LASIK Q&A

	Question: Conventional or Wavefront treatment ? Which is suitable for me ? Answer: As a general rule, the quality of vision with wavefront is superior to conventional laser surgery, but that does not mean that wavefront-guided treatment is best for everybody. Individual circumstances will vary. Wavefront is actually used in two separate steps. The first is a wavefront evaluation and diagnosis of existing aberrations. The second is using what is learned from the diagnosis to create a wavefront-guided ablation for Lasik, PRK, or Epi-Lasik. Wavefront diagnostic can determine if a wavefront guided ablation is an absolute requirement, conventional ablation would be fine, or the patient should not have surgery at all. Wavefront-guided treatment is FDA approved for a wide range of correction, but this is a range that does have limits. If you are too myopic, too hyperopic, or have too much astigmatism, you may not be eligible for wavefront-guided Lasik, PRK or Epi-Lasik. You will need to discuss this issue in detail with your doctor. Wavefront is just better, not perfect. Question: Can LASIK be done if I have diabetes? Answer: Having diabetes is not a restriction for undergoing LASIK surgery as long as the diabetes is under good control. It does require an increased amount of caution though. Their vision is noticeably fluctuated and their wound's healing process is slower than that of people without diabetes. But LASIK should not be performed if the patient has complications related to diabetes such as diabetic retinopathy and hemorrhages. Question: I have large pupils, would this keep me from being a candidate for the surgery? I intend to have the wavefront lasik -- would that make a difference? Answer: The latest studies on pupil size show that treatment pattern is more important than pupil size. Later more advanced technology has solved many of these earlier problems. Wavefront –guided LASIK ,which treatment pattern is created by wavefront measurement data, has been shown to reduce the amount of glare and haloes and we tend to recommend it for patients with larger pupils or higher prescriptions. You and your doctor can make the final decision together about which option is best for you personally. Question: I have dry eyes, would this keep me from being a candidate for having the surgery? Can I be treated before the surgery for dry eyes so that I am able to have the surgery? Answer: Dry eyes can sometimes be a contraindication to having LASIK surgery but it depends on the level of dryness, the cause, and the treatability of the problem. Some patients have dry eyes because of contact lens wear and LASIK improves the condition. While others lack sufficient tear production or have a tear layer insufficiency. These conditions can be exacerbated by LASIK treatment. Treatment for dry eye generally takes several weeks to several months and would not be possible if you are going to be in Thailand for only a brief period of time. I would suggest treatment in your home country before arriving in Thailand if your case of dry eye is particularly severe. Question: Why do I have to stop wearing my soft contact lenses before surgery? Answer: Soft lenses can actually change the curvature of your corneas (especially poorly fit lenses). It's very important that you stop wearing them a minimum of 7 days before the initial examination to give your eyes adequate time to regain their original curvature. In addition, contact lenses also deprive your eyes of oxygen and cause dry eyes. We would like your eyes to be at full health at the time of the pre-operative exam and also for the day of surgery. We ask that you wear glasses instead during this period of time. Please refer to page steps to new vision. Question: How long will I need to be in the hospital after the procedure? Answer: When undergoing LASIK surgery, it is not necessary to be admitted into our center as an in-patient. LASIK is strictly an out-patient procedure. Patients are able to return home the same day and generally can even return to work the day after. There are some general restrictions during the first two weeks but life can generally be resumed normally without the need for full-time contact lenses or glasses. Question: I would like to know my suitability for LASIK. What does it depend on? Does age have anything to do with it? Answer: Suitability for LASIK depends on a variety of factors: health of the eye, glasses prescription, thickness of the cornea, and general systemic health. An initial screening visit will help the doctor and patient make a decision together on whether LASIK is a good option. One option that will also be discussed for patients over 40 who have had presbyopic problem is monovision. Age is not a contraindication for LASIK . Eye health is a more important consideration than age. As we get closer to our 60's it is possible cataracts will become a concern. If cataracts need to be removed, then refractive surgery may not be a good idea and the cataract surgery can take care of most refractive error. In fact, some people elect to have cataract surgery for purely refractive purposes. This is called Refractive Lens Exchange. If the natural lens is clear and healthy, then Lasik, PRK, Epi-Lasik are all possibly appropriate techniques. Question: Should I wait for refractive surgery to improve ? Answer: There will always be new technologies just around the corner and thereby reasons to postpone any elective surgery. Consider not just what the future may hold, but consider too what the present can provide. In the next 100 years, every surgical procedure that is today considered “state-of-the-art” will probably have been abandoned. It would be a pity if you deprived yourself of the reasonably expected benefit of any elective surgery because you are waiting for the next best thing. It would also be a pity to rush into a surgical procedure that will not meet your personal needs. Consider your motivation for the surgery. Talk to your doctor. If you cannot reasonably expect to achieve the desired result that will meet your motivation, don't do it. Learn as much as you can about your own circumstances and take a reasoned approach to what is available today. Question: Do you have the advanced technology? Answer: We have wavefront-guided technology which is the most advanced technology for further improve the quality of a patient's vision after LASIK. This achieved by measuring the wavefront aberrometer is the name of the instrument used to measure the so-called “wavefront” of a patient's eye. A “wavefront” is the 3-D plane created as light waves are reflected off the patient's retina and return back to the cornea. This determines the higher-order aberrations that are present within the cornea. Question: Does LASIK flap heal? Answer: The cornea heals but not like something similar to a cut on your arm. LASIK flaps do heal very securely and eventually contribute at least to some degree to the bio-mechanical strength of the cornea. Without proper technique by skillful surgeon, it is certainly not easy to lift it up. post op immediately the flap is re-positioned and the doctor squeezes out excess moisture under the flap, the negative osmotic pressure is created that “sucks” the flap onto the stromal beds and holds it there. The flap is held in place fairly well at this time, barring physical trauma such as rubbing the eye or poke in the eye. - first week During this period the epithelium (surface cell layer) regenerates along the flap, sealing and bonding the flap more secure in place. That's the reason why you have to wear eye shields at night for 1 week . - First month . The corneal cells at stromal bed and the flap produce an adhesive protein that bonds or “glues” the flap to the stromal bed. These processes have generally rather strongly secured the flap to the srtomal bed. So until end of first month, do not rub your eyes.

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