I'm
not sure I understand the difference between LASIK and PRK?
Both
LASIK and PRK utilize an excimer laser to reshape the cornea. The
laser is so precise that it takes several pulses of light to remove a
single cell. In PRK, the laser is used on the surface of the eye,
which requires a slightly longer healing time. LASIK involves creating
a thin flap of tissue, retracting the flap, and applying the laser
underneath the flap. The flap is then replaced, and it adheres very
quickly on its own. Discomfort
with PRK is typically mild, but it is more noticeable than with LASIK.
LASIK patients typically describe the procedure as completely
painless.
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I'm
considering LASIK and PRK. How do I know which procedure is right for
me?
Both
LASIK and PRK produce excellent results for most patients, however
LASIK is by far the most commonly performed refractive procedure
worldwide. LASIK offers the advantages of very rapid recovery of
vision, minimal or no discomfort, and excellent accuracy. There are
some patients who are better candidates for PRK however. Generally
speaking, these are patients with very thin corneas, or corneas with
certain types of surface abnormalities. Additionally, a few patients
with very large pupils may also be better candidates for PRK, but this
is determined on an individual basis. A complete eye exam with one of
our doctors can identify the best options for you.
Dr. Gollance
provides a very extensive pre-operative work-up,
utilizing technologies unavailable at most laser clinics. Most clinics
simply measure the curvature of the front surface of the eye. We use a
sophisticated device called an Orbscan II to measure the front and
back curvature and elevation of the cornea, as well as the thickness
of every point on the cornea. We also perform advanced wavefront
analysis of the entire optical power of the eye, from the front of the
cornea all the way back to the retina. Next we perform a sophisticated
infrared measurement of your maximum pupil size in near total darkness
using the Procyon Pupillometer. These instruments help us customize
the best treatment options for your individual situation.
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What
is Custom-LASIK and Custom-PRK?
Custom-LASIK and Custom-PRK: No two eyes are alike, and like your DNA or fingerprint, your vision is unique. For hundreds of years, glasses have been used to correct vision by eliminating one or more of the three basic elements of blurring; nearsightedness, farsightedness and astigmatism. However, advances in optics have demonstrated that these three basic elements are only part of the picture. There are tiny imperfections or distortions in every eye, even when the perfect glasses or contact prescription is used. To understand this further, imagine two people who visit the eye doctor and obtain exactly the same glasses prescription. Using standard laser correction, those two individuals would be treated with exactly the same laser treatment plan, despite the fact that their eyes each have a unique set of naturally occurring tiny imperfections and distortions. And while we have achieved excellent results by treating only these three basic elements (nearsightedness, farsightedness, and astigmatism), we can now offer even more.
Results
of an FDA clinical trial of this technology demonstrated that an
incredible 94% of patients treated were able to see 20/20 or better
without glasses. Four times as many people in the trial were very
satisfied with their night vision after LASIK, compared to their night
vision before with glasses or contacts. These results are superior to
those obtained with standard
laser correction, and the dramatic improvement in night vision may
be the greatest single advantage of Custom laser correction. Custom
correction can be applied to both LASIK and PRK treatment.
You
are probably already familiar with one application of wavefront guided
optical technology. In December, 1993 Space Shuttle Mission STS-61
installed the COSTAR (Corrective Optics Space Telescope Axial
Replacement) upgrade to the Hubble Space telescope to correct a
spherical aberration in the lens system of the telescope. Spherical
aberration is one of the main phenomena corrected by Custom wavefront
guided laser correction.
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Is
the surgery painful?
The
surgical procedure itself is essentially painless. Most LASIK patients
tell us they have no discomfort following the procedure, and they
generally feel comfortable returning to work the following day. PRK
patients have slightly more discomfort, and require more eye drops and
oral medications for relief. Many PRK patients schedule a day off from
work on the day following surgery.
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What
will my vision be like the day after the surgery?
LASIK
patients generally see well enough to pass the driver's license
examination on the first day after the surgery. Many are 20/20 only
hours after their surgery, while others take a little longer to
achieve that result. PRK patients typically recover more slowly, and
often will not see well enough to drive for a few days.
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What
if I move or jerk or do something to create a problem during the
actual surgical procedure?
This
is probably the one of the greatest concerns that many patients have
when contemplating laser eye surgery. We understand that this
procedure may be routine for us, but it is a life changing event for
you. It is perfectly normal to be apprehensive. Our first goal is
ensure that you are made comfortable before you enter the laser suite
by giving you a sedative. During the actual treatment, many patients
worry that they will move their eyes too much and cause a problem. All
of the lasers that Dr. Gollance uses are equipped with automated eye
tracking devices. The laser is able to follow the movements of your
eyes, and keep the treatment properly aligned, even if your eyes are
in motion.
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Will
I have glare at night?
