- What is Lasik Surgery?

The last few years have seen sweeping change in the medical field by way of the revolution in vision, LASIK eye surgery. Many people with vision problems get excited at the thought of corrective surgery. But just what is LASIK eye surgery?

Refractive errors in the cornea are corrected by lasers in LASIK surgery. The laser precisely controls the tearing of the corneal tissue, reshaping the cornea and changing its focus. LASIK surgery is a very simple two step process:

1. A slight, thin flap of tissue is created on the outside layer of the eye or cornea. The flap helps heal and provide comfort on the way to better vision. 2. The doctor then folds open the flap on the inner cornea to correct the vision. Finally, the flap is closed to its original position and sealed with stitches.

The word LASIK stands for Laser-Assisted In Sutu Keratomieusis, a process which reshapes the cornea to refract light in the lens. While LASIK surgery isn’t close to perfect, it is a very viable and increasingly safe surgery.

Improvements have been made by government regulations regarding the types of lasers allowed for LASIK surgery. A good idea for those who are considering the surgery is to research the types of lasers used by local doctors during LASIK.

As improvements are made and doctors are regulated the cost of LASIK surgery continues to drop, making it a possibility for some who could only dream of such improvement a few years back. Some surgeries are referred to as “bladeless” or “custom” LASIK, meaning they are more efficient and tailored to the individual.

LASIK surgery is an exciting prospect to anyone who has suffered from vision problems in the past. However, much like buying a car or house, it is important to do your homework first.


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- Who Qualifies for LASIK Surgery?

The possibility of complications or imperfect vision after LASIK vision correction can be greatly reduced if you simply find out if you are a good prospect for the surgery. Not everyone who wants LASIK vision correction is necessarily a good candidate to have the surgery. You should consider a few things before you settle on LASIK:

• If you don’t like to take a chance every now and then, you probably shouldn’t have LASIK vision correction. There are possibilities of complications as a result of LASIK that you should research before having the procedure done. • If having LASIK vision correction could affect your career or is not covered by your insurance you should think of another alternative. The cost of LASIK is getting cheaper, but is still quite expensive and you’ll want to make sure it isn’t prohibited by your employer. • You must be an adult with refractive stability to be accepted for LASIK vision correction. Refractive instability is determined by patients who are 20 or younger with fluctuating hormones due to such things as diabetes or someone who is pregnant or breastfeeding or taking medications that cause fluctuation in vision. • If you regularly engage in contact sports or suffer from a condition or disease may affect wound healing you should consider an alternative to LASIK vision correction. There are a number of other situations you should discuss with your doctor prior to LASIK vision correction. If you have herpes or shingles involving the eye area you should disclose that information. Also, any glaucoma, ocular hypertension, eye diseases, eye injuries, previous eye surgeries, or keratoconus should be discussed.

You should also ask your doctor to screen you for the following conditions prior to LASIK vision correction:

• Blepharitis • Large pupils • Thin corneas • Previous refractive surgeries • Dry eyes Once you have researched all of these conditions or discussed them with a LASIK surgeon you can determine if you are a candidate for LASIK vision correction.


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- The Risks of LASIK Surgery

Whenever a patient undergoes any type of surgical procedure there is a possibility for complications. It is natural that when a person’s body is opened up and tools are in use that bacteria of some can enter the patient or the body could have a reaction related to the medication. LASIK surgery is no different, there are risks to LASIK surgery, but they are few and far between.

LASIK risk continues to drop as doctors and engineers perfect the equipment used in the process. The risks involved in LASIK also drop as doctors continue to screen for the right candidates to have the surgery. Research now shows that with the right pre-testing and surgical care the risk of any complications in LASIK surgery are less than 1%.

The most common risk with LASIK surgery is a complication with the flap created by the surgeon to cover the cornea. In traditional LASIK surgery the flap is created when tissue is cut by a surgical tool known as a microkeratome. Since this tool, a metal blade is used by a human being there remains a risk related to human error.

