Why should I have my surgery at UT Southwestern Laser Center for Vision Care?
Can I have vision correction (laser eye surgery)?
How does laser eye surgery work?
What is the difference between PRK, LASIK and LASEK?
What are the benefits of laser eye surgery?
Is it safe?
Do I need an eye exam first?
How long do I need to go without makeup?
How long do I have to be out of my contacts?
How much time does it take to get laser vision correction?
What will my vision be like after surgery?
Can I finance my surgery?
Is the cost of refractive surgery tax deductible?
Can I use funds from a Health Saving Account (HSA), or Flexible Spending Account (FSA) to pay for surgery?
How does wavefront LASIK compare to conventional LASIK?
What is "All-Laser LASIK" and how does it compare to traditional LASIK surgery?
What percentage of patients attain 20/20 vision or better without glasses or contacts?
What should I expect before, during, and after surgery?
What's next?
Why should I have my surgery at UT Southwestern Laser Center for Vision Care?
We want you to be certain you've made the right choice when it comes to deciding where to have your corrective laser surgery. The physicians and services at the Laser Center for Vision Care offer patients uniquely tailored care:
- Outcomes: Our patient outcomes are among the best (and most publicly available) in the world, and reflect how closely we follow patients' progress before, during, and after surgery.
- Peer-reviewed publications: Our surgeons have authored or co-authored hundreds of research papers on refractive surgery, which have appeared in peer-reviewed journals and other publications. Peer-review is the gold standard of scientific research.
- Experience: UT Southwestern is the place that trains doctors in the expanding field of refractive surgery. This means our surgeons stay abreast of and use the latest technologies
- Personalized care: Our surgeons are with you every step of the way, from initial screening and evaluation to post-operative follow-up. You will get to know us at one of our free seminars in Dallas or Fort Worth and if you can't make it to one of these, you can schedule a free private consultation with one of our doctors.
- Quality vs. quantity: At the Laser Center for Vision Care, what you see is what you get. Beware of “as low as” advertised prices other surgeons offer. These ads are frequently used to attract patients, and then add-ons inflate the final price. The surgeon’s practice should be professionally, NOT profit, driven. At UT Southwestern, we are upfront about our basic and customized vision correction surgeries. When we quote you a price, it includes all of your eye care for all stages of the preparation, surgery, and aftercare.
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Can I have vision correction (laser eye surgery)?
The basic guidelines for having laser vision correction include: You must be at least 18 years of age; you must have healthy eyes; you must have stable vision (your distance prescription should not have changed in the past 12 months).
The ophthalmologists at UT Southwestern's Laser Center for Vision Care also provide additional information and advice during our educational seminars. A private screening may be made during business hours if evening hours are inconvenient. After the informational seminar, you’ll be able to schedule a one-on-one appointment with one of our ophthalmologists. During this appointment, a comprehensive eye exam will help us determine if you are a good candidate for laser eye surgery, and if so, which particular type of surgery is best suited to your visual needs.
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How does laser eye surgery work?
An excimer laser delivers short pulses of a cool beam of ultraviolet light that removes a small amount of corneal tissue, usually less than the thickness of a human hair. The corneal curvature is adjusted to reduce the refractive error (how out of focus the eye is), therefore reducing or eliminating the need for glasses or contact lenses. Watch a video to see how an eye exam and laser surgery are performed.
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What is the difference between PRK, LASIK and LASEK?
The difference between
PRK,
LASIK and
LASEK
is how the outermost layer of the cornea (corneal epithelium) is treated during the laser vision correction procedure.
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What are the benefits of laser eye surgery?
Laser vision correction reduces or eliminates your dependence on contact lenses and glasses, so there is a cost savings in not buying new frames and contacts. Some people find wearing glasses or contacts uncomfortable or inconvenient, particularly while participating in some sports. Some patients just want to be able to see the clock when they wake up.
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Is it safe?
More than 17 million laser vision correction procedures have been performed worldwide since 1990. Data obtained during exhaustive clinical trials show that all patients experience a significant improvement in uncorrected vision (vision without glasses or contact lenses) after laser vision correction. Infection is a rare but treatable complication.
