PRK/LASIK 954-217-6500

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• Who is not a candidate?
  
  People under the age of 18. People with collagen vascular or ocular diseases such as kerataconus, or herpetic scarring. Pregnant women. People with changing (unstable) glasses correction.
  
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• Who invented refractive surgery?
  
  Actually, no one person invented refractive surgery. There has been a keen interest in surgically changing the eye as long as there have been glasses. The modern era started at the turn of the century, when a Dutch ophthalmologist began investigating radial keratotomy. This was continued in Japan in the 1930's, but without success. Finally in the 1970's, after observing a young boy with eye trauma, Dr. Fyodorov of Russia developed and popularized a successful and useful radial keratotomy procedure. This procedure was introduced in the United States in 1978. Since it was introduced in 1978, over 2 million people in the U.S. have had the procedure. As in all fields of medicine, research continued and finally a laser was discovered that could help with refractive errors. The excimer laser has been used for industrial applications for many years. In the mid 1980's, an ophthalmologist, Dr. Trokel, suggested the energy of this laser could effectively and precisely cut human cornea tissue. The excimer laser beam breaks the carbon bonds in the molecules of cornea tissue, actually vaporizing the tissue. There is no heat involved so the cut is very precise and measured in microns. When the procedure was found to be effective, the FDA approved the use of the lasers. Dr. Bosem began investigating the use of the Eximer Laser 5 years prior to FDA approval. Laser refractive surgery has proven popular and effective in the rest of the world and over a million procedures had been done by 1994.
  
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• What is R.K. or radial keratotomy?
  
  Radial keratotomy or RK is a surgical procedure during which the periphery of the cornea is reshaped with a hand held diamond instrument. This effectively changes the shape of the central cornea allowing the image in the eye to be correctly focused on the retina. The center of the cornea is not involved in the surgery and left untouched. The number and length of the incisions determines the amount of correction achieved. These incisions are not visible to observers. During the past 20 years, millions of people around the world and in the U.S. have reduced their dependence on glasses and contacts with RK. RK is performed very little today as the laser is more accurate in most cases.
  
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• Can you guarantee that I won't have to wear glasses after the procedure?
  
  NO!! There are no guarantees other than that our goal is to make your results perfect. We will spare no effort in making sure your visual goals are reached and you are happy with the results.
  
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• If I need correction after surgery, can I still wear contact lenses?
  
  Yes. Contact lens wear is still possible after any of the procedures and we will assist in the fitting of the appropriate lenses as necessary.
  
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• How long will this correction last or will I become nearsighted or farsighted again with time?
  
  Once the eyes have stabilized after the procedure, the correction should last a lifetime. There may be fluctuations in your vision initially. If the eyes are undercorrected with any of the procedures, enhancements can be done to improve the result. There is no additional charge for enhancement procedures during the initial period after LASIK. Also, it is important to remember that other diseases such as cataract, diabetes, or glaucoma can change the correction necessary later in life and is unrelated to refractive surgery.
  
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• What is monovision?
  
  Monovision is a different refraction for each eye so that one eye is used for distance and one eye for nearvision. This is designed to eliminate the need for reading glasses over the age of forty. It is best for people who have tried this with contact lenses before having refractive eye surgery.
  
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• What are the complications of these procedures?
  
  The worst possible complication is the remote possibility that your eye will end up seeing less well after the surgery than before. This might happen as a result of infection, scarring, or some accident during the surgery. This has never happened at Correct Vision, but that doesn't mean it is not possible. All surgery carries some risk, no matter how small or remote. Each procedure is different and subject to its own complications. Below are some difficulties people have had with refractive surgery in general. During your screening exam, the problems associated with the procedure for you will be discussed in detail. Negative side effects possible: *Fluctuating vision *Difficulty with night vision *Increased sensitivity to bright light *Overcorrection/Undercorrection *LOSS of best corrected vision *Corneal irregularity *Corneal haze *Infection MORE THAN ONE YEAR AFTER SURGERY Clinical studies showed that at one or more years after surgery, the following percentages of patients still had problems with their vision. Difficulty with night vision 3.9% of patients Increased sensitivity to bright light 3.0% of patients At least one diopter worsening of nearsightedness 2.8% of patients Double vision worse after surgery if present before surgery 1.3% of patients Custom cornea prodcedures have decreased the incidence of night vision problems
  
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• What is LASIK?
  
