasses/ contacts prescription that can be corrected by the LASIK procedure – the correctable prescription by bladeless LASIK is a narrower window than with PRK
  • Healthy corneas
  • Healthy eyes
  • You can have regular astigmatism, but not irregular astigmatism- irregular astigmatism can signify other issues (see blog post: https://www.manhattaneyenyc.com/what-is-astigmatism-what-is-regular-or-irregular-astigmatism/)
  • Your corneas need to be healthy and your overall eye health must be good.
There are also certain characteristics that disqualify you for LASIK procedures:
  • A prescription that is changing and not stable
  • A prescription that is above the parameters for LASIK eye surgery
  • History of overactive scarring
  • Certain dermatologic diseases that can affect healing
  • Uncontrolled dry eye or blepharitis
  • Corneas that are too thin
  • A history of recurrent corneal scratches
  • Eye diseases such as glaucoma, macular degeneration, retinal or corneal scarring
  • Visually significant cataract
  • Diabetes mellitus that is poorly controlled
  • Pregnant or nursing women
  • Keratoconus (cone-shaped cornea) (see blog post: https://www.manhattaneyenyc.com/what-is-keratoconus-and-how-can-i-treat-it-what-is-collagen-cross-linking/)
  • Family history of a corneal transplant/corneal disease
Send us your the self-assessment found below to find out about your candidacy and come in for a few consult:

What Should I know Before My Evaluation?

If you are interested in medical advice in finding out if you are a candidate for LASIK, or Laser-Assisted In Situ Keratomileusis, you need to come in for a full consult. You will need to remain out of your contact lenses for a specific amount of time before the evaluation. If you have a soft contact lens prescription with only a spherical correction (no astigmatism), you need to be out of your contacts for 10 days prior. If you wear soft lenses with astigmatic correction, you need to be out of your contacts for 21 days prior. If you wear rigid gas permeable lenses, you need to be out of the lenses for a week for each decade of contact lens wear. For example, if you wore rigid gas permeable lenses for 20 years, you need to not wear them for 20 weeks prior to the measurements. Please bring your glasses and contacts into the evaluation.
It is important to remain out of contacts so that your cornea returns to its original shape and thus the measurements and calculations are accurate.
Your LASIK experience begins in the office during the free consult. During the evaluation with Dr. Rapoport in the office, your prescription will be checked multiple times using advanced technology. Your current glasses will be measured, the manifest refraction (your best correction), and the cycloplegic refraction (the refraction after your eyes are dilated). The corneal curvature will be checked several ways. Advanced technology to image your cornea includes a Pentacam, a type of topographer, that will image your cornea to check for any irregularities that would exclude you from the procedure. Regular astigmatism is allowed, but irregular astigmatism is not. Your medical and ocular history will be thoroughly discussed. A history of certain medical conditions, such as untreated diabetes, autoimmune diseases, will prevent you from being a candidate. Certain findings on the exam, such as corneal or retinal scars, corneal dystrophies, history of certain types of infections, will also preclude you from being a candidate. A family history will also be obtained, with particular care looking at history of keratoconus or corneal transplants. If you have any ocular surface disease (blepharitis/ meibomian gland dysfunction or dry eye) that will have to be optimized and your evaluation/ measurements rechecked before proceeding with the procedure. If you cannot achieve 20/20 vision with your glasses and contacts, you will not achieve 20/20 vision with bladeless LASIK either – LASIK eye surgery will imitate whatever best corrected vision you have with glasses and contacts. You should bring in your glasses and contacts to be measured. The goal is to have stable vision for a stable vision for at least 20 years afterwards.

What Should I Expect During LASIK Procedure?

Both LASIK and PRK are both types of laser vision correction performed at a laser center.
You will be offered an oral relaxing medication to take ahead if time if you choose.
No systemic anesthesia is required.
You will start antibiotic drops 2 days prior to the LASIK procedure.
If you choose, you will take the oral relaxing medication 1 hour prior the LASIK procedure, and bring the other medication with you if you choose to take a 2nd dose.
Numbing drops, along with antibiotic and steroid drops, will be placed in your eye.
A suction ring is applied to the eye, and the Intralase femtosecond laser is then docked and creates a 100-110 micron thick flap.
During this time you may feel a little pressure.
The flap is then lifted under the microscope, and the excimer laser then changes the shape of the cornea underneath the flap.
The excimer laser is preprogrammed with the specific measurements of your eye.
The flap is then placed back to its original position and the edges are smoothed into position.
The same LASIK procedure is then performed on the other eye. The flap will attach on its on within a few minutes, but it is very important that you do not rub your eyes the first few days after the LASIK procedure, and especially the first night.
A see-through shield is placed over the eye, which you sleep with for a few days.
The day of the LASIK procedure, you should plan to go home from the LASIK center and take a nap or relax after the surgery and not use your eyes to read, use your phone or watch TV.
It is safe to resume normal activities of Daily Living the following day during post op.
Exercise is limited the first week and contact sports and swimming are limited for a month during post op.
Your eyes may feel scratchy or like they are burning for a couple of days during post op.
Your 20/20 vision should be stable for at least 20 years.





LASIK Experience with Dr. Rapoport in NYC

Dr. Rapoport is a leading expert in refractive surgery, having published and spoken nationally, and appeared on Dr. Oz and Inside Edition. She underwent LASIK herself 14 years ago and is therefore better equipped to provide counseling and guidance. At Manhattan Eye, we perform customized imaging and testing to ensure you have the safest and most precise treatment. Dr. Rapoport has an extensive in-depth discussion regarding an individualized plan for each patient. Dr. Rapoport brings years of expertise on the IntraLase femtosecond laser, VISX, and Alcon Contoura and the latest technology in custom laser correction to each patient.

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