Frequently Asked Questions
For a detailed diagram of the eye and descriptions of Myopia, Hyperopia, Presbyopia and Astigmatism, please refer to our LASIK eye surgery page.
The same surgeon and medical staff who work with you prior to surgery will provide your continued care during surgery and through your crucial post-operative visits. Our expert staff is comprised of experienced refractive surgery counselors, assistants and world-renowned laser eye surgeons.
The Shiley Eye Center at the University of California at San Diego is one of the nation’s premier research and clinical facilities dedicated solely to the health of the eye. Under the direction of world-renowned laser eye surgeons, The Shiley Eye Center in La Jolla offers the entire range of corrective surgeries to help people with nearsightedness, farsightedness (hyperopia) and astigmatism. For more information on specific procedures, please follow the links to the left.
Choosing the right procedure is a decision that should be made by both you and your laser eye surgeon. You should consider your lifestyle, your occupational needs, and your expectations of discomfort and speed of recuperation. We will help factor in your unique prescription, anatomy, and health characteristics to arrive at the right decision for you. What makes it tricky is that each individual has a different prescription, a different occupation, and unique lifestyle demands. Clearly, no single procedure is best for everyone. The procedure that is best for you and your needs should be chosen after careful consideration of every alternative. Below is a general guideline that might help let you know what is possible.
The VISX Star excimer laser received FDA approval for the treatment of up to -4.00 diopters of myopic astigmatism in early 1997. This will expand our ability to treat almost any combination of myopia with astigmatism.
Each refractive surgical procedure is different in terms of the potential discomfort.
Laser assisted in-site keratomileusis (LASIK) has become the procedure of choice for most dedicated refractive surgical practices in part because there is normally little if any discomfort associated with this procedure. On average, most patients will describe any discomfort they experience as similar to the tired sensation of having over-worn a contact lens.
Intacs are similar to LASIK in visual recovery and patient discomfort. Vision returns to normal quite rapidly (1-7 days), and discomfort during and after the procedure is minimal for most patients.
Photorefractive keratectomy (PRK) is usually associated with moderate discomfort. The PRK procedure requires the laser eye surgeon to make a 6 mm diameter scratch on the surface of the eye. While patients use medications to decrease their discomfort, a normal reaction to this procedure can range from minimal discomfort, a slight scratching sensation, to severe discomfort that requires oral pain medication for relief. Visual recovery is typically longer than with LASIK.
The incisional procedures such as radial keratotomy (RK) are usually associated with mild to moderate discomfort.
Here again each refractive surgical procedure is different in the length of recovery.
The rapid return to functional and normal levels of vision is one of the strong advantages of the LASIK technique. While each patient may respond in an individual manner to the treatment performed, on average most patients have a usable level vision within the first 24 hours. It is not unusual for vision to be anywhere between 20/70 and 20/10 within the first 24 hours. As with any other surgical procedure, after treatment the tissue treated may swell as it is healing. This swelling can create temporary blurred vision and even cause the vision to fluctuate over the course of the day. This effect normally subsides rapidly with a return to stable, clear, comfortable vision.
In comparison, PRK takes significantly longer for the vision to stabilize. During the first three days the cornea's surface epithelial cells are healing over the scratch created during the procedure. A bandage contact lens is used to help this surface heal rapidly without interference from the constant action of the eyelid. While the surface cells are healing, the vision can be quite blurry. Normally, by day three the surface cells are sufficiently healed that the bandage contact lens maybe removed. At this point the vision begins to improve dramatically. Over the next couple of weeks patients will usually see a return to their best level of vision. Within 3 months most patients' vision is equivalent to wearing glasses before their surgery. Stability of the final result is usually achieved somewhere between three and six months.
Results vary with each individual and procedure. In a recent study, 98% of patients treated for nearsightedness and/or astigmatism saw well enough to pass a drivers test without glasses. These results were for patients who have had the LASIK procedure. While the results with PRK are similar, the time it took to achieve this same level of vision was several weeks longer.
Our chief laser eye surgeon has performed thousands of LASIK procedures since the procedure was first developed in 1995. Although the doctor and his staff have a wealth of experience with refractive surgery, we do not measure our success in volume. We believe that attention to detail and individual treatment is the best way to achieve expectations.
Expect most treatments to cost between $3,000 and $5,000 depending upon the procedure. Some medical plans may cover the cost; please ask your health insurance provider for details. The Shiley Eye Center does provide affordable payment plans. Some plans allow for no initial payment with the balance financed over three years. Other financing plans charge 0% interest with the balance paid over 6 months.