  LASIK which is an acronym for combining PRK or excimer with another procedure which enables Dr. Bosem to bypass the step of removing the epithelium of the cornea. A special instrument called a keratome is used to make a thin flap like a lid in the cornea leaving the epithelium alone. The flap is lifted and the excimer laser is used to reshape the cornea and the flap closed. The cornea still has all of its structures intact and there is essentially no recovery time or discomfort at all. Nothing has to grow back. LASIK also had the advantage of being more effective in nearsightedness, farsightedness and astigmatism and, when necessary, enhancements are easily performed by lifting the flap and applying laser.
  
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• Am I a good candidate for refractive surgery?
  
  Good candidates are people who are nearsighted or farsighted with or without astigmatism within the limits of the procedures being done. Other than this generalization, the only way to tell if you are a good candidate and which procedure would best benefit you is to come in for a free consultation with one of our doctors. Soft contact lenses should not be worn for three days prior to your consultation and hard lenses for three weeks.
  
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• What is A.K. or astigmatic keratotomy?
  
  AK is a variation of RK where incisions are placed in the peripheral cornea to reduce or eliminate astigmatism. Astigmatism is a condition of the cornea in which the corneal shape is oval instead of round. This causes the light to focus in an odd blurred shape on the retina. AK is used with RK in nearsightedness with astigmatism or in other conditions such as after cataract surgery or corneal transplant surgery that leaves the patient's vision blurred by an "oval" cornea.
  
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• What is PRK/LASEK or photorefractive keratectomy?
  
  PRK/LASIK was the first procedure used to correct farsightedness or nearsightedness using the excimer laser. With PRK/LASEK, no incisions are made. The cornea is re-shaped by the laser which is controlled by the doctor and computer program. The epithelium or skin of cornea is removed, and pulses of excimer laser energy are used to reshape the cornea. The procedure takes less than five minutes and is completely painless. The epithelial layer re-grows in a few days. There may be mild discomfort during this time which is managed with drops. PRK/LASEK can be used to correct myopia, nyropism, and astigmatism.
  
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• When can I drive?
  
  You cannot drive home after the surgery, but you can drive the next day depending on how well you are seeing and feeling and whether both or one eye was done. Each patient is different.
  
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• Why should I consider refractive surgery?
  
  Many people are taking a more serious look at refractive surgery because of its continued success, the availability of long term results and its improved accuracy. People view this as an investment in themselves and their futures. Whether you want to attempt to free yourself from dependence on glasses or contact lenses for reasons of occupation, recreation, social opportunities, or improved activities of daily living, refractive surgery can be helpful and provide you a "new view of the world".
  
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• When can I return to work?
  
  Patients can return to work the next day, but of course, this depends on the visual demands of your job and your own motivation to return to work.
  
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• Is the surgery painful during or after the procedure?
  
  LASIK is generally free of pain, PRK/LASEK may have some mild discomfort and you don't have to worry about blinking or keeping your eye still. It is all taken care of for you. Afterwards, there may be some minor discomfort and tearing that is treated with drops for several days to several weeks.
  
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• What are the long term complications?
  
  There has been no long term pattern of complications with these procedures. RK has been around the longest and PRK/LASEK and LASIK a shorter period. We can only assure you that no late complications have been observed in the worldwide experience so far and none are anticipated.
  
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• How likely are these problems in me?
  
  It is impossible to predict who will have problems with refractive surgery. We do a detailed exam prior to recommending any surgery to insure as much as possible good results and no bad side effects. While there are a few patients with annoying negative side effects, practically everyone is happy the procedure was done and would do it again.
  