All
LASIK patients will experience some degree of temporary night glare
for about 6 weeks post-op. This is due to microscopic swelling in the
flap which goes away. Many describe it as comparable to their vision
at night with a soft contact lens. With Dr. Gollance's technique of
measuring the pupil size in near total darkness using an automated
infrared pupillometer, adjusting the excimer beam size to suit the
pupil, and using sophisticated eye tracking technology, night vision
complaints are very unusual. Many of our patients tell us that their
night vision is superior after to surgery to anything they had prior
to surgery.
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I've
been told I have astigmatism. Can you treat that?
All
of the lasers Dr. Gollance uses are FDA approved to treat astigmatism,
using either LASIK or PRK. Astigmatism correction generally adds only
a few seconds to the overall treatment of the laser.
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Can
the laser treat farsightedness?
The
FDA has approved the treatment of farsightedness, both with and
without astigmatism. Dr. Gollance conducted one of the original FDA trials
for farsightedness correction with LASIK.
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Do
you treat both eyes at the same time?
Dr.
Gollance typically treats both eyes on the same day. Some patients elect
to have their eyes treated on separate days for financial or other
reasons.
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Can
I have LASIK if I have dry eyes?
Yes.
Dr. Gollance has treated many patients with pre-existing dry eyes. The
important issue is to aggressively manage the dry eye condition prior
to the surgery. This is because LASIK will temporarily make your eyes
drier than usual post-operatively, and it is more difficult to deal
with this situation if it has not been addressed prior to surgery.
With these precautions, even patients with severe dry eyes can usually
be treated.
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I
have worn contacts for monovision. Can you treat my eyes for
monovision with the laser?
We treat patients for monovision (one eye for near,
and one eye for distance) who have previously
successfully worn monovision contact lenses. We will
also do trial fittings of contact lenses to see if you
might like this option. A good number of our patients
over forty select this form of treatment. Please feel
free to discuss monovision with us.
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Will
the results of my laser surgery last?
Long
term results have demonstrated that the treatments performed with the
laser years ago are permanent; in fact some patients are now over ten
years post-op, with stable results. LASIK and PRK will not accelerate
other aging changes in the eye such as cataract formation, or the
development of presbyopia (the need for reading glasses). On the other
hand, laser vision correction will not protect you from these natural
aging changes in the eye. A yearly eye exam is still recommended
following your laser treatment.
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Why
is it important to choose a good surgeon?
Laser
vision correction is possible because of tremendous advances in
medical technology; however the role of the surgeon is more critical
than ever. While complication rates with laser vision correction are
very low, Dr. Gollance spends a good deal of his time providing second
opinions for patients who have experienced complications related to
laser surgery performed elsewhere. Very often it is possible to
correct these problems, but these complex cases underscore the
importance of selecting the right surgeon the first time.
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Do
you have financing plans?
Dr. Gollance
offers a variety of financing plans, and we will
work with you to develop a plan to meet your needs. All financial
arrangements must be completed prior to the day of surgery.
Apply online right now with Care Credit at:
www.carecredit.com/patients/apply.htm
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I
have seen LASIK advertised for ridiculously low prices. What
should I know about this?
This
excerpt from an ABC Action News report explains why the Federal Trade
Commission has filed a complaint against Lasik Vision Institute.
This company is currently advertising $299 LASIK which they perform
out of the back of a truck which is temporarily parked in an New Jersey
shopping center parking lot. Click
here to read more on this
story.
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Does
insurance cover laser vision correction?
Generally,
health insurance does not cover laser vision correction; however, a
few health plans provide a small contribution to the total cost of the
procedure. We are happy to investigate this possibility for you. Many
corporate cafeteria plans allow pre-tax dollars to be used toward
laser vision correction.
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Is
laser vision correction tax deductible?
YES.
A new ruling from the IRS allows many patients to deduct the cost of
laser vision correction. See the IRS
website for further details.
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Why do you use both the VISX and LADAR "flying spot
lasers"?
Dr. Gollance uses both these lasers for either
standard or custom lasik or PRK. Individual
differences determine which procedure is best for
getting the finest visual result possible. Ever
changing improvements are constantly integrated into
patient care. Dr. Gollance regularly attends the
Refractive Surgery meetings of the American Academy of
Ophthalmology and the American Society of Cataract and
Refractive Surgery as well as regional meetings.
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What
is Refractive Lens Exchange?
Refractive
Lens Exchange is a procedure that is essentially identical to the
procedure used to treat cataracts. Patients who have some degree of
cataract formation may actually benefit from having their cataracts
removed as a method of eliminating their glasses prescriptions. The
reason for this is that at the time of removal of the cataract, an
implant lens can be placed which has the prescription power necessary
to reduce or eliminate the need for glasses. The recovery period for
this procedure is similar to LASIK; however, only one eye is treated
at a time. This procedure is occasionally used for some younger
patients with extremely high prescriptions, well outside the range of
LASIK or PRK. During our evaluation of your eyes, we can determine if
this option is appropriate for you.
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