LASIK LASER VISION CORRECTION

Laser In-Situ Keratomileusis (LASIK). The doctor uses a microkeratome to create a corneal flap. The cool laser beam then gently reshapes the cornea, and the flap is closed. LASIK is an extremely effective outpatient procedure that is suitable for higher prescriptions. It can be used to correct even the most severe 1% of prescriptions, and has generated significant excitement in the eye care community around the world.

LASIK dramatically reduces your recovery time (versus PRK) and decreases the chance of many of the procedural risks (compared to ALK). The procedure itself takes only a few minutes to complete and involves minimal discomfort. LASIK requires more technical skill and training than other laser procedures. Dr. Lehmann has performed thousands of LASIK procedures with impressive results.

With both PRK and LASIK, the greater your prescription, the longer your procedure takes. Even the most sever prescriptions require only about one minute of laser time and utilize only a topical anesthetic in the form of eye drops.

Although no procedure is perfect, excimer laser technology allows for an unparalleled degree of precision and predictability. This makes Laser Vision Correction, in our opinion, the best procedure available for suitable candidates. Each pulse of the laser can remove 39 millionths of an inch of tissue in 12 billionths of a second. This enables doctors to achieve remarkable accuracy while maintaining excellent control throughout the procedure.

While we can never promise patients "perfect" or 20/20 vision, most laser patients do achieve 20/20 vision. In fact, 98% of our typical nearsighted patients achieve vision within two or three lines of 20/20 vision on the eye chart after one or more procedures. This means that they can drive legally, play sports, join the police or the fire departments, all without depending on glasses or contact lenses. With these remarkable results and an exceptional safety record, Laser Vision Correction is the procedure of choice for most suitable candidates.

The success of your laser procedure is dependent not only on the expertise of your doctors, but also on the safety, accuracy, and sophistication of the equipment used. Our primary objective is to provide you with the most advanced technology available to achieve the best results in the safest way. Automated equipment is used to test your vision, measure the degree of your visual problem, and create a map of the surface of your eye. Over 6,000 separate points on the eye are measured. The information from your eye exam is used to program the state-of-the-art computer software which calculates the required corneal change and then helps the laser make this change. Dr. Lehmann programs and operates the laser, maintaining control throughout your procedure.

What is a refractive error?

A refractive error is a defect in the way light passes through the eye. In normal vision, light enters the eye through the cornea and is focused at a single point on the retina at the back of the eye. With a refractive error, light rays do not refract (bend) properly to achieve a single focus point. Instead, light rays focus in front of the retina, behind the retina, or at two different points. Refractive errors usually result from a defect in the length of the eye or shape of the cornea.

What is astigmatism?

Astigmatism, a condition in which objects at all distances appear somewhat indistinct and distorted rather than sharp and clear, is caused by a misshaped cornea. Because the curve of the cornea is uneven or warped instead of an even curve, the light rays are not refracted equally in all directions. As a result, a single focus point on the retina is not achieved and distorted vision occurs.

What is myopia?

Myopia is a condition in which close objects are seen clearly but distant objects appear blurred. Nearsightedness results from a lengthened eyeball (which is more oval than round) or a cornea which is curved too steeply. The increased length of the eye or the steep curve of the cornea causes the light rays to be focused in front of the retina.

By now, you may be wondering what it might be like to experience Laser Vision Correction. If you decide to proceed with Laser Vision Correction, you will go through three distinct steps:

• The Pre-Procedure Consultation
• The Laser Procedure
• Post-Procedure Care

Before you proceed with Laser Vision Correction, we suggest you have a pre-procedure consultation with your eye doctor. If you schedule a consultation, there is no obligation to move forward with the procedure.
The primary objective of the consultation is to determine whether you are a candidate for Laser Vision Correction, and if so, which procedure would be most appropriate for you.

