Q: What is LASIK (laser assisted in-situ keratomileusis)?
A: LASIK is a procedure that corrects nearsightedness (myopia), farsightedness (hyperopia) and astigmatism. The procedure involves creating a thin flap of cornea using a precise, highly engineered instrument called a microkeratome. This flap is gently lifted exposing the underlying corneal tissue. The excimer laser is then applied according to a highly scrutinized mathematical calculation to custom shape the cornea. When the cool beam of the laser contacts the corneal cells the cellular bonds are broken and vaporize into the atmosphere. These cells, called stromal cells, are never regenerated by the body, which is how we know the effects of the laser are permanent.
Q: How do I know if I'm a good candidate for this procedure?
A: Patients age 18 and older, with no marked vision changes in the past year, can consider the procedure. It is especially popular among very active people who feel hindered by glasses or contact lenses. If you are considering refractive surgery we offer complimentary consultation appointments. At this visit your vision will be assessed with specialized diagnostic equipment to determine if you are a good candidate. The surgeon will personally meet with you and answer all of your questions and you will be able to see our state-of-the-art facilities located at Glenbrook Hospital.
Q: What is monovision and am I a good candidate for it?
A: Monovision corrects one eye to see at a distance and the other to see up close. Many factors like lifestyle, personality and visual need determine whether you are a good candidate for monovision. The surgeon can individually discuss this with you at your consultation appointment.
Q: What are the risks?
A: There are very few risks or complications. According to a recent article in Time magazine, estimates of complication rates are less than 1 percent when a corneal specialist performs LASIK. The surgeon will be more than happy to discuss risks and complications with you during your complimentary consultation appointment.
Q: Does it hurt?
A: No, there is very little discomfort involved with LASIK. Most patients describe their symptoms as a slight scratchy, foreign body sensation for 4-6 hours after the procedure.
Q: What will I experience after the procedure?
A: The day of your procedure, we ask that you go home, eat and go to sleep for several hours. After that you can simply relax at home for the remainder of the day and watch TV. You will see your surgeon for a quick, post-op check the morning after your procedure, then most patients return to work that day. The percentage of patients that achieve 20/40 vision or better is 98%; the state requires 20/40 or better to drive without restrictions.
Q: Do you do enhancements?
A: Yes. This occurs in about 5% of the patients who have LASIK performed. The reasons for enhancements can vary, typically it's related to the corneal cells not responding to the excimer laser in the manner in which they were expected to.
Q: Can you bill my insurance company for the procedure?
A: Typically few plans cover the cost of LASIK because it is considered "elective surgery". However call your insurance carrier and get an explanation of benefits, you might be surprised.
Q: Do you offer financing?
A: Yes. We have 0 percent financing for three (3) or six (6) months or twelve (12) months with 1/4 of the cost due at the time of the procedure.
Q: How many surgeries has Dr. Herz performed?
A: Our doctors have performed several thousand laser vision correction procedures.
Q: Will I need reading glasses after the procedure?
A: If you are over 40 and currently need reading glasses you will still need to have correction for your near vision. Many people that are over 40 and do not currently need reading glasses (or bifocals) may in fact need them after the procedure. There are a few options for this and they can be discussed with you individually at your complimentary consultation appointment.
Q: Do you perform bilateral procedures - both eyes at the same time?
A: Most patients choose to have both eyes done at the same time. Because the procedure is predictable and safe patients choose this option because of the convenience of having both eyes treated together to eliminate unbalanced vision between procedures. A very small percentage of patients choose to have one eye treated at a time or only need one eye treated. All patients are treated as they choose.
Q: What about glare and halos?
A: Glare and halos are related to a patient's pupil size. If a patient's pupil, at night, dilates larger than the diameter of the treatment zone, this patient is at great risk for developing glare and halos. To reduce this risk at the Eye and Vision Center the patient's pupils are measured preoperatively with an infra red instrument to measure their largest pupil size at night or in dim lighting. The treatment zone is then customized to be larger than the patient's pupil size greatly reducing the risk of developing glare or halos at night. Treating the larger optical zone of your eye is the key to reducing or eliminating glare and halos.
Q: How long do I need to stay out of my contact lenses and why?
