WHAT IS LASIK?
Laser in-Situ Keratomileusis, commonly known as LASIK, is an outpatient procedure that uses the excimer laser to correct nearsightedness and farsightedness with or without astigmatism. The surgeon makes a flap in the cornea with an Intralase™ – FS (femtosecond) laser. An Intralase™ – FS laser creates tiny bubbles inside the cornea that are linked together and under computer control create the appropriate shape and depth of the flap desired by your surgeon. The excimer laser then removes the calculated amount of tissue to change the shape of the cornea, allowing the cornea to more accurately focus images on the retina. The number of pulses and the size and shape of the laser beam control how much tissue is removed. The corneal flap is then returned to its original position where it bonds after a few minutes.
WHAT IS THE INTRALASE METHOD™?
The Intralase Method is a blade-free technique used to perform the first step in the LASIK procedure: creating the corneal flap. The creation of the corneal flap prepares the eye for the second step of the LASIK procedure, where an excimer laser is used on the inner cornea to correct vision.
HOW DOES THE INTRALASE METHOD WORK?
The Intralase Method uses tiny, rapid pulses of laser light to create your corneal flap – instead of using a metal blade – during the first step of LASIK. Each pulse of light passes through the top layers of your cornea and forms a microscopic bubble at a specific depth and position within your eye that is determined by the doctor. The Intralase™ laser moves back and forth across your eye, creating a uniform layer of bubbles beneath your corneal surface.
Just prior to applying laser vision correction, the doctor creates your corneal flap by gently separating the tissue where the bubbles have formed. The corneal flap is then folded back so the doctor can perform the second step of your LASIK treatment.
WHAT IS THE EXCIMER LASER?
The excimer laser produces a beam of ultraviolet light, which is used to correct a variety of visual disorders. The incredibly precise laser, controlled by a doctor, delivers rapid pulses of cool ultraviolet light to reshape the surface of the eye, allowing light rays to focus properly. Prior to the procedure, the system’s computer calculates the exact amount of corneal tissue to be removed, an amount typically less than the diameter of a human hair. Removing this tissue through a laser technique known as photoablation allows the eye to focus properly. During LASIK the excimer laser emits a series of rapid pulses, each of which removes a microscopic amount of corneal tissue. The laser does not penetrate the eye and leaves other areas of the eye undisturbed.
WHO IS ELIGIBLE FOR CUSTOMVUE LASIK?
To qualify for CustomVue with the VISX-Excimer laser, nearsighted individuals must be at least 21 years of age and have healthy, stable eyes, which are free from eye disease or corneal abnormality. Our eye care professionals can advise patients on their chances of a beneficial result based on pre-surgical levels of nearsightedness and/or astigmatism.
Patients who are pregnant, nursing or have collagen vascular, autoimmune or immunodeficiency diseases should not have CustomVue LASIK surgery.
WHO IS A GOOD CANDIDATE FOR CUSTOMVUE™?
Patients with a spherical equivalent of -1.00
to -11.00 diopters of nearsightedness at the corneal plane, or nearsightedness with between 0.00
and -3.00 diopters of astigmatism. As well as, farsighted patients with or without astigmatism up to +3.00 diopters spherical equivalent, with astigmatism up to +2.00 diopters.
- Patients who require rapid visual recovery.
- Patients with realistic visual expectations.
- The goal of refractive surgery is to reduce a patient’s dependency on glasses and contact lenses.
- Refractive surgeons cannot guarantee that patients will not need glasses or contact lenses for distance or near vision ever again.
- Patient’s job and leisure activities must be taken in to consideration.
WHAT IS THE CUSTOMVUE™ LASER VISION CORRECTION?
CustomVue LASIK uses a tool called the wavefront analyzer to accurately measure the way light travels through your eye. The resulting map of your eye is then programmed into the laser, and the laser treats your eye based upon that personalized 3D map. CustomVue LASIK helps treat “higher order” aberrations, which are tiny imperfections in the eye that can have a significant impact on one’s quality of vision. In fact, higher order aberrations have been linked to visual glare and halos. Higher order aberrations have not been previously treatable with contacts, glasses or Conventional LASIK.