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• Who can benefit from refractive surgery today?
  
  The techniques that are available and proven are for people with myopia or near-sightedness, hyperopia or farsightedness, and astigmatism. Presbyopia or vision of age, still requires magnifying glasses whether you have a refractive procedure or not. Presbyopia can also be corrected with Crystalens IOL.
  
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• I am interested, what should I do next?
  
  The next step is to schedule an exam in our offices so that we may discuss all of this with you in detail and examine your eyes. After that, we will make a recommendation to you as to what we think should be done to help you achieve your visual goals.
  
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• What is a refractive error or why do I need glasses?
  
  Think of the eye like a camera. A picture is taken when the front of the camera focuses the light of the image directly on the film. Likewise in the eye, the front structures of the eye, the cornea and lens, focus light on the retina in the back of the eye. The retina is a nerve like structure which is like the film in the camera. In an eye with a refractive error (myopia, astigmatism or hyperopia), the front structures focus the light incorrectly and not on the retina. Glasses and contact lenses correct the poor focus. Refractive surgery also corrects this focusing error by slightly altering the shape of the cornea, the front window of the eye to focus light on the retina.
  
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• Will I have to wear reading glasses?
  
  After the age of forty, the muscle in the eye that helps focus on reading material or other near objects begins to tire. Reading glasses or bifocals are used to help with near vision. Refractive surgery is only for distance and you will need glasses for near eventually as you age, regardless of having the surgery. People over the age of forty who are near sighted and do not need reading glasses may need them as a result to having the surgery. Some people have a special treatment, monovision, to allow simultaneous focus of both near and far. Talk to Dr. Bosem about that.
  
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• Can I have both eyes done at the same time?
  
  Due to considerations of time and convenience, most patients are having both eyes done at the same time. Discuss this with Dr. Bosem at the time of your screening exam as the answer depends on your motivation and also the configuration of your eyes and the amount of correction you need.
  
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• What are some of the risks?
  
  Some of the risks of LASIK include conditions such as dryness, under or over healing, night glare, and loss of best-corrected vision and/or complications in making the surgical flap. In most cases, in the rare event any of these occur, they can either be corrected or will resolve over time. At Las Olas Laser Eye Center, these and other risks of the surgery are discussed fully with the patient prior to the procedure. Proper pre-operative screening ensures that we proceed with the procedure only when it is medically advisable. As well, diligent post-operative care helps to identify and address any potential healing complications. The potential benefits of laser vision correction are very compelling, especially the thought of living without contact lenses and eyeglasses. When considering laser eye surgery, you should understand not only the benefits, but also the possible risks, so your decision is as informed as possible. As with any medical procedure, there is a risk for complications. In addition, patients may experience short-term side effects after surgery. More rare are conditions, which may last long-term, and this page details some of those risks. Laser technology and surgeon skill have advanced significantly over the 10 years that patients have been having laser vision correction, but no one can completely account for how each eye will heal once the procedure is complete. As a result, most LASIK risks are due to the varied healing processes of individual people. Below we examine some of the risks that should be discussed with your surgeon. Examining some LASIK Risks: Lost vision: Occasionally, some LASIK patients will actually see a reduction in their best-corrected vision (referred to as best corrected visual acuity, or BCVA). In other words, you may not see as well following laser eye surgery as you did with eyeglasses or contact lenses prior to surgery. Reduced low-light vision: Following their procedure, some LASIK patients may not see as well in reduced light, such as at night or in foggy, hazy conditions. These patients often see "halos," "starbursts," or a bothersome "glare" around lights, such as headlights. Severe dry eye syndrome: In some cases, LASIK surgery may result in an inability to produce enough tears to keep eyes moist. Mild dry eye is a side effect that usually disappears in about a week, although some patients may experience symptoms permanently. When evaluating if laser vision correction right for you, tell your doctor if you have suffered from dry eye symptoms before, are bothered by contact lenses, are going through menopause, or are taking birth control pills. In any event, all of our patients are tested pre-operatively for dry eye.
  
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