Monday, January 08, 2007

Lasik Resources

Medical Schools
Albany Medical College
Albert Einstein College of Medicine
Arizona University of Arizona College of Medicine
Baylor College of Medicine
Boston University School of Medicine
Bowman Gray School of Medicine
Brown University School of Medicine
Case Western Reserve University School of Medicine
Charles R. Drew University of Medicine and Science
Columbia University College of Physicians and Surgeons
Cornell University Weill Medical College
Creighton University School of Medicine
Dartmouth Medical School
Duke University School of Medicine
East Carolina University School of Medicine
East Tennessee State University James H. Quillen College of Medicine
Eastern Virginia Medical School
Emory University School of Medicine
Finch University Health Sciences/The Chicago Medical School
Florida State University Program in Medical Sciences
George Washington University School of Medicine
Georgetown University School of Medicine
Harvard Medical School
Howard University College of Medicine
Indiana University School of Medicine
Jefferson Medical College of Thomas Jefferson University
Johns Hopkins University School of Medicine
Loma Linda University School of Medicine
Louisiana State University School of Medicine in New Orleans
Louisiana State University School of Medicine in Shreveport
Loyola University of Chicago Stritch School of Medicine
Marshall University School of Medicine
Mayo Medical School
MCP Hahnemann University School of Medicine

Recommended Sites
Cataract information from a cataract doctor in your area
Learn about cosmetic surgery from a cosmetic surgery doctor
Find a cosmetic dentist in your area
Dermatology information from a dermatologist in your area
Learn about diagnostic testing
Find a Fertility doctor in your area
Glaucoma information from a glaucoma doctor in your area
Learn about hair loss from a hair loss doctor
Find an inFertility doctor in your area
Laser dentistry information from a laser dentist in your area
Learn about laser surgery from a laser surgeon
Find a LASIK doctor in your area
Macular degeneration information from a macular degeneration doctor in your area
Learn about plastic surgery from a plastic surgeon
Find a vision loss doctor in your area
A Botox resource guide
Learn about breast augmentation from a breast augmentation doctor
Cataract information from an eye doctor near you
A collagen resource guide
Learn about cosmetic dentistry from a cosmetic dentist
Cosmetic dentistry information from a dentist near you
A cosmetic surgery resource guide
Learn about face lift from a face lift doctor
Glaucoma information from an eye doctor near you
A hair loss resource guide
Learn about inFertility from an inFertility doctor
LASIK information from an eye doctor near you
A LASIK resource guide
Learn about LASIK from a LASIK doctor
LASIK information from an eye doctor near you
A LASIK resource guide
Learn about LASIK from a LASIK doctor
Liposuction information from a liposuction surgeon near you
A liposuction resource guide
Learn about LASIK from a LASIK doctor
Presbyopia information from an eye doctor near you
A rhinoplasty resource guide
Learn about vision loss from a vision loss doctor
Breast augmentation doctors' websites in your area
Cosmetic dentists' websites in your area
Dermatologists' websites in your area
Face lift doctors' websites in your area
Liposuction doctors' websites in your area
Rhinoplasty doctors' websites in your area
Find a bariatric surgeon in your area
Cosmetic surgery information from a cosmetic surgeon
Learn about cosmetic dentistry
Find a dermatologist in your area
Facial plastic surgery information from a Facial plastic surgeon
Learn about Fertility
Find a glaucoma doctor in your area
Hair loss information from a hair loss surgeon
Learn about LASIK
Find a maxilloFacial doctor in your area
Optometry information from an optometrist
Learn about plastic surgery
Find a presbyopia doctor in your area
Find a doctor in your area
Vision loss information from a vision loss doctor

LASIK & PRK - Frequently Asked Questions

LASIK & PRK - Frequently Asked Questions

How do I know if I am a good candidate for LASIK?

A large percentage of nearsighted, farsighted, and astigmatic patients are potential candidates for LASIK. Patients who are 18 years of age or older, have healthy eyes that are free from retinal problems, corneal scars, and any eye disease are suitable. Along with being medically suitable, the best candidates are people with a lifestyle or occupation in which they are dissatisfied with their contact lenses or glasses. By having an evaluation, examination, and consultation with you, the doctor will be able to determine if you are a good candidate.

