LASIK FAQ & Myths
Frequently Asked Questions About LASIK
Stephen Slade MD: We have two different lasers that make the ablation, two different lasers that make flaps. There’s a very simple answer to why we have four lasers for LASIK. Because we have more than one patient. And by that I mean our patients are so varied. People are different. Some people have a lot of nearsightedness. Some people have a lot of astigmatism. Some people have this requirement or that requirement. So we find that we use the different lasers for different eyes. Different prescriptions. And we find the sweet spot. So we’re able to better offer the patient what might be a solution that suits their eye, their individual eye better. The more tools you have – it just makes sense. And it’s helped us with our results.
Stephen Slade MD: All-laser Lasik is using two lasers on each eye. Both components. Remember, LASIK is making a very thin flap of corneal tissue, laying the flap back and then reshaping the eye with a laser, replacing the flap. Initially, we used a metal blade to make that flap. And that was back in 1991, when we started Lasik and did the first ones. And then [we use] the laser to reshape . All-laser LASIK is using a laser to make the flap, and then a second laser to reshape the eye. We actually have the nation’s longest experience in all-laser LASIK as well as LASIK. We went to it early. Well, we went to it earlier than anybody, because it simply made sense. A laser can make a flap more precisely with unique safety factors that you simply do not have in a metal blade. The metal blade was great. But the laser was an improvement in technology. It gave us so many different options.
Stephen Slade MD: There’s lots of LASIK doctors in Houston. Some very good ones. And, it’s important for any patient, though, to do their homework. To make the choice that’s best for them. Luckily the technology is good. The doctors are good. What I would do, if I were a patient, and I think that’s the best way to answer it, is I would want first to know if I was a candidate. Again, go in, have an exam. Find out if this is something that really is an option. Then start investigating it, finding out, you know. “Is this something for me?” So what are the questions that I ask? I certainly want to know how long the doctor’s been doing the procedure. That would be important to me, that he is experienced. I would want to know does he have different options for me? Does he have different lasers? Might one laser fit my eye better than another? Rather than sort of everybody getting the same tool, you know. I would want to know is he on the forefront? This is rapidly moving stuff. These lasers are developing, the different algorithms, the ways of applying them, the pharmacology. The drops we use. All of this is rapidly evolving stuff. I would want to know, is this a doctor who is engaged? Is he out there nationally, internationally, giving talks, learning from other doctors? I would be impressed if he was teaching other doctors. If he had the latest information that he was sharing with other doctors. Probably one of the most important things I’d want to know is, what do the other doctors, his peers, think of him? Does he do surgery on other doctors? Have other doctors come to him, specifically eye doctors, to have their own surgery done? And then, since I’m probably going to spend a lot more time with [the] staff than with [the surgeon], what’s the vibe there? How do I feel about them? What messages are they giving me? Are they proud to be where they are? Are they happy to be where they are? Are they enthusiastic to be working for this doctor? All those things, I think, are important.
Stephen Slade MD: The best thing for anybody who’s thinking about this technology, who’s looking at our website, is to come in, have a screening evaluation. There’s no charge to it. You come in, it doesn’t take that long. It doesn’t cost anything. I’ll talk to you. Dr. Baker will talk to you. You’ll have the exam. We’ll run you through the machines. And we’ll be able to give you a good idea of whether you’re a candidate or not. Then, you can go home, research it. Get more information from the website, and kind of start thinking about whether you want to have it done. Who typically is a candidate? Most people with nearsightedness. Most people with farsightedness. Importantly, we have wonderful ways now to treat astigmatism as well. Up to very wide ranges. Very, very high ranges. Now, there are people who are too nearsighted for LASIK. Luckily, there are little tiny soft contact lenses now, the ICL that can be implanted for those people. So there are options. It’s very important to go to a doctor who has other options, than LASIK, so that he’s not trying to fit everybody into something that might not be for everybody. In any case, you want to learn what your options might be and if you’re a candidate. Most people are indeed candidates.