When this type of traditional LASIK is performed the risk is when the flap is then used as the natural bandage at the end of the surgery it is not the right size. Therefore, the complication is an irregular bandage that irritates the eye and causes what is known as an irregular astigmatism. This LASIK risk is greatly reduced by a newer “bladeless” LASIK procedure.

In bladeless LASIK the risk of complication is reduced because the blade or microkeratome is no longer used. It is replaced by IntraLase, or another type of laser, that eliminates the human error.

When assessing these LASIK risks it is recommended that when you are considering LASIK surgery that you ask your doctor how he/she goes about correcting these problems. Some complications that arise from LASIK can be made even worse by over or under correction. Ask your doctor as part of your original process how they handle this situation.


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- What to Look for in a LASIK Surgeon

After considering if you are the right candidate for LASIK you should then begin shopping for a LASIK surgeon. Even though the risks of LASIK are quite a bit less than normal surgeries, you should still take researching a LASIK surgeon seriously. Take the normal precautions of comparing, setting criteria, doing your homework, and understanding what will happen in the surgery.

Compare what each LASIK surgeon relies on as their procedure of choice. Do they rely on the traditional LASIK that uses a blade to make the incision or do they use “bladeless” InterLase lasers to make all of the cuts. Ask what they believe is most reliable and what they do the most.

Set forth a base of criteria that you will hold each LASIK surgeon to. Don’t base it solely on cost or on the doctor’s experience, but see if they perform what you feel most comfortable with. This decision will affect YOU for the rest of YOUR life, not the surgeon’s.

Do your homework to avoid scams related to the “20/20 vision or guaranteed money back”. Make sure you check these doctors against the consumer affairs office or better business bureau to ensure that they do good practice. Understand what your rights are when it comes to having surgery and LASIK in general.

Understand what can happen during the surgery and ask your potential LASIK surgeon how they handle a situation that could potentially end a procedure. There is a chance a mistake could lead to permanent damage to your eye without even a chance to have corrective surgery.

Ask the same questions of your LASIK surgeon in relation to how he deals with situations after surgery. Question your LASIK surgeon about how they handle migration of the flap, inflammation or infection, intensive eye drop treatments, or additional procedures after the initial surgery.

LASIK surgeons are also held to an FDA standard regarding the type of laser used during the surgery. Make sure you find out what laser your potential LASIK surgeon uses and double-check it against the FDA’s approved list.


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- The Cost of LASIK

The cost of LASIK surgery is generally considered to be high because of the idea of using lasers and other high tech equipment. However, the cost of LASIK continues to come down due to improvements being made to the overall process. Don’t simply go to the lowest cost when choosing a surgeon; consider the following that may increase cost.

• Leasing or purchasing of the laser as well as maintenance of the blades or lasers can increase LASIK cost. • Per eye fee to the developer or manufacturer of the laser to pay for the cost of the machine. • Gowns, masks, gloves, medications, or surgical solutions to keep the operating room sterile and safe. • Advertising and insurance for the office. • The cost of LASIK can be reduced if the surgeon is part of the staff, eliminating his fee. When you are considering different LASIK surgery opportunities you should question your surgeon on what is included in the cost of the LASIK surgery.

• What is and isn’t included in the LASIK cost? • What will I be charged for if complications occur or enhancements are needed? • What is the cost for LASIK medications such as anti-inflammatory or painkillers? • What is the cost for temporary contact lenses if they are needed after LASIK? • What is the cost of the follow-up visits related to LASIK? Finally, you should get in contact with your insurance company to determine if they will cover the cost of the LASIK surgery. Some insurance companies don’t cover LASIK cost because they consider the surgery to be cosmetic. If financing is not a problem you should strongly consider using the LASIK surgeon who best suits your needs and concerns.

The FDA considers the average cost of LASIK surgery to be $1,344 in 2005, a significant decrease from the original numbers listed in 2002 of nearly $1,600. Many consider this LASIK cost to be marginal in relation to the comfort created by newly improved vision.


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- Preparing for LASIK Surgery

Preparing for any type of surgery is an unenviable and tedious process. You must make sure you have everything ready and your body in tip-top shape. While preparing for LASIK eye surgery may not be quite as difficult, there are some things you need to prepare for before LASIK.