In general, to be a candidate for Laser Vision Correction, you should:

• be at least 18 years of age or older
• have stable vision for a year prior to the procedure
• be free of certain diseases of the cornea and retina
• be in good general health

The secondary objective of the consultation is to educate you regarding all aspects of Laser Vision Correction.

Learning everything you can about your options is the key to making an informed decision. The consultation process will help you to understand what you can reasonably expect from the procedure.

Monovision

If you are a nearsighted laser candidate, then monovision may be for you. Monovision is a technique in which the doctor fully treats one of your eyes, usually your dominant eye, for distance vision. The doctor then under corrects your non-dominant eye, or does not treat it at all (depending on your initial prescription). This leaves the eye slightly myopic for improved reading vision. Monovision lets you maintain your reading vision in one eye, which may help you to avoid reading glasses once you develop presbyopia. As always, you must give up a little distance sharpness to gain this near vision.

During your consultation you can discuss this option with your eye doctor and, together, you can decide what the best choice is for you.

The Laser Procedure

On the day of your procedure, you should arrive at the center as rested and relaxed as possible, and should allot approximately two hours for the entire process. You will first go though a complete preparation process. After this, you will enter the Laser Suite for treatment, which will last only a few minutes.

Things to Note Before Your Procedure

• The most natural response prior to your procedure is a mixture of both eager anticipation and nervousness. Most laser patients describe similar feelings to this before their procedure, so be reassured this is extremely normal. In fact, some patients are even more nervous with their second eye, for fear that it will not work out as well as their first eye did.
• There are no restrictions on eating, drinking or medications before the procedure. However, you should avoid alcohol and medications that may produce drowsiness.
• Wear comfortable clothing to the center on the day of your procedure.
• You cannot wear eye makeup on the day of your procedure.
• You should remove soft contact lenses at least 2 weeks prior to your examination as well as procedure.
• You should remove hard or gas permeable lenses for one month per decade of wear!
• You will need to bring a driver with you on the day of your procedure, as you cannot drive immediately afterward.
• Plan to allow yourself at least three days to rest following your procedure.

The Day of Your Procedure

On the day of your procedure, if you have not previously completed all your testing and preparation, your typical experience would begin with:

• having a number of routine eye tests performed
• signing a consent form
• arranging payment for your procedure
• meeting with your doctor to discuss any remaining questions or concerns

You will then be cared for by our clinical staff in the patient preparation area.

• Anesthetic drops will be placed in your eyes in order to numb them.
• Typically, no sedation will be given to you prior to PRK unless it is absolutely necessary. Being a little nervous is perfectly normal and helps you to stay alert and react better to the instructions. Sedation can actually make fixating on the target light more difficult.
• If you are having LASIK, you may receive sedation prior to the procedure.
• When you are ready, you will be taken to the Laser Suite.

During PRK

• The typical PRK procedure takes less than five minutes. Each step will be explained to you by the doctor as it is performed.
• An eyelid holder will be placed in your eye to prevent you from blinking. You will feel a little pressure, but no discomfort, as the anesthetic drops will have taken effect.
• The doctor will then treat your eye to remove the surface layer, either using the laser or a manual instrument. Both methods are painless. The surface layer is naturally replaced by your body within three days.
• You will be asked to stare at the red target light.
• The laser will make a clicking sound as it works.
• Most PRK procedures take less than 30 seconds of actual laser time.
• It is not uncommon for patients to move their eyes during the procedure. A little movement does not cause any undue risk or danger to your eye, but you should try to remain as steady as possible.
• The laser can be stopped and started precisely within a fraction of a second. The doctor maintains control through the procedure.
  

During LASIK

• The typical LASIK procedure takes five to ten minutes. Each step will be explained to you by the doctor as it is performed.
• An eyelid holder and a ring will be placed on your eye to keep it steady and prevent you from blinking. You will feel a little pressure but no discomfort as the anesthetic drops will have taken effect.
• You will not see anything or feel any discomfort during the creation of the corneal flap.
• The laser will then be applied to the cornea beneath the flap.
• The flap will be closed and your eye will be left to settle for a few minutes.
• Your eye creates a natural vacuum to keep the flap shut until the protective layer of the eye grows to keep it together, within 24 hours.
  

