Frequently Asked Questions about Lasik
For most of our patients, the answer is yes. Over 99% of our patients achieve 20/40 or better vision without glasses or contact lenses, with 96% achieving 20/20 or better vision without glasses or contacts. Many of our patients see better after laser treatment without any glasses or contacts than they did prior to the treatment with their glasses or contacts.
Almost all of the time, the answer is yes. Overall, 4% of our patients will get close to but not a total correction. These patients can be corrected with a “touch-up” treatment.There is no additional fee for a touch-up if performed within 18 months of the first treatment. We like to wait at least three months before performing a touch- up, and most of the people waiting for a touch-up see well enough that they are not using any glasses or contacts in the meantime.
You will be able to see during the entire treatment. The Zeiss laser technology enables full vision throughout the treatment.
There are three common complications that I like to emphasize with our patients. Of course, other problems are possible, but these are the major problems:
- Need for enhancement.
Lasik and Advanced Surface Treatment are not one hundred percent accurate one hundred percent of the time. We get patients very close to perfect almost all of the time, but in around 4% of the treatments we are close to but not perfect. Most of these people can see very well and are not using any glasses or contact lenses for distance vision, but if we can make the vision even a little sharper, that is our goal. In these situations, we like to wait 3-6 months to be sure that we have the final results, and then perform an enhancement treatment. We do not charge any additional fee for this enhancement treatment, as long as it is performed in the first 18 months. If we can make the vision any better, we will offer a touch-up. We will do everything possible to enable you to see as well as you are capable of seeing.
Increased dryness on a temporary basis is very common after Lasik. Permanently increased dryness is rare. Dryness after treatment is more common in people who have a lot of dryness before treatment, and will often last up to three months. For people who have extreme dryness prior to treatment, we often recommend the PRK version of treatment.There are many treatments for the temporary dryness following Lasik treatment. The most effective seems to be taking fish oil liquid or pills (or flax seed oil for vegetarians). The omega-3 fatty acids in fish oil makes the tears much more effective and greatly reduces symptoms of dryness.
- Halos and night vision symptoms.
Night vision issues are not much of a problem anymore since we began using the Allegretto laser. However, this still remains a problem with other lasers (that we do not use), so we like to discuss it.All people, whether or not they have Lasik, have some degree of halos at night. To prove this to yourself, go out and look at the full moon at night, and you will notice that there is softness to the edge of the moon. We call this a halo. When you view the full moon during the daylight, this softness is not present. In the past, and with other lasers, the halos were made worse in around 25% percent of patients. Although this almost never interfered with the ability to drive or live your life, it was annoying for some people.
With the Allegretto laser, there is commonly a short-term increase in the night halos, lasting for up to several months. However, on a permanent basis, the Allegretto laser is the only laser in which the average patient typically experiences less halos than with glasses or contact lenses. This is one of the major advantages of the Wavelight Allegretto laser over all other lasers being used today.
This is by far the most important concern of our patients, as it should be. After performing more than 30,000 laser vision correction treatments, not a single one of our patients has lost his or her vision from laser vision correction. None. And we intend to keep it that way. We are extremely careful and meticulous. The safety of Lasik when performed by an experienced and careful team is extremely great.
We can stop the treatment at any time. Patients move all the time and move their eyes all the time. The laser has a built-in eye tracker that follows the eye as it moves, and will automatically shut the laser off if the eye moves too far.
Your eye will be gently held open by a lid retractor, so you do not have to worry about blinking.
About one-third of the patients who come to us for treatment are deemed less than ideal candidates. We will perform treatment only if we expect to obtain an excellent result. Otherwise, we will advise against correction and not perform the treatment.There are many factors that can make a patient less than ideal. These include:
- If you are perfectly happy with your glasses and contact lenses, then there is no need for treatment.
- If you are young and your eyes have not stopped changing. Most people reach ocular maturity by the age of 16-20, but for some it takes longer.
- If you have certain eye diseases including keratoconus and keratitis sicca.
- If you are pregnant. If you are breast-feeding we like to wait until after the breast-feeding is complete.
- If your cornea has too much or too little curvature, or an abnormal thinness, or other measurements which are not ideal.
You can typically drive and return to work and your normal activities the very next day. We ask that sleep in clear goggles for a total of six nights and that you avoid swimming pools, whirlpools and saunas for the first week. It is okay to travel on an airplane the very next day.
Lasik does not cause or advance cataracts. If we live long enough we will probably all develop cataracts. Cataracts occur in a different part of the eye (the lens inside the eye) and can easily be treated later in life after Lasik.
Astigmatism means that the light is being focused irregularly. It causes blurriness of both the near and far vision. Most people have at least some astigmatism and it is routinely corrected with Lasik treatment.
Yes. For our patients 40 years old and over who are experiencing difficulty with close-up vision, Lasik can free you up from total dependence on reading glasses.
Laser vision correction has been performed for over twenty years. There are no long-term health problems from Lasik. However, Lasik will not stop your eyes from natural changes that can occur as you age. If your eyes change years in the future from aging enough that you again need glasses for clear distance vision, an enhancement treatment can usually be performed.
This is entirely up to the patient, as it depends to a large degree upon your schedule and what makes you feel most comfortable. Patients having Lasik usually see very well the day after the procedure, and most choose to have both eyes treated on the same day. Patients having “Lasik without a flap” heal more slowly, so some of these patients choose to have the treatments on separate days.
here are no tests that can absolutely tell us if a person will have dry eye after Lasik, but we can get some indication of who is more likely to experience this problem. The most important information has to do with the degree of dry eye before Lasik — those with severe dry eye who cannot wear contacts and who have dry eye with their glasses are at the highest risk, and should consider PRK/LASEK, which do not increase dry eye. Tests such as the Tear Breakup Time and the presence of corneal stippling are also important.
Andrew Caster, MD
Caster Eye Center
Beverly Hills, CA