HOW DOES THE LASER KNOW WHAT TO CORRECT IN MY EYES?
Laser vision correction is based on precise measurements of the imperfections in your vision. These measurements are taken with a powerful measurement tool known as the WaveScan.® The WaveScan information is transferred to the laser to guide the treatment.
WHAT IS A WAVESCAN® AND A WAVEPRINT MAP®?
WaveScan technology provides a measurement and a visual representation of your vision based on the behavior of light waves. It compares light passing through your eye to the same light pattern from an eye that needs no vision correction. The WavePrint Map is the output of the WaveScan, it captures the unique imperfections of a person’s visual path.
HOW DOES THE CUSTOMVUE PROCEDURE WORK?
First, the WaveScan technology measures the imperfections in the eyes and produces a WavePrint ® Map. Much like a fingerprint, no two WavePrint maps are alike. Then, the treatment information is transferred to the VISX STAR S4™ laser. The doctor then uses that information to fine-tune the procedure thereby providing a new level of precision and accuracy.
HOW ACCURATE IS WAVESCAN TECHNOLOGY?
WaveScan technology identifies and measure imperfections in an individual’s vision 25 times more precisely than standard methods used for glasses and contact lenses.
DOES THE WAVESCAN HURT?
No, the Wavescan is a measurement device that you simply gaze into while it measures the vision imperfections in your eyes.
We do offer free screenings to evaluate whether you are a candidate for laser vision correction and to determine the best procedure for you. Please call Heidi, our refractive surgery coordinator, at 269-329-5860 to schedule a free screening. You will need to bring your glasses or a copy of your prescription in order to help us evaluate if you are a candidate.
AM I AWAKE DURING THESE PROCEDURES?
Yes, you are awake. You will be given Valium to relax you, but it doesn’t put you to sleep.
HOW DO I KEEP MY EYELIDS OPEN? WILL IT CAUSE A PROBLEM IF I BLINK?
Many people are worried about blinking or not being able to focus on the fixation light during the procedure. An eyelid holder is used to hold the eye open during the procedure. The doctor can stop the procedure at any time during the laser treatment if you were to look away from the light. The computer will remember exactly where the doctor stopped the treatment and it will not have an impact on your outcome. The laser also has an eye tracker to follow eye movement and provide for better centration of the laser treatment.
CAN I WEAR MY CONTACTS WHEN I COME IN FOR MY PRE-REFRACTIVE SURGERY EXAM?
YES, you will wear your contacts for your initial exam, but you will need to have the exam repeated once you have been out of your contacts prior to surgery. Or, if you have had exam with dilation in the last six months, then you could remove contacts before your first exam.
Soft contact lens wearers must not wear their contacts for 14 days prior to their second exam.
Hard and gas perm contact lens wearers must discontinue their contacts a full 4 weeks before the exam.
I CAN'T GO WITHOUT MY CONTACTS FOR 4 WEEKS, WHAT CAN I DO?
For hard and gas perm contact lens wearers, we can substitute soft contact lenses for 3 weeks. Then you must wear your glasses for 1 week prior to the exam. There is no charge for the temporary contact lenses, or fitting if you proceed with surgery.
CAN LASIK OR PRK HELP ME ELIMINATE MY NEED FOR READING GLASSES?
No, Presbyopia, the need for reading glasses is not corrected with these procedures. Successful patients, who have both their eyes corrected for distance vision, will need some kind of help for reading just like most people over age 40.
However, you may have the option of monovision. With the monovision approach, one eye is corrected for distance vision, while your other eye is corrected to see clearly when you read. If you have an interest in this type of surgical correction, it would first be tried with contact lenses to see if you would tolerate monovision. This type of correction is not agreeable with everyone and may affect your depth perception.
IS THE CUSTOMVUE LASIK PROCEDURE PAINFUL?
The CustomVue procedure is considered to be a “painless procedure”. Your eye is numbed with eye drops and you are alert during the entire procedure.
With CustomVue LASIK, since only the edge around the corneal flap needs to heal, visual recovery is rapid and most patients generally report little or no postoperative pain the day of the procedure.