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Do I need an eye exam first?
Before treatment you will have a thorough eye examination to determine whether your eyes are healthy and suitable for laser vision correction. If you have been wearing contact lenses, it is important that the lenses be removed prior to the examination. The rule of thumb is to remove the lenses two weeks before the exam if they are soft lenses, three weeks if they are gas permeable and four weeks if they are hard lenses. A detailed video and computer image is taken of your eye that will detail the curvature, shape and overall smoothness and regularity of the cornea. Corneal thickness measurements are taken and refractive stability is verified.
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How long do I need to go without makeup?
You should not wear eye makeup to your initial eye exam or on the day of surgery, and you should not wear eye makeup for two weeks after surgery. Base, powder and blush are okay if you take care not to get anything in your eyes.
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How long do I have to be out of my contacts?
Because contact lenses reshape the cornea slightly, you should remove your soft contact lenses two weeks before the initial eye exam. If you wear gas permeable lenses, you should remove the lenses three weeks ahead of time, and four weeks for hard lenses.
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How much time does it take to get laser vision correction?
First, we require a pre-operative eye exam. Later, when you schedule surgery, we recommend you plan to have laser vision correction when you can take a few days to relax. The actual surgery takes minutes, but you will need time before and after the surgery for preparation and post-operative procedures. Post-surgery follow-up visits are required at the following intervals: 24 hours, one week, one month, three months, six months, and 12 months.
Your eyes will be light sensitive for up to one week after surgery. The eye heals during this period so we recommend you take a day or two off work and avoid light exercise. You should not drive for 24 hours after the surgery and be careful not to get soap or shampoo in your eyes while bathing.
For one to eight weeks, you should avoid any activities that might cause you to get dirt or dust in your eyes, such as rubbing the eyes, gardening, strenuous exercise, heavy-duty house cleaning, or contact sports. You should not swim or use a hot tub or whirlpool during this time. Your doctor can give you a specific length of time to avoid these activities or tips for protecting your eyes while they heal.
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What will my vision be like after surgery?
This depends largely on the amount of correction required. Most people require a low to moderate degree of laser vision correction that should result in vision similar to that with glasses or contact lenses. Vision is usually blurry in the first day or two after the laser vision correction procedure. It is expected that most patients should be able to legally drive without corrective lenses within one week.
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Can I finance my surgery?
The Laser Center for Vision Care offers the Chase HealthAdvance Vision Care plan, which allows patients to apply for 0% interest for up to 24 months.
You can also use Flex dollars from your employer-based Flexible Savings Account, or Health Savings Account. Some insurance plans and employers offer discounts for refractive surgery procedures; check your employee benefits and health insurance plan.
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Is the cost of refractive surgery tax deductible?
It is possible that your surgical procedure can be claimed as a medical expense to be itemized on your federal income tax return.
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Can I use funds from a Health Saving Account (HSA), or Flexible Spending Account (FSA) to pay for surgery?
Yes. Refractive surgery is an eligible medical expenditure for HSAs and FSAs.
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How does wavefront LASIK compare to conventional LASIK?
Wavefront adds an automatic measurement of more subtle distortions (called higher order aberrations) than just nearsightedness, farsightedness, and astigmatism corrected by conventional LASIK. However, these higher order aberrations account for only a small amount (probably no more than 10%) of the total refractive error of the average person’s eye. Conventional LASIK increases higher order aberrations. Although wavefront-guided treatments attempt to eliminate higher order aberrations, results from the clinical studies have shown that the average aberrations still increase, but less than they do after conventional LASIK. In a few studies comparing wavefront-guided LASIK to conventional LASIK, a slightly larger percentage of subjects treated with wavefront LASIK achieved 20/20 vision without glasses or contact lenses compared to subjects treated with conventional LASIK. Patient selection and the experience and competence of the surgeon are still the most important considerations.
[
Source: FDA Medical Devices,
http://www.fda.gov/MedicalDevices
]
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What is "All-Laser LASIK" and how does it compare to traditional LASIK surgery?