How long does LASIK take?

In our practice, LASIK is performed as an office procedure in the comfort and convenience of an excimer laser suite. The entire treatment takes about 5 to 7 minutes per eye or approximately 15 minutes for both eyes.

Is the effect of LASIK permanent?

Yes. Following an initial healing period of two to three months, the effect of the treatment is lifelong.

Will I need reading glasses after the treatment?

Generally, patients under 40 years of age read well without glasses following the treatment. Patients over 40 may need magnification for reading fine print. Presbyopia is the term that refers to the natural weakening of the focusing muscles that occurs in our early to mid 40s, causing us to need the magnification that reading glasses provide. The LASIK treatment does not correct or prevent presbyopia. We also will be glad to discuss another option called monovision.

How many times do I need to be seen following the treatment?

Most patients are usually seen the day following the treatment and then atleast 1 month and 3 months following the treatment. Some patients require more visits. Remember, we are available 24 hours a day when you have any questions, concern or need attention.

How soon after the treatment can I bathe and take a shower?

Your physician will advise you as to the specific, however typically you can bathe the same day as the treatment but you should not shower for 2 days after the treatment. As always, avoid getting soap or water directly into your eyes. Avoid rubbing your eyes during the first month after surgery.

When can I drive after the treatment?

You should not drive the day of treatment. After that, you may drive when you feel confident that your visual acuity and eye comfort allow you to drive safely.

How soon can I use eye makeup?

You may resume wearing eye makeup starting 1-2 weeks after your treatment. We strongly recommend that you purchase new eye makeup, specifically mascara, to avoid potential infection following your treatment.

How soon after the treatment can I exercise?

Non-contact sports can be resumed as soon as you feel capable. Eye protection is always recommended for racquet sports or rough sports where there is a risk of being hit in the eye.

How soon can I swim?

You should stay out of swimming pools for one week after your treatment, and rivers, lakes and oceans for two weeks following your treatment.

What kind of Anesthesia is used during the treatment?

Numbing eye drops are used. Sometimes an oral medication is used to help with relaxation. Don't worry - no needle or intravenous drugs are used.

Can you have both eyes treated at the same time?

Treatment can be performed on both eyes on the same day. This decreases the troblesome effect of being nearsighted in only one eye between the two treatments. You may elect to have one eye done at a time.

Does LASIK hurt?

The treatment itself is painless because we put a few numbing drops in your eyes to make you even more comfortable. You will feel pressure on and around the eye during treatment. With LASIK, some patients may experience a feeling of "something in the eye" for a day or so after treatment.

Can I see the treatment as it is being performed?

You will be "awake" but very relaxed. You will not be able to see any of the details of the treatment. You will see a number of lights, but the images will be blurred.

Will I experience pain after the treatment?

Some patients experience a feeling of burning or scratchiness. This feeling generally lasts from one to three hours following the treatment. Most people feel fine if they can take a nap soon after the treatment.

How soon after surgery will I see well?

Each patient is different. The eye drop medications cause some blurring, but most patients notice a dramatic improvement even as they leave the office. More that 4 out of 5 patients can pass a driving test without glasses or contact lenses after the treatment.

Will my eyes be patched?

No, but clear, protective eye shields will be placed over your treated eye(s) following the treatment, and will be removed in our office the next morning. You will continue to wear these eye shields at bedtime for 1 week for protection.

When can I go back to work?

Most patients are back to work full-time the day after treatment. An additional day or two is rarely required before returning to work. If you can we, recommend that you take it easy for a couple of days.

Will I need glasses or contact lenses after the treatment?

The goal of refractive surgery is to reduce your dependence on glasses and/or contact lenses, but LASIK patients still may benefit from reading glasses or distance glasses when they desire perfect near or distance vision. A nominal percentage of patients wear a thin pair of prescription glasses for night driving.

Four Easy Steps

Four Easy Steps

LASIK@Home couldn't be easier. Just follow these four easy steps and you'll be seeing clearly before you know it!

