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LASER REFRACTIVE SURGERY
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Lasik Pre-Op Instructions
LASER REFRACTIVE SURGERY [ TOP ]
LASER VISION CORRECTION AND YOU [ TOP ]
Laser vision correction can be a life-changing event. Are you tired of your glasses fogging up, slipping down your nose, or being misplaced at a critical time? Everything from caring for your toddlers to greater ease in sporting activities can be yours. Not everyone is a candidate, but many will live their lives with little or no need of optical correction. Dr. Cottone can tell you about his experience and those of his patients.
WHAT MAKES COTTONE FAMILY EYECARE LTD SPECIAL? [ TOP ]
Cottone Family Eyecare has 19 years of experience in the care of refractive patients, unparalleled in the Chicago land area. Dr. Cottone had Lasik surgery in November of 1999 after having worn hard contact lenses, gas permeable contact lenses, soft toric and bifocal contact lenses. His experience gives him an understanding of the options in solving optical and refractive problems.
OUR SURGEON [ TOP ]
Dr. Cottone has Drs. Mark & Bruce Golden perform his Laser surgeries for Cottone Family Eyecare. Drs. Golden, are Fellows of the American Academy of Ophthalmology and the American College of Surgeons, has performed thousands of refractive procedures and is frequently invited to lecture to doctors in this country and internationally on a variety of topics including the care of laser refractive patients. Dr. Cottone and Dr. Golden have co-managed hundreds of patients.
WHAT IS THE EXCIMER LASER? [ TOP ]
The Excimer Laser was initially invented by IBM to make smaller computer chips because of its extraordinary precision. The cool laser beam is precise to less than one twenty five thousandth of an inch. In just seconds, this cool beam of light allows the reshaping of the cornea without damage to the delicate surrounding structures. It was first used to treat nearsightedness in 1988; the patient who underwent that procedure maintains 20/20 vision.
LASER IN-SITU KERATOMILEUSIS (LASIK): [ TOP ]
Lasik combines the use of the Excimer Laser with a microkeratome. The microkeratome makes a cut across the top surface of the cornea. This flap of tissue is then hinged off to the side. The computer guided Excimer laser beam accurately reshapes the cornea by removing corneal tissue based upon the measurements in our office. The flap is then placed back in position and allowed to heal. Dr. Cottone found that he had excellent vision the day following surgery and was easily able to work an entire day. He has found that essentially all of his patients see well enough to work and drive the morning after surgery. LASIK takes advantage of the Excimer Laser and allows for fast healing.
THE KEY ADVANTAGES TO LASIK INCLUDE: [ TOP ]
1.The ability to treat both eyes at the same time.
2.Rapid recovery of vision (usually overnight).
3.No pain
4.Very few complications in hands of experienced surgeons.
LASIK surgery produces consistently accurate results with more than 98% of individuals demonstrating 20/40 vision without the use of glasses or contact lenses. The Excimer laser is important for accurate results with LASIK, but the surgeons experience in performing LASIK and our knowledge of your eyes along with the pre and postoperative visits are the most important factors that determine the success of your surgery.
Near-sightedness (Myopia), Astigmatism, and Far-sightedness (Hyperopia) can all be corrected with Excimer Laser during the LASIK procedure. However, there are limitations and these are addressed at the preoperative evaluation.
FOLLOWING LASIK SURGERY: [ TOP ]
The surface (epithelial) layer of your cornea will usually be healed overnight. You will be asked to use drops for a week to help the healing. To prevent rubbing of the eyes at night, you will be given plastic shields to protect your eyes while sleeping. The eyes will be somewhat light sensitive and dry at first, but this condition eases over the first six weeks. Most eyes are completely healed within a few weeks and all should be stable by 3 months from the time of surgery. The use of artificial tears is always helpful in dry environments.
We urge you to be gentle and careful with your eyes in the first weeks and months after surgery. You must be careful not to rub your eyes for the first few weeks after surgery. You should not use eye makeup for the first week after surgery. No swimming for two weeks after surgery. We encourage you not to get pregnant during the first three months. Protective sunglasses are always encouraged, but especially important for the first six months. In hazardous situations, you should always use appropriate protective eyewear.
WHICH REFRACTIVE PROCEDURE IS FOR ME? [ TOP ]
Determining the right procedure based upon your profession and overall lifestyle is very important. There are many considerations to make before recommending a procedure that would best suit you as an individual. During our preoperative examination we will talk with you in detail not only about the procedures that are available, but also about your visual needs, expectations and demands. The goal of the preoperative examination is not only to educate you, but also to ensure (both you and us) that refractive surgery is the appropriate choice for you.
AM I A CANDIDATE FOR REFRACTIVE SURGERY? [ TOP ]
Today, almost anyone with refractive vision problems may improve their vision through refractive surgery procedures - allowing greater freedom from glasses or contact lenses. Even people who do not totally eliminate their need for glasses may be able to reduce the thickness and strength of cumbersome eye wear that can interfere with an active business or leisure lifestyle.
Women who are pregnant, breast feeding, or planning on pregnancy should delay surgery for at least three months after pregnancy or the end of their breast feeding.
