LASIK Basic Questions

The eye is a complex and beautiful organ. It is often referred as the window to your soul. It is roughly the size of a golf ball (7 cubic centimeters) but is very advanced. In order to understand the steps in Lasik, it is helpful to know the anatomy of the eye.

The anatomy of the eye and the steps to seeing clearly:

1. Cornea - The cornea bends and focuses an image. The cornea is the structure changed during Lasik.
2. Lens - The lens helps to focus images. It changes as we get older.
3. Retina/ Optic Nerve - When an image is focused on the retina, this image is transported to the brain through a cable called the optic nerve.

Most people presenting for lasik surgery at the San Diego Lasik Institute have either Myopia (nearsightedness), hyperopia (farsightedness), and astigmatism (eye shaped like a football). These are common causes of decreased vision and can prevent you from seeing well. These are the common conditions that patients have when presenting for a Lasik consultation. We have performed lasik surgery in San Diego succesfully in all of these conditions but it is important to have an examination with Dr. Pham to see if you are a candidate.

Myopia

Myopia is nearsightedness. Without your glasses or contact lenses you may have terrible distance vision but may see things very well when they are very close to you. For example, you may not want to drive down the San Diego freeway without your glasses but may be able to read a book several inches from your face. This is the most common type of decreased vision that may require you to wear glasses or contacts. The cause of nearsightedness is either an eye that is too large or a cornea that is too strong. This causes images to be focused in front of your eye (retina) instead of right on it.

• Myopia - The eye is too big or the cornea is too strong. The stop sign is focused in front of the retina causing a blurred image.

Hyperopia

Hyperopia is farsightedness. Without your glasses or contact lenses you may have difficulty focusing on near objects and find that you have to strain to see distance objects. As you get older, it gets increasingly difficult to function without your glasses or contacts if you have hyperopia. Hyperopia is also treatable with lasik. We offer custom lasik for hyperopia in San Diego as well. In hyperopia, your eye may be a little too small or your cornea too weak.

• Hyperopia - The eye is too small or the cornea is too weak. The stop sign is focused behind the retina causing a blurred image.

Astigmatism

Astigmatism can be confusing. Instead of your eye being round like a basketball it is irregularly shaped like a football. Light does not focus on a single point in your eye. Rather, it can focus on two separate lines causing significant distortion in your vision. Astigmatism can be from an irregularly shaped cornea or lens. It is very important to correctly treat your astigmatism during lasik surgery. Both custom lasik and advanced custom lasik help to treat your astigmatism. Dr. Pham will be happy to discuss with you the best treatment options for your astigmatism.

• Astigmatism - The eye is irregularly shaped like a football. This causes significant image distortion.

For the right candidate, lasik surgery can treat myopia, hyperopia, and astigmatism. Please call us for a free examination for Lasik in San Diego!

LASIK has helped many people decrease their dependence on glasses. LASIK can treat nearsightedness (myopia), farsightedness (hyperopia), and astigmatism. It can be helpful in decreasing your dependence on contact lenses and glasses. Many people who have LASIK in San Diego enjoy the increased freedom of the many outdoor activities that we have. People in certain professions such as firefighters, policemen, and servicemen enjoy LASIK. Even the United States Air Force and Navy are performing LASIK for our fighter pilots! Some people may simply not want to deal with the expense and hassle of glasses and contacts.

However, LASIK is not for everyone. Dr. Pham individually analyzes every eye to see if they are a LASIK candidate. When you have LASIK surgery in San Diego, it is important to find a surgeon who will personally examine your eye. When you come in for your free LASIK consultation, Dr. Pham will evaluate your cornea's thickness, the shape of your cornea, the level of near or far sightedness that you have, as well as your astigmatism. He will take an in depth history of your eyes and probe for family conditions or medical conditions to make sure that LASIK is safe for you. Each person is a unique case and we will tailor our recommendations to each person considering LASIK surgery. One of the major advantages of considering LASIK at the San Diego Lasik Institute is that Dr. Pham is a fully trained refractive surgeon. Besides LASIK, he can offer PRK, LASEK, Intralasik, Multifocal Lenses, and Implantable contact lenses. Instead of going to a center that can only recommend LASIK, Dr. Pham can recommend the safest and best treatment for you.

Contact us today to schedule a free consultation ($250 value)!

Lasik can help correct your vision by reshaping your cornea. The cornea is the area of your eye that is responsible for the majority of your eyes ability to focus light. Lasik involves two steps. First a flap needs to be made to access the middle layer of your cornea. Next, a laser is used to reshape and remodel your cornea.

After the flap is made, the flap heals in place without stitches! The process is due to drying and osmotic pressure. After about 1-2 weeks you will be able to resume most of your normal activities.

The most important things to consider when having a procedure are safety, predictability, and precision. Traditionally, the first step of Lasik involves the creation of a flap. There are two ways to make a flap - either with a mechanical blade (microkeratome) or an all laser method (Intralase). When creating a flap with a microkeratome, there are risks involved. These risks rarely occur but when they do they can make the procedure more challenging.

Although the risks are low with standard microkeratome lasik, they are included here. Some of the risks in using a micokeratome or a blade during Lasik include:

1. Damaged Flaps
2. Torn Flaps
3. Wrinkled Flaps
4. Buttonhole flaps
5. Decentered flaps
6. Epithelial Loosening or Defect
7. Poorly adherent flap

Several studies have shown that the all laser method (Intralase) can potentially decrease the risks of flap creation. They have also shown that all laser Intralasik (Intralase) results in better vision, greater safety, and a higher degree of precision. In addition, many patients prefer all laser lasik to lasik with a microkeratome.