Thursday, January 04, 2007

Learning About LASIK

Learning About LASIK

LASIK is a surgical procedure intended to reduce a person's dependency on glasses or contact lenses. The goal of this Web site is to provide objective information to the public about LASIK surgery. See other sections of this site to learn about what you should know before surgery, what will happen during the surgery, and what you should expect after surgery. There is a glossary of terms and a checklist of issues for you to consider, practices to follow, and questions to ask your doctor before undergoing LASIK surgery.

LASIK stands for Laser-Assisted In Situ Keratomileusis and is a procedure that permanently changes the shape of the cornea, the clear covering of the front of the eye, using an excimer laser. A knife, called a microkeratome, is used to cut a flap in the cornea. A hinge is left at one end of this flap. The flap is folded back revealing the stroma, the middlesection of the cornea. Pulses from a computer-controlled laser vaporize a portion of the stroma and the flap is replaced. There are other techniques and many new terms related to LASIK that you may hear about.

FDA Lasik--Learning about LASIK

Wednesday, January 03, 2007

FDA-Approved lasers for LASIK

FDA-Approved lasers for LASIK
Approval Number for a particular laser will connect you to another FDA page with links to the Approval Order, Indications for Use, the Summary of Safety and Effectiveness (SSE) and the Labeling for Physician and Patient (labeling is often combined into one document with the patient labeling following the physician labeling).

Company and model

Approval number and date

Approved indications
(D = diopters)

- LADARVision
Myopia less than -9.0D with or without astigmatism from -0.5 to -3.0D
- LADARVision
Hyperopia less than 6.0D with or without astigmatism less than -6.0D
- LADARVision
Wavefront-guided LASIK: Myopia up to -7.0D with or without astigmatism less than 0.5D
- LADARVision
Wavefront-guided LASIK: Myopic astigmatism from -0.5D to -4.0D
- Apex Plus
Myopia less than -14.0D with or without astigmatism from 0.5 to 5.0D
Bausch & Lomb Surgical
- Technolas 217a
Myopia from -1.0 to -7.0D with or without astigmatism less than -3.0D
Bausch & Lomb Surgical
- Technolas 217a
Myopia less than -11D with or without astigmatism less than -3.0D
Bausch & Lomb Surgical
- Technolas 217a
Hyperopia between 1.0 and 4.0D with or without astigmatism up to 2.0D
Bausch & Lomb Surgical
- Technolas 217z
Wavefront-guided LASIK: Myopia up to -7.0D with or without astigmatism up to -3.0D
Dishler P970049
Myopia from -0.5 to -13.0D with or without astigmatism between -0.5 to -4.0D
Kremer P970005
Myopia from -1.0 to -15.0D with or without astigmatism up to -5.0D
- LaserScan LSX
Myopia from -0.5 to -6.0D with or without astigmatism up to 4.5D
- EC5000
Myopia from -1.0 to -14.0D with or without astigmatism less than 4.0D
- Star S2 & S3
Hyperopia between +0.5 and +5.0D with or without astigmatism up to +3.0D
- Star S2 & S3
Mixed astigmatism up to 6.0D; cylinder is greater than sphere and of opposite sign
- Star S2
Myopia less than -14.0D with or without astigmatism between -0.5 and -5.0D
- Star S3 (EyeTracker)
Same as S2, except with eye tracker
- Star S4 & WaveScan WaveFront System
Wavefront-guided LASIK: Myopia up to -6.0D with or without astigmatism up to -3.0D
- Star S4 & WaveScan WaveFront System
Wavefront-guided LASIK: Hyperopia up to +3.00D with or without astigmatism up to +2.00D
- Star S4 & WaveScan WaveFront System
Wavefront-guided LASIK: Mixed astigmatism from 1.0 to 5.0 D
- Star S4 & WaveScan WaveFront System
Wavefront-guided LASIK: Myopia from -6.0 to -11.0 D with or without astigmatism up to -3.0 D
Myopia up to -12.0D with or without astigmatism up to -6.0D.
Hyperopia up to +6.0D with or without astigmatism up to +5.0D.

