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FAQ: Lasik Boston
At the Boston Eye Group, we blend the potential of the latest technology to the skills and ethics of our medical team. Expect nothing short of excellence, whether towards your convenience or your eye’s safety. We are genuinely committed to providing you the highest level of care, care with comfort. You will find below brief answers to the most commonly asked questions about laser vision correction. More details and individualized answers will be provided at the time of your evaluation.
- What is LASIK?
- What is LASEK?
- Am I a candidate for laser vision correction?
- How well will I be able to see following Laser Vision Correction?
- How long does the procedure take?
- What is involved in the treatment?
- What if I accidentally blink during the procedure?
- Is the procedure painful?
- How much time must I take off from work following the procedure?
- How often do I return for follow-up examinations after the procedure?
- What kind of vision can I expect after the procedure?
- Will I need glasses or contact lenses after the procedure?
- Can both eyes be treated at the same time?
- What is an enhancement?
- How long do the results last?
- What is Nearsightedness?
- What is Farsightedness?
- What is Astigmatism?
- What is presbyopia?
- What is the difference between RK and Laser Vision Correction?
- What is the difference between PRK and LASIK?
- Are there any risks or side effects?
- How can I find out if I am a candidate and which procedure is best for me?
- What does 20/20 mean?
- Does my health or vision insurance cover LASIK and PRK?
- Is there financing available?
What is LASIK?
One of the most exciting procedures performed at the Boston Eye Group is Laser In-situ Keratomileusis (LASIK.) LASIK is performed by folding back a thin layer of the cornea without damaging the surface. The surgeon then uses the laser to reshape the cornea, improving the way light is focused on the retina and thus producing clearer vision.
LASIK is performed as an outpatient procedure in the comfort and convenience of our laser suite. Normally, the entire procedure lasts less than 20 minutes, with most patients experiencing an improvement in their vision immediately following the procedure. The LASIK procedure allows patients to enjoy a faster visual recovery than PRK (Photorefractive Keratectomy), with most people achieving driving vision within several hours of their treatment, and healing is quite rapid with little or no discomfort.
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What is LASEK?
LASEK is a relatively new laser vision procedure that combines certain elements of both the PRK and LASIK procedures, and may offer some advantages for patients. Instead of removing the epithelium as with PRK, a flap of surface epithelium is loosened with a diluted alcohol solution and moved aside. The surface under the epithelium is treated with the laser and the epithelium is returned to its original position, as with LASIK. A protective, soft contact lens is then placed over the cornea to make the eye more comfortable while it heals.
Using the epithelium flap as a natural protective bandage with LASEK as opposed to completely removing the epithelium as with PRK, may improve healing, reduce postoperative discomfort and the incidence of postoperative haze. And, the margin of safety with LASEK is increased over LASIK as the need for a microkeratome is eliminated.
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Am I a candidate for laser vision correction?
We recommend that you come in for a complimentary evaluation at the Boston Eye Group. By looking at your current glasses or prescription, we will determine if a refractive procedure will offer you any benefit. During your free consultation, we will perform a computerized imaging of the cornea in order to determine its curvature. Infrared measurement of your pupils will also be performed to ensure minimize the risk of visual disturbances after the procedure. A thorough and personalized discussion with Dr. Melki will explore your options for laser vision correction.
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How well will I be able to see following Laser Vision Correction?
Laser Vision Correction has been shown to reduce people's need for glasses and contact lenses. Over 95% of the treated patients will achieve 20/40 vision or better. This will usually enable you to pass a driver's license eye examination without glasses or contact lenses.
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How long does the procedure take?
On the day of surgery, you will be at the laser center for approximately two hours. The time in the treatment room is 20 to 25 minutes. The actual laser treatment time is approximately one minute.
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What is involved in the treatment?
