General Information and Questions About Lasik

What is laser vision correction?

A precise, minimally invasive laser treatment which reshapes the cornea - helping your eye to focus properly - which can reduce or eliminate the need for contact lenses or eyeglasses. This is done using a thoroughly tested and clinically proven excimer laser. Over a million patients have been treated worldwide using this device.

What are important questions I should ask prior to surgery?

Recommended Responses:

1. How long has Dr. been performing refractive surgery? At least 3 years.
2. How many refractive procedures have been performed total? Not less than 500 
3. How many refractive procedures were performed in the last 12 months? Not less than 100
4. What percent of refractive surgery patients achieve 20/40 or better? About 90%. 
5. What percent of patients report complications such as infection? Less than 1% 
6. Has the doctor ever had malpractice insurance coverage denied? No 
7. Has the doctor ever had his medical license suspended or restricted? No 
8. Is the laser the doctor will use specifically approved by the FDA? Yes Some doctors use lasers built overseas that are not made to FDA approved standards.

What are Intacs?

Intrastromal Corneal Ring Segments (Intacs) are a device approved by the FDA in early April 1999 for low myopia. The concept of ICRS is to insert small semicircular plastic rings of various thickness on both sides of the cornea to reshape the cornea and accommodate refractive error. Intacs can also be removed in the event a patient has unsatisfactory results.

What is an informed consent?

Informed consent provides patients with detailed information regarding the procedure, alternative treatments, potential risks and benefits associated with the procedure and can make an informed decision. In refractive surgery, the most common Informed Consent is for the LASIK procedure.

When will the doctor provide you a copy of the informed consent?

The doctor should offer to provide a copy immediately upon asking this question or during your pre-screening procedures. A week before surgery is considered adequate.

If an optometrist will be performing all pre- and post- operative care, can I see the surgeon at any time without my optometrist's authorization?

In a co-management arrangement you should be provided unrestricted access to your surgeon or any of the staff members in his office at any given time.

Will the doctor provide names of at least ten previous patients you may contact?

The doctor and/or the Refractive Coordinator should be pleased to provide you with this information. It is common for such a list to already be compiled and distributed to prospective patients.

Will the doctor allow me to observe a surgery?

Many laser centers have open days and times where prospective patients may come and observe a procedure. Please be aware however that operating suite access restrictions may preclude surgery observation. In this case, a video of the procedure and what to expect should certainly be provided.

Is there a difference among lasers?

There are many different lasers and different stages of development between the individual lasers that are being used. In principal for routine procedures most of these machines work in a fairly comparable manner. Certainly, the doctor's experience is an important factor with all of them. If you have certain unique problems, which could only be determined during the course of an evaluation, then certain lasers may be more suitable than others.

What are outcomes? What is an appropriate outcome?

Almost everyone who is considering refractive surgery wants to know what his/her chances are for obtaining a satisfactory outcome. Patients want to know what the "track record" has been for the procedure and surgeon he/she is considering. Unfortunately, this is not as easy to do as it may seem. Physicians in the United States are prohibited by law from advertising procedures that are not approved by the FDA, from making claims as to the efficacy of experimental procedures, and from making efficacy claims regarding any medical procedure unless those claims can be proven. Ophthalmologists are required by law to inform patients fully about the risks and benefits of any surgical procedure they may recommend, as well as alternative forms of treatment.

How long should I wait after my first surgery before I have an enhancement?

This depends on the type of refractive surgery. With LASIK and PRK, most surgeons wait three to six months after the first surgery, however there are exceptions. Intrastromal Corneal Ring Segments (Intacs) require significantly less waiting time. If your surgeon wants to perform an enhancement, ask why he wants to do the enhancement in the timeframe suggested. 

If an enhancement is required, will the doctor charge for the additional procedure?

The answer to this question should be now however if it is yes you should be required to pay no more than $250 per eye.

Since my refractive surgery I see fine in the day time but I get starbursts coming out from lights at night. Is there cause for concern?

Starbursts from light sources are a known complication of many types of refractive surgery. Starbursts can occur in daylight, but happen most often at night. With PRK and LASIK, starbursts seem to be caused most often by uneven ablations, but can also be caused by ablation zones smaller than the dilated pupil or other imperfections. In many cases, the starbursts dissipate over time. Ask your doctor about the probable cause of your starbursts and possible treatment.

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