| |
Q&A |
 |
Q : How should I prepare myself if I want to have LASIK done during my vacation in Phuket? |
| |
A : Laser vision correction is generally completed in 3 steps
1. initial eye evaluation and testing
2. The procedure itself
3. Follow-up exams and testing
Practical points for your LASIK trip to Phuket
- Please make an appointment first.
- If you are using contact lenses, please stop wearing them before the initial eye evaluation.
- You need to stay at least one night in Phuket to have the initial eye evaluation and the laser surgery in the same day and you need to come back to clinic for eye examination the next morning.
After LASIK, the most important visits are the 1-day and 1-week visits. If possible, we would like to keep you in Phuket for the 1 week follow-up visit which can be arranged 5 to 7 days after surgery.
- For the later routine-follow ups, then you can see an ophthalmologist in their own country. We can also provide a record summary of the evaluation and treatment.
- If you would like us to organize your stay, please contact us for your information |
| |
|
|
Q: Will I have to limit my activities after surgery, and for how long? When can I go back to work ? |
| |
A: After LASIK, there are some minimal activities limited. Please refer to page activity schedule.
When you can return to work after refractive surgery will depend on the type of refractive surgery, the amount of refractive error, what complications are presented after surgery (if any), and the type of work you do. Although many refractive surgery patients are back to work the next day, others have great difficulty for days and weeks.
Everyone's individual situation needs to be evaluated based upon the probability of contact with the eye and type of work. Since every person is different and every situation is unique, it will be necessary to discuss with a competent doctor the probable recover period and when the patient can return to work.
|
|
Q: How safe is the laser treatment ? |
| |
A: The safety of LASIK operation is one of the main reasons it has become so popular. Severe complications are extremely rare. The complication rate and the infection rate from LASIK are much less than those with contact lens wear. When performed by the experienced surgeon, LASIK treatments are extremely safe.
The laser has been in widespread use for the treatment of myopia (nearsightedness) and astigmatism over 20 years. Millions of successful procedures have been performed around the world.
Our laser is calibrated before every single procedure to ensure the most accurate results. We monitor and control the temperature and humidity in our laser room strictly, which improves the accuracy of our results. We use one microkeratome blade per patient to avoid infection and potential flap complications from a damaged or progressively dulled blade.
One of the most important steps to avoid complication is in the thorough testing and careful consultation of our patients. Some important measurements will be performed two or more times, and will be further repeated if necessary.
At the Phuket Laser Center , we will only perform LASIK operation on you if we believe that we can obtain a very good result. |
| |
|
|
Q: What other options are available for correcting my vision? |
| |
A: Refractive surgery is an elective procedure -- people have it done because they want it done. As a result, insurance rarely pays for it. Of course, there are other options for correcting refractive error. The following options may fulfill your needs better than refractive surgery. Your eye doctor can help determine which correction method is best for you.
- Glasses
Glasses are the traditional way to correct refractive error and presbyopia. Technological advances have made frames and lenses better than ever. Nevertheless, remember that whenever you have a new pair of glasses, it will take time to get used to them. Your eyes will adjust more quickly if you wear them all the time, instead of taking them on and off, or going between your old and new glasses. Patients with significant astigmatism may have a particularly difficult time getting used to their glasses in the beginning since the world may look particularly distorted.
- Contact Lenses
Modern contact lenses generally fall into one of two major categories: soft or rigid gas permeable (RGP)
To receive contact lenses, you must first have an eye examination. During an eye examination, the doctor evaluates eye focusing, the external eye health, and tear chemistry. Based on the exam findings and your own needs, your doctor can recommend which type of contact lens is best for you.
Some patients mistakenly believe the “power” of the contact lens is the only important parameter in a contact lens prescription. The contact lens prescription may also includes crucial parameters such as lens material, center thickness, diameter, base curve, secondary and peripheral curvatures. During the contact fitting and associated follow-up, it is common for the doctor to change certain lens parameters for optimal performance. You should also know that the “power” of your contact lenses is often different from that of your glasses due to optical mathematics.
All contact wearers should own a pair of glasses. There are instances when contact lenses wear is not comfortable or convenient. In such instances, glasses serve as a back-up. |
| |
|
|
Q: What vision can I expect in the first few months after surgery? |
| |
A: First few weeks after LASIK you will probably notice fluctuating vision, dry eyes, sensitivity to lights, and glare and halos. These are typical during the recovery period and tend to subside as the eyes heal over the ensuing days to weeks. However, some of these changes continue for several months.