LASIK is based on procedures which have been performed for over 30 years with highly effective results. LASIK is a combination of a proven manual technique with state-of-the-art technology. It is considered by many leading eye care professionals throughout the world to be the best procedure available for correcting moderate to severe prescriptions.

Post-Procedure Care

• Once your procedure is complete you will be able to go home almost immediately to rest.
• Additional drops will be placed in your eyes and medication may be given to you to use over the next few days.
• If you had PRK, a bandage contact lens will typically be placed in your eye. It is a very thin, clear lens which along with the eye drops used dramatically reduces any discomfort you may feel following the procedure. Even if you have never used contact lenses before, do not be concerned, as our staff will insert and remove the lens for you.
• If you have LASIK, you will not receive a contact lens, but rather an eye shield that will be placed over your eye for the first 24 hours. You should use the shield nightly for the first week to protect your eye while you are sleeping.
  

You will typically notice dramatic visual results within the first few days following the procedure. By the end of the third day, you will usually be able to resume all of your regular activities.

It is important for you to remember the following during this period:

• We recommend that you rest as much as possible following your procedure as sleep helps to speed up your recovery tremendously. You may find that placing a cold compress over your eyes while resting is very comfortable and soothing.
• You should avoid swimming, hot tubs, or whirlpools for one week.
• Showers and baths are fine, but try to keep your eyes closed in the shower and avoid getting water and shampoo in your eyes for the first few days.
• We recommend you avoid eye makeup, gardening and dusty, dirty environments for one week.
• Smoking is allowed, but you may find that smoke will be quite irritating.
• Watching TV and reading will strain and irritate your eyes for a few days. These activities should be done in moderation.
  

If you are planning to have both your eyes treated at the same time, we recommend you rest for one week following your procedure.
If you follow these guidelines, your post-procedure recovery should be smooth and trouble-free, and you should expect to enjoy improved vision shortly following your procedure.

It is important for you to understand that follow-up care is as important to your results as the actual procedure.

When you leave, you will be given complete instructions to follow for your post-procedure regimen, including a list of eye drops and possibly, some oral medication to take. You will also be given your recommended post-procedure appointment schedule to follow.

Unrealistic Expectations

One of the more important difficulties you can experience with this procedure is unrealistic expectations. Many RK or laser advertisements you hear on the radio or see in the newspaper "promise" that you can "throw away your glasses." These ads are misleading. While it is true that almost all patients who have Laser Vision Correction will significantly reduce their dependence on glasses or contact lenses, most patients will eventually require reading glasses and some may require a thin pair of glasses for critical distance activities, such as night driving.

It is best for you not to think of the procedure as eliminating your need for glasses, but rather, as reducing your functional dependence upon them and improving your vision.

Long Term Stability

People often ask how long the benefits of their procedure will last. Laser Vision Correction has been prevalent in many countries around the world since the late 1980s. Many clinical studies have looked at the long-term effects of the excimer laser on the cornea. All these studies, without exception, have failed to demonstrate any long term negative effects of the laser on the eye's integrity or strength. In fact, the first sighted (patient's) eye ever treated with Laser Vision Correction (which was in the U.S. in 1987), achieved 20/20 vision following treatment and is still 20/20 nine years later.

Doctors have performed thousands of laser procedures since early 1991. A high proportion of our patients achieved 20/20 vision following the procedure, and today, they are still 20/20 with no difficulties. In general, patients who require an enhancement procedure or develop a problem will do so within the first few months following the procedure, not years later.

Prevention is the best medicine

Regular eye examinations are an important part of total eye care. Eye exams are necessary not only to measure vision and determine if any correction is necessary but also to monitor the health of the eye. With early detection and treatment, vision loss from many eye diseases can be prevented.