LASIK is an outpatient procedure that generally takes between 15 and 30 minutes. Your entire stay at the Center that day will be about 2 hours. You are given some relaxing medicine to take before the procedure is done and then brought into the Laser Suite about 30 minutes later. First, you will relax in a reclining chair while some numbing drops, the only anesthetic needed, are placed in your eye. Dr. Melki will then position your head under the microscope so he has an excellent view of your eye. A small retainer is placed to hold your eye open during the procedure. Then, Dr. Melki will use a device called a microkeratome to create a thin flap of cornea. Most patients feel some pressure and see a few seconds darkness at this point. You will then focus on a blinking light for 15-30 seconds while the laser is gently sculpting your cornea. The flap is then re-positioned and you are allowed to relax for about 20 minutes. Dr. Melki will then do a final check of your cornea before sending you home for a much-deserved nap!
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What if I accidentally blink during the procedure?
It is not possible for patients to blink during a procedure. An instrument is used to gently hold the eyelids open. Because eye drops have already numbed the eye, the reflex that gives patients the desire to blink is lost, so keeping the eye open is painless.
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Is the procedure painful?
No. The only anesthesia needed is few eye drops and a Valium to calm your nerves. There are no injections. Following the treatment, most patients experience little or no discomfort. Your eyes may feel scratchy or watery. These symptoms are only temporary symptoms and are not a problem for most patients.
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How much time must I take off from work following the procedure?
This depends on your job. In general, LASIK patients can return to work the day after the procedure. For those jobs in which good visual acuity in both eyes is necessary (such as a pilot or professional driver), it may take several days for vision to return to an acceptable level.
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How often do I return for follow-up examinations after the procedure?
In general, very few follow up visits are necessary. The examination schedule is tailored to your specific situation.
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What kind of vision can I expect after the procedure?
Most patients achieve improved vision in the first 24 hours after the procedure and are functional without their corrective lenses at the one-day post procedure examination. Patients continue to see a gradual increase in their vision during the first week after the procedure.
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Will I need glasses or contact lenses after the procedure?
LASIK and PRK are designed to reduce your dependency on glasses and contact lenses. Patients may need glasses for reading, night driving, or other specific tasks. Most patients can do most things without glasses or contacts after the procedure.
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Can both eyes be treated at the same time?
Depending on your eyeglass prescription and other factors, you will make that decision with the input of your physician on the day of your evaluation.
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What is an enhancement?
The goal of refractive surgery (LASIK/PRK) is to provide excellent vision without glasses. Although the laser provides excellent results, up to 15-20% of patients will still need glasses or contacts after the procedure. Some of these patients will elect to have an enhancement procedure to improve their uncorrected visual acuity. Studies have shown that the chance that someone would need an enhancement is proportional to the original amount of refractive error (so someone who had 10 Diopters of myopia is more likely to need an enhancement than someone with just 2 Diopters of myopia). If an enhancement procedure occurs up to one year after the original surgery, the corneal flap will be lifted rather than creating a new flap. The risks of an enhancement are similar to the risks of the original procedure.
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How long do the results last?
Refractive surgery is usually a permanent procedure. However, PRK and LASIK will not prevent age related problems such as presbyopia or cataracts.
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What is Nearsightedness?
The normal eye is a perfect sphere, where the cornea and lens focus light to form an image on the back inside surface of the eye, known as the retina. With nearsightedness, or myopia, the cornea curvature is too steep for the shape of the eye. The light is focused in front of the retina, causing images of distant objects to appear blurry.
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What is Farsightedness?
In a farsighted, or hyperopic, eye, the image focuses beyond the retina. In our youth, the innate accommodating (focusing) power of the eyes often compensates for farsightedness. But as we age, our eyes become lass able to accommodate. For this reason, farsightedness most commonly becomes a problem later in life. Many farsighted individuals do not need correction until they reach their forties or fifties.
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What is Astigmatism?