The difference between traditional LASIK and "All-Laser LASIK" (also known as "Bladeless LASIK") is the method by which the LASIK flap is created. In "All-Laser LASIK," a laser device called a laser keratome is used to cut a corneal flap for LASIK surgery. This is a newer method to create a corneal flap than the traditional method of using a microkeratome, a mechanical device with a blade. There is no absolute agreement among eye surgeons on the better choice for flap creation. Some of the factors a surgeon considers when choosing a preferred method of flap creation during LASIK are as follows:
- Quality of vision
- Rate of complications
- Pain during and after surgery
- Precision of flap size and thickness
- Time to recovery of vision
- Expense
Discuss with your doctor any questions and concerns you have about how they chose their preferred method of flap creation.
[Source: FDA Medical Devices,
http://www.fda.gov/MedicalDevices
]
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What percentage of patients attain 20/20 vision or better without glasses or contacts?
Data in the Approval Orders and related documents summarizes the outcomes from the clinical trials submitted to the FDA for each approved device. Links to these documents are included on the
FDA-Approved Lasers
page.
[Source: FDA Medical Devices,
http://www.fda.gov/MedicalDevices
]
For over 15 years, our surgeons have extensively published their refractive research results pertaining to corrective laser eye surgery.
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What should I expect before, during, and after surgery?
What to expect before, during, and after surgery will vary from doctor to doctor and patient to patient. This section is a compilation of patient information developed by manufacturers and healthcare professionals, but cannot replace the dialogue you should have with your doctor. Read this information carefully and discuss your expectations with your doctor.
Before Surgery
If you decide to go ahead with LASIK surgery, you will need an initial or baseline evaluation by your eye doctor to determine if you are a good candidate. This is what you need to know to prepare for the exam and what you should expect:
If you wear contact lenses, it is a good idea to stop wearing them before your baseline evaluation and switch to wearing your glasses full-time. Contact lenses change the shape of your cornea for up to several weeks after you have stopped using them depending on the type of contact lenses you wear. Not leaving your contact lenses out long enough for your cornea to assume its natural shape before surgery can have negative consequences. These consequences include inaccurate measurements and a poor surgical plan, resulting in poor vision after surgery. These measurements, which determine how much corneal tissue to remove, may need to be repeated at least a week after your initial evaluation and before surgery to make sure they have not changed, especially if you wear RGP or hard lenses. If you wear:
You should tell your doctor:
- about your past and present medical and eye conditions
- about all the medications you are taking, including over-the-counter medications and any medications you may be allergic to
Your doctor should perform a thorough eye exam and discuss:
-
whether you are a good candidate
- what the risks, benefits, and alternatives of the surgery are
- what you should expect before, during, and after surgery
- what your responsibilities will be before, during, and after surgery
You should have the opportunity to ask your doctor questions during this discussion. Give yourself plenty of time to think about the risk/benefit discussion, to review any informational literature provided by your doctor, and to have any additional questions answered by your doctor before deciding to go through with surgery and before signing the informed consent form.
You should not feel pressured by your doctor, family, friends, or anyone else to make a decision about having surgery. Carefully consider the pros and cons.
The day before surgery, you should stop using:
- creams
- lotions
- makeup
- perfumes
These products as well as debris along the eyelashes may increase the risk of infection during and after surgery. Your doctor may ask you to scrub your eyelashes for a period of time before surgery to get rid of residues and debris along the lashes.
Also before surgery, arrange for transportation to and from your surgery and your first follow-up visit. On the day of surgery, your doctor may give you some medicine to make you relax. Because this medicine impairs your ability to drive and because your vision may be blurry, even if you don't drive make sure someone can bring you home after surgery.
During Surgery
The surgery should take less than 30 minutes. You will lie on your back in a reclining chair in an exam room containing the laser system. The laser system includes a large machine with a microscope attached to it and a computer screen.
A numbing drop will be placed in your eye, the area around your eye will be cleaned, and an instrument called a lid speculum will be used to hold your eyelids open.
Your doctor will use a laser keratome (a laser device) to cut a flap on the cornea.
When a laser keratome is used, the cornea is flattened with a clear plastic plate. Your vision will dim and you may feel the pressure and experience some discomfort during this part of the procedure. Laser energy is focused inside the cornea tissue, creating thousands of small bubbles of gas and water that expand and connect to separate the tissue underneath the cornea surface, creating a flap. The plate is then removed.