HOW WELL WILL I BE ABLE TO SEE FOLLOWING REFRACTIVE SURGERY? [ TOP ]
There are multiple issues that are common to all or nearly all refractive surgical procedures. Among these are factors involved in assessing the outcome of a refractive procedure. The ideal outcome of a refractive procedure would be one in which the patient can see very soon afterwards at least as well without glasses or contacts as he/she had previously been able to see with the best possible glasses or contacts and do so with no side effects. It is important that your expectations are reasonable and that you understand the possible ways in which your expectations might not be met. It is helpful to know that, although there are exceptions, as a general rule, the higher the myopia (nearsightedness) you begin with, the less likely you are to have an ideal outcome with the first procedure. However, some of our happiest patients are those who begin with high or extreme myopia along with the heightened dependence on glasses or contact lenses which can make them frightened of situations in which they might lose their glasses or contact lenses. Our distinction between the variation of myopia is as follows:
Low: 0 to 3 diopters
Moderate: 3 to 6 diopters
High: 6 to 9 diopters
Extreme: 9 diopters and up
In general, the higher the correction, the greater the probability for fine tuning the correction with enhancement surgery.
IS LASER SURGERY DIFFERENT AFTER THE AGE OF 40? [ TOP ]
The surgical technique for patients over the age of 40 is no different than that of younger patients, but there are additional issues that must be addressed during the preoperative evaluation. Everyone requires glasses for reading up close, if they have good vision for distance, once they reach their mid forties. Nearsighted individuals find that they can remove their glasses or contact lenses and see up close. Once you have surgery, you no longer have that ability. Therefore Dr. Golden recommends to all of his patients that they fully correct their dominant eye and undercorrect their non-dominant eye. This leaves the dominant eye for distance and the non-dominant with better vision for reading. This may disturb depth perception and if someone has this done and does not like it, then it is easy to lift the flap and add correction to bring the two eyes to full distance correction. All patients that have full correction will have to wear reading glasses for close work once they reach their mid-forties if they do not have this monovision undercorrection of one eye. Dr. Cottone can help you decide what is best for your lifestyle.
WILL I BE HOSPITALIZED FOR REFRACTIVE SURGERY? [ TOP ]
Refractive Surgery is performed at a laser center. You may have some Valium, if you choose. You must have a ride home and should not plan to drive until the day after surgery.
DOES INSURANCE COVER REFRACTIVE SURGERY? [ TOP ]
Most insurance companies do not cover refractive surgery but some will. The best way to learn quickly is to call your insurance carrier directly and ask if refractive surgery is a covered benefit (the procedure code to refer to is 65760). Some have Laser Vision Correction as a company benefit.
HOW LONG DOES REFRACTIVE SURGERY TAKE? [ TOP ]
Laser Vision Correction usually takes less than 15 minutes. We ask that you plan to be at the facility 1 hour prior to surgery for paperwork, discussions, and to meet Dr. Golden. Most people spend less than 90 minutes total at the center.
**Contact Lens Wearers**
Before you come in for your evaluation you must be out of your daily soft contact lenses for at least three days to 3 weeks, extended wear soft contact lenses for at least a week to 3 weeks or gas permeable contacts for at least six weeks. If you are a hard or gas permeable contact lens wearer, it could take longer for your cornea to stabilize. Call our office to arrange for temporary soft lenses while the cornea stabilizes.
HOW SOON WILL I BE ABLE TO RETURN TO MY NORMAL ACTIVITIES FOLLOWING REFRACTIVE SURGERY? [ TOP ]
In most cases, you may return to work the following day. However, you may want to take a few days off if you work in a particularly dusty environment.
WHAT ARE THE STEPS FOR REFRACTIVE SURGERY? [ TOP ]
THERE ARE THREE PHASES TO LASER VISION CORRECTION:
1) The pre-surgical evaluation. This is performed in our office and takes approximately one and half-hours. This visit is concerned with collecting all the data that are needed to determine the health and optical status of your eyes, whether or not you are a candidate for the procedure, determination as to what level of correction will meet your needs best, and finally to answer all of your questions concerning the correct procedure for you.
2) An appointment is then scheduled with our extremely experienced surgeon, Dr. Mark I. Golden, M.D., F.A.C.S. of Eye Surgeons and Consultants. He will perform your laser procedure per our preoperative evaluation.
3) Your follow-up visits are all included for the next year. These are done in our office.
WILL I NEED AN ENHANCEMENT PROCEDURE? [ TOP ]
More than 99% of patients will have at least driving vision or better. Some people, particularly those with higher amounts of nearsightedness, may find their correction is not adequate for their needs. In that situation, enhancement or fine-tuning surgery may bring the correction closer. The vast majority of people are corrected closely enough to the goal to feel very pleased with their outcome and to see well for most purposes without glasses.
Most see well enough without glasses for most activities, but some patients will still need glasses for at least occasional use. Remember, if you aimed for good distance vision and are over 40 you can expect to need reading glasses; and if you aimed for "reading" vision, you can expect to need distance glasses.
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