LASIK SURGERY

 

At Sun Laser Vision Center we have been working consistently to bring the latest and safest technology in laser vision surgery to the El Paso region. Dr. Michael Foote has been performing laser vision correction surgery since 2005. Our facility was the first to introduce the IFS femtosecond laser for LASIK and the first to adopt the iDesign imaging system locally. We are committed to being the leader in vision corrective surgery and we are committed to El Pasoans.

 

Our goal is to provide you the best possible vision with the technology available while being focused on patient safety. The laser procedures we perform to correct vision include LASIK and PRK. We use the IFS femtosecond laser to perform blade free all laser LASIK. We do not use the mechanical bladed microkeratome. We use the latest iDesign wavefront mapping system for measurement and corrections of the optical imperfections of the eye. The vision outcomes for our patients is very good and mirrors the FDA tests of these systems.

Miriam Leyva - IMG_0603@2x

QUESTIONS TO ASK WHEN CONSIDERING LASIK

When considering LASIK there are several things that you need to know and some questions that you should ask before you decide where you ultimately will have your surgery performed. LASIK for better or worse has become commoditized over the years. As a result people often ask just one question when considering surgery: how much does it cost? While cost certainly is important to consider, patients need to understand LASIK isn’t a commodity, it’s surgery. There are other questions and considerations that are just as important if not more important; remember, you only have one pair of eyes. The treatment you receive may not be the same from one surgical facility to the next. There are differences in technology, in surgeon availability and surgical options that are offered and you need to be aware of the differences.

 

The questions you might want to ask include:

  • Who is performing my surgery?
  • Can I meet him or her before surgery and will that person be taking care of me as I recover?
  • What technology are you using in my surgery – especially what laser will be used and if I am having LASIK is it all laser LASIK or will a mechanical microkeratome with a blade be used?
  • Are you using the most up to date devices for measuring the optical errors of my eye which are used in the laser?
  • Am I an ideal candidate for LASIK or are there other procedures that are better suited for my eyes or my goals?
  • And finally back to the question of cost, ask what the surgery fees cover. Is all of the postoperative care covered?
  • And up to how long after surgery?
  • Are there any hidden fees or add-on charges not discussed with you over the phone or in marketing materials?

YOUR SURGEON

Choosing to have laser vision correction is a very personal decision. It’s important that you trust your surgeon to treat you and your eyes well. You should have the opportunity to meet your doctor before you have surgery. Make sure that you feel comfortable with your doctor and with the answers he or she gives to your questions. Do not rush your decision. Laser vision correction is an elective procedure and you shouldn’t feel pressured to have surgery or to have the procedure with a surgeon that you don’t know or trust.

It’s important to know if your doctor is going to be doing your pre- and postoperative care. Is your surgeon located locally and will you be able to see him or her urgently if you think you’re experiencing a problem?

Dr. Michael Foote has been performing laser eye surgery at Sun Laser Vision Center since 2005. Laser vision correction surgery was a key component of his residency training program. He will be with you every step through the surgery and recovery.

What technology is used?

Design Advanced Wavescan Studio 2.0:

iDesign is the same imaging technology that NASA is using in the James Webb Space Telescope. Sun Laser Vision Center has chosen iDesign—as has NASA—because it is the most sophisticated and reliable mapping technology available today. The iDesign is an advanced mapping technology used during the preoperative iLASIK exam. Essentially it is a laser device that measures and analyzes the optical imperfections of the eye. It precisely measures the imperfections in your eye, such as nearsightedness (myopia), farsightedness (hyperopia), or astigmatism, or some combination of these conditions. iDesign provides 5 times the resolution of earlier mapping technologies and remains the highest resolution measuring device available. The device uses wavefront technology. Wavefront works by shining a laser light onto the retina and then analyzing the reflected light beam. An array of lenslets measures the deviation of the reflected light from where it should be if it were perfectly focused. Using complex calculations the optical abnormalities of the eye can be reconstructed. More than a diagnostic tool, wavefront technology is applied to the laser treatment during the surgery. Once calculated, the optical abnormalities of an eye can be removed by programming the laser to precisely treat the abnormal areas. This is what is referred to as “custom cornea” laser vision correction. Think of this map as a fingerprint of your eye. No two are exactly alike!

