Lasik Questions

You can fly immediately after LASIK. As long as you fly back the next day for your follow up appointment. Many of our patients ask me this question and we are not sure where the misconception originates from but flying is perfectly ok even within hours after the procedure. That said, keep in mind that airplanes are dry environments and you may need to lubricate your eyes in-flight even a few months after LASIK.

LASIK does not affect the rate at which your eye muscles get weaker. If you are currently near-sighted, you could potentially take your glasses off to read after age 40. By fixing your nearsightedness, you lose that advantage. This is why you should explore the monovision option.

Yes you can. There is a slight chance this may affect your candidacy and if it does, you can always remove your lenses then. So it is ok to get evaluated with your lenses in as long as you dont mind coming back for a final prescription measurement once you have decided to proceed ahead.

There is a 10-15% chance you may not like monovision. This can be easily corrected by an enhancement procedure to correct the nearsightedness that was left behind. This is usually free of charge.

85-90% of patients do adapt to monovision after an adaptation period of 3 weeks. Those who do not adapt may experience headaches, dizziness, difficulty driving at night, loss of depth perception.

When LASIK was performed with a blade, wed say that LASEK is safer. With the advent of blade-free LASIK, I feel that both procedures have the same safety profile. I typically recommend LASIK if somebody is a good candidate for it.

Yes, we tell patients that they can have LASIK today and get pregnant a few days later without any problem. We just want to make sure you are not pregnant when you are having LASIK. You may experience visual changes during pregnancy (whether you had LASIK or not). This is typically due to fluid shifts in your body. The vision usually goes back to baseline after delivery or breastfeeding

This is probably the most common question we get from people considering LASIK. I tell everybody that anything could happen including having a heart attack and dying! We know this sounds drastic but in reality, death and blindness are probably as likely as being hit by a truck crossing the street. We would not refrain from considering the procedure because am concerned about blindness. LASIK is not without risks but we take risks on a daily basis. Consider contact lenses.They also have a significant risk of infection, damage to the eye, etc. Yet, many of us will take the risk of contact lenses for the convenience they provide. In general, LASIK is a very safe FDA-approved procedure for a good candidate. It is not for everybody. The key is to ensure that you are a good candidate.

Monovision is not a good idea if you tried it in the past with contact lenses and did not like it. It is also not a good idea if the primary purpose of LASIK is to play sports that require very good depth perception such as golf and tennis.

LASIK takes about 12 minutes to perform in both eyes. Usually, your stay at the laser center that day will be about 2-3 hours. It is better to inquire with your doctor as this can vary from place to place.

In general, LASIK is not FDA-approved for anybody younger than 18 years old. In exceptional circumstances, i have performed LASIK on teenagers. These are situations where there was a large prescription difference between the 2 eyes and the person could not tolerate a contact lens. There is no upper age limit for LASIK. I have performed LASIK on people in their eighties and they were delighted! As long as the eye is healthy without other conditions (such as cataracts, glaucoma), LASIK is a possibility.

As you get older, you will be more and more dependent on near vision glasses. This involves all tasks 20 inches and closer such as a computer, cell phone, dashboard, etc.

LASIK does not affect the rate at which your eye muscles get weaker. If you are currently near-sighted, you could potentially take your glasses off to read after age 40. By fixing your nearsightedness, you lose that advantage. This is why you should explore the monovision option.

It is possible for some people to avoid reading glasses because they are nearsighted in one or both eyes. As we get older it is practically impossible to see distance and close up without glasses in both eyes unless we are nearsighted in one eye (monovision).

There are many modalities to treat and relieve dry eyes these days, yet it can be quite annoying. It is therefore important to know whether you are predisposed to have dry eyes after LASIK. The factors that increase the risk of dry eyes after LASIK are: Dry eyes before LASIK: this mainly applies to those who have dry eyes even without contact lenses. It is quite common to have dry eyes with contact lenses and in fact, many contact lens wearers have LASIK because their eyes become dry when wearing lenses. You are not necessarily at risk for dry eyes after LASIK if: You have been \u201ctold\u201d that you have dry eyes but you have no symptoms. It is a good idea to mention this to your LASIK surgeon but significant dry eyes are usually symptomatic. You have \u201cGPC\u201d (contact lens allergy/\u201cbumps\u201d under your lids). This does not affect your LASIK result and will not increase your chance of dry eyes after LASIK.

Any person who has chances of being hit, punched, or poked in the eye should consider PRK/LASEK rather than LASIK. Although the LASIK flap heals very well within a week of the surgery, severe trauma may move the flap. We recommend wearing protective goggles when engaged in sports/situations where you could be hit in the eye. This is good protection anyway, even if you did not have LASIK. With PRK/LASEK, there is no corneal flap and the eye goes back to the exact same shape as before the procedure.

As long as your eye has been determined healthy, this will not result in damage to your eye. The only risk you incur is a higher chance of a laser touch-up (repeat surgery). In general, the risk of a touch-up is 3%. Having LASIK despite an unstable prescription will just increase that percentage.

