LASIK and Refractive Surgery Questions

LASIK and Refractive Surgery Questions

LASIK and Refractive Surgery Candidates

Is there an age limit?

A candidate must be at least 18 years old, but there is no upper-end limit. The decision to have refractive surgery depends greatly on the overall healthiness of the eye and the lifestyle of the patient. The patient's vision must also be stable, which is usually achieved by the time a patient is in his/her early twenties.


How do I know if I'm a good candidate and which procedure is best for me?

A patient's age and level of refractive error are used to determine which procedure is best. Through a free screening, BayCare Clinic Eye Specialists staff can help with this determination as well as give specific information about the procedures.


A good candidate is also someone who is in good, general health (or whose conditions like diabetes, thyroid disorder, AIDS, etc. are under control). The overall healthiness of the eye can be determined prior to surgery with a thorough, dilated eye exam.


The vast majority of individuals with refractive errors (95%) fall within the range of eligibility for refractive surgery of some kind. The remaining 5% of the nearsighted, farsighted, and astigmatic population have refractive errors or other contraindications that would give poor results. With today's advancing technology, there may some day be hope for everyone.


LASIK and Refractive Surgery Fees

How do fees compare?

The cost of refractive surgery varies among practices based on procedure type, surgeon experience and involvement, technology used, and what is included in the fee. Be careful of "bait and switch" offerings of different technology based upon prescriptions, ages, and patient goals. Another tactic allows patients to choose from "good, better, best" options. Though you cannot be expected to understand all your own eye issues and have taken your own measurements, you are left to choose between a menu of options where technology and what you want to risk is priced at good, better, or best values.


At BayCare Clinic Eye Specialists, we feel your surgeon is best qualified to help you choose how to meet your goals and achieve your desired outcome. We offer only what we feel is the best technology and treatments, and our prices and services do not change simply because you might have astigmatism or a higher prescription than other patients. Why would a surgeon want anything less than the best for patients?!


Many discount centers charge a minimum fee, but the patient pays for the add-ons. One of these add-ons may be prescriptions for drops to use before or after surgery. This, alone, could add up to an extra couple hundred dollars. In addition, you can also expect to pay extra for post-operative care if you are seen for more than the maximum three visits. Eyes take 6 months to a full year or more to heal after most vision correction procedures. Thus, you may not receive the proper post-operative care if you do not know when to make a decision to return or are not prepared for the additional costs and travel for more visits. At BayCare Clinic Eye Specialists, followup care for 3-6 months for procedures such as ICL and RLE, and for up to one full year for LASIK, are included in our global fees.


Discounters also separately sell enhancement policies or a lifetime of retreamtents (like a guarantee). Unfortunately, no one can guarantee a perfect outcome. In many cases, too, patients must qualify for a retreatment under these policies. Patients who do choose to pay extra for an enhancement package may discover they are not even eligible to get a retreatment, even if they paid for it. Furthermore, a retreatment of the same procedure may not even be the best choice of intervention post-operatively. A different technology or procedure may work better as a complementary treatment to achieve the desired goal. Many discount centers do not have alternative options available. Thus, patients may feel pressured to do an enhancement, since they paid to get it, even if it is not in their best interest. Again, BayCare Clinic Eye Specialists "Lifetime Commitment Policy" is all part of our global fees.


How much should I expect to pay for laser vision correction and other procedures?

It is only natural to want to get the best price; nonetheless, remember that quality and service are extremely important when it comes to personal medical care. We are neither the least nor most expensive provider, and we will not sacrifice safety and service in order to save you money. Also, current technology can be costly. We have invested in some of the best advanced laser and diagnostic technology, which directly reflects on surgical results and patient satisfaction. Every patient at BayCare Clinic Eye Specialists gets the best we have to offer.


BayCare Clinic Eye Specialists fees vary according to procedure and are structured as global packages, which include the surgeon and facility fees, technology royalties, medications and drops for surgery, up to a full year of post-care, enhancement, and lifetime commitment policies.


What are my financing options?

We have applications available for patients who choose to finance. Details about financing can be found in your informational folder.


Can I use flexible spending for vision correction?

Vision correction procedures are considered qualified for reimbursement under flexible spending accounts, cafeteria plans, or medical itemizing on year-end taxes, which can show savings up to 35%. We recommend you have a surgeon's exam prior to setting aside pre-tax dollars, just to be sure you are a candidate, since many flex accounts have stipulations that you will forfeit your funds if the money is not used during the fiscal flex plan year designated by your company. Because full fees are due on procedure days, patients are required to pay up-front for elective procedures. Patients are given receipts to send in for reimbursement from flexible spending accounts.


Are refractive surgeries covered by insurance?

Because there are other, non-surgical, means of correcting vision (namely glasses and contacts), refractive surgeries are considered elective and are typically not covered by insurance companies. However, there are some policies that do cover them or offer discounts, so it may be helpful to check with your particular provider.


LASIK and Refractive Surgery Information


Are refractive surgeries painful?

Although there is some pressure and bright lights, the procedure itself should not be painful. Topical anesthetic eye drops are used to numb the eye for the surgery, and a mild sedative can be given to help relax the patient. Afterwards, recommendations are given as to what medications may be used to relieve discomfort.


Can both eyes be done at one time?

Most LASIK patients may choose to have one or both eyes done at a time. When deciding to have both eyes done the same day, patients need to understand that the risk of a complication increases slightly.


In the case of most other procedures, only one eye can be done at a time. The time between surgeries may range anywhere from a few days to weeks to months, depending on how quickly the first eye heals and responds to treatment. Your doctor will help make this decision.


Can I drive home after my procedure?

