February 17th, 2013
Often a big concern among patients is how they will pay for LASIK eye surgery. One tactic that I see far too often is for the patient to call various offices seeking the lowest LASIK price then set about trying to save enough money to pay for the surgery. The problem with this is twofold: first the patient may be selling themselves short. Remember that this is vision for a lifetime. Instead of choosing the cheapest LASIK surgery, patients should be searching for the best LASIK eye surgery. Second, one of the advantages of LASIK surgery is cost savings versus glasses and contact lenses. The more time spent trying to save up for LASIK, the more money spent on glasses and contacts in the interim. T
The sooner you have LASIK eye surgery, the greater the savings.
his reduces the cost advantage.
The best way to pay for LASIK eye surgery is the same way you pay for any major purchase like a car or new furniture: if you don’t have the cash readily available, finance the purchase. Interest rates are historically low right now and most providers of LASIK eye surgery can provide you with financing. You typically may finance for anywhere between one and five years. Some providers may even be able to provide interest free financing. Before you schedule your LASIK eye surgery, you will typically meet with a LASIK counselor. A savvy counselor will check to make sure you take advantage of any insurance discounts when they provide you with the total cost of your procedure. Many can offer several different finance options.
For those who are ill at ease about taking on additional debt, remember that unlike many purchases, LASIK eye surgery is an investment typically saving the patient thousands of dollars. The sooner you undergo LASIK, the greater the potential savings.
November 3rd, 2012
Two potential side-effects of LASIK eye surgery are “starbursts” and “halos”.
The short answer is yes. The more precise answer is “It doesn’t have to matter.” The pupil acts as the apperature in a camera constricting in bright sunlight to protect and dilating under dim illumination situations to allow maximum light for visual function at night. Many pupils can be as small as 2 mm in bright light and enlarge to as much as 7 mm or more in the dark. The side-effect of halos and starbursting around lights at night is well known in LASIK and various other eye surgeries and is easy to understand if you consider that LASIK, as originally performed, treated only the central 5.5 to 6 mm of the cornea. The admonition against LASIK in patients with large pupils was easy to understand and was logical when all LASIK was conventional, as performed over 10 years ago. Today, however, we have the ability to treat with much larger treatment zones and with a technology known as “custom” or wavefront-guided LASIK. Several large studies found that pupil size had no relation to night vision problems when wavefront technology was utilized to perform the LASIK procedure. Data from studies utilizing a VISX laser with wavefront guided LASIK treatments found that night vision problems were reduced 20-fold compared to conventional LASIK. Patient satisfaction with their night-vision actually had a tendency to increase compared to night-vision satisfaction with glasses or contacts when wavefront-guided LASIK was performed.
So, as long as your LASIK surgeon is using the latest technology, you can ignore the out-dated advice warning against LASIK in large pupils. Of course, before undergoing LASIK or any other type of surgery, you should discuss all risks and concerns and be sure you understand and are comfortable with these before proceeding. Improvements in LASIK technology continue to improve success rates and reduce the risk of side-effects. To maximize your chances for success, don’t settle for just LASIK: insist on wavefront-guided LASIK.
September 23rd, 2012
Thanks to advanced LASIK, many more now are pilot candidates.
Used to be if you weren’t blessed with naturally good vision, you were disqualified from becoming an airforce pilot or astronaut. Thanks to LASIK eye surgery and some of the newer innovations in vision correction surgery, all of that has changed. After years of study, the Air Force has decided to change their long-standing policy which disqualified applicants who have had LASIK surgery from flight training and navigator training. Prior to the change, officers who had had the surgery, prior to flight school could not become Air Force aviators. Under the old policy, a select-few pilots and navigators who had already graduated from flight training could apply to have the surgery and become part of an on-going study group. The change also removes the altitude and high-performance aircraft restrictions for people who have had LASIK.
The results of the study are in, and the Air Force found that there was little to no effect on LASIK-treated eyes when subjected to high G-forces of combat fighter aircraft, the wind blast experienced during aircraft ejection, or exposure to high altitude.
Due to stresses placed on the eyes during flight combined with the active lifestyle of military members, the recommended refractive surgeries are Wave Front Guided Photorefractive Keratectomy, or WFG-PRK, and Wave Front Guided Laser In-Situ Keratomileusis, know as WFG-LASIK, using the femtosecond laser (IntraLase). The eyes are more trauma resistant after surgery using one of these methods compared to other forms of refractive surgeries.
Shortly after the Airforce and Navy removed the LASIK restriction for fighter pilots, NASA followed suit in allowing LASIK for astronauts. Prior to the removal of these restrictions, poor vision was one of the most common causes for disqualification of aviator candidates. Now thanks to LASIK eye surgery, the future is looking a lot brighter for those who want to reach for the stars. Of course, as with any surgery, there are no guarantees and individuals interested in an aviation career must still meet the vision standards dictated by the armed forces.
