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Q: How long has LASIK been around?

A: The FDA approved the excimer laser for use in 1995. Dr. Miller performed one of the first excimer laser procedures in the Sacramento region in December 1995. He began LASIK the following year and still leads the technology in our area.

Q: How can LASIK help my vision?

A: LASIK may be able to significantly improve your vision if you are nearsighted (myopia), farsighted (hyperopia), or have astigmatism. With nearsightedness, the intent is to flatten the cornea; with farsightedness, the intent is to steepen the cornea. Astigmatism can be corrected by smoothing an irregular cornea into a regular shape.

Q: Can everyone have LASIK?

A: Most people can have LASIK, however approximately 5-15 percent of applicants do not qualify. This may be influenced by their overall medical history, the status of their eyes, the thickness of their corneas, or the degree of correction required.

Q: Am I a good candidate for LASIK?

A: The doctors and staff at Advanced Valley Eye Associates can determine your candidacy for LASIK with a simple, thorough eye exam. To have LASIK, you must be at least 18 years of age, not pregnant, have no significant changes in prescription for the last year, and have a eye prescription in a range that can be corrected.

Q: Can I have LASIK if I’ve had RK (Radial Keratotomy)?

A: Yes, however you will need to go through a thorough evaluation first to be sure. With RK, cuts have been made around the cornea to change the shape. Over many years, many of the patients treated with RK have become more farsighted. This farsightedness can often be treated with Advanced Surface Treatment using Photorefractive Keratectomy (PRK) or LASIK.

Q: What other options besides LASIK and PRK are there for correcting nearsightedness?

A: Radial keratotomy, PRK, LASIK, implantable corneal rings, intra-ocular lenses, phakic intraocular lenses, and clear lens extractions are all options. All have their pros and cons, but the majority of patients in the U.S. are choosing LASIK as the best way to reduce their need for corrective lenses.

Q: What is the difference between LASIK and PRK?

A: PRK uses the excimer laser to reshape the surface of the cornea. With LASIK, a corneal flap is first created, allowing the excimer laser to work deeper in the cornea and providing a protective cover immediately after the surgery. Recovery is much faster with LASIK, which is one of the reasons it has become the treatment of choice over the past decade.

Q: What if I have astigmatism?

A: The excimer laser is approved by the F.D.A. to treat astigmatism as well.

Q: Can both eyes be done the same day?

A: Yes, typically both eyes are treated at the same time.

Q: Is LASIK safe?

A: Almost a million LASIK procedures are performed in the United States each year. While all surgeries involve some risk, LASIK is less risky than most. It is a highly technical process using a computer-controlled laser, but still under the guidance of a seasoned refractive surgeon. Talk to Dr. Miller about your worries. Information can help you feel comfortable about your choice.

Q: Will I need to remove my contacts before my exam?

A: If you wear contact lenses, you will need to leave them out for a certain amount of time period prior to your LASIK candidacy exam. Wearing contact lenses can change the curvature of your cornea. Removing your contacts for a period of time allows the cornea to return to its natural shape. This is important for proper measurements to be made, prior to scheduling your procedure. In general, we would like to evaluate you after you've had no "hard" contacts in the eye for at least a month, and no "soft" contacts for at least a week. Please discuss this with our coordinator when you call.

Q: How long does the LASIK procedure take?

A: LASIK takes approximately ten minutes. The actual laser time is normally less than a minute! Of course, plan on about 1-2 hours with us on your surgery day. There are preparations, drops, and a "little relaxing pill" that makes things go a bit smoother!

Q: Are people scared going into the procedure?

A: A little apprehension is to be expected, and a sedative will be available to help you relax since you will be awake during the entire procedure. Most patients actually say that they found the experience to be enjoyable, and confirm that with Dr. Miller's comforting voice, they felt confident as the procedure was performed.

Q: Is there any pain involved with LASIK?

A: A majority of patients report that they experienced no pain. You will receive a sedative before surgery to keep you relaxed, and topical anesthetic eye drops to numb your eyes just prior to the laser treatment. You will feel sensations, but most patients report no actual "pain". There may be slight pressure as the flap is being made and as the eyelids are opened by the lid protector.

Q: Will I feel any pain following surgery?