Nearsighted patients undergoing LASIK generally return to functional vision the day after surgery. However, patients in their late 30's often experience reading difficulty the first few days after surgery. This is expected. Normally it takes time to adjust for new vision. For patients already with presbyopia, they can buy over-the-counter reading glasses for temporary help focusing things up close (wearing these glasses will not affect how the eyes heal). Reading glasses're usually be prescribed between 1 to 3 months after the surgery, depending on when the eyes have stabilized.
Farsighted patients undergoing LASIK often experience dramatically improved near vision the next day although distance objects may be blurry. As the eyes heal, patients with presbyopia typically lose some near vision but gain the distance vision. In this regard, vision recovery from farsighted LASIK is different than for nearsighted patients.
|
| |
|
|
Q: Will I be able to wear contact lenses after laser surgery if I need them? |
| |
A: In our experience, post operative patients required to wear contact lenses (mostly “fashion” contact lenses) have been able to use them successfully
After LASIK the main attribute that changes is the shape of the cornea, so it is conceivable that if someone needed to go back to wearing contact lenses, he or she might have to be fitted with a new pair of lenses, and that the fitting might required more effort than usual. |
| |
|
|
Q: How is LASIK likely to affect my need to wear glasses or contact lenses as I get older? |
| |
A: You are asking about “Permanence of visual results” after having LASIK or other vision correction surgery (refractive surgery).
All refractive surgery techniques make permanent changes to the eye. Some more permanent than others.
Excimer laser assisted surgery techniques conventional or custom wavefront Lasik, PRK and Epi-Lasik all remove corneal tissue. Regression back toward the original refractive error is more common with high degree of error. It is not likely regression with any excimer laser assisted surgery will regress all the way back to the original refractive error, but it is a possibility in some circumstances.
Despite the permanence of the changes from surgery, your eyes will continue to change at the same rate they did before surgery. Aging changes is unavoidable. Around the age of 40 just about everyone will become presbyopic and require reading glasses. |
| |
|
|
Q: Can it be corrected if my eyesight after surgery is not “0”? Have I to pay additional fee for second surgery? |
| |
A: It is not necessary to have “zero” in prescription to indicate good result after LASIK. General eyes with excellent vision have a little refractive error.
Every patient and refractive surgeon want to achieve perfect vision correction with one refractive surgery procedure. Nevertheless, the most common unwanted result is “over” or “under” correction, meaning there is residual refractive error impairing vision. “Over-” and “under corrections” are actually misnomers because is exceedingly rare that the surgeon attempts to correct the wrong prescription. While the laser does what it's told to do, the uncertainty is how the eye heals. Every eye heals a little differently. We are talking about microsurgery on human biological tissue, not a piece of plastic. Eyes can heal more or less than expected, thereby determining whether the final prescription is more or less than what the surgeon targeted. Consequently, it is often more correct to use the terms over and under “response”. Over and under response is more common with high prescriptions.
It is possible to perform an enhancement or “touch-up” procedure. In LASIK, this typically involves lifting up the flap with a special instrument and reshaping the cornea with the laser. Most enhancements are performed between three and six months after the first surgery, but can be performed earlier and much later when the prescription has stabilized. Discuss the probabilities with your doctor before you proceed.
Enhancement procedures have many of the same risks as the initial surgery so the patient and doctor will decide together concerning further laser enhancements regarding safety and benefit.
The duration of performing laser enhancement is limitless and free of charge, except for costs of medications. |
| |
|
|
Q: Does LASIK flap heal? |
| |
A: 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. |
| |
|
|
Q: Do you have the advanced technology? |
| |
A: 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. |
| |
|
|
Q: Should I wait for refractive surgery to improve ? |
| |
A: 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. |
| |
|
|
Q: I would like to know my suitability for LASIK. What does it depend on? Does age have anything to do with it? |
| |
A: 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. |
| |
|
|
Q: How long will I need to be in the hospital after the procedure? |
| |
A: 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. |
| |
|
|
Q: Why do I have to stop wearing my soft contact lenses before surgery? |
| |
A: 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 |
| |
|
|
Q: 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? |
| |
A: 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. |
| |
|
|
Q: 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? |
| |
A: 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. |
| |
|
|
Q: Can LASIK be done if I have diabetes? |
| |
A: 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. |
| |
|
|
Q: Conventional or Wavefront treatment ? Which is suitable for me ? |
| |
A: 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. |
| |
|