No. Arrangements need to be made to have someone drive you home after surgery. Though there is an immediate change in your vision following surgery, you will have hazy vision, light sensitivity, and tearing.


How long is recovery time?

Recovery varies from one individual to the next and from one procedure to the next. The average person is able to go back to work in one to two days following surgery. With all procedures, vision continues to improve as the eye heals.


Patients generally have dramatically improved vision within a few days, though fluctuation and mild blur or hazy vision can occur for a couple of weeks. Visual recovery with PRK is slow, and a temporary surgical contact "band-aid" is placed on the eye to help speed the healing process. The first eye that is surgically corrected with PRK may have hazy vision for some time, taking anywhere from a few weeks to months before it is in a vision range where the second eye can be operated on. With all procedures, full vision recovery can take several months. Recovery will be longer for a patient who needs an enhancement, a procedure to fine tune vision if it is not fully corrected. Generally, enhancements can be done about 3 to 6 months after the initial surgery.


LASIK and Refractive Surgery Results/Expectations

What side effects may occur?

Immediately following surgery, patients can expect watering of the eye and a burning and/or scratchy feeling. These symptoms typically last a few hours to a few days. It is also common for eyes to be dry for several weeks after surgery.

Some patients heal very quickly with little or no side effects, while others heal more slowly and have lingering after effects. Usually, resulting symptoms are minor and go away with time; however, there are recorded cases in which side effects have become permanent. Some of these side effects include light sensitivity, halos and/or starburst patterns around lit objects at night, fluctuating vision, and a decrease in night vision.


Will I have 20/20 vision following vision correction?

The odds are that if you are a good candidate and elect to have refractive surgery, you will become less dependent on your glasses or contacts. However, even with excellent surgery results, there may be times when you occasionally will want to "fine tune" your vision with glasses. There is also a small percentage of individuals who need to continue to wear correction full-time after surgery in spite of the fact that they were good candidates for surgery. Furthermore, for some patients, 20/20 vision in both eyes may not even be the surgical target.

Also, regardless of whether or not you have a successful surgery, when you develop the age-related condition called presbyopia, you will still need reading glasses. Be wary of anyone that makes extravagant promises. No one should ever GUARANTEE that you will never need glasses again.


What visual outcome can I expect?

Studies show that nearly all good refractive surgery candidates obtain 20/40 vision or better without glasses or contacts. (A visual acuity of 20/40 is the legal vision needed to pass a driver's test.) Regardless of which procedure they choose, these candidates have very few post-operative complications, as long as the procedure is appropriate for their refractive error.


If I do not achieve full correction after surgery, can I wear contact lenses?

Most, but not all, patients who wore contacts before refractive surgery can wear them after.


Are any scars or marks noticeable after surgery?

LASIK patients may have a very faint outline of the flap visible under a microscope. As time goes by, the outline becomes less apparent. In most PRK cases, little evidence remains once the eye has healed completely, even when looking at the cornea under a microscope.


LASIK and Refractive Surgery Technology/Differences

What is meant by "blade-free LASIK" or IntraLASIK?

IntraLase® is a laser technology used in the first step of LASIK to create the corneal flap rather than using a mechanical microkeratome with a metal blade. IntraLase is a femtosecond laser that pulses across the eye surface very quickly, accurately, and precisely to create micron-size bubbles. These bubbles lift and separate the corneal tissue. The distinct advantages of IntraLase compared to mechanical microkeratomes include precise flap positioning, even thickness throughout the flap, and lower incidences of flap complications such as buttonhole flaps, thin or thick flaps, or epithelial defects. In addition, patients report better quality of vision, less post-operative dryness, and there are fewer slipped flaps. BayCare Clinic Eye Specialists introduced IntraLase as a part of our LASIK process in November of 2004.


What is the difference between conventional LASIK and custom LASIK?

LASIK is a two-step procedure. The first step is creating a corneal flap to fold back, so that an excimer laser can be used to vaporize tissue to modify the eye surface. When the excimer laser is applied in a smooth pattern across the entire eye surface to help reduce nearsightedness and farsightedness with or without astigmatism, this is called conventional LASIK. However, there are other imperfections in the eye's optical system that may affect quality of vision, causing halos, glare, and other annoying visual disturbances. These visual distortions are called "higher order aberrations." Advanced wavefront technology makes it possible to measure and address these higher order aberrations in a custom LASIK treatment. Wavefront mapping makes it possible to capture your eyes individual irregularities, perfectly align the treatment to match your eye, and finally treat with the excimer laser to a unique customized pattern to accurately reshape your cornea. BayCare Clinic Eye Specialists was the first in Northeast Wisconsin to offer Custom LASIK treatments.


Is all laser vision correction the same?

No. Many discount laser centers want you to believe that LASIK is like buying a disposable product. These discount centers want you to believe that surgeon experience, lasers, diagnostic technology, and follow-up care don't affect outcomes. Laser vision correction will impact the way you see for the rest of your life. Vision is not something to be replaced if it is not the right fit or if you don't like it. You need to make the decision for eye surgery carefully, not quickly. We encourage you to learn as much as you can about the options available. There's a lot of information to understand about the differences and what is right for you and why. We provide you with all this information because we feel that the more you know, the more confident you will be making the choice of vision correction at BayCare Clinic Eye Specialists.

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BayCare Clinic,, is the largest physician-owned specialty-care clinic in northeastern Wisconsin and Michigan’s Upper Peninsula. It is based in Green Bay, Wisconsin. BayCare Clinic offers expertise in more than 20 specialties, with more than 100 physicians serving in 16 area communities. BayCare Clinic is a joint partner in Aurora BayCare Medical Center, a 167-bed, full-service hospital. Follow BayCare Clinic on Facebook and Twitter.