 

With iDesign Advanced WaveScan technology, more people may now be eligible for iLASIK—even some who may have previously been told they did not qualify. That’s because iDesign can provide a more detailed “fingerprint” of the eye than what was possible with previous mapping technology.

 

IFS – INTRALASE FEMTOSECOND LASER

The Intralase laser was developed to create an all laser procedure for LASIK. Prior to the development of the Intralase laser, the LASIK flap was made using a mechanical device called a microkeratome which used a metal blade. Though uncommon, the device could fail and create flap complications. The advantage of the Intralase is that it creates flaps which are much more consistent, reliable and with a greater than 90 percent lower complication rate.

The IFS is the most upgraded femtosecond laser produced by Johnson & Johnson surgical. It uses an incredibly fast laser firing rate allowing for very smooth flap creation and better visual outcomes. It is a very flexible device and in fact we use it in other surgical procedures including corneal transplantation, Intacs and Kamra procedures and it’s the foundational technology for modern laser cataract surgery.

The IFS has over a decade of clinical research and has been used in the treatment of millions of people world-wide and in the United States for blade free LASIK surgery.

 

VISX STAR S4 IR

The VISX excimer laser has been on the leading edge of technological development in laser vision from the very beginning. Also owned by Johnson & Johnson surgical, the VISX laser has pushed the evolution in safety and quality of vision outcomes. The latest version features integration with the iDesign Advances Wavescan system, active pupil tracking and treatment centration and has over many years incorporated more and better safety features leading to continually better results. This along with its dependability and durability has made it one of the most successful lasers available.

The VISX laser is used during the surgery to re-contour the cornea correcting the curvature and eliminating optical imperfections that cause blurred vision. It is used in both PRK and LASIK.

Better technology, better outcomes, better vision!

How is it Performed?

There are three ways to correct a person’s vision with laser: LASIK, PRK and SMILE. LASIK is performed in a two-step process where a partial thickness flap of corneal tissue is made (similar to a man hole cover), folded over the top of the cornea and then an excimer laser is used to change the corneal curvature to reduce near-sightedness, far-sightedness and or astigmatism. The flap is then placed back over the cornea. In PRK (photorefractive keratectomy), a microsurgical device is used to remove surface cells (protective epithelial cells which later grow back) and the same excimer laser is used. In SMILE (small lenticule extraction), only a femtosecond laser is used to create in essence a negative contact lens within the cornea. This “lenticule” is then removed through an incision. We are not currently offering SMILE because it can only be used to treat nearsightedness and does not yet have the same outcomes as LASIK (it’s getting closer over time – but not yet fully matching LASIK or PRK).
Long-term studies have shown no statistical difference in maximal visual improvement between LASIK and PRK, and by six months after surgery, the vision is essentially identical between the two techniques.
The advantages of PRK over LASIK include a mechanically stronger cornea and no potential for problems associated with the flap. LASIK has the advantage of faster healing and recovery of vision and a slightly lower risk of infection. Both are effective and reliable methods of correcting vision.

 

VIDEO OF LASIK                                                VIDEO OF PRK

 

 

Do you know your options?
Laser vision correction represents just one of several ways that vision can be improved with surgery. Options such as the Visian ICL (an implantable lens that can correct nearsightedness and astigmatism), Intacs (which can correct irregular astigmatism and nearsightedness), Kamra Inlay (which can improve near vision in patients 45 years old and over), Clear lensectomy (for patients with extreme amounts of nearsightedness or farsightedness or early cataract) and cataract surgery are other options that we provide. We have more information about these procedures on this website.

