How much does it cost?

The cost has recently dropped dramatically.  The fee for the procedure is $1495 per eye or $2990 for both eyes.

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Are all patients who wear contacts and glasses candidates for LASIK eye surgery?

Patients with practically every amount of nearsightedness, farsightedness, and astigmatism are enjoying great results from the LASIK procedure. A complete examination is needed to determine how much laser vision correction can be achieved.

Is LASIK new?

Yes and no. Historically keratomileusis has been performed for over 30 years. Early surgery consisted of lifting a cap of cornea tissue (dissection was done by hand), removing it temporarily and reshaping the cap to achieve the vision correction desired. The cap was frozen and lathed to thin it. The surgery was a testimony to the surgical skill of the pioneering surgeons but the great difficulty precluded its widespread use.

What did the early surgery teach us?

Among other things, that the eye could tolerate this surgery - so LASIK really has a lengthy history.

So what is new about LASIK?

First, the microkeratome - an instrument which cuts the corneal flap to the thickness of about one human hair, predictably. It is usually motor driven with the depth set so the surgeon does not have the arduous and almost impossible task of performing the cut by hand.

Second, the reshaping is performed by a computer driven laser - this results in minimal damage to the cornea with extreme accuracy. Both were not possible with earlier keratomileusis.

What can I expect my vision will be the day after surgery?

Most patients notice improved vision immediately after the procedure and can function without their corrective lenses at the one day post operative exam. Patients will continue to see a gradual increase in their vision during the first five to seven days after the procedure.

Are the results permanent?

Yes, however, LASIK will not prevent age related conditions such as cataracts or presbyopia (the condition of needing reading glasses when you reach your forties). If you are currently in that age range, however, it is possible to create "monovision" during surgery. This allows one eye to be stronger at near and the other stronger for distance vision.

Is the laser painful?

You'll be awake throughout the procedure. In fact, we'll be talking to you and your responsiveness is important. After the procedure, most patients experience little or no discomfort. Your eyes may feel scratchy, gritty, or watery. These symptoms are temporary and are not a problem for most patients.

Who is not a candidate?

Anyone with lupus, rheumatoid arthritis, keratoconus, herpes simplex of the cornea (herpes elsewhere is of no consequence), AIDS, autoimmune diseases, or anyone with unrealistic expectations.

What's the worst thing that can happen to an eye during LASIK?

As with any surgery, complications are possible, and infection would be the worst possible complication. Fortunately it is extremely rare as modern sterile technique and antibiotics guard against this problem. An infection, if caught early can often be cured with minimal damage. Therefore it is imperative that each patient have a good relationship with his or her surgeon, and understand clearly the doctor's on call philosophy.

What is LASIK?

It is laser assisted in situ keratomileusis. There are three steps. A keratome, acting like a lathe lifts a cap of cornea much like opening the front cover of a hardbound book. The cap looks like a perfect contact lens and is attached at one point like a hinged door. Then the computer driven laser etches or removes a minute amount of corneal tissue beneath the flap, the amount and shape determined by the computer, which is programmed with the patient's visual error. Finally the cap is replaced, again like closing the cover of the book.

Risks of LASIK?

Infection, a wrinkled flap (requiring repositioning), inflammation under the flap (requiring drops or sometimes lifting and treating the flap).

Risks common to both LASIK and PRK

Night glare - if the person's pupil dilates wider than the zone of treatment, the person may notice glare around lights at night. This is very bothersome but usually subsides with time. Night glare can also result if there is left over correction which needs to be addressed with glasses or a repeat treatment.

Loss of reading vision after the age of 40 - a nearsighted person, by definition, sees up close. Treatment to restore distance vision will remove the nearsightedness and therefore the ability to see up close after the person is 40, this is very important to fully appreciate.

Less than perfect vision. All people want perfection, and it is possible, but it is unwise to demand perfection of this surgery or your doctor. Each person absorbs laser energy slightly differently and heals differently. A very high percentage of patients see very well (20/40 or better - legal driving vision) so this surgery represents a major lifestyle change BUT if perfection is demanded surgery may not be a good choice.

What about touch-up or enhancement surgery?

If the person sees less than the desired result and there is a treatable correction left, the flap can be lifted at a later date and more treatment administered. This possibility is a comfort to those who preoperatively are perfectionists and to those postoperatively who are not completely satisfied with their result.

