Frequently Asked Questions
We know you need more information to make an informed decision, so we'd like to answer some of the questions you may have while considering the laser procedure.
What is Excimer Laser Surgery and LASIK?
The VISX CAP method uses a proprietary beam-shaping module to narrow and redirect the scanning array of the STAR S4 for more precise ablation patterns.
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Excimer Laser Surgery is an outpatient treatment that uses a cool beam of light to gently reshape the surface of the eye - the cornea - thereby improving vision. LASIK is the most advanced vision correction procedure available today. Doctors have been routinely treating refractive vision errors with incisions for over 30 years. Today's technologically advanced Excimer laser is now in its 2nd decade of use for treating nearsightedness, farsightedness and astigmatism. To date, medical doctors around the world have performed over 11 million procedures. Dr. Miller's own statistics show that 100% of his patients achieve "driving vision" or better without glasses.
"LASIK" is an acronym for LASer In-situ Keratomileusis, which simply means, "to shape the cornea from within using a laser." The laser is guided by an advanced computer and is able to reshape the cornea precisely. Its "cool" or non-thermal light beam gently pulses to remove a microscopic amount of tissue, correcting vision by reshaping the cornea (outer window of the eye). This allows light rays to focus more precisely, producing a sharper image on the retina, thereby eliminating or reducing refractive errors and the need for glasses or contacts.
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Where and when was the Excimer laser developed?
It was developed by IBM in 1979 to etch circuits in computer microchips. In the early 1980's researchers found the Excimer laser to have medical applications as well. The first human procedures were done in Berlin in 1987. Since then, over the past eleven years more than 5,000,000 procedures have been performed.
What are the benefits of Laser Vision Correction?
Laser Vision Correction for nearsightedness, farsightedness and astigmatism is designed to be a one time, permanent treatment to reduce or eliminate your dependence on glasses and contact lenses. This innovative procedure may restore your natural vision and provide you with a new sense of freedom in your life and may eliminate dry, uncomfortable contact lenses or glasses.
What's the difference between PRK, LASIK, and RK?
You may have heard about PRK, which stands for Photorefractive Keratectomy, the medical name for the laser procedure. PRK and LASIK (Laser in-situ Keratomileusis) both use the VISX Laser System to remove corneal tissue in order to reshape the cornea. In the PRK procedure, the laser works on the surface of the cornea. With LASIK, the surgeon first creates a flap on the cornea and then uses the laser for treatment below the corneal surface. RK (Radial Keratotomy) is a non-laser procedure, in which the surgeon uses a diamond blade to make a series of radial cuts into the cornea. Both LASIK and PRK are approved by the U.S. Food and Drug Administration as "safe and effective".
What is VISX CustomVue (individualized laser vision) correction?
VISX CustomVue individualized laser vision correction is WaveScan®-driven, which, enables the physician to measure and correct unique imperfections in each individual's vision. Many of these imperfections could never be measured before using standard methods for glasses and contact lenses.
Who is a candidate for VISX CustomVue procedure?
If you are 21 years of age or older and wear glasses or contacts to correct nearsightedness and/or astigmatism you may benefit from CustomVue™. If you meet the criteria, Dr. Miller will discuss this option with you.
What is Personal Best Vision?
Because every individual's eyes are unique, each individual may benefit from a correction custom-tailored for them. For the first time, CustomVue using WaveScan technology can measure and correct the unique characteristics of each individual's vision, potentially providing them with the best possible vision for their eyes, or their Personal Best Vision.
What is WaveScan® technology?
WaveScan technology was originally developed for use in high-powered telescopes to reduce distortions when viewing distant objects in space. This technology has now been applied to laser vision correction, measuring imperfections in the eye never before measured using standard methods for glasses and contact lenses. WaveScan-based digital technology identifies and measures imperfections in an individual's eye 25 times more precisely than standard methods. Physicians use this information to treat individuals with the CustomVue™ procedure.
Why is WaveScan technology so important to the CustomVue procedure?
Until now, physicians were forced to practice one-size-fits-all vision. An off-the-shelf lens corrects an individual's vision fairly well, but it does not correct it precisely because it is not uniquely tailored to that person's fingerprint of vision. Now, with WaveScan technology, we can custom tailor a correction for the unique characteristics of each individual's vision.
How is the information transferred from the WaveScan to the laser?
The WaveScan digital information is transferred to the laser on a computer disk, providing a new level of precision and accuracy.
Can you briefly explain what a patient will experience during the course of this procedure?
The individual will initially meet with the physician for an evaluation to determine if he or she is a good candidate for the CustomVue procedure. A WaveScan measurement will be taken to map the unique characteristics of his or her vision. The physician will assess several criteria including level of correction, and overall eye health and discuss the benefits and risks of the procedure with the patient. Once it is confirmed that the individual is a good candidate, he or she can be scheduled for CustomVue. The physician will provide details for the individual on how to prepare for the day of the procedure.