Patients usually feel ok the day after the procedure. Some patients may experience what they describe as a slight discomfort, similar to the feeling as if there is something in your eye.
IS THE CUSTOMVUE LASIK PROCEDURE SAFE?
As with any medical procedure, there is risk involved. These procedures have been performed for many years. Many advancements have made the techniques safer, reducing the complication rate. Laser vision correction is a minimally invasive procedure that deals with the top few layers of the cornea. Because the laser is a non-thermal laser, there is little or no risk of damage to surrounding tissues. Most of the complications or side effects are temporary and go away with time. Overall, Custom Vue LASIK is a relatively safe procedure in experienced hands.
WHAT SHOULD PATIENTS KNOW FOR THE DAY OF PROCEDURE?
You should eat a normal meal, limit your caffeine intake and avoid alcohol the day of the procedure. You must arrange for someone to bring you to and from your surgical appointment and also to bring you to a follow-up appointment the next day.
Patients should wear:
Patients may not wear:
Hairspray, scented mousse or gel
Perfume, cologne, scented body lotions or suntan lotions
Any eye make-up on either eye.
Any facial make-up including blush, foundation, or scented facial creams
Jewelry above your neck, like earrings.
HOW LONG DOES THE PROCEDURE TAKE?
Overall, the procedure takes less than 15 minutes per eye. However, the laser is used on the eye for less than 60 seconds. Plan to be at the laser center for up to 1 1/2 hours. This will include prepping your eye prior to surgery, the instillation of a series of drops, and the administration of the medication to relax you.
WHAT CAN PATIENTS EXPECT AFTER SURGERY?
After CustomVue Lasik, the doctor will place some drops in your eye. You will leave with eye shields, pain pills and sleeping pills, and be instructed to go home and sleep. This is the best way to avoid discomfort and is the most beneficial for the healing of your eye. Most people experience very little discomfort and by the next day are able to see fairly well. It is not uncommon for your eyes to tear and have a gritty or “foreign body” sensation and vision may fluctuate for the first few weeks. This will usually stabilize after the first month. You will be placed on antibiotic and steroid drops for about two weeks to promote healing and prevent infection.
WHAT ARE SOME OF THE RISKS?
As with any surgical procedure, risks and/or potential complications do exist. Early and temporary complications for laser vision correction are considered to be:
Discomfort – few people experience discomfort, which is normally described as a slight stinging feeling or the feeling as if you have something in your eye. You may take Tylenol or another over-the-counter pain reliever to relieve this discomfort.
Light sensitivity – we provide you with a pair of sunglasses to wear upon leaving the center to assist with light sensitivity that will affect you for the first few days after the procedure.
Haze – is sometimes associated with PRK, not LASIK. Corneal haze usually resolves itself shortly after surgery; extreme cases are treated with eyedrops or laser enhancement.
Under/Over response – unless severe, these situations do not usually affect the overall results. High amounts of under response are generally treated with an enhancement procedure. Low amounts may be corrected by wearing glasses for activities such as driving. Over-responder eyes are extremely rare and most tend to regress back toward the intended outcome as the eye heals. However, some patients may require glasses for reading.
Infection Rate – this risk is greatest in the first 48 hours following the procedure and is usually treated with antibiotic drops. The risk of infection is around 0.02%. This risk is decreased by the use of post-operative medications. It is important that you carefully follow all of your post-operative instructions and see the doctor for all your post-operative visits or, immediately, if any problems were to arise.
Halos/Glare – If you experience problems driving at night or have halos and glare prior to the procedure, having the procedure may or may not affect those problems. Most of the time halos and glare go away with time. It is possible that halos and glares could be permanent, making your nighttime driving more difficult.
The risk of a serious vision threatening complications is significantly less than 1%
WHAT RESTRICTIONS WILL I HAVE AFTER MY LASER VISION CORRECTION SURGERY?
Do not use a hot tub, whirlpool, sauna, or swimming pool for 2 weeks.
Do not wear eye make up for 2 weeks.
Do not participate in contact sports for 2 weeks. Patients should wear protective eyewear when they do begin to participate again.