FDA-Approved lasers for PRK and other refractive surgeries

Company and model

Approval number and date

Approved indications
(D = diopters)

- LADARVision
PRK; Myopia from -1.0 to -10.0D with or without astigmatism less than -4.0D
- Apex & Apex Plus
PRK; Myopia from -1.5 to -7.0D
- Apex Plus
PRK; Myopia from -1.0 to -6.0D with or without astigmatism from -1.0 to -4.0D
- Apex Plus
PRK; Hyperopia from +1.5 to +4.0D with or without astigmatism less than -1.0D
Bausch & Lomb Surgical
PRK; Myopia from -1.5 to -7.0D with or without astigmatism less than -4.5D
- LaserScan LSX
PRK; Myopia from -1.0 to -6.0D with or without astigmatism less than 1.0D
- EC5000
PRK; Myopia from -0.75 to -13.0D
- EC5000
PRK; Myopia from -1.0 to -8.0D with or without astigmatism from -0.5 to -4.0D
- ViewPoint CK System
4 /11/02
Conductive keratoplasty; Hyperopia from +0.75 to +3.25D with or without astigmatism up to 0.75D
- ViewPoint CK System
Conductive keratoplasty; Monovision in patients with presbyopia with or without hyperopia
- Hyperion
Laser Thermokeratoplasty (LTK); Hyperopia from +0.75 to +2.5D with or without astigmatism less than 0.75D
- Model B & C (Star & Star S2)
PRK; Myopia from 0 to -6.0D
- Model B & C (Star & Star S2)
PRK; Myopia from 0 to -6.0D with or without astigmatism from -0.75 to -4.0D
- Model B & C (Star & Star S2)
PRK; Myopia from 0 to -12.0D with or without astigmatism from 0 to -4.0D
- Star S2
PRK; Hyperopia from +1.0 to +6.0D
- Star S2 & S3
PRK; Hyperopia from +0.5 to +5.0D with or without astigmatism +0.5 to +4.0D
- Star S2 & S3
Add myopia blend zone; increase overall ablation zone from 6.5 to 8.0mm

LASIK Surgery Checklist

LASIK Surgery Checklist

Know what makes you a poor candidate

Career impact - does your job prohibit refractive surgery?
Cost - can you really afford this procedure?
Medical conditions - e.g., do you have an autoimmune disease or other major illness? Do you have a chronic illness that might slow or alter healing?
Eye conditions - do you have or have you ever had any problems with your eyes other than needing glasses or contacts?
Medications - do you take steroids or other drugs that might prevent healing?
Stable refraction - has your prescription changed in the last year?
High or Low refractive error - do you use glasses/contacts only some of the time? Do you need an unusually strong prescription?
Pupil size - are your pupils extra large in dim conditions?
Corneal thickness - do you have thin corneas?
Tear production - do you have dry eyes?

Know all the risks and procedure limitations

Overtreatment or undertreatment - are you willing and able to have more than one surgery to get the desired result?
May still need reading glasses - do you have presbyopia?
Results may not be lasting - do you think this is the last correction you will ever need? Do you realize that long-term results are not known?
May permanently lose vision - do you know some patients may lose some vision or experience blindness?
Dry eyes – do you know that if you have dry eyes they could become worse, or if you don’t have dry eyes before you could develop chronic dry eyes as a result of surgery?
Development of visual symptoms - do you know about glare, halos, starbursts, etc. and that night driving might be difficult?
Contrast sensitivity - do you know your vision could be significantly reduced in dim light conditions?
Bilateral treatment - do you know the additional risks of having both eyes treated at the same time?
Patient information - have you read the patient information booklet about the laser being used for your procedure?

Know how to find the right doctor

Experienced - how many eyes has your doctor performed LASIK surgery on with the same laser?
Equipment - does your doctor use an FDA-approved laser for the procedure you need?
Informative - is your doctor willing to spend the time to answer all your questions?
Long-term Care - does your doctor encourage follow-up and management of you as a patient? Your preop and postop care may be provided by a doctor other than the surgeon.
Be Comfortable - do you feel you know your doctor and are comfortable with an equal exchange of information?