The front of the astigmatic eye has an irregular shape, more oval, like a football. Incoming light focuses at multiple points instead of one. Astigmatism can make wearing contact lenses difficult or eve impossible. Laser vision correction with VISX Excimer laser is now FDA approved to treat astigmatism.
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What is presbyopia?
Presbyopia is the medical term for the natural aging process of your eyes. Around the age of forty, most people will begin to need reading glasses. This is a normal event. LASIK does not treat presbyopia, so you will still experience a need for reading glasses as you age.
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What is the difference between RK and Laser Vision Correction?
RK (Radial Keratotomy) is a surgical procedure where the cornea is flattened to allow light rays to properly focus on the retina. Radial cuts are made on the cornea with a diamond blade knife. With Laser Vision Correction, the cornea is reshaped using a computer-controlled Excimer laser, which is programmed for each patient's specific needs.
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What is the difference between PRK and LASIK?
In PRK, the surface epithelial cells are first removed and the laser treatment is applied. The cells regrow in about three days and vision improves. In LASIK, the epithelium is left intact and a thin flap of corneal tissue is raised using an instrument called a microkeratome. The laser treatment is then applied beneath this flap and the flap is returned to its normal position. Since the epithelium generally does not need to heal after LASIK, visual recovery is faster and, in general, there is little discomfort. In addition, the second eye can be treated sooner than with PRK. There is a small additional risk to creating the flap, however, and less long-term published data are available on LASIK treated eyes.
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Are there any risks or side effects?
There are always risks with any surgical procedure. These will be discussed at the time of your initial consultation. Please feel free to discuss this matter with Dr. Melki at any time. As with any kind of surgery, there is no guarantee of full success. In general, there are four possible side effects important to consider:
Undercorrections and overcorrections. While we aim for perfect vision, some patients may be undercorrected and others overcorrected due to differences in healing reaction. Even if you are undercorrected, your vision is usually significantly improved but not to 20/20. If overcorrected, the same is true and reading glasses may be necessary. Enhancement procedures may fine-tune your vision closer to the initial target.
The need for reading glasses. Some patients, especially those older than 40 years old, may need reading glasses after the procedure.
Halos and glare. On occasion, especially at night, a patient may experience glare from lights or "ghost" images. Measurement of your pupil size prior to the surgery is crucial to help reduce the risk of this complication.
Dry eyes. Make sure you inform Dr. Melki if you currently experience dry eye problems. Occasionally, this can be worsened after the procedure.
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How can I find out if I am a candidate and which procedure is best for me?
At your preoperative visit at Boston Eye Group, we will evaluate your situation and will discuss with you the options that are available. There is no charge for this consultation.
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What does 20/20 mean?
Visual acuity is usually measured with a Snellen chart. The Snellen chart displays letters of progressively smaller size. "Normal" vision is 20/20. This means that the test subject sees the same line of letters at 20 feet that a perfect eye sees at 20 feet. 20/40 vision means that the test subject sees at 20 feet what a perfect eye sees at 40 feet. Another way of saying this is that a person with 20/40 vision has vision that is only half as good as perfect -- or, objects must be at half the normal distance for him to see them clearly. A person with 20/20 vision is able to read letters 1/10th as large as someone with 20/200 vision. However, 20/15 vision is better than 20/20. A person with 20/15 vision can see objects at 20 feet that a person with 20/20 vision can only see at 15 feet.
Levels of Vision
- 20/20: Normal vision. Fighter pilot minimum. Required to read the stock quotes in the newspaper or numbers in the telephone book.
- 20/40: Able to pass Driver's License Test in all 50 states. Most printed material is at this level.
- 20/80: Able to read alarm clock at 10 feet. News headlines are this size.
- 20/200: Legal blindness. Able to see STOP sign letters.
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Does my health or vision insurance cover LASIK and PRK?
As a general rule, most insurance companies consider refractive surgery an elective procedure. It is worth checking with your insurance company, however, and we encourage you to do so.
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Is there financing available?
Yes. Please contact us for more information.
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