You will be able to see, but you will experience fluctuating degrees of blurred vision during the rest of the procedure. The doctor will then lift the flap and fold it back on its hinge, and dry the exposed tissue.
The laser will be positioned over your eye and you will be asked to stare at a light. This is not the laser used to remove tissue from the cornea. This light is to help you keep your eye fixed on one spot once the laser comes on. NOTE: If you cannot stare at a fixed object for at least 60 seconds, you may not be a good candidate for this surgery.
When your eye is in the correct position, your doctor will start the laser. At this point in the surgery, you may become aware of new sounds and smells. The pulse of the laser makes a ticking sound. As the laser removes corneal tissue, some people have reported a smell similar to burning hair. A computer controls the amount of laser energy delivered to your eye. Before the start of surgery, your doctor will have programmed the computer to vaporize a particular amount of tissue based on the measurements taken at your initial evaluation. After the pulses of laser energy vaporize the corneal tissue, the flap is put back into position.
A shield should be placed over your eye at the end of the procedure as protection, since no stitches are used to hold the flap in place. It is important for you to wear this shield to prevent you from rubbing your eye and putting pressure on your eye while you sleep, and to protect your eye from accidentally being hit or poked until the flap has healed.
After Surgery
Immediately after the procedure, your eye may burn, itch, or feel like there is something in it. You may experience some discomfort, or in some cases, mild pain and your doctor may suggest you take a mild pain reliever. Both your eyes may tear or water. Your vision will probably be hazy or blurry. You will instinctively want to rub your eye, but don't! Rubbing your eye could dislodge the flap, requiring further treatment. In addition, you may experience sensitivity to light, glare, starbursts or haloes around lights, or the whites of your eye may look red or bloodshot. These symptoms should improve considerably within the first few days after surgery. You should plan on taking a few days off from work until these symptoms subside. You should contact your doctor immediately and not wait for your scheduled visit if you experience severe pain, or if your vision or other symptoms get worse instead of better.
You should see your doctor within the first 24 to 48 hours after surgery and at regular intervals after that for at least the first six months. At the first postoperative visit, your doctor will remove the eye shield, test your vision, and examine your eye. Your doctor may give you one or more types of eye drops to take at home to help prevent infection and/or inflammation. You may also be advised to use artificial tears to help lubricate the eye. Do not resume wearing a contact lens in the operated eye, even if your vision is blurry.
You should wait one to three days following surgery before beginning any non-contact sports, depending on the amount of activity required, how you feel, and your doctor's instructions.
To help prevent infection, you may need to wait for up to two weeks after surgery or until your doctor advises you otherwise before using lotions, creams, or make-up around the eye. Your doctor may advise you to continue scrubbing your eyelashes for a period of time after surgery. You should also avoid swimming and using hot tubs or whirlpools for 1-2 months.
Strenuous contact sports such as boxing, football, karate etc. should not be attempted for at least four weeks after surgery. It is important to protect your eyes from anything that might get in them and from being hit or bumped.
During the first few months after surgery, your vision may fluctuate.
- It may take up to three to six months for your vision to stabilize after surgery.
- Glare, haloes, difficulty driving at night, and other visual symptoms may also persist during this stabilization period. If further correction or enhancement is necessary, you should wait until your eye measurements are consistent for two consecutive visits at least 3 months apart before re-operation.
- It is important to realize that although distance vision may improve after re-operation, it is unlikely that other visual symptoms such as glare or haloes will improve.
- It is also important to note that no laser company has presented enough evidence for the FDA to make conclusions about the safety or effectiveness of enhancement surgery.
Contact your eye doctor immediately if you develop any new, unusual or worsening symptoms at any point after surgery. Such symptoms could signal a problem that, if not treated early enough, may lead to a loss of vision.
[Source: FDA Medical Devices,
http://www.fda.gov/MedicalDevices]
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What's next?
First, learn about your vision correction needs. Call us today toll-free at 1-888-663-2020 to attend one of our educational seminars. An individual consultation can also be arranged at a time that is convenient for you.
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