LASIK (Laser In-Situ Keratomileusis)

The doctors and staff are still very pleased with the LASIK performed on them over 20 years ago. "For anyone who has struggled with poor vision for a long time, it is a life-changing experience. Because of our own personal experience with LASIK, we feel we can do a better job in advising our patients regarding LASIK surgery." We provide essential pre and postoperative care and have partnered with only surgeons that have consistently excellent outcomes. This partnership has enabled almost everyone to have 20/20 vision, as we have no financial interest in the laser and are therefore not pressured to try to "sell" the procedure. Most unsatisfactory LASIK results are from perfroming the procedure on poor candidates, from those having dry eyes, a thin cornea, or a myriad of systemic conditions. Our extensive testing will determine if this elective procedure is safe for your eyes.
Nearsightedness (myopia) and astigmatism are the ideal refractive eye disorders that can be corrected with LASIK or PRK (Photo Refractive Keratectomy). Farsightedness (Hyperopia) can be corrected, but the outcomes are not as favorable.

What Is The LASIK Procedure Like?

Today's LASIK is a painless, totally bladeless, outpatient procedure that takes less than 15 minutes to perform. All the data from the pre-operative examination is entered into the computer. The procedure begins with the surgeon using the Intralase laser to create a corneal flap. The flap is then lifted and the surgeon applies the Excimer laser between 5 to 40 seconds to reshape the cornea. The length of time the laser is applied is determined by the patient's prescription. Prior to the addition of the Intralase laser, a sharp blade (microkeratome) was used to create the flap. This additional laser has made LASIK even safer and more accurate. The flap is thinner and more consistent in thickness, providing a much better outcome. Be cautious of Laser Centers that quote a low prices as they may still be using a microkeratome. Surgical skill is still the key component in the creation and repositioning of the corneal flap. Because the surface layer (epithelium) of the cornea is preserved, there is very little discomfort following LASIK surgery.

A second, different (Intralase) laser is used to create the flap, and has eliminated most complications caused by the older microkeratome technology.

WHAT ARE THE ADVANTAGES OF LASIK?

• A quick, painless outpatient surgery

• Less chance of infection

• Rapid recovery, usually 1-2 days

• Clear vision without corrective lenses, usually in a couple of days and sometimes within 24 hours

• Greatly reduced chance of error due to the precision of computer-assisted lasers

• Less chance of hazing

• A thinner, more precise flap obtained with the development of Intralase laser

WHAT ARE THE RISKS OF LASIK?

1. NIGHT GLARE

This is usually from having larger pupils or those that have a high pre-lasik prescription.

2. DRY EYES

The corneal nerves are cut when creating the flap. This decreases the blink rate which can cause temporary dry eyes. This is managed by instillation of preservative free artificial tears several times a day. The dry eye dissipates in a few months after the corneal nerves regenerate.

3. ECTASIA
This is post operative thinning and distortion of the cornea. This can develop years after the surgery. It occurs if LASIK is done on a diseased cornea or a cornea that is too thin, ie a poor candidate.

All the risks above can be avoided if identified during the pre-LASIK evaluation. These risks are also minimized with new upgraded Excimer Laser programs and the use of the Intralase laser to create the flap. It is vital to get a thorough pre-op evaluation to determine if you are a good candidate. We have a high success rate (almost 100%) because we advise many (as much as 20%) patients against having LASIK for various reasons sited below.

LASIK CONTRAINDACATIONS

• Thin Cornea
• High glasses prescription
• Dry Eye
• Keloid (scarring) history
• Large Pupils
• Keratoconus
• Irregular Astigmatism
• Corneal scarring
• Pregnant / Nursing
• Auto immune diseases
• Thin Cornea

CONTACT LENS PROTOCOL:

If you wear contact lenses, there are certain criteria that need to be met prior to LASIK to ensure the best outcome.

Rigid Gas Permeable Contact Lenses (RGP)
Wearing RGP's must be discontinued so the cornea can stabilize. RGP's act like braces on your teeth. Following the removal of braces, the teeth shift, as does the cornea after removal of the RGP's. LASIK can not, and should not be performed until it is certain that the eyes are stable.

Soft Lenses (including Disposables)
These lenses need to be off the eye for 72 hours prior to surgery.

Photorefractive Keratometry (PRK)

PRK is a painless, 20-minute outpatient procedure and is done if it is determined that the CORNEA IS TOO THIN for LASIK. Instead of creating a flap, the laser surgeon gains more treatment area by gently removing the top layer (epithelium) from the eye. The laser procedure is then performed to reshape your cornea just as if you were having LASIK. A bandage contact lens is placed on the eye for 3-5 days. Vision will be blurred until this top layer regenerates. Eyedrops will be used to minimize any foreign body sensation.

OUR CONSULTATION

In our consultation and examination, we go to great lengths to ensure you are a good candidate, and that you understand the entire LASIK procedure from start to finish. If needed, we can place contact lenses on your eye to demonstrate how your reading and distance vision will be the following the procedure. LASIK does not correct for reading vision on those patients over 40. Some decide against having surgery since they would still need to wear glasses for reading. When that happens, we feel we have done our job. At Skowron Eyecare, we will take the extra time and effort to make sure you fully understand and will be happy with your LASIK outcome.