 

Is LASIK right for me?
Take our questionnaire on the home page to find out if you are a candidate!
Most patients look forward to having laser vision correction so that they can have normal vision with limited if any dependence upon vision aids. They look forward to being able to wake up in the morning and see without having to hunt for glasses or be able to swim or enjoy their activities with good vision. Others are tired of the distortion from their glasses, or cleaning smudges from their glasses or having multiple different pairs of glasses for distance, computer and reading. Some are tired of the poking of their eyes with contact lenses or dealing with the ongoing costs of contacts lenses, cases, solutions and glasses expenses. Finally some just look forward to being able to wear normal sunglasses.
Whatever your reasons that you may be seeking LASIK, you need to be sure you have realistic expectations, understand what your goals are and what LASIK can do for you. LASIK doesn’t reverse aging, it doesn’t cure diseases of the eye and it is surgery – no one can ever give you a guarantee that your eyes won’t change over time, that you may not have complications or that you will be fully satisfied. Know what the alternatives to LASIK are and ask lots of questions to make sure that you are making the right choice for you.

 

What if I’m afraid to have LASIK?
The most common issue holding back a person who is considering laser vision correction is fear. It is normal for people to feel anxious about any type of surgery. With laser vision correction, patients often voice concerns about pain or movement during surgery and worry about poor vision after surgery. Perhaps most disabling for some is the anxiety of anticipation – meaning they’re afraid they may panic right before surgery. These feelings are not uncommon and are best addressed with knowledge. So let’s become more familiar with the results of the procedure.
Laser vision correction is one of the most commonly performed surgeries with nearly a million procedures performed annually in the United States. In the largest patient satisfaction study done to date (over 5,800 patients), 95.0% of patients reported that they were happy or very happy with their vision after surgery. 94.2% indicated that laser vision correction had improved their lives for the better. 82.8% stated that their vision was better after surgery than it had been with spectacles or contact lenses prior to surgery. 96.5% would recommend the surgery to his or her friend or family member. These numbers clearly reflect a very high satisfaction rate with the surgery. So while it is normal to have anxiety or fear before surgery nearly all patients who have had laser vision correction are happy with the decision they made.
Pain during surgery is one of the most frequently voiced concerns. For those who undergo PRK, the procedure is painless for virtually everyone. Those having LASIK will notice a pressure sensation for several seconds while the flap is being made which is usually mild to moderate. The remainder of the surgery is likewise painless. Both techniques take just a few minutes and patients rarely if ever need more than mild sedation.
While visual results have always been good after laser vision surgery they have only gotten better with time. The latest studies show that more than 99% of patients have uncorrected distance vision of 20/40 or better – the threshold in most states for being able to drive without glasses. Most studies now also report 95% of patients seeing at least 20/20 without glasses and greater than 50% of patients with visual acuity of 20/16 or better. With the development and refinement of technological breakthroughs such as all-laser LASIK, wavefront technology, iris registration and pupil tracking technology more and more patients have better uncorrected vision after laser vision surgery than they could attain with glasses or contacts before.
Similarly the procedure has only become safer over time. Pupil tracking technology automatically stops laser treatment if more than 1 mm of eye movement is detected. If movement does occur, the patient can be realigned and the treatment picks up right where it left off.
It is always important to remember however that laser vision correction is surgery and no surgery is free of risk. Your surgeon will further explain these risks to you prior to your surgery.
Complications associated with laser vision correction are infrequent and serious problems such as the risk of infection may in fact be lower than with contact lens wear – something that most people consider “safe”.
So to summarize, it is normal for patients to have concerns and anxieties associated with surgery. Laser vision correction is for most patients a positive, life changing event and a choice that they are happy they made. Focusing on your knowledge of the procedure is the best way to alleviate anxiety before the surgery. Visualize waking up the day after your surgery and seeing the alarm clock without your glasses or contacts. Try always to think positively – and leave your fears behind with your glasses!

What are some other questions people ask about Lasik Surgery?

