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. 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 and people in hazardous occupations. A complete eye exam with one of our doctors can identify the best options for you.
Drs. Robert and Stephen 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 sophisticated devices either the Orbscan II or the Pentacam 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. These instruments help us customize the best treatment options for your individual situation.
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What
is Custom-LASIK and Custom-PRK?
Drs. Robert and Stephen Gollance offers the technological advantage of Custom wavefront guided laser vision correction. Custom laser correction involves a diagnostic device that maps the entire optical path of your eye, including the tiny distortions and imperfections naturally present all eyes. This is effectively a unique "fingerprint of your vision," and provides us with extremely precise and detailed information about your vision. The technology involved is highly complex, and it is based upon mathematical techniques used to improve the performance and image quality of deep space telescopes. This customized unique map of your eye is then loaded into the computer of the excimer laser which generates a wavefront customized and/or wavefront optimized treatment appropriate for the individual "fingerprint" of your eye.
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?
Most LASIK and PRK patients will experience some degree of temporary night glare post-operatively. This is due to microscopic swelling in the flap in the case of Lasik and the healing response in the case of PRK. These which go away. Many describe it as comparable to their vision at night with a soft contact lens. With the techniques of Drs. Robert and Stephen Gollance and custom corneal analysis which allows for adjusting the excimer beam size to suit the pupil plus the use of sophisticated eye tracking technology, night vision complaints are very unusual. Most 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 Drs. Robert and Stephen Gollance use 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. Drs. Robert and Stephen Gollance employ similar techniques to those for nearsightedness. Both Lasik and PRK techniques can be used.
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Do
you treat both eyes at the same time?
Drs. Robert and Stephen Gollance typically treat 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 Refractive Surgery if I have dry eyes?
Yes. Drs. Robert and Stephen Gollance have 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 Refractive surgery (lasik or PRK) 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. There is evidence to suggest that PRK has some advantages in the patient with dry eyes.
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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, Drs. Gollance Robert and Stephen spend 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?
Drs. Robert and Stephen Gollance offer 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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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 ALLEGRETTO lasers?
Drs. Robert and Stephen Gollance use 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. Drs. Robert and Stephen Gollance regularly attends the Refractive Surgery meetings of the American Academy of Ophthalmology as well as other national and regional meetings.
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