Your Vision Correction Questions Answered
At Kugler Vision in Omaha, Nebraska, we specialize in improving vision at all distances: far, intermediate, and near. You deserve your best possible vision, and our customized solutions are sure to meet your visual needs. We hear many questions from our patients. Below are a few of the most frequently asked questions we hear concerning LASIK, including “Does LASIK wear off?”
Before the LASIK procedure begins, your eye is numbed with anesthetic drops. While you may feel a pressure sensation as the corneal flap is being made, actual pain is rare. The eyes usually have some mild soreness for a few hours after surgery, but significant pain is rare. Lubricating eye drops and ibuprofen are usually enough to counteract any discomfort.
No. In millions of LASIK procedures done worldwide, no one has ever gone completely blind from LASIK or Advanced Surface Ablation (also known as PRK). The risk of vision after LASIK being worse than it was before the procedure is less than 1 percent, and most of those issues are correctable with glasses or contacts if needed. LASIK is one of the safest procedures performed in the United States.
This is one of the most common questions we are asked about LASIK. In all our years of experience, we have never met a patient who LIKES to have his or her eyes touched! We all have a natural reflex to protect our eyes and therefore we are sensitive to instruments and objects around our eyes. During the surgery we use gentle, topical numbing medications that reduce this reflex. Our expert staff keeps you comfortable throughout the procedure, which only lasts a few minutes, so sensitivity does not interfere with the procedure or affect the results.
Most patients with sensitive eyes believe that they are more sensitive than average. In our experience, this isn’t the case. Lance Kugler, MD, has never encountered a patient who could not have the surgery comfortably.
LASIK is often done on both eyes at the same appointment. Most people undergoing LASIK surgery prefer to have both eyes done on the same day. The advantage of bilateral surgery is the convenience of having one surgery date and one recovery period. Our brains also prefer to have eyes that are matched together, and surgery on the same day allows that to happen.
Eyes typically stabilize around three to six months after surgery. Once that occurs, the laser correction to your cornea is permanent. Any additional need for glasses after that would be the result of normal aging processes that befall everyone, and not due to any instability in the refractive procedure.
Ultimately, the results of any surgery depend on the human body’s ability to heal, and every person heals slightly differently. In the event that your healing process yields less visual acuity than expected after your initial LASIK treatment, it is possible to get an additional treatment. Your eye must first stabilize and be healthy enough to undergo another surgery. Typically, enhancement of LASIK usually takes place no earlier than three months after the original procedure. In the event that you are in need of an enhancement within one year of your initial LASIK procedure with Kugler Vision, Lance Kugler, MD, will happily provide that enhancement service at no additional charge.
Many patients seeking refractive surgery do so because they have dry eyes and are unable to wear contact lenses. In many cases, it is important that dry eyes be treated prior to LASIK surgery. Your surgeon will determine at the time of your LASIK evaluation whether dry eye treatment is necessary. Treatment usually involves the use of tear supplements, topical medications, and punctal plugs.
After the procedure, your operated eye may feel temporarily drier because the corneal nerves are severed during LASIK surgery, causing the eye to make fewer tears. This condition is temporary and typically lasts three to six months. With older technology, patients were more likely to have dry eyes after LASIK, but with modern laser systems and appropriate preoperative and postoperative evaluations, this condition has become much less common.
Dry eye symptoms can be particularly noticeable if you use the computer frequently, read for long periods of time, or drive extended distances. These types of activities exacerbate dry eyes because they cause you to stare and not blink as often, thus the tears evaporate. It is important to use ample lubrication, especially during the first few months after surgery. We recommend using preservative-free tears every 60 minutes for the first week, and every two hours for the second week.
If you have a residual refractive error and choose not to have an enhancement procedure, you may elect to wear contact lenses in four weeks. If you were a good contact lens wearer before LASIK, it is unlikely you will have problems afterward.
The more nearsighted a patient is, the more tissue must be removed from the cornea in order to achieve the desired correction. Because we specialize in all-laser bladeless LASIK, we are able to perform the procedure with a minimal amount of tissue removal, typically much less than surgery performed with a blade. So there are patients who were previously not good candidates who can now safely have LASIK performed. However, some patients still do not have enough corneal tissue for LASIK, so other procedures, such as an ICL, may be a better choice. Lance Kugler, MD, performs the full array of available refractive procedures and can customize a treatment plan for each patient’s individual needs.