During our pre and post-operative care, we will:

• Confirm that you are a good LASIK candidate
• Assess the thickness of your cornea.
• To ensure that there are no contraindications that would impact the LASIK results.
• Make certain that you have adequate tears to support the procedure.
• Allow you to see and experience what your post LASIK vision will be (with contact lenses)
• Provide the surgeon with your eye history, clinical findings, and precise target prescription.
• Provide your post-procedure follow-up care to ensure desired vision and proper healing
• Any needed communication with the LASIK surgeon
• Monitor the health of your eyes at your annual comprehensive eye exam

What Happens On The Day Of My Procedure?

It's natural to feel a mixture of eager anticipation and nervousness before your procedure. On the day of your procedure, you should arrive at the Laser Center as rested and relaxed as possible. Please allow approximately two to four hours for the entire process.

• Wear comfortable clothing.
• DO NOT wear eye makeup, perfume, or hairspray.
• DO NOT wear any jewelry or earrings.
• Bring someone to drive you home, or make other arrangements for transportation.
  
  

The success of your laser procedure depends on our accuracy, the skill of the laser surgeon, and also the safety, accuracy, and sophistication of the equipment. Our goal is to provide you with the most advanced technology, with greatest degree of safety to generate the best results. Automated, state-of-the-art equipment is used to test your vision, measure, and map your cornea health by taking readings over 1,000 separate points, creating a 3D topographical survey of the shape of your eye.

Immediately prior to your procedure, your eyelids and lashes will be cleaned. Antibiotic, anti-inflammatory, and anesthetic drops will be placed in your eyes. A mild sedative may be given.

​​​​​​​You will enter the laser room and lie down on a reclining chair below a microscope that is part of the laser. Your eyelids and lashes will be cleaned. Antibiotic, anti-inflammatory, and anesthetic drops will be placed in your eyes ensuring a painless procedure. A mild sedative may be given. The information from your exam is entered into laser's software, determining the amount time needed to reshape the eye to get a 20/20 result. It could take as little as 5 to as long as 40 seconds to properly reshape your eye. ​​​​​​​The surgeon then programs the laser, and will maintain control throughout your entire procedure. An eyelid holder will be placed between your eyelids to prevent you from blinking. Your other eye not being operated on will be covered. You will be asked to stare at a light. You may feel slight pressure but no discomfort during the creation of the flap. As a perfectly normal part of this procedure. YOUR VISION WILL BLACKOUT FOR A FEW SECONDS during this flap formation. After the laser creates the flap, you will be able to see the fixation light again. Your surgeon will ask you to look directly a “fixation” light while the procedure is performed. The new software has a tracking feature that will shut off the laser if you look away. The surgeon lifts back the corneal flap. The doctor then uses his/her skill to reposition the flap and ensure that it is tightly secured without folds or wrinkles. At this point, then the other eye is prepped and goes through the same procedure. You will be given eyedrops with instructions and a pair of goggles to wear during sleep for about a week to protect against injuring the flap from eye rubbing. You will be instructed to see us in 1-3 days.

Recovery

Most patients notice dramatic visual results after the first day following their LASIK procedure. However, the speed of visual recovery depends on the personal healing patterns of each individual patient. Immediately after the surgery, your vision will still be somewhat blurred and smoky, almost like wearing very dirty contact lenses. Taking a nap shortly after your procedure is suggested. LASIK patients usually see quite well the next day, but patients with higher prescriptions may recover more slowly.

Will My Activities Be Restricted?

Many patients can return to work the next day, others a few days later. You will need to restrict the activities mentioned below. Otherwise, as long as you follow your doctor's instructions, you should be free to resume all your normal activities.
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• Wait one full day before taking a shower, and then be careful not to get soap or water in the eye.
• Resume driving usually after one day, as your doctor advises.
• Wear sunglasses for the first few days to keep debris from hitting your eye.
• Do not wear eye makeup for one week.
• Do not rub your eyes for up to 6 months. You can gently rub them after one month.
• Eliminate heavy exercise for one week (we don't want any perspiration getting in the eye).
• Avoid swimming and hot tubs for one month. When swimming, don't open your eyes under water. If swimming for exercise, wear goggles.
• Avoid gardening and dusty environments for one week.
• Avoid contact sports that could result in an eye injury for one month.
  
  

LASIK CAN GIVE A FALSE SENSE OF SECURITY BECAUSE YOU FEEL FINE AND SEE FINE, BUT THE FLAP IS STILL VERY FRAGILE DURING THE FIRST MONTH AND CAN BE DISRUPTED. SO BE CAREFUL!!!! ERROR ON THE SIDE OF CAUTION. YOU COULD PERMANENTLY REVERSE ANY GREAT RESULTS BY BEING CARELESS!

Will My Vision Be Corrected Forever?

YES. However, LASIK does not guarantee your vision will remain the same forever. Your eye can still change. As long as that does not occur, the 20/20 LASIK results will remain indefinitely. We have thousands of patients that have had LASIK over 20 years ago and are still seeing 20/20. In addition, clinical studies have shown NO long-term effects of LASIK. Following an initial healing period of two to three months, the effect of the treatment is lifelong. It is uncommon, but if a regression of nearsightedness occurs, it usually happens within the first 90 days of healing, which can be fully corrected with a second enhancement procedure.