Why should I have my laser vision correction with Dr. Foote?

We have the newest, most up-to-date lasers and laser vision correction equipment in El Paso. We can provide the widest array of treatment options. All of our lasers are permanently located on site and are not leased from a company that transports the lasers from city to city. Laser vision correction was part of Dr. Foote’s training during residency.

We take a conservative approach and consider patient safety our top priority.

When can I return to work?

Patients undergoing LASIK can usually return to work in one to two days. Patients having PRK usually require three to five days due to slightly longer healing. An individual’s experience may vary however depending upon your body’s healing process and the type of work to which you are returning.

Is there any pain?

Patients having LASIK may experience a pressure sensation during flap creation that can be uncomfortable for some. There is no pain during the laser procedure itself for patients having LASIK or surface treatments. In the days following the procedure patients undergoing LASIK or surface treatment can experience some discomfort, foreign body sensation or mild to moderate pain.

 

These symptoms are usually well tolerated by most patients and can, when needed, be treated with eye drops or oral analgesics. The symptoms can last longer for patients having PRK. Most patients report minimal if any pain with the procedure.

Will I need glasses after?

All patients who have laser vision correction to improve their distance vision will have to wear reading glasses after age 44 to 45. It is normal for a healthy eye with good uncorrected distance vision to lose near vision with age. Laser vision correction can improve your near-sightedness, far-sightedness and astigmatism but unfortunately it does not stop aging! So whether you’re 35 when you have laser vision correction or 50, don’t expect that you’ll be the lucky one to miss out on the need for reading glasses after your mid-40s.

What if my uncorrected vision isn’t 20/20 after?

Some patients can become very fixated on numbers after surgery thinking that if they don’t see 20/15 or 20/10 that their surgery was a failure or that if they are 20/25 or 20/30 that there was a problem. It is important to understand that not everyone will have 20/20 uncorrected vision in both eyes after surgery.

Instead it is much better to remember the purpose of having laser vision correction is to reduce dependency on glasses and/or contacts. Provided that a patient’s uncorrected vision is better than 20/40, about 2% of patients having laser vision correction will need to have an enhancement usually due to a small under or over correction caused by the laser.

Will I need reading glasses after laser vision?

Yes. There is now however a surgery available to improve near vision with or without prior LASIK called the Kamra Inlay. Another option is custom monovision treatment which may lessen the need for reading glasses. However loss of up-close vision is a natural aging process for all of us and is unavoidable.

Any near-sighted patient who is more than 45 years old who values his or her near vision more than far vision should probably reconsider proceeding with the laser vision correction for distance only.

What are the risks associated with laser vision?

It is normal for patients undergoing eye surgery for any reason whether cataract surgery, laser vision surgery or other eye surgeries to experience dry eye syndrome after surgery. For most patients the symptoms are brief lasting several weeks but often can last several months. Occasionally some patients may have long-term dry eye syndrome. This is particularly problematic for us here in El Paso given our arid climate. Fortunately most patients’ symptoms resolve however some patients can experience long-term dry eye syndrome which may require use of artificial tears or other medicated eyedrops.

 

It is not uncommon for some patients to experience halo and glare after laser vision correction. Studies indicate that fewer patients report problems with halo and glare after surgery than prior to surgery. However some patients may have more halo and glare after surgery while others may have less.

 

Under-correction or over-correction after surgery is probably the most frequent problem encountered after laser vision correction. The over- or under-correction is significant enough to require an enhancement in approximately 2% of patients.

 

Rare but serious complications can include infection, corneal ectasia (a progressive weakening and bowing of the cornea) or unmasking of keratoconus (a rare corneal condition causing a misshapen cornea). Other complications though rare can occur. Your physician will discuss these with you further at the time of your consultation.

How much does it cost?

Our laser vision correction coordinator will go over with you in greater detail the cost of surgery, the financing options available to you, as well as what is included with your treatment in consultation with you. There is no charge for this consultation.