In addition, the Intralase allows Dr. Pham to make a thinner flap. This will help preserve more of your corneal tissue. By saving more of your corneal tissue, you can potentially decrease the risk of weakening your cornea. This may also decrease your risk of keratoconus, a condition where your cornea is weaker.

One of the major reasons Lasik surgeons and people do not endorse or use the Intralase is because of costs. Dr. Pham believes that every patient deserves the best technology and treatment for his Lasik patients at the San Diego Lasik Institute. He believes in making Intralasik as affordable as bladed (microkeratome) Lasik for all of his patients.

The eye is an inherently unique and beautiful organ. No two eyes are exactly alike! When Dr. Pham performs Custom Lasik he uses a device that uniquely maps out your eye. This process is 25 times more accurate than standard measurements for lasik. Custom Lasik is the same as wavefront lasik. In order to perform Custom Lasik a wavefront is used to map out your cornea. This wavefront makes a map of your eye that includes all the different levels of your myopia (nearsightedness), hyperopia (farsightedness), and astigmatism. It also maps out the "higher order aberrations" in your vision that can be responsible for decreased vision. Dr. Pham believes that by using the VISX CustomVue procedure he is able to offer the best custom lasik technology to San Diego lasik patients. We believe in treating patients with the best in Custom Lasik surgery. During your lasik consultation, Dr. Pham will go into detail about the custom lasik option and treatment if you are a candidate.

Lasik surgery has helped millions of people. It is one of the safest surgery procedures in medicine today. However, every surgery has some risk. Major complications are extremely rare. Minor complications do occur but are usually treatable. Often, they will reduce or disappear within months of surgery. We would be happy to discuss all of the risks and all of the things that we do to make all laser Intralasik as safe as possible for your eyes.

It may. ALthough for many people there is very limited pain associated with the LASIK procedure, some patients may be more sensitive or prone to pain. Each individual may have a different pain threshold and pain response. We give valium or a local relaxing drug at the San Diego Lasik Institute. During your LASIK procedure, "numbing eye drops" are used. Some patients may experience mild pressure and discomfort but this is usually last several moments. After the procedure, you may have irritation for approximately 8 hour. Dr. Pham advises patients to sleep and by the time they wake up most of the irritation is usually gone. We do everything to ensure your comfort. We also offer a "hand holder" to comfort you through the process. Most patients feel very comfortable throughout the LASIK procedure.

Lasik surgery and all laser Intralasik surgery have revolutionized laser vision correction. However, there are no guarantees in surgery. All surgeries have risks that need to be discussed with your doctor. Many people like you have been helped with this surgery. Many patients have an improvement in vision but some may still need to wear corrective lenses. Generally, if this happens the necessary correction will be much smaller. Patients over 45 years of age may do very well with distance vision but may need reading glasses. However, there are things Dr. Pham can do such as monovision that may help with near reading (presbyopia). Some patients may also need to do a lasik touch up or enhancement as long as the eye is healthy. Dr. Pham would be happy to discuss all of this with you in a free Lasik consulation.

For the right person, LASIK can be a life changing event. A recent Harris survey** showed that 90 percent of LASIK patients are satisfied with its effects on their vision. 94 percent of LASIK patients agree that LASIK has improved their lives. Four out of five report that they are happier since the procedure.

However, LASIK is not for everyone! At the San Diego Lasik Institute, Dr. Pham personally examines every patient to determine if they are a candidate. If they are not a candidate for LASIK he may recommend no surgery, PRK, an implantable contact lens, or a multifocal lens. We believe safety is the most important aspect and will not compromise it. Our advantage is that we offer services beyond lasik so it is not the only thing we recommend. This allows us to recommend what we fill will be the best treatment or non treatment of your eye.

** Conducted on behalf of AMO (Advanced Medical Optics)

Possible Contraindications for Lasik

1. Unrealistic Expectations
2. A family history of corneal diseases such as keratoconus, severely scarred corneas, or weak corneas
3. Thin Corneas
4. Very Irregularly Shaped Corneas and irregular corneas. Corneas with irregular corneal mapping may pose increased risks during LASIK surgery. Dr. Pham will discuss with you any irregularities in your cornea.
5. Severe Dry Eyes - This is a relative contraindication in that there have been many options for the treatment of dry eyes before and after Lasik surgery.
6. Unstable Refractions
7. Severe medical conditions that are uncontrolled such as rheumatoid arthritis, autoimmune diseases, HIV, uncontrolled diabetes.
8. Pregnant or nursing mothers can eventually have lasik but not during their pregnancy.
9. Patients taking medications such as accutane. Accutane may eventually have lasik once they have stopped the use of accutane. Dr. Pham would love to discuss this with you.
10. History of severe eye infections such as herpes simplex corneal ulcers. The herpes simplex virus may potentially reactivate during the procedure.

Most people are candidates for lasik. There are other conditions that are not listed that may be contraindications to surgery. This is just a sampling of some of the aspects of your examination that your lasik surgeon should check. Dr. Pham would be happy to do a free lasik screening for you to determine if you are a candidate. He may also discuss with you the many new and exciting technologies available to you if you are not a candidate.

The FDA (Food and Drug Administration) plays a very important role in setting the general guidelines for your LASIK treatment. It determines a lasik surgeon's guidelines for using a particular medical device or technology. All of the FDA trials are conducted in a safe and stringent matter. Dr. Pham uses FDA approved lasers including the custom wavefront LASIK system with VISX and the all laser flap device (Intralase). When considering LASIK surgery, it is important to ask your surgeon if the treatment is within FDA guidelines. Sometimes, a surgeon can do treatments not originally approved by the FDA. This is because new scientific evidence or applications of a technology can become mainstream after the original FDA trials. Dr. Pham would be happy to discuss with you all of the FDA approved uses of lasers as well as new developments since the FDA trials.