We determine if somebody is a good candidate for LASIK by the things we don’t want to get after LVC: Dry eyes: I usually ask my patients if they have dry eyes without contact lenses. This is usually an indicator of an underlying dryness. At your consultation, a dry eye test and discussion about your symptoms is usually conducted to assess your specific risk for this. Glare/halos around lights at night: These are concentric rings or starburst effects that you may see around lights at night. There are 3 risk factors for these: large pupils, high prescription, high astigmatism. That said, custom LASIK or iLASIK technology has significantly reduced the risk of halos even in the patients who have risk factors. When you go for your consultation, an infrared test is done in the dark to measure your pupil size so your risk can be assessed. Keratoconus: this is a condition where the cornea of the eye becomes \u201ccone shaped\u201d. This can happen in people who have a family history of keratoconus, have too thin of a cornea or have a corneal shape that makes your doctor suspicious of keratoconus. This is why your corneal thickness as well as corneal shape (topography) are measured at your evaluation. Your should also ask your family if anybody has keratoconus. An indication is usually a young member of the family who underwent a corneal transplant.

Sometimes between ages 40 and 45, the eye muscles start to weaken and do not allow us to read close up anymore. This is called presbyopia and will sooner or later affect everybody. This process is not affected by LASIK. That said, if you are near-sighted and get that corrected by LASIK, you may lose the ability to see close-up that near-sightedness afforded you after 40. This is why we advocate monovision after age 40, it allows retaining a little nearsightedness to help with some close up tasks.

Some patients have a prescription not correctable by LASIK. They may benefit from extracting the lens of the eye and replacing it with a lens implant. This is the exact same procedure as cataract surgery but without waiting for the cataract to happen. It is usually quite beneficial especially in farsighted patients after age 40 as it allows having vision at distance as well as near with very little dependency on glasses.

We don’t exactly know and it probably varies between people but a conservative approach is to wait 3 months after you deliver or after you stop breastfeeding.

In general, LASIK is not FDA-approved for anybody younger than 18 years old. In exceptional circumstances, we have performed LASIK on teenagers. These are situations where there was a large prescription difference between the 2 eyes and the person could not tolerate a contact lens. There is no upper age limit for LASIK. We have performed LASIK on people in their eighties and they were delighted! As long as the eye is healthy without other conditions (such as cataracts, glaucoma), LASIK is a possibility.

There are very few instances where contact lenses damage the eye to the point where you cannot have LASIK. Blood vessels in the cornea are not a problem. They usually get better after LASIK as the daily trauma of the contact lens is removed.

The visual outcomes and rate of complications vary from center to center. At the very minimum, you should ask whether the center you are being evaluated at tracking their own results every year. This is preferable to relying on general numbers. Tracking outcomes and complication rates allow surgeons to continuously improve and fine-tune their results.

Some patients are not candidates for laser vision correction. They may be candidates for an implantable lens. This is an artificial lens inserted inside the eye and stays there permanently. It takes about 15 minutes to do. The results are as good as LASIK. One advantage is that the lens is removable. Ask your doctor for more details about it.

Yes, I tell my patients that they can have LASIK today and get pregnant a few days later without any problem. We just want to make sure you are not pregnant when you are having LASIK. You may experience visual changes during pregnancy (whether you had LASIK or not). This is typically due to fluid shifts in your body. The vision usually goes back to baseline after delivery or breastfeeding.

Yes, there are certain situations that are considered absolute contraindications for lasik: Pregnancy: We prefer to wait till 3 months after delivery to perform LVC Breastfeeding: We prefer to wait till 3 months after breastfeeding to perform LVC Autoimmune Disorders: e.G., lupus, rheumatoid arthritis History of herpes infection in the eye It will jeopardize your career: Some jobs prohibit certain refractive procedures. Be sure to check with your employer/professional society/military service before undergoing any procedure. Less than 18 years old Your prescription is too high (other options exist such as the implantable contact lens) You take retinoic acid (retin a). This may increase your chance of dry eyes. You may be asked to stop it for 6 months before the procedure. There are relative contraindications for lasik where the procedure has to be approached cautiously. Your doctor can assess your personal risk. Your prescription is not stable. This has to be determined with your surgeon. If you have old prescriptions, bring them to your appointment. In general, the vision stabilizes as we get older. You feel dryness in your eyes (just being told your eyes are dry is not a good indicator) You have other eye diseases or conditions

Many people have LASIK because they have dry eyes with their contact lenses. I usually ask my patients if they have dry eyes without contact lenses. This is more of an indicator of an underlying dryness. In any case, your consultation should include a dry eye test and discussion with your surgeon if you are concerned about it. Dryness is one of the \u201cnuisance\u201d complications that can happen after LVC. It does not significantly affect the vision in general but can be annoying.