On procedure day, the individual will be seated in a reclined position. Anesthetic drops will be placed in the eyes and a flap will be created in the cornea. The individual's treatment information is transferred from the WaveScan to the VISX® laser in order to drive the CustomVue procedure. The actual laser procedure typically takes several seconds. The majority of individuals feel no pain during the procedure.
After CustomVue, individuals will notice results immediately, and vision will continue to improve over the next few days. The individual will be scheduled for a follow-up visit the next day, and again several weeks after the initial procedure.
Will I need glasses or contacts after the CustomVue™ procedure?
Probably not. Six months after the clinical study, all participants saw well enough to drive a car without glasses or contacts. Ninety-four percent had 20/20 vision. However, individual results may vary
What vision problems can be successfully treated with LASIK?
Nearsightedness, farsightedness and astigmatism can all be successfully treated today with LASIK.
To treat nearsightedness, the cornea must be made flatter (less steep). This is accomplished by removing tissue from the center or central portion of the cornea.
To treat farsightedness, the central cornea must be made steeper (less flat). This is accomplished by directing the laser beam to remove tissue from around the peripheral (outside) area of the exposed cornea.
To treat astigmatism, the cornea must be made more spherical and uniformly curved (instead of irregular like a football or egg). By changing the beam's pattern, tissue is removed in one direction more than the other.
How do I know if I am a candidate for Laser Vision Correction?
If you currently wear glasses or contact lenses for distance vision, you could benefit from laser vision correction. The overwhelming majority of Americans with nearsightedness, farsightedness or astigmatism fall within the FDA-approved ranges for treatment of these conditions. Dr. Miller is a trained expert and can tell you if the laser procedure is right for you.
Some guidelines are:
You must have healthy eyes, and be at least 18 years old for nearsightedness and 21 years old for astigmatism.
Your vision must be stable for at least one year before the laser procedure.
You are not a good candidate if you have degenerative or autoimmune diseases, or if you're pregnant or nursing, or if you have a condition that makes healing difficult.
Is Laser Vision Correction safe?
Yes. Over five million patients worldwide have had this treatment performed on them successfully. The FDA has recognized laser vision correction for nearsightedness, farsightedness and astigmatism, and found the treatment safe and effective for all eligible patients. All surgical procedures entail some risk; please discuss this with Dr. Miller.
Does Laser Vision Correction hurt?
No, the procedure itself is painless. Needles are NOT used, only numbing drops. You may experience some discomfort the first 12-24 hours after the procedure as the surface cells of the cornea begin to heal. Many patients compare this to a sensation of a speck of sand in the eye. We can prescribe pain medication to alleviate any discomfort during the recovery. By the next morning, most people feel fine and resume their usual activities.
How long does the procedure take?
The procedure itself takes only seconds under the skilled eye and hands of an experienced surgeon. To maximize precision, safety and cost savings for the patient, Dr. Miller performs all his LASIK procedures at the San Diego Eye Bank's new, state-of-the-art laser center. As the patient, you will want to plan on being there about 1 hour, and will need to be driven home. (Your friend or family member can even view the procedure, if desired). Many of our patients are able to drive without glasses the next day, and nearly all are able to return to work that day as well.
How long does it take the eye to heal?
The front surface of the eye takes 24-72 hours to heal.
Can I have both eyes done at once?
Yes, this is called a bilateral procedure. This is determined on an individual basis. Dr. Miller will advise you if you are a candidate.
Will my vision remain stable after the procedure?
The results of Laser Vision Correction are permanent. However, the laser will not stop the natural aging process of the eye. Less than 3% of our patients require a vision enhancement procedure within the first year. (A nominal fee may apply.)
How many visits are required after the surgery?
Initially, patients are seen within 24 hours after the surgery. Follow-up visits thereafter are one week, one month, three months, six months, and twelve months.
Do I have to wait for my regular eye exam?
No. You can have the laser procedure as soon as you're ready and eligible to do it. You may call THE EYE CENTER at (619) 442-3937 (that's 442-EYES) or toll-free at 1-(877)442-EYES to request an information packet or schedule a complimentary consultation.
Can I include my family eye doctor (Optometrist) in my refractive surgery care?
Yes, you can. In fact, we encourage it! Your family eye health specialist is familiar with you and your current vision care, and most patients will continue to see their current eye doctor for yearly examinations after the surgery process is complete. Involving your family eye doctor in your refractive procedure allows a continuance in his/her awareness of your vision care needs. We believe that continuity of care is an important factor in the health of your eyes and allows you the comfort of visiting a doctor with whom you are already familiar.
What should I do before having Laser Vision Correction?
Have a complete eye exam and discuss the benefits and risks of the laser procedure with Dr. Miller. Make sure you read the information supplied, and have all questions answered fully. At THE EYE CENTER, we want you to feel comfortable with your decision.
What happens before the treatment?
We will conduct a thorough examination to determine whether your eyes are healthy and suitable for the laser procedure. Your eye will be photographed and a computerized map made, called corneal topography. This will assess the shape of your cornea, and is one of the many diagnostic tests we use to help ensure precise results.