Avoid getting soap, water, perfume, hairspray and aftershave in your eyes for 2 weeks.
Do not drive until your vision is clear.
WILL MEDICAL INSURANCE COVER THE COST OF LASER VISION CORRECTION?
If you wonder if your insurance covers this procedure, you will need to contact them. Because Conventional LASIK and CustomVue LASIK are elective procedures, most insurance companies will not cover it.
Your insurance company will ask you the Procedure Codes and Diagnosis Codes.
S0800 – CustomVue LASIK
367.10 – Myopia (Nearsightedness)
367.20 – Astigmatism
367.00 – Hyperopia (Farsightedness)
WHAT DOES CUSTOMVUE LASIK COST?
Please call our refractive surgery coordinator to discuss the fees of CustomVue LASIK and INTRALASE CustomVue LASIK and to see if your insurance company qualifies you for a discounted rate or to learn about our financing options.
FOR MORE INFORMATION ON INTRALASE VISIT:
DO YOU HAVE FINANCING OPTIONS AVAILABLE FOR LASER VISION CORRECTION?
Yes, we offer financing options Care Credit. We encourage you to check out their website to view the financing options we have available through them.
VISX EXCIMER LASER SYSTEMS
VISX received FDA approval for its Excimer Laser System, March 27, 1996.
VISX is the first and the only excimer laser approved for use in patients 22 years of age and older.
Approximately 90 percent of Americans with mild to moderate levels of nearsightedness may be candidates for procedures with the VISX laser.
On November 2, 1998, VISX announced that the FDA had approved the use of the Excimer Laser for treating hyperopic patients between +1.00 to +6.00 diopters with no more than 1.00 diopter of astigmatism.
On October 19, 2000, VISX announced that the FDA had approved the use of the Excimer Laser for the treatment of hyperopic astigmatic patients between +0.50 to +5.00 diopters of sphere with refractive astigmatism from +0.50 to +4.00 diopters.
On March 20, 2001,VISX announced that the FDA had approved the use of variable spot scanning (VSS) to achieve larger treatment zones for myopia.
On November 6, 2001, VISX announced that the FDA had approved the use of the Excimer Laser for the treatment of mixed astigmatism.
On May 23, 2003, VISX announced that the FDA had approved CustomVue laser vision correction. The approval is specifically for wavefront-guided LASIK for correction of myopic astigmatism up to -6.00D MRSE, with astigmatism between 0.00 and -3.00D.
On December 15, 2004, VISX announced that the FDA approved CustomVue treatment of patients with farsightedness and astigmatism. The approval is specifically for wavefront-guided LASIK for correction of hyperopia with or without astigmatism up to +3.00D MRSE, with cylinder up to +2.00D.
On March 2, 2005, VISX announced that the FDA approved Iris Registration technology, the first iris-based, automated non-contact method of aligning and registering wavefront corrections for CustomVue treatments.
On March 22, 2005, VISX announced that the FDA approved CustomVue treatment of patients with mixed astigmatism. The approval is specifically for wavefront-guided LASIK correction of mixed astigmatism from 1 to 5 D of cylinder.
On October 5, 2005, VISX announced that the FDA approved CustomVue treatment of patients with high myopia. The approval is specifically for wavefront-guided LASIK correction of high myopia from -6 D to -11 D, with astigmatism up to 3 D.
During the U.S. clinical trials, VISX collected more than six years of data and treated 1,600 eyes.
All patients in the clinical trials experienced a significant improvement in uncorrected or natural vision after Photorefractive Keratectomy with the VISX Excimer Laser System.
Overall, 95 percent of eyes treated achieved at least 20/40 vision allowing them to see their clock from across the room, conduct everyday tasks and pass a driver’s test in most states.
In the FDA study, one year after the VISX CustomVue™ procedure:
- 100% of participants could pass a drivers test without glasses or contact lenses.
- 98% of participants could see 20/20 or better without glasses or contact lenses.
- 70% of participants could see better than 20/20 without glasses or contact lenses.
Want to learn more about the lasers used in laser vision correction and the latest innovation in laser surgery correction? Visit the Visx website.