A: Afterwards, some patients report mild sensations of watery, gritty or scratchy eyes. These are temporary symptoms and not a problem for most patients. Pain medications are rarely prescribed. Dr. Miller wants to know if his patients are having problems, and we welcome you to call us if you have questions during your recovery.

Q: What if I sneeze or move suddenly during surgery?

A: If you sneeze or move, the advanced "eye tracker" will immediately stop the laser. After the eye is repositioned, the laser will restart and continue with the surgery. The software keeps track of how much treatment has been done, and can pick up where it left off!

Q: What keeps my eyes from closing and from drying out during the procedure?

A: During the procedure, a device will be used to gently hold your eyelids open, comfortably keeping your eye exposed. With anesthesia drops, this is not as much of a problem as you might expect. Of course, your eye will be kept irrigated, so it won't dry out.

Q: When will I be able to see well?

A: Most people experience some better vision immediately following the procedure. However, for a few hours it may appear as though you are looking through some fog. This clears up soon, and even by the next day approximately 80% of patients see 20/20 or better. Nearly all patients have 20/40 or better vision, which is the level required to drive without corrective lenses. This is reinforced by the fact that many of our patients drive themselves to their first day appointment!

Q: How much time do I need to be off work?

A: If your work is not too taxing then you may go back to your job on the first postoperative day. We usually schedule our LASIK days on Friday, so that you'll have the weekend to recover. It is essential that you avoid direct contact with your eyes (rubbing or touching) for several days to allow the outer surface of the cornea to heal. We recommend taking it easy for 2-3 days. We will make a recommendation for your recovery based on your individual vision needs and work environment. Photorefractive Keratectomy (PRK) requires 3-5 days of recovery to be comfortable, and then there is a gradual improvement in vision over the next 2-3 weeks.

Q: When does my new vision become permanent?

A: Vision is typically dramatically improved within the first 24 hours after LASIK. For the first couple of weeks, it is normal for vision to fluctuate some each day. Usually, it takes 2-4 weeks for your vision to stabilize completely. LASIK is permanent once healing is complete. This is one of the reasons why laser eye surgery is so popular. Naturally, like the rest of our body, our eyes can change with aging, and no surgery can prevent underlying changes such as cataracts, AMD, or presbyopia. When new circumstances arise, it's sometimes possible to perform a LASIK enhancement to minimize a new refractive error.

Q: Can my vision results be guaranteed?

A: As in any medical procedure, there can be no absolute guarantee of results. Even though LASIK is very precise, variations in outcomes occur due to other unknown factors.

Q: Will I need glasses or contacts after LASIK?

A: A FDA clinical trial following LASIK demonstrated that 100% of participants could pass a driving test, and over 90% of participants could see 20/20 or better! At Advanced Valley Eye Associates, the vast majority of our patients have excellent vision after LASIK surgery. Still, some people find that “fine tuning” glasses are helpful for certain “visually critical” tasks such as night driving. Dr. Miller will work with you to determine your needs, and we’ll do our best to make you a happy patient!

Q: Will I experience glare or halos at night?

A: The small number of patients who experience halos or glare at night generally improve after one month and the problems typically resolve by three months. The biggest cause of "glare" is a small degree of residual glasses prescription. Most patients are not bothered by this, but some find that wearing a pair of mild "night driving" glasses can help a great deal. This is unusual, but can be very effective in reassuring patients that they have NOT had a "complication". We want our patients to fee great about their vision results!

Q: Does insurance cover LASIK?

A: In general, refractive surgery is not covered by medical insurance plans. Occasionally, a plan will offer partial coverage, but this is usually limited to that plan’s “preferred surgeons”; (who often have higher fees to begin with). Often, the final price ends up costing the patient as much or more than our usual fee.    Of course, some people may be able to use their medical savings accounts (MSA's or HSA's) through their employer. Please discuss any special circumstances with us, and we’ll be happy to help!

Q: Does Advanced Valley Eye Associates offer financing?

A: We believe that financial issues should not be the main obstacle to having LASIK. Knowing that everyone has different needs, we provide several flexible payment options. We work with financing companies who can offer financing alternatives (some with deferred interest) for our patients. Cash, personal checks, and credit cards are also accepted.

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