You definitely need to stop wearing your contact lenses in the weeks leading up to your consultation before LASIK. Since the surgery is dependent on the shape and measurement of your cornea you must let it regain its shape. Lenses sometimes reshape the cornea themselves, causing problems with LASIK. Here are some FDA recommendations based on your contact lenses:

• Soft contact lenses should be removed and not worn for at least two weeks prior to your LASIK evaluation. • Rigid gas permeable lenses should be removed and not worn for at least three weeks prior to LASIK evaluation. • Hard lenses should be removed and not worn for at least four weeks prior to LASIK evaluation. When you meet the doctor to discuss LASIK eye surgery you should let him know a few things about yourself. Let the doctor know about any past or present medical and eye conditions as well as all medications you are taking or are allergic to. It is important that you disclose all of this to your doctor before deciding if LASIK is right for you.

After you’ve disclosed this personal information to the doctor, you should then discuss if you are a good candidate for LASIK surgery. Let him explain to you the risks, benefits, and alternatives of the surgery as well as what you can expect from beginning to end.

You should stop using any lotions, perfumes, or creams the day before the surgery as well as any makeup that may cause debris to get in the eye. The doctor may even request that you scrub and wash out your eyes for a good time before LASIK surgery to prevent the chance of any type of infection.

Finally, you should definitely arrange with a loved one for transportation to and from the LASIK surgery. Before LASIK surgery some doctors will arrange for you to take some medicine to help you relax that could impair your vision and reaction time. After LASIK surgery you may need a few days to recover your vision, hence the need to arrange for a drive home.


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- Custom LASIK

What if you went in for brain surgery and the doctor told you they weren’t going to do what was best for you, but what seemed to work best for MOST people? Would you be concerned? Do you think this type of surgery would be safe for your future or the doctor’s career? I didn’t think so, now there is something to correct this problem, a new procedure called custom LASIK.

Custom LASIK uses three dimensional images of your eyes and how they accept light to determine the best route for your surgery. This procedure called custom LASIK using wave-front technology is more precise than any pair of glasses, contacts, or even other LASIK procedures.

By using a few simple computer-generated tests to analyze the way your eye refracts light, the computer determines the best course of action. The fact that this custom LASIK uses the three dimensional image particular to the patient, the chance for an uneven or poorly constructed flap over the cornea is reduced.

There are more hoops for you to jump through if you are going to be a patient in custom LASIK surgery:

• You must be qualified by the FDA based on your eye condition before receiving custom LASIK. • Your doctor will present your choices regarding extra costs for your custom LASIK. • Your doctor will determine if your eye’s condition is such that custom LASIK presents the best result. What are the advantages of custom LASIK? • Better chance of 20/20 vision or better. • Reduced chance of night vision disturbances or glaring. • Reduced chance of losing visual quality or contrast sensitivity. Studies show that despite the cost of custom LASIK, more people are opting for this procedure than regular LASIK. However, it is important to discuss with your doctor what is correctable before the surgery. Even though custom LASIK is the most efficient form of LASIK it does not correct any type of eye problem at this time.


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- Bladeless LASIK

While LASIK is a relatively low risk surgery, bladeless LASIK eliminates the one area where most complications arise, the metal blade. Aside from the fear it strikes into the heart of those who fear traditional surgery, it still has a very human error rate in a very difficult low-percentage situation.

While many people who are rejected for LASIK are rejected for thin corneas, bladeless LASIK offers these people a second chance. IntraLase lasers offer a more controlled environment in the bladeless LASIK surgery. Instead of cutting through with a blade, the laser is guided by computer technology.

The IntraLase laser allows for more curvature during the bladeless LASIK surgery, reducing the margin for error. The fact that it is a laser and not a blade also lends to the idea of avoiding infections or contaminations. Bladeless LASIK prevents long-term recovery that accompanies most surgeries.

Prior to LASIK a lot of people had unsafe or imperfect surgeries to correct vision that eliminated them from the opportunity to try LASIK. With bladeless LASIK, these potential customers get a second chance because of the near 100% success rate of the procedure.

