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Commonly Asked Questions about LASIK

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					                           Commonly Asked Questions about LASIK




What is Laser Vision Correction?
Laser Vision Correction is an outpatient surgical procedure that corrects vision problems using a VISX S4 laser
to re-contour and alter the surface of the cornea.

Worldwide, many of the ever growing number of people who have had their vision improved with the excimer
laser no longer need to wear eyeglasses or contact lenses for distance vision. It is one of the most
technologically advanced means by which people can achieve excellent vision without external optical
assistance.

There is a growing idea among eye care specialists that laser vision correction is the refractive procedure of
choice. There are a number of reasons why this is true. The excimer laser is computer-controlled and when
used by an experienced, well-trained surgeon, can achieve extraordinarily precise changes in the shape of the
cornea, while affecting only a small area of corneal tissue.



Is Laser Vision Correction Right for Me?
Although this is completely determined after a pre-operative evaluation, if all or most of the following
statements are true for you, then you may be a good candidate for laser vision correction:
    • My dependence on eyeglasses and/or contacts feels like a handicap, or impairs my daily activities
    • I do not tolerate contact lenses well
    • I am active in sports, and I feel my performance would be enhanced without my corrective lenses
    • I sometimes worry that if a crisis arose when I was wearing my glasses or contact lenses I would not be
       able to help myself or others
    • My career opportunities would be improved if I did not have to rely on eyeglasses or contact lenses for
       distance vision
    • I would be happy with the results if my vision improved significantly, even if I still had to wear corrective
       lenses for some purposes
    • I prefer the way I look without glasses
    • I adapt well to change
    • If Laser Vision Correction can reduce the hassles of contact lenses or glasses, and improve the quality
       of my life, it is worth the investment.




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Vision Problems
It is estimated that 142 million Americans suffer from refractive error that can be corrected by eyeglasses,
contacts lenses and/or lasers. Refractive errors are not diseases, rather conditions that fall into the following
categories:

   •   Myopia (Nearsightedness) Individuals with myopia are said to be “nearsighted” because objects seen
       at a distance are blurred, while those in closer range can be seen very clearly. If the degree of
       nearsightedness is very high, this near point of clear vision may be as close to two to three inches form
       the eyes, and vision at the usual reading distance of 16 inches would be blurred. One in four Americans
       are myopic. This condition is the most readily treated by laser vision correction.

   •   Hyperopia (Farsightedness) Individuals with hyperopia are said to be “farsighted” because they are
       able to focus better on distant objects, rather than object closer to them. If the degree of farsightedness
       is high enough, distance vision can also be affected. Laser Vision Correction is available for the
       correction of hyperopia, but remains less common than the correction of myopia.

   •   Astigmatism for individuals with astigmatism, the cornea lacks a uniform surface; it has two different
       curvatures, which results in the inability to clearly focus the entire image on the retina. Light rays
       entering the eyes are distorted, which blurs vision along a certain center or axis of the cornea. For
       instance, normal corneas are round like basketballs; astigmatic corneas are elongated like footballs.
       Astigmatism can be, and often is, present in individuals with myopia or hyperopia and it can be
       corrected by the excimer laser.

   •   Presbyopia Sometime around the age forty a natural weakening in the eye’s near focusing ability
       begins. This condition is called presbyopia, and it makes reading and other “close” work increasingly
       difficult. As this occurs, people who have been nearsighted or farsighted begin to wear bi-focals.
       People who have never worn glasses begin to wear reading glasses for up-close work. Although the
       excimer laser is not used to treat this condition, there are methods that can help compensate for
       presbyopia.

                                       Vision Correction Options
    • Eyeglasses
With the bountiful selection of designer frames, super-thin lenses and no-line progressive bi-focals, eyeglasses
are more cosmetically pleasing than ever before. However, even the newest glasses have many of the same
old problems, like peripheral vision distortion, physical discomfort, fogging during sports, etc.
    • Contact Lenses
With over 275 contact lens options, almost every imaginable refractive error can be corrected. Many agree that
contacts are preferable to eyeglasses, however, they, too, are not an antidote. For many, contacts remain less
than perfectly comfortable, provide less than optimal vision, and still require an annoying amount of cleaning
care.
    • Laser Vision Correction
Laser-In-Situ-Keratomileusis (LASIK) and Photorefractive Keratectomy (PRK) are laser procedures that
eliminate or reduce your dependency on glasses and contact lenses. LASIK and PRK are elective procedures
and you should be fully informed of the risks and benefits before undergoing either procedure.
    • OrthoKeratology (Ortho-K)
Ortho-K is a non-surgical process which reshapes (flattens) the cornea of the eye using contact lenses to
reduce refractive errors. Accelerated Ortho-K uses reverse geometry contact lenses. Flattening the cornea
reduces the focusing power of the eye. If the amount of corneal flattening is accurately controlled, it is possible
to bring the eye into correct focus and compensate for myopia (nearsightedness). After the contact lens is
removed, the cornea retains its flattened shape for part or all of the remainder of the day. A retainer lens must
be used each day to maintain the corneal flattening, or the myopia will revert to the pre-treatment level.