Enhancements can be considered once the eye has stabilized and a reliable residual error can be measured - usually three to six months.

What are the Long Term Effects of Vision Correction Surgery?

According to the most recent data available on vision correction surgery, it is considered safe, stable, and effective over the long term. A recent report on patients who underwent vision correction surgery more than 10 years ago, indicated that more than 75% of the participants still did not require glasses or contacts to pass their driver's test.

Can a 'no glasses no contact lens' result be guaranteed?

No. Each patient must accept the slim possibility of needing correction part time or all the time. AND, unless one eye is left nearsighted purposely reading glasses will be necessary for all people some time after the age 40.

Is this surgery helpful for reading?

NO, it is a distance surgery only --- unless one eye is made nearsighted on purpose which means that eye does not see far. This situation is done with contact lenses so it is possible but a person should be very sure he or she wants this type of result before surgery. Discuss this with your surgeon carefully.

Should both eyes be operated on at the same time?

You can but you must do what is comfortable for you and what is consistent with what your surgeon believes. Bilateral simultaneous surgery is preferred because of the convenience and rapid rehabilitation. Sequential e=surgery is done for a greater margin of safety as far as risk of infection. Statistics have shown that infection is extremely rare, but not impossible.

What are the alternatives?

Glasses, contact lenses, radial keratotomy (deep vertical incisions made to reshape the cornea - an old effective surgery still performed but largely replaced by lasers), intraocular lens implants ( new technology not approved by the FDA but in use in Europe and helpful for patients with vision errors beyond the reach of the laser), intra-corneal implants called Intacs (FDA approved ring implants placed in the layers of the cornea - a non-laser option which does not remove tissue, does not directly affect the central cornea, which is potentially reversible but works only for minor degrees of nearsightedness. Thermal treatment of the cornea (non FDA approved reshaping of the cornea by virtue of laser energy changing the shape with heat changes.

Who can be treated with LASIK?

Near and farsighted eyes as well as astigmatism but not those eyes which need reading glasses. There are limits to what the laser can do thus each person needs to consult a physician.

How do I pick a surgeon?

Pick a doctor who has extensive micro surgical experience, is board certified, is certified with the laser and keratome he is using. Advertising is merely that and does not guarantee any level of expertise. There are different approaches you will encounter - choose what is comfortable for you. Some surgeons state they are LASIK specialists only and do a volume oriented practice in which personal contact with the surgeon is minimal and most evaluation is performed by technicians or other doctors. Other surgeons are less geared towards volume and work on a more personal basis, providing comprehensive care for all eye problems while also performing LASIK. The MD's usually do most if not all of your pre and post operative care as well as the surgery.

How long does the LASIK take?

About 5-10 minutes per eye.

What is the recovery like?

Your vision immediately after the surgery is blurry like looking under water. Usually you are to go home and take a nap to let the flap stabilize in position. The next morning your vision is usually quite good, and should continue to clear. Pain is rare and mild and usually just the first few hours after surgery.

How much work will I miss?

In most cases, patients go home following surgery and rest. They usually feel fine the next morning. We perform the procedure on Thursdays and patients return to work on Friday.

Instructions after surgery?

Usually the patient wears a shield the first night to prevent rubbing the eye. Do not rub the eye for any reason for two weeks. Antibiotic and moisturizing drops are used for about two weeks. Full activity can be resumed almost immediately as long as the flap is respected - avoid swimming, hot tubs, steam rooms and makeup for three or four days, and again, do not rub the eye!

 

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Read more: • FDA Report on Laser Eye Surgery • AARP Article: The Vision Thing -   Laser Surgery after 50 -is it worth the risk? • Is LASIK Laser Eye Surgery Good For Senior Citizens? Sources: National Eye Health Institute LaserSurgery4You.com William A. Cies M.D. Newport Laser Center, CA New Bern Office             Village Square 3515 Trent Rd.  New Bern, NC 28562 252.514.2155 800.358.9693 Morehead City Office Makenzie Square 3332 Bridges St.  Morehead City, NC 28557 252.808.0200 800.358.0357 252.514.2155  Email: eyedoctor@davidsoneyeclininc.com Email is for information purposes only. Call our office for appointments and eyecare emergencies.

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