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Pre-Op LASIK surgery questions
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Pre-Op LASIK surgery questions

I hope this isn't too long of a message.  Thanks in advance for your replies.

I have found who I believe to be a very well quailfied LASIK surgeon in my area (St. Petersburg, FL) and am about ready to undergo the procedure, but, since I only have two eyes, I am still a bit nervous and have some questions that I'd rather have answered by someone other than the doctor who will profit from my surgery...

Background:
- I'm a 35 year old male who has had a single vision prescription for the last 19 years.
- My prescription is approximately -2.25 and -2.75.  No astigmatism.
- I have never been able to get used to contacts. Dryness, burning, etc. made them unbearable. (My most recent attempt at contacts was not more than 2 years ago).
- I have some small floaters in my eyes once in a while.

- The office performed very thorough evaluation including corneal topography mapping, prescription verification, undialated and dialated eye examination, pupil size, and corneal thickness measurements.
- I was told that I have thick corneas, normal sized pupils, no other issues, and was a good candidate for LASIK.

- While I have a goal of getting rid of my glasses, I do not want to trade my glasses for a poorer quality of vision such as night vision and sharp contrast.  I see 20/15 with glasses and I see quite well at night.

- The surgeon only performs Custom LASIK.
- He owns all his equipment in a stationary, professional, and sanitary looking office with  a professional, courteous staff.
- They use IntraLase FS30 Laser for the corneal flap.
- They use the Visx Excimer Laser with Custom Guided Wavefront Technology.
- The surgeon claims to have done over 30,000 LASIK procedures.
- They quoted an all inclusive, global fee of $4,680 for both eyes including all followup visits and enhancements if needed.

Questions:

- Is the price too high ($4,680 global fee), even for a good surgeon with an excellent reputation?

- Night vision: I am extremely concerned about possible night vision side effects which I have heard so much about.  If they are temporary (a few months), I can deal with that as part of the healing process. But, I would be most unhappy if I simply traded my glasses for poor night vision.  At least I can see 20/15 with glasses.

- Is contrast likely to be lessened?  

- How long is my vision likely to fluctuate and what is the liklihood that I will need temporary glasses?  What is the real duration of the healing process?

- If the eye is being modified on the order of just a few microns, and the surgeon is manually placing your flap back at the end of surgery, is the benefit of Custom LASIK possibly reduced by improper placement of the flap at the end of surgery?  How is a surgeon, being human, capable of perfect flap placement at the end of the surgery?

- Does the flap ever completely reattach to the cornea as if nothing ever was done?  If not, has this permanent damage put the eye at a substantially higher risk of trauma from activities that would not have normally caused trauma in an eye that had not had LASIK performed?

- Are floaters likely to worsen?

- Any issues with flying in pressurized airplanes very soon after the surgery.  Is 4 days after surgery too soon?

- Does my inability to adjust to contacts tell you anything about how I might do with LASIK.  Am I likely to have dry eyes, experience more pain, or have a harder time healing than someone who has been able to wear contacts with no issues?

- Will LASIK cause complications future surgeries should they be needed, such as lens replacement for cataracts.
- If I should develop Glaucoma later in life, will the LASIK put me at any additional risk?


That's about it.  I just want to be well informed before I jump into this.

Thank you very much for your answers.
Related Discussions
3 Comments Post a Comment
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233488_tn?1310696703
1. You want to buy the lowest priced parachute nor the lowest priced laser. In our area there is a laser semi-truck that pulls into town, a itinerate eye surgeon flys in from Florida, they do the surgery in the truck parked in a parking lot. If the wind blows to much surgery is post-poned due to the wind shaking the truck. After the surgery the surgeons gets on a plane and flies somewhere else to do his itinerent surgery, the patient is told to see his optometrist (that receives a cut of the lasik fee) and if they need a MD-physician to go to the closest emergency room. They advertise a lasik fee of $600+ but use bait and switch add on's to often charge more than your surgeon.  

Your price is fair for what you're getting.

You need to discuss night vision concerns with the surgeon. Your are receiving state of the art technology to give you the best possible vision under all circumstances.

You will have to ask your surgeon about flying. Nornally it won't be a problem but he may want you to use artifical tears while on the plane.

Some people do report and increase of floaters or even a posterior vitreous detachment after lasik.

If you have moderate or severe dry eyes it could affect your healing and post operative comfort.

Lasik will not increase the risk of glaucoma, it can alter the accuracy of readings taken to measure your intraocular pressure. It will not make cataract surgery more difficult.

As to your other questions: No surgery is every routine, no matter how much patients and trial lawyers try to make it. Every surgeon no matter how skillful can guarentee a good result or assure you that you will not have complications. Surgeons are humans and humans are imperfect. That doesn't mean you shouldn't have the surgery but unless you are willing to accept the risks you should not have the surgery. You mention that you are taking a plane trip after surgery. You know that people die in plane (and car) accidents all the time. But you fly and you drive, because you know the risks are small. It's the same way with surgery.

JCH III MD
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Avatar_n_tn
I'll just add my two cents. I have had an increase in floaters post Lasik. Just the exception I guess. I hope they go away soon, but they came post Lasik. It's about 3 or four per eye, distracting in bright light and computer use.

You might want to post this on usaeyes.org as well. That's a complete Lasik community.
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