Frequently
Asked Questions
DoesThe
Surgery Hurt?
The laser procedure itself does not hurt. A slight pressure may be
felt during the procedure. There is, however, the possibility of discomfort of some degree
after the procedure for approximately 2 to 3 days. The discomfort may be very mild.
Approximately 10% of patients experience pain that is more significant.
Can You Guarantee Me 20/20Vision from
PRK?
No. We cannot absolutely guarantee a certain result -from the
surgery, but we can quite accurately let you know the probability of you achieving 20/20
vision.
95% of our patients with low through moderate ranges of myopia
and/or astigmatism achieve normal or near normal natural vision from just one surgery. For
those who do not achieve this quality of vision from one surgery, enhancement surgery can
usually give the rest of the desired correction.
People with high ranges (8 to 13 diopters of nearsightedness; 3 to 5
diopters of astigmatism) of nearsightedness and astigmatism also have a very good
probability of achieving good natural vision, but an enhancement surgery is more likely to
be necessary for full correction.
Are There Any Negative Long-Term
Effects Of PRK?
The medical community can only speak for the future by assessing the
data from the surgeries performed within the last ten years. The data reveals a very
positive healing response of the eye giving doctors no reason to be concerned about
effects beyond ten years.
Surgeons have studied the eyes of people who have had other types of
surgery, or who have been in accidents where the outer layers of the cornea were modified
in similar but more invasive ways several decades ago. After healing these eyes
have not shown negative effects, giving doctors even more confidence about the
ongoing health of the eye after PRK surgery.
Risks And Side Effects Of PRK
As with any surgical procedure, PRK laser surgery has some possible
risks that must be taken into account. Each candidate should remember that a specific end
result cannot be guaranteed, although it can be closely predicted based on data from
thousands of previous cases.
Serious complications are very rare. Infection is the largest risk,
but its occurrence is extremely infrequent. Even if it develops, infection can usually be
cleared effectively with medications. Other possible complications include haze, scarring,
induced astigmatism, and too much or too little healing response. Most, but not all,
complications are treatable with medications or further surgery.
During the healing process, most people can expect to experience at
least some of these effects:
- Initial exaggerated effects of surgery (since small amounts of the
removed tissue do heal back, the laser is programmed to remove
enough tissue for the eye to stabilize at the desired correction.
This initial effect may seem to be overcorrection).
- Increased sensitivity to light.
- Halo effect from bright lights at night.
- Decreased visual clarity in dim light.
- Slightly dryer eyes.
In most cases these effects decrease and disappear as the eye heals.
Occasionally, some may persist. Contact lenses, although rarely necessary, cannot be
worn on the operative eye for several months following surgery.
Risks And Side Effects of LASIK
Creating a cap of corneal tissue instead of a flap
by fully removing the top of the cornea rather than just lifting it. This removed tissue
still heals back into place but requires extra care in positioning.
- Infection - Very rare and usually controlled with medications
- Epithelial tissue growth underneath the flap - Can usually be solved
by lifting the flap and gently removing these tissue cells. Increased or decreased
response to surgery - Surgery can usually be modified by lifting the flap and removing
more tissue with the laser. Sometimes other types of surgery can be combined with LASIK to
give improved results.
Side effects are minimal following LASIK surgery
since most of the surface of the cornea has not been affected by the procedure. But people
who have the surgery may experience some light sensitivity and glare for a few days or
weeks. Full visual stabilization may take several weeks.
How Long Will The Correction Last?
Probably for the rest of your life. The cornea is a
very stable tissue. Medical experience shows that once the cornea has been modified, it
tends to stay modified permanently. There are rare cases of regression, which may be
corrected with further surgery, but the vast majority of corrected eyes continue to stay
in focus.
What Is Monovision?
An Alternative to Reading Glasses for Patients with
Presbyopia.
The need for reading glasses is a common problem for most people as they enter their
middle years. As people age, the natural lens in their eyes hardens and loses its
flexibility, impairing its ability to vary its shape for different ranges of focus. This
condition is known as presbyopia and develops in most people between 45 and 50 years of
age.
There are a number of ways to deal with the focusing
problems caused by presbyopia. People with a small amount of nearsightedness can simply
remove their glasses to read. However, people with previously normal vision, or those who
wear contact lenses for nearsightedness may need to use reading glasses for close work
such as reading, using a computer, or sewing. Bifocals can also be used to provide both
near and far vision without having to constantly put on and take off a pair of glasses or
repeatedly switch back and forth between two pairs of glasses. However, some people find
it difficult to adjust to bifocals and others consider reading glasses to be an
inconvenience. Another option, known as monovision, is available for some people with
presbyopia.
Monovision can be achieved through corrective lenses
or through refractive surgery. If a person has less that two diopters of nearsightedness
(vision of 20/100 or better), one eye can be surgically corrected to provide good distance
vision, and the other eye can be left uncorrected for near vision. People with greater
amounts of nearsightedness may have one eye corrected for distance vision, and the other
eye undercorrected to provide better close vision. If this option seems desirable, people
may wish to consider trying to achieve the similar effect with contact lenses prior to
surgery, to determine its suitability for their individual needs and their ability to
adapt to this situation.
The chief advantage of monovision is the freedom it
provides from reading glasses. Monovision makes it possible to repeatedly change the range
of focus, without having to constantly remove or add corrective lenses. This can be
particularly useful for people who change their focus frequently - particularly teachers,
public speakers, salespersons, and people involved in the performing arts.
As with any good thing, monovision comes with some
drawbacks. People with monovision may have decreased depth perception without corrective
lenses. They may also notice blurred vision in the "near" eye when glancing in
the side mirror of their cars or when the vision in the "distance" eye is
blocked by an object. Some people with monovision elect to wear corrective lenses for
activities such as driving or prolonged reading so that both eyes are then in focus.