Stephen Slade MD: There are people who are not candidates. Perhaps, you know, the first person that I would think of as not a candidate is somebody who has an unrealistic expectation of what the surgery can do. The surgery is a wonderful surgery. But it is not perfect. It is not going to make every single person see 20/20. If a person is over 40, they might still need reading glasses. If a person has a very large correction, or if a person has any other problem in their eye. If their retinas are weak, they might not be a perfect candidate. Might not have a perfect result. And of course nobody can be guaranteed to have any particular result. So that would be one person. Somebody who’s just hoping, or expecting more out of it. Somebody who simply would come up and say, “I’m not going to be happy unless I’m absolutely perfect and never have to wear glasses again for the rest of my life.” Maybe not a good candidate. There are people with retinal diseases that are not good candidates for LASIK. There are people with corneal diseases of the front part of the eye, the part that we’re operating on – inherited diseases, such as keratoconus that are not necessarily good candidates for LASIK. They may have other options now. We’re doing a wonderful trial with cross-linking. It’s a vitamin trial with ultraviolet light that’s specifically for people with keratoconus. But those people may not be candidates for LASIK, certainly. There are people that have other different conditions of the eye or diseases of the eye that would rule them out. But in general, most people are candidates for LASIK or PRK. And the majority of the patients we do, we do LASIK with. On the other hand there are patients who really do better with PRK. So that’s why we do both. [Update, SMILE for myopia is now fully FDA approved!]
Stephen Slade MD: That’s a great question. Which is safer, LASIK or contact lenses? Interestingly, there was a study by the University of Oregon that confirmed what many of us cornea specialists have always believed. In terms of several conditions, LASIK is safer. Now, I’m thinking specifically of infections. We see more eyes that have infections from patients wearing contact lenses than we do from LASIK. And this is borne out by this recent study from the University of Oregon. Certainly, if you want the absolute safest choice, then you would wear glasses and stay inside, and never leave your house, so that nothing could ever hit you in the eye and break the glasses and shatter them. If you really wanted the very safest option you wouldn’t buy a car. You’d walk. If you really wanted the very safest option you wouldn’t go out at night. You’d stay inside. If you really wanted the very safest option, you probably wouldn’t live in Houston. You’d probably live somewhere out in the country. So, you know what we do with our lives is we take risks and benefits, and we balance them. And we decide, will the benefit of anything, you know, living in Houston, driving a car, going outside, wearing contacts, having LASIK, will the risks of that outweigh, or will they be balanced by the benefits? And the benefits of LASIK are just tremendous. The potential benefits of LASIK are just tremendous. While there are risks, the risks tend to be one-time risks, clustered around the surgery itself. And with all-laser LASIK, they’re low. Now, consider the benefits. The benefits are the wonderful vision without glasses or contacts that you enjoy every waking moment of the day. Typically for the rest of your life. I don’t know of a procedure other than eye surgeries, such as cataract surgery, LASIK or PRK, where you get the benefits, you get to enjoy the benefits of these surgeries, as a group, cataract surgery, LASIK surgery, PRK surgery. You get to enjoy the benefits of these procedures every waking moment of your day. And, you know, there’s a lot of things that I enjoy. You know, whether it’s golf, riding bikes, sports, a nice dinner. But certainly, it’s not every waking moment of my day. So the potential benefits of eye surgery is phenomenal. Yes, there are risks. But for many people, in many different situations, the benefits far outweigh the risks.
Top 10 LASIK Myths – Fact vs. Fiction
It can be hard to know where to turn for information about laser vision correction. In the recent past, the media has been peppered with conflicting stories about this procedure. As a result, a lot of myths about the surgery have developed. Below, we will address some of the most common myths about LASIK. For more information or to find out if you are a good candidate call us today!
Fiction: LASIK is not real surgery.
Fact: LASIK is surgery and should be treated as such. With proper care, it is not a dangerous or risky procedure. There are risks associated with LASIK, as there are with any procedure. However, several clinical studies have identified the chance of serious vision-reducing complications as being extremely low.
Fiction: Complications and side effects, such as night glare and dry eyes, should be expected after having laser vision correction.
Fact: As with any other surgery, there are risks associated with laser vision correction. Clinical studies of laser vision correction have documented the risk of having a serious vision-reducing complication as being extremely low. Many complications can be treated if diagnosed and treated at the early stages.