September 17th, 2012
Many consumers are confused by the various claims made by advertisers about LASIK. Many LASIK providers claim to have the “latest technology” or “most advanced technology”. Some consumers assume that LASIK provided anywhere is the same. Is there a difference between different types of LASIK and is so is there any “best LASIK”?
LASIK is a general term referring to a vision correction procedure consisting of two steps: the creation of a flap and reshaping of the cornea underneath the flap. Both steps of the LASIK procedure have had refinements over the years and several different medical companies have offered instruments used in the procedure. LASIK surgeons are free to use instruments from any company they choose to perform vision correction. And just like the making any purchase decision: a car, a computer, a dishwasher etc., a variety of factors, including cost, quality and reliability can come into play in deciding what instruments a LASIK surgeon decides to use. Not surprisingly, the better quality instruments cost more to purchase and use than lower quality instruments.
So what are the various choices in LASIK technology? Basically it comes down to customization and precision. The more “customizable” and precise the technology, the safer and more reliable the oucome.
The iFS model of IntraLase laser is the most sophisticated laser to make the LASIK flap.
For the flapmaking step of the LASIK procedure, at present, the most sophisticated and safest method is using AMO’s iFS laser. It has the lowest complication rate and offers the most secure flaps.
AMO’s CustomVue technology uses wavefront mapping to yield the highest quality vision with fewest side-effects.
For the vision correction part of the LASIK procedure, the undisputed best method to reshape the cornea is using AMO’s CustomVue technology. This method gives the highest percentage of 20/20 results and the lowest incidence of night time side effects such as starbursting around headlights.
So while selecting the “best” car or refrigerator may not be obvious, the clear choice for the best LASIK procedure is the OmniLase technique: the combination of a customized LASIK flap with the iFS laser combined with AMO’s CustomVue technology.
September 9th, 2012
Some of the costs of a LASIK eye surgery can be offset by tax deductions.
LASIK eye surgery has been proven to save money over years of glasses and contact lens wear and every year of delay costs the individual contemplating vision correction surgery hundreds of dollars in potential savings but recent changes in tax laws can make a delay even more costly. That’s because new provisions in the Affordable Care Act, (commonly referred to as ObamaCare) raise the threshold for deduction of medical expenses from 7.5% of adgusted gross income to 10% of AGI. In addition, individuals who participate in Flexible Spending Accounts at work will find allowed contributions of up to $5000 in 2012 drop to just $2500 in 2013.
LASIK eye surgery is recognized as a legitimate medical expense by the IRS because it improves body function. In addition to the cost of the procedure, travel expenses associated with it are also deductible for those taxpayers who itemize.
Because of the looming changes in the tax code and todays advances in LASIK technology, there may never be a better time to have vision correction surgery. But time is running out and patients interested in the tax savings should check with their accountant to be sure they are eligible.
September 2nd, 2012
Optical aberrations can effect the quality of vision after LASIK
- Early in the history of LASIK eye surgery, a small sub-group of patients complained about the quality of their vision. Some actually had 20/20 levels of vision but described issues of “vision not being crisp” or “poor contrast”. Some complained of disturbed night vision: star-bursting or halos around lights. Out of a desire to solve these patients complaints, the science of wave-front guided LASIK science was born.
A standard LASIK procedure is based solely on a patient’s eyeglass prescription. A wavefront-guided LASIK is a treatment based on all of the eye’s measured optical aberrations. These aberrations are measured with a sophisticated device called a wavefront-analyzer, which essentially takes a “fingerprint” of the eye. This unique “fingerprint” is then recorded and used to correct vision with a sophisticated, computer-controlled laser.
But the use of a wavefront-analyzer to perform LASIK added time and cost to the procedure. A “shortcut” was developed to reduce time and cost: the wavefront-optimized LASIK procedure. An “optimized” LASIK procedure was designed to be aberration-neutral, neither creating nor reducing aberrations. The treatment is still based on the refractive prescription in glasses. It does not measure and cannot correct optical aberrations in the eye.
A wavefront-optimized procedure is better than a standard LASIK procedure because it tends to reduce the incidence and severity of new aberrations. A wavefront-guide procedure is even better than a wavefront-optimized procedure because it actually measures and treats pre-existing higher-order aberrations Wavefront-guided LASIK procedures, just like optimized, can minimize induction of spherical aberrations. But it can also measure and treat other higher-order aberrations.
There is no disputing that wavefront-guided LASIK uses much higher technology and is more expensive than standard or wavefront-optimized LASIK. But the real advantage of a wavefront-guided LASIK is more than just higher technology. Studies have demonstrated that a wavefront-guided LASIK results in better outcomes and better visual quality — especially when it comes to vision at night or in a dark environment, or when there is a high visual demand.