One of the common myths about LASIK surgery is that it causes people to need reading glasses. As people reach their early to mid-40s, regardless of whether they have LASIK, they develop difficulty focusing up close. So if a patient has LASIK when they are 25 years old, then they will still need reading glasses in their 40s just like everyone else. This does not mean that the LASIK stops working when they reach their 40s, as their distance vision is still excellent in their 40s.
One of the most common myths about LASIK surgery is that it cannot be performed on patients with astigmatism. Although this was somewhat true when LASIK was first introduced, modern laser systems can now correct astigmatism. Dr. Kugler takes astigmatism treatment a step further. At Kugler Vision, we perform advanced astigmatism analysis using vector planning – the most sophisticated astigmatism analysis technologically available. Taking this extra step increases the success of astigmatism treatment and enhances the patient’s quality of vision.
For patients who already experience difficulty with near vision in their distance correction, it is possible to treat one eye for near vision and the other for distance vision. This decreases the necessity for both near and distance glasses. Although this may sound confusing, the fact is that monovision rarely causes problems and most patients do very well with it. For patients over 40 who wish to avoid glasses altogether, this is an excellent option. At the time of your LASIK evaluation, your surgeon may simulate monovision for you so that you can see for yourself whether it is something that meets your needs.
This is very unlikely. LASIK is a form of lamellar refractive surgery, and lamellar refractive surgery (myopic keratomileusis) has been performed since 1949. Patients who have undergone these related but less accurate and more invasive procedures 50 years ago have not had any unusual problems.
Yes. The surgical technique used will not change. However, your lens implant will be calculated using a different formula. To further enhance the success of cataract surgery in eyes that have had LASIK, Lance Kugler, MD, relies on advanced astigmatism analysis using vectors. This advanced analysis allows him to perform LASIK with your future in mind and provide a lifetime of quality vision, even after cataract surgery.
No. LASIK does not change the normal aging process of the eye, therefore it does not prevent cataracts, glaucoma, macular degeneration, or any other eye disease. Ophthalmologists term LASIK as disease neutral: It doesn’t cause disease, it doesn’t prevent disease, and it doesn’t prevent diseases from being treated.
It is not possible to know if you are a good candidate for LASIK without a thorough evaluation. Call 402.558.2211 to schedule a consultation today.
Generally we consider LASIK to be safe in good candidates who are 18 or older. In some circumstances, it may be performed on patients younger than 18.
There is no age at which LASIK becomes unsafe, and it has been performed on patients in their 90s! However, as people age and start to develop cataracts, often it is advisable to consider a refractive lens exchange (RLE) or cataract surgery instead of LASIK. Your surgeon will discuss this with you at the time of your evaluation.
With LASIK you can usually drive within one to three days. The majority of patients are able to drive themselves to see their surgeon the day after surgery. The Department of Motor Vehicles typically grants unrestricted driving privileges to individuals who possess 20/40 or better vision. More than 90 percent of all patients who undergo LASIK surgery have this level of vision or better by the first day after their procedure.
The majority of patients can return to work the next day, although it is advisable to take 24 hours off following surgery on both eyes. This is particularly the case if patients work in a dusty environment or perform strenuous work. While most patients can function normally at work the day after their LASIK procedure, we recommend that you not schedule any unbreakable appointments or meetings on that day. If your recovery is delayed slightly, you will still be able to accommodate the delay without any undue stress.
Advanced Surface Ablation (ASA), also known as PRK, was developed before LASIK and has a longstanding history of safety and success. ASA is a procedure in which the front surface of the cornea is directly sculpted by the excimer laser. In contrast to LASIK, no flap is made in the cornea for ASA. The surgeon prepares the eye by gently removing the surface layer, known as the corneal epithelium. This layer regenerates itself within a few days. The entire procedure takes approximately five minutes per eye. ASA is a nice procedure, particularly for patients who cannot have LASIK for a variety of reasons.
Both LASIK and ASA are laser eye surgery procedures that use an excimer laser to reshape the cornea and correct nearsightedness, farsightedness, and astigmatism. With ASA, the laser is used on the surface of the eye, while in LASIK, the laser work is performed under a thin corneal flap that is made with a second laser. Both procedures are excellent and the long-term results are similar. If you are a candidate, then your surgeon will recommend the procedure that is best for you.