Moderate glare and dry eyes are common side effects immediately following the procedure, but typically last just three to six months. Proper testing before the procedure can identify patients who are at a high risk for long-term risk for long-term complications.
Fiction: Laser vision correction is so new that no one really knows if there are any long-term side effects.
Fact: Although laser vision correction became widely available in the United States in the mid-1990s, the technology was first developed in the early 1980s. The first patient was treated in the United States in 1987. To date, no long-term ill effects of the procedure are known. It has been over twenty years.
Fiction: There is only one type of laser used to treat all patients.
Fact: Actually, there are a variety of lasers that can be used to treat a patient’s eyes. After a proper screening and confirmation of the condition that needs to be corrected, a surgeon can identify the most appropriate laser needed to treat your condition. Surgeons who have access to a wider variety of lasers, ensure that their patients are treated with the laser best suited for their condition. At Slade & Baker Vision, we have different lasers to choose from. It is not one-laser-fits all.
Fiction: It does not matter which doctor performs your procedure, the outcomes are all the same because the laser does all the work.
Fact: The surgeon’s skill and the level of care he/she offers is an essential element in the success of any surgical procedure. The laser is one of the tools that the surgeon uses to perform the procedure. The surgeon must also create and manipulate the corneal flap, a delicate surgical procedure.
Two important contributors to the success of the surgery are the pre- and post-operative care. This is best achieved if your surgeon works closely with your own personal eye doctor, who is most familiar with your eyes and will continue to care for you years after your procedure. The surgeon, the LASIK technicians and your own eye doctor should work as a team to provide you with a quality outcome.
Fiction: The best indication of a surgeon’s ability is the number of procedures he or she has performed.
Fact: While the number of procedures performed by a surgeon can be a good indication of his or her level of experience, surgeons should not be judged solely on the number of procedures they have completed. Anyone considering the procedure should do their homework before selecting a surgeon. Potential patients should first consult their own eye doctor to determine if they are a candidate and for recommendations on surgeons. You should also consult your family and friends who have had LASIK to ask them about their experiences with surgeons.
Fiction: LASIK can forever end patients’ needs for glasses.
Fact: While LASIK has proven to be overwhelmingly successful in reducing dependence on glasses and contact lenses, the degree of improvement may vary depending on the individual. Each patient’s need for glasses depends on how well he/she heals and the severity of the patent’s original prescription. Most patients with mild to moderate prescriptions can achieve 20/20 vision or within 1 to 2 lines 20/20 on the eye chart. Such success can end a patient’s dependence on vision aids for driving, sports and watching television or movies. During the pre-surgical screening, your doctor should be able to determine the range of your probable outcomes. Keep in mind, as a patient ages the need for reading glasses is quite common.
Fiction: Anyone who wants to have LASIK is a candidate.
Fact: Not everyone is an appropriate candidate for LASIK. In fact, potential patients evaluated by many reputable providers are routinely rejected as candidates for the surgery. The best way to determine if you are a candidate is to undergo a thorough screening by your eye doctor. LASIK can treat patients with nearsightedness, farsightedness and astigmatism. Appropriate candidates must be at least 18 years old, in good health and have healthy eyes free of diseases such as cataracts and glaucoma. Appropriate screening is the first, and one of the most important stops in preventing complications. Often complications result when surgeons operate on patients who are not appropriate candidates.
Fiction: Because the outcomes are all the same, the cheapest surgery is no different than the most expensive one.
Fact: The old adage, “You get what you pay for,” also applies to laser vision correction. Patients should remember that they only have one set of eyes and it’s probably not a good place to compromise. Patients should be cautious of discount centers that may not be as focused on patient screening and care. Consumers should make sure they are comparing equivalent care and experience when doing their research. Often the more expensive procedures include added benefits that discounters do not offer. These added benefits can include lifetime commitments and follow-up care with your personal eye doctor.
Fiction: LASIK is still being developed, and new technologies are being introduced every year. Patients might be best served waiting until doctors find the best one.
Fact: The current LASIK technologies provide better outcomes than ever before. Many LASIK surgeons themselves have had laser vision correction performed on their own eyes. New technologies introduced in the future may make LASIK available to a wider group of potential patients whose vision cannot currently be corrected.