A wavefront-optimized LASIK procedure tends to reduce the incidence of visual side-effects as compared to standard LASIK but for the ultimate in outcomes, choose a wavefront-guided LASIK procedure.
New aberrations created from standard LASIK can cause “starbursting” at night. Wavefront-guided LASIK can minimize or eliminate starbursting.
August 19th, 2012
Vision: A LASIK Alternative
What if you could have a contact lens to correct your vision that you couldn’t feel, didn’t have to remove or clean and never had to replace. That’s the idea of a Visian implantable lens. This lens, unlike a standard contact lens, doesn’t sit on the eye, it resides inside the eye.
So how does the Visian implantable lens compare withe LASIK? For many patients, a Visian implantable lens may have advantages over LASIK? LASIK is a great procedure, is safe and yields excellent results for the majority of patients. However, for some individuals, LASIK may carry risks of side effects that can be prevented by choosing another procedure to correct vision. In a LASIK procedure, tissue is removed and reshaped with a laser. This process can lead to excessive thinning of the cornea or a decrease in vision quality as a result of extreme reshaping of corneas with high prescriptions. The Visian procedure leaves the shape and thickness of the cornea virtually unchanged. This gives the implantable lens procedure a significant advantage over LASIK in patients with thin or irregular corneas or patients with very high prescriptions. They may also be a better choice for patients with certain cornel disorders.
The optical quality of an implantable lens is excellent leading to excellent quality of vision. Implantable lenses also do not tend to cause the significant dry eye side effects experienced by some LASIK patients. In addition, once LASIK eye surgery is performed, because tissue is removed, the results are irreversible. In contrast, an implantable lens procedure is potentially reversible. Removal of the implant may remove the source of any il effects or side effects.
Both LASIK and Visian implantable lenses have a very high level of patient satisfaction. There is no one best procedure.
If you are not an excellent candidate for LASIK, you may be a great candidate for implantable lenses. Of course, all medical procedures have risks, and the risks of implantable lenses are different than that of LASIK. Make sure you discuss these risks with your surgeon. Want to compare and contrast the risks and benefits of LASIK vs implantable lenses? Make sure you consult a physician who performs both!
At the Laser Eye Center of Carolina, we offer LASIK and numerous other procedures for patients in North Carolina and beyond. Our consults are free so the only thing you risk is. Little of your time to make sure you are informed of all your options.
July 7th, 2012
Consumers have long recognized the value of cerification, accreditation and seals of approval. So when choosing a LASIK surgeon, what sort of qualifications should you look for? Technically, any licensed physician can perform LASIK. The medical specialist that performs LASIK eye surgery is the ophthalmologist. Ophthalmologists have completed a residency in eye surgery but, it is entirely possible to go through an ophthalmology residency program without performing a single LASIK eye surgery. Board certification means the physician has demonstrated competence in the field of ophthalmology through a testing process, but again, this does not insure competence in LASIK.
Most LASIK centers claim technological superiority and report that they have performed a large number of LASIK surgeries but these claims are unsubstantiated and cannot be verified. That is why there is value to organizations like the Better Vision Network. The Better Vision Network is headed by an advisory board of distinguished LASIK surgeons who screen other LASIK surgeons for consumers. Surgeon members of the Better Vision Network are the most qualified and use only the safest, most sophisticated LASIK technology. Potential LASIK patients can feel confident in the competence of the surgeon who has been selected to be a part of the Better Vision Network and looking for the Better Vision Network seal can help streamline the search for a qualified LASIK eye surgeon.
Looking for the Better Vision Network seal can help streamline the search for a qualified LASIK surgeon.
Gold medal skier Lindsey Vonn is the celebrity spokesperson for the Better Vision Network.
June 17th, 2012
- You should wear shields or goggles on your eyes to protect against flap displacement.
If you decide to have LASIK eye surgery to correct your vision, what will you experience? It’s important to know that different patients mave have different perceptions of the LASIK procedure and the immediate recovery period because of differences in anxiety level or different levels of discomfort tolerance. Patients are often apprehensive about the actual LASIK procedure and while we can’t give you specifics about your particular case we can provide you with some generalities.
After you have arrived, registered and filled out any necessary paperwork, your surgeon may want to have certain tests performed or repeated to insure accuracy. Most patients become very nervous just before the procedure. You may be offered a medication such as Valium to help calm you. Valium is not essential but it’s calming effect may make the procedure much more pleasant. We find that anxious patients often have heightened sensation and may report normally innocuous events such as putting drops in the eye as extremely unpleasant. Valium may take a few minutes to take effect but if you are convinced that the Valium has had no effect it is certainly accceptable to ask for a little more. You will have antibiotic drops instilled into the eye before the procedure in an effort to “sterilize” your eyes and prevent infection. After donning a paper bonnet, you will be led into the laser room and be asked to lay flat on your back in a reclined chair.