Compared to what you would spend on glasses, contact lenses, and lens care over the course of 20 years, laser vision surgery is cost-effective. The difference is that you will have clearer, natural vision, and have reduced or eliminated your dependence on glasses or contacts. To many, this makes the procedure invaluable.
The first step is to call and speak with a member of our staff. They can then either schedule you an appointment for a complimentary consultation with a patient counselor for information or schedule the complete exam with our doctors to determine if you are a candidate.
Regular seminars at our office in La Jolla, California are scheduled for informal education sessions in a small group format. The seminars provide: an overview of our services, an opportunity to meet the staff and laser eye surgeon, and a chance to have your questions answered.
To speak with a Vision Correction Center staff member, please call 858-822-2566 or 877-921-EYES (toll free).
There are a few restrictions before refractive surgical procedures. To prevent infections, do not wear eye makeup 24 hours prior to the procedure. One of the most important steps is to begin using a topical antibiotic drop the day before your procedure. We will give you a prescription for these drops on the day of your exam.
Since any contact lens wear can cause subtle distortions to the shape of the eye, we recommend that you discontinue soft contact lens wear a minimum of three days prior to both your exam and procedure. Rigid gas permeable (RGP) or hard (PMMA) contact lens wear can cause dramatic molding to the shape in the eye. We recommend that you discontinue rigid contact lens wear at least four weeks prior to both your exam and procedure. For patients who have worn rigid contact lenses for many years, it may take months without rigid contact lens wear before the shape of the eye begins to stabilize. However, in most cases it is possible to wear a soft contact lens as a transition to stability.
The usual care required after LASIK is not complicated. The normal post-operative scheduled visits occur in day one, week one, month one, month three, month six. You will be required to take antibiotic drops to prevent infection, and drops to prevent inflammation for one week after surgery.
Eyes recover quickly after Intacs or LASIK, but there are a few precautions that you should take. Eye rubbing could disturb the treatment within the first week. You should try to avoid touching the eyes early on. We recommend that you wear a plastic shield over the eyes at bedtime for the first seven days to prevent eye rubbing during sleep. The only other common restriction is to avoid getting foreign matter into the eye. Cosmetics such as eyeliner and mascara could be a source of eye infection. We recommend that these cosmetics not be used around the eye for the first five days. Fluids such as perspiration, pool water, ocean water, and tap water could also bring an infection to the eye. Perspiration in the eye should be avoided for the first five days, however, ocean water that might enter the eye from surfing should probably be avoided for four weeks. You may want to be a little extra cautious and wear eye protection if you plan to be around dust or debris.
Yes, in fact we encourage it. Having the doctor who knows you best as a part of our team is a great way to ensure your good results. We often look to your primary eye care provider when questions of eye health history or refractive stability arise. In addition, we have developed co-managing relationships with a number of excellent doctors in San Diego County. We have chosen these individuals because of their experience, interest, and ability to successfully manage patients before and immediately following refractive surgical procedures. If you are currently under the care of one of these doctors then you have already begun your refractive surgery evaluation. Simply call their office to express your interest in refractive surgery and their trained staff can help you take the next step to better vision without glasses.
The risks of any refractive surgical procedure include infection, loss of best vision, over correction, and under correction. There are other risks that should be discussed individually with your doctor. The overall complication rate for PRK and LASIK is about the same for each of the different procedures in the hands of a skilled laser eye surgeon. While the risks are different with each procedure, their incidence is roughly equal.
Reading vision requires that the eye expend some effort to focus up close. Before age forty this close focusing is easily accomplished. After age forty, presbyopia begins. At that point magnification for reading will make this task easier. Nearsighted people often discover that the natural magnification created by their nearsightedness is a useful effect. This natural magnification will be exchanged for better distance vision, and these patients will now often require reading lenses for fine detail or for prolonged reading just as their friends do.
The FDA is responsible for approval of new medical devices but not surgical procedures. LASIK is a new use of two currently approved devices. These are: the microkeratome, to make the corneal flap; and the excimer laser, to change the focus of the eye. The microkeratome has been in use for other refractive surgical procedures since the 1950's. The excimer laser has been approved in the United States to treat myopia since 1995. This procedure is not considered experimental and has been practiced worldwide since 1993. By definition, the FDA would not approve any procedure, only the devices used during the procedure.