Know preoperative, operative, and postoperative expectations

No contact lenses prior to evaluation and surgery - can you go for an extended period of time without wearing contact lenses?
Have a thorough exam - have you arranged not to drive or work after the exam?
Read and understand the informed consent - has your doctor given you an informed consent form to take home and answered all your questions?
No makeup before surgery - can you go 24-36 hours without makeup prior to surgery?
Arrange for transportation - can someone drive you home after surgery?
Plan to take a few days to recover - can you take time off to take it easy for a couple of days if necessary?
Expect not to see clearly for a few days - do you know you will not see clearly immediately?
Know sights, smells, sounds of surgery - has your doctor made you feel comfortable with the actual steps of the procedure?
Be prepared to take drops/medications- are you willing and able to put drops in your eyes at regular intervals?
Be prepared to wear an eye shield - do you know you need to protect the eye for a period of time after surgery to avoid injury?
Expect some pain/discomfort - do you know how much pain to expect?
Know when to seek help - do you understand what problems could occur and when to seek medical intervention?
Know when to expect your vision to stop changing - are you aware that final results could take months?
Make sure your refraction is stable before any further surgery - if you don't get the desired result, do you know not to have an enhancement until the prescription stops changing?

What should I expect before, during, and after surgery?

What should I expect before, during, and after surgery?

What to expect before, during, and after surgery will vary from doctor to doctor and patient to patient. This section is a compilation of patient information developed by manufacturers and healthcare professionals, but cannot replace the dialogue you should have with your doctor. Read this information carefully and with the checklist, discuss your expectations with your doctor.

Before Surgery
If you decide to go ahead with LASIK surgery, you will need an initial or baseline evaluation by your eye doctor to determine if you are a good candidate. This is what you need to know to prepare for the exam and what you should expect:

If you wear contact lenses, it is a good idea to stop wearing them before your baseline evaluation and switch to wearing your glasses full-time. Contact lenses change the shape of your cornea for up to several weeks after you have stopped using them depending on the type of contact lenses you wear. Not leaving your contact lenses out long enough for your cornea to assume its natural shape before surgery can have negative consequences. These consequences include inaccurate measurements and a poor surgical plan, resulting in poor vision after surgery. These measurements, which determine how much corneal tissue to remove, may need to be repeated at least a week after your initial evaluation and before surgery to make sure they have not changed, especially if you wear RGP or hard lenses. If you wear:

  • soft contact lenses, you should stop wearing them for 2 weeks before your initial evaluation.
  • toric soft lenses or rigid gas permeable (RGP) lenses, you should stop wearing them for at least 3 weeks before your initial evaluation.
  • hard lenses, you should stop wearing them for at least 4 weeks before your initial evaluation.
Before your initial exam, stop wearing contact  lenses.

You should tell your doctor:

  • about your past and present medical and eye conditions
  • about all the medications you are taking, including over-the-counter medications and any medications you may be allergic to

Your doctor should perform a thorough eye exam and discuss:

  • whether you are a good candidate
  • what the risks, benefits, and alternatives of the surgery are
  • what you should expect before, during, and after surgery
  • what your responsibilities will be before, during, and after surgery

You should have the opportunity to ask your doctor questions during this discussion. Give yourself plenty of time to think about the risk/benefit discussion, to review any informational literature provided by your doctor, and to have any additional questions answered by your doctor before deciding to go through with surgery and before signing the informed consent form.

You should not feel pressured by your doctor, family, friends, or anyone else to make a decision about having surgery. Carefully consider the pros and cons.

The day before surgery, you should stop using:

  • creams
  • lotions
  • makeup
  • perfumes

These products as well as debris along the eyelashes may increase the risk of infection during and after surgery. Your doctor may ask you to scrub your eyelashes for a period of time before surgery to get rid of residues and debris along the lashes.

Also before surgery, arrange for transportation to and from your surgery and your first follow-up visit. On the day of surgery, your doctor may give you some medicine to make you relax. Because this medicine impairs your ability to drive and because your vision may be blurry, even if you don't drive make sure someone can bring you home after surgery.

During Surgery
The surgery should take less than 30 minutes. You will lie on your back in a reclining chair in an exam room containing the laser system. The laser system includes a large machine with a microscope attached to it and a computer screen.