If you are prone to infections with contact lenses, you should seriously consider eyeglasses or LASIK surgery. I have not seen many severe infections after LASIK (although they can happen on rare occasions) but have seen many bad infections from contact lenses. Every few years a contact lens infection epidemic breaks out and many people get severe infections sometimes necessitating corneal transplants. No such epidemics have been reported with LVC. There is no correlation between having an infection with a contact lens and having one with LVC.

Yes, you can. As said above, there is a slight chance this may affect your candidacy and if it does, you can always remove your lenses then. So it is ok to get evaluated with your lenses in as long as you don’t mind coming back for a final prescription measurement once you have decided to proceed ahead.

We usually give eye drops for 4 days after LASIK. LASEK/PRK requires a longer regimen for about a month or so. I also recommend taking Vitamin C with LASEK/PRK as it minimizes the risk of scarring.

This may come as a surprise but we stress to all my patients that LASIK is a procedure to reduce dependency on glasses. This is in fact language mandated by the FDA. That said, the vast majority (more than 90%) of patients do not need distance glasses afterward. What about the other 10%? They also have a drastic improvement in their vision without glasses but may still need a thin pair of glasses for a few activities such as driving at night. The vast majority of patients are happy going from 100% dependency to 5-10% dependency if needed. Above age 40, you will need glasses for near tasks (closer than 20 inches). It is difficult to predict when that will happen. Ask your doctor about the different options available to delay or avoid reading glasses. This includes monovision. Please refer to the monovision questions for more details.

There are some recognized credentials that will help you assess the level of expertise of your surgeon such as board certification, whether they are corneal specialists or not, whether they have done a specific fellowship training in laser vision correction, whether a LASIK is a significant part of their practice or not. Above all, you need to assess whether you are in the hands of somebody who has good judgment. This is why it is important to meet with your surgeon ahead of your procedure. When all goes well, who performs the procedure is not as important. You are preparing for the unexpected. You need to be in good hands if you happen to experience any problem during or after LASIK.

In all likelihood this is ok especially for soft lenses. I usually tell my patients that this is acceptable as long as they were not cheating for longer than that.

If you want to follow the FDA-recommendations, the answer is yes. The best way to go about it if you really do not want to stay out of lenses is to go for an evaluation, set a date for your surgery and then stay out of your lenses (once) for the required period. You then just go back for a quick check 2 days before your procedure.

Contact lenses may change the shape of your cornea and make your doctor recommend PRK/LASEK rather than LASIK. In some cases, they may recommend no surgery at all based on shape appearance. Your contact lenses may affect your prescription by pressing on your eye. This is usually minimal, especially with soft lenses. Assuming this is the case, the worst thing that can happen is a slight increase in your chance of a touch-up. There is no evidence that something bad will happen. We usually recommend for my patients to stay out of their soft lenses for 2 weeks because it is an FDA recommendation. I recommend at least 4-6 weeks if you wear RGP/hard lenses because they tend to have a more long-lasting effect on the shape of the eye.

It is extremely unusual to experience either of these 2 events. Although some people may need more laser treatment, usually they would have noticed a significant improvement.

Some surgeons have their own laser suite while others will use another facility. It is an outpatient procedure. You go home afterward and are usually told to keep your eyes shut for about 4 hours that day.

This is probably the most common question we get from people considering LASIK. We tell everybody that anything could happen including having a heart attack and dying! This sounds drastic but in reality, death and blindness are probably as likely as being hit by a truck crossing the street. I would not refrain from considering LASIK because of concern about blindness. This is not to say that the procedure is not without risks but we take risks on a daily basis. Consider contact lenses. They also have a significant risk of infection, damage to the eye, etc. Yet, many of us will take the risk of contact lenses for their convenience. In general, LASIK is a very safe FDA-approved procedure for the good candidate. It is not for everybody. Be sure to be evaluated thoroughly and meet with your surgeon ahead of time so you ensure that you are a good candidate.

Yes, it is ok. This will have no impact on your testing or visual results.

Everybody heals differently. Even the 2 eyes of the same individual will heal differently. This is one of the main reasons on why the outcome is not as close to 20/20 as we want it too in about 3% of cases. There are also other variables at play that are difficult to control. That said, repeat laser treatments are very successful (and easy to do), i rarely have to do more than one repeat treatment on a patient.

Although having done a few hundred procedures is a good basis, we would not consider the number of procedures performed as the most important element in my decision. There are 2 to 3 other questions that we feel are more relevant: How many procedures does the person perform currently on a monthly basis? Research has shown that higher-volume surgeons tend to have lesser complications. Does your surgeon have specific fellowship training in LASIK? Even if somebody has performed thousands of LASIK cases, they may not have seen a complication that happens 1:5000 times. Fellowship training prepares somebody for all unexpected situations and is a reasonable gauge on the level of preparedness. How does your surgeon track their own outcomes? Do they have electronic records allowing them an automated record review? How often do they do it? Ask to see the results. Remember, it does not matter as much who is flying the plane when the skies are blue. You want to be in the hands of a pilot who has flown in all sorts of weather and who is going to land that plane on the Hudson should birds hit the engine!