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Refractive Surgery Co-Management


Refractive surgery is a big decision. Many factors should be considered prior to surgery, especially the long-term health of your eyes and how your vision affects your lifestyle. All surgery involves some risk, so careful consideration is prudent before deciding to undergo this elective surgery. Today’s laser procedures are better and safer than ever before, but results of the surgery are permanent and irreversible. At Uptown EyeCare, our doctors provide careful refractive surgery consultations and attentive pre-op and post-op care.

What Refractive Surgery Options are out there?

LASIK, often referred to as laser eye surgery or laser vision correction, has been used since 1988 and is a type of refractive surgery for the correction of myopia, hyperopia, and astigmatism. LASIK surgery is performed by an ophthalmologist who uses a laser to reshape the eye’s cornea in order to improve visual acuity. For most patients, LASIK provides a permanent alternative to eyeglasses or contact lenses. LASIK is most similar to another surgical corrective procedure, photorefractive keratectomy (PRK), and both represent advances over radial keratotomy (RK) in the surgical treatment of refractive errors of vision. For patients with moderate to high myopia or thin corneas which cannot be treated with LASIK and PRK, the phakic intraocular lens (such as Visian ICL) is an alternative.

Who Are The Optimal LASIK Candidates?

The best candidate for LASIK is age 21+, has healthy eyes with adequate corneal thickness and stable refraction. This is necessary because LASIK procedure permanently removes tissue from the cornea to reshape the eye.

Chronic dry eye, corneal disease or other abnormalities may disqualify a candidate from LASIK surgery. A comprehensive eye exam is required to be sure. For your convenience, we are happy to provide LASIK pre-operative exams and consultations at our office.

Note that LASIK is an elective procedure and proper consideration must include the weight of personal needs, potential gain and willingness to accept the risks involved. There are no guarantees that LASIK will absolutely succeed to your expectations. The results are not always perfect vision. In some cases, your vision after LASIK may be permanently less clear than it was with glasses before LASIK. This outcome must be factored before deciding on LASIK surgery.

Specifics of The LASIK Procedure

LASIK is an ambulatory, two-step procedure. First, the surgeon creates a thin, hinged flap of tissue on your cornea with a laser. This flap is folded back so the laser reshaping of your eye can begin. After laser treatment, which lasts a minute or less, the flap is repositioned and the surgeon proceeds to your other eye.

What Is Wavefront LASIK?

Wavefront LASIK -wavefront-assisted, wavefront-guided or custom LASIK- uses laser treatment (ablation) mapped by computerized analysis. Wavefront-guided procedures are much more precise than ablations determined by using standard eyeglasses prescriptions. They can correct subtle optical imperfections of the eye called “higher-order aberrations” that regular ablations cannot treat. Studies prove wavefront-guided ablations provide sharper vision than conventional, non-wavefront LASIK and can improve night-vision, eliminating or reducing the risk of halos or glare.

After The Surgery

Following the LASIK procedure, you will use medicated eye drops and clear protective shields to cover your eyes. You can open your eyes and see well enough to walk without glasses, but you must not drive yourself home. You will use medicated eye drops several times a day for a week or more to prevent infection and help the healing. You may also use artificial tears to keep your eyes moist and comfortable.

You should rest your eyes as much as possible the day of your surgery. You may find it more comfortable leaving the house lights on low dim. The next day, you should see well enough to drive and resume your normal activities. Use care though not to rub your eyes until it is safe to do so. You will be asked to return to visit your surgeon the following day to check on your eyes. They will want to check your vision and be sure your eyes appear to be healing as they should. You will be given any additional instructions necessary about eye drops and/or artificial tears, and you can ask the doctor any questions you may have.

Additional postoperative care will be performed by an eye doctor other than your LASIK surgeon. This is referred to as co-management. We are happy to provide post-operative care for you at our office through a co-management agreement with your surgeon. Ask us for further details.

If My Vision Is Blurry After LASIK ...

Though most patients see clearly within a day or so after LASIK, it can take several months before your eyes completely stabilize. Until then, improvements in your vision can still occur in fits and jumps. If several months pass and your vision is still blurred, be sure to communicate and visit with your LASIK surgeon. It may be appropriate to have a second LASIK surgery -an enhancement- to sharpen your eyesight further. If an enhancement is not required, eyeglasses or contact lenses may be used to help. We will be happy to examine your eyes and discuss the options available to you.

After Refractive Surgery Eyewear

Even if your vision seems perfect after refractive surgery, you may still require or be more comfortable with eyewear. When outdoors, it’s important to protect your eyes from the sun’s strong and harmful rays. Use sunglasses that provide 100% UV A/B protection. For sports-sunglasses, the lenses need to be poly-carbonate for extra strength and protection. Anytime you work with power tools or do any activity where eye injury is possible, be sure to use safety glasses with poly-carbonate lenses.

Refractive surgery is not a “cure all”. Most people will benefit from night driving glasses at some point in their life for added safety, sharpness and comfort at night. If you are over the age of 40 (or close to 40), you will still need glasses for reading and computer after the surgery.

After Refractive Surgery Eye Care

Remember to continue to schedule routine eye exams post-refractive surgery. Even with perfect vision you still need to have your eyes examined for glaucoma and other potential problems on a regular basis. Routine annual exams will help insure that your vision remains stable after your refractive surgery.