LASIK (or “Laser Assisted In Situ Keratomileusis”), is one of the safest and most effective vision correction procedures. The first LASIK cases were performed in the US in 1989 and now an average of 700,000 cases are performed annually. LASIK eye surgery is an outpatient refractive procedure that is used to treat nearsightedness, farsightedness, astigmatism, and presbyopia.
During laser eye surgery, a laser is used to reshape the cornea, which is the transparent layer on the front of the eye that covers the iris and pupil. The shape of the cornea determines whether you are nearsighted (myopic), farsighted (hyperopic), or have astigmatism. During LASIK eye surgery, San Diego ophthalmologist Dr. Tracy uses a laser to re-shape the cornea and improve the way the eye focuses light rays onto the retina in the back of the eye.
LASIK is a two-step process. The first step involves creating a thin round corneal flap. This can be done either with a laser (Intralase femtosecond laser) or with a blade (microkeratome). The laser or blade creates a flap on the cornea, which is lifted to reveal the corneal tissue underneath. The second step involves using another laser (Excimer laser) to reshape the cornea.
Often, LASIK that utilizes the microkeratome for the first step is referred to as “conventional” or traditional LASIK, because initially this was the only option to access the deeper layers of the cornea. However, today most surgeons use the Intralase laser to create the corneal flap. When both steps are performed by lasers, this is often called “blade free LASIK” or Intra-LASIK.
Since everyone’s eyes are different and unique, San Diego ophthalmologist Dr. Tracy will map your eyes carefully during your LASIK consultation. If appropriate for your treatment, a Wavescan machine will map your cornea before the procedure, to determine your custom treatment.
During the actual LASIK surgery, San Diego ophthalmologist Dr. Tracy creates a thin circular flap in the cornea using the Intralase laser. He then lifts the flap and uses the VISX Excimer laser to reshape the exposed corneal tissue based on your prescription and a custom map of your eye. Dr. Tracy then replaces the flap to its original position. The flap and the epithelium are allowed to heal naturally, which can take 1-3 days. Over subsequent weeks, the vision stabilizes as the cornea heals. This can take a few weeks to a few months, depending on how large your treatment was and your individual healing rate.
Dr. Tracy uses only the Intra-LASIK method, which is a blade-free, all-laser procedure. Dr. Tracy has performed thousands of Intra-LASIK procedures and can help you decide on the best choice for your needs and lifestyle.
Candidates For LASIK
While LASIK is extremely common, it’s not the best option for everyone. Here is a checklist of ten requirements you should meet to be considered for LASIK surgery.
1) You should be 21 years of age or more.
The best LASIK candidates are at least 21 years of age since your eyes need time to mature.
2) You need to have stable vision.
You must have had the same prescription for at least a year.
3) Free of eye infections or injuries.
Any types of diseases of the eyes such as herpes, corneal diseases, or retinal diseases may cause additional risks. Dry eyes should also be brought to the doctor’s attention.
4) You must be free of autoimmune disorders.
Many disorders like Lupus, Rheumatoid Arthritis, and Multiple Sclerosis can prevent healing.
5) Be aware of any interfering medications.
Some steroids or immunosuppressants may cause a delay in healing after LASIK surgery. Others can promote dry eye syndrome. Any current or past medications should be brought to the doctor’s attention before the procedure.
6) Your corneas cannot be scarred or abnormal.
The reshaping of the cornea involved in LASIK may be affected if your cornea is abnormal or scarred. There are many possible causes for scarred or abnormal corneas, including past disease or trauma.
7) You should not be pregnant or nursing.
Often hormonal changes in pregnant and nursing women can affect stability in their prescription. Discuss with your surgeon if you are considering pregnancy.
8) A patient’s pupils must be of appropriate size.
Patients with larger pupils sometimes experience a glow or halo effect. They may still be candidates for PRK (Photorefractive Keratectomy).
9) A good candidate needs to have sufficient corneal thickness.
LASIK requires a minimum corneal thickness, depending on how much treatment you need. If the cornea is too thin, you may still be a candidate for PRK.
10) A candidate cannot have severe refractive errors.
LASIK surgery cannot correct every refractive error. Patients with severe refractive errors should consider other procedures such as implants. Your doctor will inform you of the best option.
How much does LASIK Eye Surgery cost?
LASIK eye surgery cost can vary based on the technology and equipment used, surgeon experience, and geographic area. It can typically cost between $2,000 and $4,000 per eye. Be careful of some of the lower fees advertised, as they may be bait-and-switch techniques, involving unreasonable conditions and restrictions, or the laser center may be using older, outdated technologies such as the microkeratome blade.
San Diego Ophthalmologist Dr. Tracy utilizes the most advanced technologies and equipment, performing blade-free, all-laser LASIK surgery. We charge one flat fee for your LASIK procedure, which includes all pre-operative evaluations, special testing, and post-operative care. At Carlsbad Eye Care, Dr. Tracy performs all pre- and post-op care himself, including the free initial consultation. We offer no-interest Credit Care financing and payment plans to help make the cost of your LASIK procedure affordable. This will allow you to make small monthly payments over a period of time in accordance with your budget.