What can I expect the day of treatment?
This is an outpatient procedure. The actual laser treatment takes less than one minute for most patients. The entire procedure usually takes fifteen minutes, and your visit will be complete in less than an hour.
First, you will relax in a reclining chair. Anesthetic drops will be placed in your eye, then you will be positioned under the laser. A retainer will be placed to gently and comfortably hold your eyelids open during treatment.
The LASIK treatment begins with the lifting of the outermost layer of the cornea. Then, you will focus on a blinking light. Microscopic amounts of tissue, less than the thickness of a human hair, will be removed from your cornea by the gently pulsing light. Afterwards, some drops will be placed in your eye for protection and comfort. You'll walk out of the treatment center with new vision immediately!
How well will I see after Laser Vision Correction?
Results vary with each individual. In a recent study, 98% of patients treated for nearsightedness, farsightedness and/or astigmatism with the VISX STAR Excimer Laser System saw well enough to pass a driver's test without glasses. 100% of Dr. Miller's patients have achieved 20/40 vision or better without glasses. Your vision should be improved immediately after treatment. Some patients may experience small vision changes during the first several months, which is a normal occurrence.
How soon can I return to work?
Most people go back the day after treatment. One to two days are the norm.
What is healing haze?
This is rarely a problem for the patient. Statistically, only 1 or 2% of PRK patients encounter haze. The haze is part of the healing process. It can appear at about six months and usually disappears by 12 months. Healing haze does NOT occur with LASIK (in fact, this is one advantage of LASIK over PRK).
Will reading glasses be required?
Presbyopia is the normal weakening of the focusing muscles of the eye, usually by the age of 45. All normally sighted patients require reading glasses by sometime in their mid-forties. Without surgery, patients must either wear bifocals or remove their distance correction to read. There is a correction called monovision that can offset this natural occurrence. Dr. Miller will be able to determine if this option is available for you.
Can I have LASIK if I have a cataract? Can I have LASIK after cataract surgery?
In general, a person with visually significant cataracts would not be a good LASIK candidate. During cataract surgery, a lens implant is used that corrects nearsightedness or farsightedness, so performing LASIK prior to cataract surgery would be redundant.
If an eye has already undergone cataract surgery and is left nearsighted, farsighted, or with astigmatism, then LASIK can be a very good way of correcting those refractive errors!
Will having LASIK now cause me to develop cataracts later?
NO! There is no evidence that having LASIK now will cause you to develop any other condition later on, including cataracts, glaucoma, macular degeneration, etc.
Are there any risks?
There are risks with any procedure. However, because the laser procedure uses a cool beam of light that is computer controlled, there is little room for error, in the hands of a skilled surgeon and cornea specialist. In a recent study, all patients experienced better uncorrected vision following the laser procedure.
What about long-term risks?
In 1987, Dr. Theo Seiler of West Germany successfully performed the first procedure. Researchers have found no unexpected long-term complications and we have no reason to believe negative effects will become apparent after this time.
Choosing your Laser Vision Correction Specialist is your most important decision.
Ideally, you should choose an MD who is an Ophthalmic Surgeon, is Board Certified (Diplomate, American Board of Ophthalmology), a Corneal and External (Eye) Disease Specialist (had significant additional fellowship training in this field) and a Specialist in Laser Vision Correction. Douglas G. Miller, MD, Medical Director of THE EYE CENTER is all of these and more. Dr. Miller has been practicing ophthalmology in Southern California since 1989, and is East County's only Board Certified Ophthalmologist, who is also a fellowship-trained Cornea Specialist!
How much will it cost?
Fees for the laser procedure are competitive and comprehensive. We are able to offer our patients the very best value. Please call (619) 442-3937 (that's 442-EYES) or toll-free 1-(877)442-EYES for more detailed information, including specifics about our easily affordable, zero money down, low monthly payment plans.
Consider the laser procedure to be very affordable and cost-effective, especially when compared to what you would have to spend on glasses, contact lenses, and lens care over the course of 10 - 20 years. The difference is, you'll have clear, natural vision and reduced or eliminated dependence on glasses and contacts. This is a true lifestyle decision.
* Some medical plans may cover the cost. However, most medical plans consider this an elective treatment and therefore do not pay for the procedure. Be sure to ask your health insurance provider.
+ The material contained on our web site is for informational purposes only and should not be used for diagnosis or treatment of any medical condition. A licensed physician should be consulted in person, for diagnosis and treatment of any and all medical conditions. We do not warrant that the information is free from all errors and omissions. We do not recommend, advise or suggest that any patient use the information as a sole resource for diagnostic or educational purposes.
This exciting, life-changing procedure can open up your world with the amazing power to see. Please contact us to schedule your complimentary, personal consultation with Dr. Miller.
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We hope these questions and answers have been helpful. If you are a good
candidate, and have determined that Laser Vision Correction is right for you-
don't let your glasses or contacts define your lifestyle any longer -
Make Your Own Statement -
" I'm Worth It! "
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