Usually there are one or two technicians in the room to assist the surgeon during your LASIK procedure. You may hear the doctor confirming the treatment settings with the technicians. Anesthetic drops are instilled into the eye just before starting the procedure. They may sting a bit and will take effect almost immediately. Anesthetic drops can prevent pain but will not eliminate temperature or pressure sensation. Also your eyelids will not be “numb”.
The first step of the LASIK procedure is creation of a LASIK flap. A suction ring is placed on the white part of the eye to prevent your eye from moving while the flap is made. You will feel pressure on your eye and your vision will dim for 15 to 30 seconds while the flap is made. When your vision returns it will be foggy. The same procedure then takes place on your second eye.
Now it is time for the second part of the procedure: the vision correction. Your chair will be rotated and you will be placed under the second laser. A lid speculum or lid holder is used for the eye to be treated first while a patch is taped over the other eye. The lid speculum will prevent blinking so you don’t need to make an effort to avoid blinking. Let the lid speculum open your lids without squeezing to insure maximum comfort. Cold saline (water) may be squirted on your eye to flush out mucous or debris before the procedure proceeds. You will be directed to look at an orange (amber) light. Try to note the direction this light is coming from so that if vision fogs during the procedure you will continue looking in the same general direction. Some time may be spent positioning your head correctly and, once again, you may hear the doctor verifying information on your treatment with the technician. Do not be alarmed by statements such as “not verified” or “negative”: your treatment will not proceed until everything is exactly as your surgeon wishes. Your vision will fog as the treatment starts as you will hear a loud “clacking noise” as the orange fixation light blinks. The blinking light may appear to move around during the procedure. Try to continue looking in the general direction of the light but you don’t need to worry about “chasing” it. The surgeon may stop the procedure to realign or dry the eye. This is common and so don’t be concerned. You may also notice a smell like something burning. This is the laser flume and this is also normal. At the conclusion of the case, Your lids will be released from the speculum. Do not squeeze the lids tightly or rub the eyes as this could cause the flaps to displace or “wrinkle”. If your eyeglass prescription was very high, you may notice that the vision is better immediately. Most patients describe the vision as foggy like “looking under” water immediately after the procedure.
Small hemorrhages on the white part of the eye from the suction ring are visible on most patients. They do not affect results and usually resolve in 2-3 weeks. The anesthetic drops wear off within a few minutes. Most patients notice burning, tearing and a “foreign-body sensation” as if there was sand or gravel in the eyes for 5-6 hours after the procedure. Keeping your eyelids likely closed (as if sleeping) may aid in comfort. Napping is great if you are able. Make sure you wear protective shields or goggles over your eyes if you plan on sleeping so you don’t forget and rub the eyes. Vision and comfort are usually dramatically improved (but not perfect) the next day. Your surgeon will see you the next day to insure that everything is as desired and offer you advice on drops and other measures to insure a successful outcome.
One of the great things about LASIK is the speed and relative comfort of the procedure as well as the quick recovery. More details on the postoperative period can be obtained from your surgeon and in future blog posts.
Hemorrhages from LASIK suction ring
May 6th, 2012
Most patients know that today’s modern LASIK is better than conventional LASIK offered 20 years ago. But many patients don’t realize that most LASIK providers do not offer the latest, safest technology.
The most common question that we field from the newly interested LASIK candidate remains ” How much does LASIK cost?” The inquirer presumes that LASIK is a product that is equivalent, no matter who the provider. Imagine how shocked the novice inquirer is to find out that almost40 percent of LASIK cases performed in the United States are still done with a blade. And, the majority of all-laser LASIK cases are still performed with earlier generation lasers that lack all the safety features of the latest generation lasers.
LASIK, like any medical procedure, has risks and potential complications. Over the years incremental improvements in technique and technology have been introduced to boost safety and results. But there is nothing to require LASIK providers to adopt newer techniques and technology. That is where the informed consumer come in. If you are willing to accept LASIK as it was performed ten years ago, then by all means, just look for the lowest price. If, on the other hand, you are interested in safety then you owe it to yourself to investigate the technology being used.
LASIK complications like wrinkled or irregular flaps, night vision problems and dry eye can be prevented or minimized with newer lasers and techniques. For those interested in understanding differences in LASIK technology and what the exact benefits are to you as a LASIK patient, we’d like to point you to an e-book available for free download on our website: http://www.visionauthorities.com.
If you’ve been waiting for LASIK to get safer, you’re in luck: it is. But, to get that safer LASIK you’ll have to do your homework and locate a provider who can offer the latest technology and the newest generation of lasers.
Not everyone stays "up to date".
The iFS laser is a fifth generation IntraLase laser