The LASIK Lasers
San diego ophthalmologist and surgeon Michael Tracy, MD uses the Intralase Femtosecond Laser and the VISX Excimer Laser to perform all-laser Intra-LASIK surgery.
Intralase Femtosecond Laser
This laser is used to create the corneal flap, which is the first step of the LASIK procedure. It has better biomechanical stability, precision, and refractive outcomes than a traditional microkeratome blade. The Intralase FS Laser allows Dr. Tracy to precisely control corneal flap dimensions and structure.
The two most important factors that come along with the Intralase Femtosecond Laser are safety and accuracy. By replacing the traditional blade with a laser, the Intralase dramatically reduces the potential risk of flap complication. Because of the precision of the computer-guided beam the accuracy of this type of laser exceeds other methods.
VISX Excimer Laser
This laser allows Dr. Tracy to tailor each treatment to the characteristics of the individual’s eyes. Cutting-edge WaveScan technology provides a detailed map of the eye and creates a unique set of treatment instructions for the laser, providing a high level of precision and accuracy. Wavefront technology has the ability to improve how well you can see in terms of fine detail.
The surface of each person’s eye, the cornea, is like a fingerprint – everyone has a unique map. The VISX WaveScan reads this map and customizes your procedure based on your personal corneal map. No two treatments are exactly alike.
What To Expect
You are required to stop wearing contact lenses prior to the surgery, for a minimum of two to six weeks, as instructed by the doctor. You need to arrange for a driver to accompany you to your procedure, as you won’t be able to drive yourself afterward, because you will be given a muscle relaxer to calm you during the procedure and you will wear eye shields over your eyes. Wear loose, comfortable clothing, and refrain from wearing any perfume or make-up. A responsible adult must accompany you on the day of surgery.
You will not be allowed to drive on the day of your surgery, so you must arrange for someone to drive you home after the procedure. During the first few days after having LASIK, you may feel some eye irritation and tearing. The white part of your eye may be red for a few days. Your eyes may also be sensitive to light. You will need to wear a shield over your eye for the first few nights or when sleeping, and you must avoid rubbing your eyes for several months. You must use the prescription eye drops given to prevent infection, and keep your scheduled follow-up appointments to ensure that your eyes are healing properly. Typically, most patients see 20/20 within a few days after the procedure.
Carlsbad LASIK FAQs
Q: Is LASIK permanent?
A: The laser permanently changes the shape of your cornea. However, your eyes may undergo natural changes in shape as you grow older, or your vision may regress. Although for most people, the procedure results in long-lasting vision correction, some may experience slight changes in vision and may wish to undergo an “enhancement” procedure to correct these changes. Less than 10% of patients ever need enhancements after having undergone LASIK eye surgery.
Q: How long will it take my eyes to heal from LASIK surgery?
A: Most people will experience significant visual improvement in 2-4 days. A complete LASIK recovery may take six months. During this period, you should avoid high-impact activities so that your eyes can heal. Contact sports run the risk of dislodging the flap created during LASIK, should you get hit in the eye.
Q: Will I still need reading glasses after having LASIK surgery?
A: Everyone needs reading glasses at some point, as the ability of the eyes to focus on objects up close decreases as we age (a condition called presbyopia, which usually occurs after age 40). Depending on your age, you may need to wear reading glasses after having LASIK surgery. An alternative for people with presbyopia is to have monovision LASIK, which may lessen or eliminate the need for reading glasses.
Monovision is where one eye is corrected for distance and the other eye is corrected for reading. Your brain adjusts and focuses on the eye needed depending on your activity. Typically, we will try this method first with glasses or contact lenses to see if you would be comfortable with it. Most patients either love it or hate it, so it is imperative to try it out before undergoing a monovision LASIK treatment. Consult Dr. Tracy to see if this is a good option for you.
Q: How long does the LASIK surgery procedure take?
A: The entire procedure takes about 20 minutes, approximately 10 minutes per eye. However, expect to be at the facility for 1-2 hours for pre-op testing, for the muscle relaxer to take effect, for the post-op exam, etc.
Q; Will I be awake during the procedure?
A: Yes, but you will be given medication to relax. Also, your eyes will be numbed with drops.
Q: Do I have to have one eye treated at a time?
A: No. Typically both eyes are treated during the same visit; however you can treat one eye at a time if this makes you more comfortable.
Q: Can I resume normal activities after LASIK?
A: You can resume your normal daily activities after a day or two, but strenuous activities and swimming should be avoided for a few weeks. For contact sports, you should wear goggles for a period of at least 3 months to ensure that your eyes do not get hit and risk dislodging the corneal flap.
Q: Can I have LASIK if I have astigmatism?
A: Yes, astigmatism is routinely corrected through LASIK. More than 60% of patients who undergo LASIK eye surgery have some astigmatism.
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