A numbing drop will be placed in your eye, the area around your eye will be cleaned, and an instrument called a lid speculum will be used to hold your eyelids open. A ring will be placed on your eye and very high pressures will be applied to create suction to the cornea. Your vision will dim while the suction ring is on and you may feel the pressure and experience some discomfort during this part of the procedure. The microkeratome, a cutting instrument, is attached to the suction ring. Your doctor will use the blade of the microkeratome to cut a flap in your cornea.

The microkeratome and the suction ring are then removed. You will be able to see, but you will experience fluctuating degrees of blurred vision during the rest of the procedure. The doctor will then lift the flap and fold it back on its hinge, and dry the exposed tissue.

The laser will be positioned over your eye and you will be asked to stare at a light. This is not the laser used to remove tissue from the cornea. This light is to help you keep your eye fixed on one spot once the laser comes on. NOTE: If you cannot stare at a fixed object for at least 60 seconds, you may not be a good candidate for this surgery.

When your eye is in the correct position, your doctor will start the laser. At this point in the surgery, you may become aware of new sounds and smells. The pulse of the laser makes a ticking sound. As the laser removes corneal tissue, some people have reported a smell similar to burning hair. A computer controls the amount of laser energy delivered to your eye. Before the start of surgery, your doctor will have programmed the computer to vaporize a particular amount of tissue based on the measurements taken at your initial evaluation. After the pulses of laser energy vaporize the corneal tissue, the flap is put back into position.

A shield should be placed over your eye at the end of the procedure as protection, since no stitches are used to hold the flap in place. It is important for you to wear this shield to prevent you from rubbing your eye and putting pressure on your eye while you sleep, and to protect your eye from accidentally being hit or poked until the flap has healed.

Good practices to follow before and  after surgery

After Surgery
Immediately after the procedure, your eye may burn, itch, or feel like there is something in it. You may experience some discomfort, or in some cases, mild pain and your doctor may suggest you take a mild pain reliever. Both your eyes may tear or water. Your vision will probably be hazy or blurry. You will instinctively want to rub your eye, but don't! Rubbing your eye could dislodge the flap, requiring further treatment. In addition, you may experience sensitivity to light, glare, starbursts or haloes around lights, or the whites of your eye may look red or bloodshot. These symptoms should improve considerably within the first few days after surgery. You should plan on taking a few days off from work until these symptoms subside. You should contact your doctor immediately and not wait for your scheduled visit, if you experience severe pain, or if your vision or other symptoms get worse instead of better.

You should see your doctor within the first 24 to 48 hours after surgery and at regular intervals after that for at least the first six months. At the first postoperative visit, your doctor will remove the eye shield, test your vision, and examine your eye. Your doctor may give you one or more types of eye drops to take at home to help prevent infection and/or inflammation. You may also be advised to use artificial tears to help lubricate the eye. Do not resume wearing a contact lens in the operated eye, even if your vision is blurry.

What to expect after surgery

You should wait one to three days following surgery before beginning any non-contact sports, depending on the amount of activity required, how you feel, and your doctor's instructions.

To help prevent infection, you may need to wait for up to two weeks after surgery or until your doctor advises you otherwise before using lotions, creams, or make-up around the eye. Your doctor may advise you to continue scrubbing your eyelashes for a period of time after surgery. You should also avoid swimming and using hot tubs or whirlpools for 1-2 months.

Strenuous contact sports such as boxing, football, karate, etc. should not be attempted for at least four weeks after surgery. It is important to protect your eyes from anything that might get in them and from being hit or bumped.

During the first few months after surgery, your vision may fluctuate.

  • It may take up to three to six months for your vision to stabilize after surgery.
  • Glare, haloes, difficulty driving at night, and other visual symptoms may also persist during this stabilization period. If further correction or enhancement is necessary, you should wait until your eye measurements are consistent for two consecutive visits at least 3 months apart before re-operation.
  • It is important to realize that although distance vision may improve after re-operation, it is unlikely that other visual symptoms such as glare or haloes will improve.
  • It is also important to note that no laser company has presented enough evidence for the FDA to make conclusions about the safety or effectiveness of enhancement surgery.

Contact your eye doctor immediately, if you develop any new, unusual or worsening symptoms at any point after surgery. Such symptoms could signal a problem that, if not treated early enough, may lead to a loss of vision.