Some patients follow traditional LASIK with follow-ups to make other corneal flaps or reduce eye-irritation. Bladeless LASIK with InterLase appear to have reduced the possibility of this happening.

The natural reaction to the thought of bladeless LASIK is that it eliminates the need for a practiced and season doctor to perform the surgery. While it may be true to a point, the fact is that bladeless LASIK requires a good deal of knowledge in physics and engineering.

While surgeons may have only been required to have knowledge of medicine and anatomy in the past, they now must be computer savvy. The advantages of bladeless LASIK seem to boil down to two basic ideas, a higher success rate and less chance of follow-up procedures.


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- During LASIK Surgery

Most of the fear related to any type of surgery lies in the unknown element of the procedure. LASIK laser eye surgery is no different than any other type of procedure. LASIK laser eye surgery is actually a very simple process that can be explained easily.

You will sit down in a reclining chair in a room specially designed for LASIK laser eye surgery. There will be a large machine with a microscope attached to it and a computer screen as part of a laser system. The whole process should not take more than 30 minutes to complete.

The first step your doctor will take is to clean your eye and place a numbing drop of liquid in it. With the LASIK laser eye surgery now underway a ring will be placed around the eye to create suction to the cornea. This will cause the first discomfort of the surgery and blurred vision, but it will only be temporary.

While the suction ring is still around your eye a cutting instrument, called microkeratome, is used to cut a flap in your cornea. From this point on during the LASIK laser eye surgery you will experience some fluctuating blurred vision.

During the evaluation for LASIK laser eye surgery your doctor should have informed you that you will need to be able to stare at a laser for 60 seconds or more during the surgery. You will do this after the tissue has been folded back and dried out by the doctor during the procedure. The laser will direct your eye to the spot that the surgical laser will use to perform the vision correction.

At this point LASIK laser eye surgery may take on an unexpected smell, that of something burning. This is probably because your eye is under the intense scrutiny of the laser that is correcting your vision problems. Though the laser may make some very human sounds (ticking) and smells (burning hair) it is still a very controlled process.

The computer in the room that is hooked up to the laser controls the amount of energy delivered to your eye. Some tissue will be vaporized and finally the flap of the corneal tissue is put back in place, effectively ending LASIK laser eye surgery.

After LASIK laser eye surgery is completed your doctor will supply you with a shield or patch for your eye to prevent irritation. You will quickly realize how many times your eye gets bumped or you involuntarily rub it when you cannot do so. Wear the patch and save yourself some heartache.


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- After LASIK Surgery

The moments after a major life-altering event are usually filled with joy, laughter, and camaraderie, but this usually doesn’t happen after surgery. LASIK surgery is no different than any other surgery, but its drawbacks may be a little different than others.

The results of LASIK surgery are much akin to the results of being pestered by a pet day after day. Instead of the healing of bruises or incisions, LASIK surgery is accompanied by more burning and itching of an area that you are completely unable to scratch or cool. At this point, any touching of the eye could undo everything the surgery just repaired.

Your vision will be blurry because of the watering and tearing up of your eye, but you cannot under any circumstances touch your eye. The eye may appear dry or bloodshot for several days, if this occurs you should consider taking time off of work. If you experience severe pain from LASIK surgery at any time you should contact your surgeon.

Within 24-48 hours after your surgery you should have a post-operative exam to make sure everything is healing well. At regular intervals after the LASIK surgery up to six months you should continue seeing your doctor for checkups.

At the first visit after LASIK surgery your doctor will remove the shield and make sure your eye is responding correctly to the surgery. You will not be able to use contact lenses for sometime to keep from further irritation and you may have to use drops or artificial tears to help with lubricating the eye.

You will be urged to abstain from any contact sports or activities for several days as well as continuing to keep from lotions or perfumes that could irritate the eye. The doctor may advise you to regularly wash your eyes out in the weeks following LASIK surgery to prevent infection.

It may take several months to stabilize your vision after LASIK surgery has taken place. You may experience some small visual impairment during this time, including halos or glare due to the eye’s healing process. These are normal in the first few months after surgery, but if they persist you should contact your doctor.


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