Monovision is most appropriate for people who answer
"yes" to two or more of the following questions:
- Would it bother me to wear reading glasses and
carry them wherever I go?
- Does my lifestyle permit a slight impairment of
depth perception for many activities?
- When I require reading glasses, would I need to wear
them most of the time?
- Could I adapt to one eye being out of focus for distances unless
glasses are worn?
People who are entering mid-life and are interested
in monovision should discuss the matter with their doctor prior to undergoing refractive
surgery. Should they choose monovision and subsequently become unhappy with it, a PRK
enhancement surgery is an option.
When
Can I Drive?
A patient is legal to drive with one eye 20/40 or
better; however, a patient should refrain from driving until they feel comfortable with
the vision in their operated eye.
When
Can I Return To Work?
Generally speaking, a patient can return to work in 2 to 4 days
post-operatively.
How Long Will I Be On Medications?
Generally speaking, a patient is on medication (drops) for 3 to 6
months. This is dependent on the level of attempted correction and your individual healing
response.
Have Any Doctors Had PRK
Surgery Themselves.
Yes, many in The USA as well as in several other countries. This
includes a full spectrum of doctors, including Optometrists and Ophthalmologists
Excimer
Laser Surgical Outcomes:
| PRK Nearsighted Surgical Outcomes |
| Amount of Nearsiglitedness |
% 20/20 or better |
% 20/40 or better |
| 0.00 to -2.00 |
87% |
98% |
| -2.01 to -4.00 |
84% |
97% |
| -4.01 to -6.00 |
83% |
96% |
| -6.01 to -8.00 |
77% |
95% |
| -8.01 to -10.00 |
75% |
94% |
| -10.01 to -12.00 |
75% |
92% |
| -12.01 to -14.00 |
68% |
83% |
| -14.01 to -16.00 |
50% |
80% |
| PRK Farsighted Surgical Outcomes |
| Amount of Farsightedness |
% 20/20 or better |
% 20/40 or better |
| 0.00 to +2.00 |
80% |
85% |
| +2.01 to +4.00 |
68% |
80% |
| +4.01 to +6.00 |
68% |
80% |
| LASIK Nearsighted Surgical Outcomes |
| Amount of Nearsightedness |
% 20/20 or better |
% 20/40 or better |
| 0.00 to -4.00 |
75% |
97% |
| -4.01 to -8.00 |
72% |
94% |
| -8.01 to -12.00 |
78% |
93% |
| -12.01 to -16.00 |
79% |
91% |
| -16.01 to -20.00 |
14% |
82% |
| -20.01 to -24.00 |
0.0% |
80% |
| LASIK Farsighted Surgical Outcomes |
| Amount of Farsightedness |
% 20/20 or better |
% 20/40 or better |
| 0.00 to +4.00 |
70% |
95% |
| +4.01 to +8.00 |
0.0% |
80% |
| Mean Post-op Astigmatism Reduction |
| Pre-op Astigmatism |
Post-op PRK |
Post-op LASIK |
| 0.00 to -1.00 |
-0.43 |
-0.58 |
| -1.01 to -2.00 |
-0.53 |
-0.59 |
| -2.01 to -3.00 |
-0.60 |
-1.00 |
| -3.01 to -4.00 |
-0.94 |
-0.75 |
| -4.01 to -5.00 |
-1.08 |
|
| -5.01 to -6.00 |
-1.25 |
|
Note: It is legal to drive without glasses or contacts with
one eye 20/40 or better. Statistics are based on initial surgery. Enhancement
surgery may improve outcome.
If I Need To, Can I Wear
Contact Lenses After PRK?
Most patients do not require the use of contact
lenses post-operatively. Generally, if a patient was able to wear contact lenses
comfortably prior to surgery, they will be successful in wearing them again after surgery.
It may require some time to build up to the same number of hours that a patient used to be
able to wear contact lenses before surgery (like starting with contact lenses all over
again).
I’m
Over 50 Years Of Age; Will The Surgery Still Work For Me?
Each of your eyes has two lenses - the cornea (the
general focusing lens) and the inside lens (the fine focusing lens). PRK surgery works
effectively to correct the general focus of your eyes, no matter what your age. However,
the inside fine focusing lens of your eye hardens and no longer provides clear reading
vision past 50 years of age. This means that even if you have PRK, you may still need
reading glasses to see clearly up close from 50 or 55 years of age on. However, PRK may be
able to give you clear vision for all the other focal distances, without regular glasses,
for the rest of your life.
If you have cataracts we recommend that you have
your vision corrected by having cataract surgery. The lens placed in your eye at the time
of your cataract surgery can correct your nearsightedness and farsightedness. Most people
develop cataracts sometime between 60 and 85 years of age. Arrangements can
sometimes be made to have your cataract surgery early, even before you develop a
noticeable cataract, for the sake of enhanced focusing benefits.
Does
Anybody’s Vision Ever Turn Out Worse After PRK
In very rare cases, yes. In order for vision to turn
out worse than it was before surgery, a significant complication would need to arise. In
our experience, these complications have not lead to loss of vision but in a slight
reduction in the quality of vision and are generally associated with astigmatism or haze
resulting from the surgery. Some of these complications are treatable with further
surgery, but some are not.
What Is The Worst Possible
Complication?
The worst Possible complication of PRK is a serious
infection, which could lead to a deterioration of the cornea. Infections very rarely
occur, and when they do, they can usually be controlled well with medications with little
or no loss of the quality of vision even if the cornea does become seriously scarred
because of an infection. Corneal transplants are usually possible to restore clear vision
again. |