A: You will need to stop wearing your rigid (gas-permeable or hard) lenses for atleast 3 weeks or soft lenses for 2 weeks prior to your preoperative evaluation. Discontinuation of your contact lenses is important because the shape and outer cells of your corneas can be altered by the contact lenses. Stable corneas are crucial to the accuracy of the measurements that are used in the programming the laser.
Q: What if I have dry eyes?
A: If you have dry eyes before the procedure you will still have dry eyes after the procedure. Your symptoms may increase for a few weeks or months after the procedure. During the procedure tiny plugs may be placed in the lower tear ducts to help with this dryness. This will help your tears remain in your eyes and not go "down the drain." In addition, frequent use of artificial tears is crucial to keeping the cornea lubricated after the procedure. We recommend this for everyone regardless of his or her tear production prior to LASIK. Keeping the corneas well lubricated afterwards will keep the outer cell layer intact, smooth and comfortable. Your vision will also remain clearer if the cells are smooth and well lubricated.
Q: Are there any restrictions after the procedure?
A: Yes you will need to take a break from swimming for two weeks after LASIK. The most important factor is protecting the eyes for a few weeks after the procedure to insure that the flap does not get displaced accidentally. The day of your procedure we only want you to nap, eat and watch TV. We do not want you to read, work on the computer or do any activity that require concentration, we need you to keep blinking to keep the corneas well lubricated. Other than that your activities are not hindered, patients typically go back to work the day after the procedure although you may consider taking an extra day off.
Q: Is the consultation screening for LASIK free?
A: At the Eye and Vision Center LASIK Suite the consultation is free. This includes corneal imaging and special testing for patients who wear bi-focals to see if they are candidates for Mono-Vision LASIK.
Q: Are the physicians that perform LASIK board-certified? Are they fellowship trained as “Cornea Specialists”?
A: Our physicians are board-certified fellowship trained cornea specialists.
Q: Will the doctor performing the surgery examine my eyes for my consultation, pre-operative appointment and post-operative visits or will my care be transferred to optometrists or other healthcare providers?
A: Dr. Herz seesr patients on every visit which includes the free consultation, pre-op visit, surgery and post operative LASIK related care for up to one year after the procedure.
Q: Does your center offer the latest technology “All LASER LASIK” with wavefront custom technology? Or does your center perform traditional LASIK with a blade microkeratome?
A: The Eye and Vision Center offers the latest technology of “All LASER LASIK” using the VISX Star 4 Excimer LASER with Custom Wavefront technology and Ziemer Femtosecond LASER to create a bladeless corneal flap.
Q: Is the staff performing preoperative testing and/or assisting in the LASIK procedure certified by the LASER manufacturer and are they certified under the Joint Commission of Allied Health Personnel in Ophthalmology?
A: The LASIK center staff who partake in the consultation, pre and post operative care are certified through the Joint Commission of Allied Health Personnel in Ophthalmology (JCAHPO). The LASER assistant is certified both through JCAHPO and the LASER manufacturers AMO and Ziemer
Q: Does the LASIK procedure take place in your practice or do I have to go to travel elsewhere? If the procedure is performed in your practice, do you own the laser or is it transported in and out of your facility?
A: All of our LASIK procedures take place in the Eye and Vision Center LASIK Suite. The Visx Star 4 excimer laser is stationary and permanently housed in a temperature and humidity controlled room. It never leaves our practice. This ensures the highest quality calibration and adjustments that the laser must maintain to meet our stringent operating standards.
Q: If I were to need a second procedure, “LASIK Enhancement,” would I have to pay extra? Under what terms are enhancements covered?
A: At our Eye and Vision Center, if an enhancement is warranted, it is at NO COST to you for up to two years after the procedure.
Q: Does your LASIK charge depend on my prescription? Does your charge depend on old vs. new technology in lasers? What is included in the cost?
A: Here at the Eye and Vision Center, we offer the latest technology “All- laser- LASIK” to all of our patients. If you are a candidate, all levels of nearsightedness, farsightedness and astigmatism, or any combinations thereof, are treated under the same price. The cost is the same for patients who wear reading glasses and choose to have “Mono-Vision LASIK”. Every LASIK related visit is included in the global fee, which includes post operative care for up to one year after your procedure. This also includes an enhancement if you and your doctor feel it is warranted, within a two year period.
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