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                                           Common Questions

Will the procedure be painful?
The actual procedure itself is painless. Local anesthetic eye drops are given about a half hour before and
again immediately before the surgeon begins. After the anesthetic eye drops wear off you may feel slight
discomfort. The level of discomfort varies due to individual patient sensitivity and tolerance. Most patients
experience only mild discomfort and light sensitivity for the next 12 to 24 hours and resume regular activities
within two or three days.

How soon after the procedure will my eyes reach their level of correction?
Ninety-six (96%) percent of patients achieve normal vision with a single laser treatment, return to work in a few
days and have 20/40 or better vision within a week. After the first few weeks, you should notice less fluctuation
in vision. With an eye examination, we can tell you what to expect.

Will I see “starbursts,” night glare or haloes?
Most patients do not experience the starburst effect commonly associated with radial keratectomy. You may,
however, experience some night glare following laser vision correction. Night glare appears as “haloes”
around lights at dusk or in dimly lit areas as the pupil expands beyond the laser-treated central area of the
cornea. Night glare usually subsides in the months following the surgery. Advancement in laser techniques
decreases the likelihood of night glare.

Will my vision be foggy?
Almost everyone experiences a trace of corneal hazing during healing, although most patients are not aware of
it. It is usually only visible to the doctor under a microscope and permanently clears in almost all patients by
their one-year checkup.

Will my nearsightedness return?
Regression, or a shift back towards myopia after laser vision treatment occurs to a small degree to all
individuals. Therefore, the laser is programmed to adjust for this. This process generally stabilizes within three
months. Small variations of under-correction or over-correction may be expected. Part-time or full-time
corrective lenses or a subsequent laser procedure may be needed to further enhance vision.




                               Other Questions to Ask Your Doctor

   •   What other options are available for correcting my nearsightedness, farsightedness and astigmatism?
   •   Will I have to limit my activities after surgery, and how long?
   •   What are the benefits or laser surgery for my amount of nearsightedness, farsightedness and
       astigmatism?
   •   What vision can I expect in the first few months after surgery?
   •   If this surgery does not correct my vision, what is the possibility that my glasses will need to be stronger
       than before surgery? Could my need for glasses increase over time?
   •   Will I be able to wear contact lenses after the laser surgery if I need them?
   •   How is laser surgery likely to affect my need to wear glasses or contact lenses as I get older?
   •   Will my cornea heal differently if I am injured after the surgery?




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Medical Contraindications for LASIK and PRK, include:
  • Pregnancy & Nursing
  • History of herpes infection of the eye
  • Collagen vascular diseases (i.e. Lupus)
  • History of retinal, corneal or other eye diseases


Laser-In-Situ-Keratomileusis (LASIK)
An instrument named a microkeratome is used to raise a flap of corneal tissue before the laser is applied.
Then, the excimer laser is used to remove a thin layer of tissue from the cornea. After the laser is applied, the
flap is then gently put back in its place. LASIK is actually a form of keratomileusis, which has one of the longest
track records of all forms of refractive surgery. Is has been performed since the 1960s.

Advantages to LASIK:
   • Less post-operative discomfort than other refractive procedures
   • A smaller incidence of corneal haze
   • Quicker visual rehabilitation
   • No necessity for use of steroid drops

However, LASIK is a technically more complex procedure to perform than PRK, and it is the surgeon’s
discretion which procedure they prefer. The choice can be discussed with the doctor in greater detail during
your visit. In general, the higher the degree of myopia, the more likely the doctor will perform LASIK over PRK.


Photorefractive Keratectomy (PRK)
Introduced in 1987, PRK uses a cool, ultraviolet excimer laser beam to reshape the outer surface of the
cornea, which is the most accessible way to modify refractive imperfections. After gently removing the
epithelial layer of the cornea, the surgeon programs the computer, which controls the laser beam. The laser’s
computer is calibrated to the exact measurements of the patient’s eye. The precise sculpting of the cornea by
the laser allows light entering the eye to focus properly on the retina.




                                            Newest Procedures
The field of correcting refractive errors will be forever changing. Now there is VISX CustomVue, individualized
laser vision correction and it is setting a new standard for laser vision correction. Just like a fingerprint, each
person’s vision is 100 percent unique to their eyes. Before the recent advancements in technology, doctors
were only able to use standard measurements to correct vision, meaning that prescriptions could only provide
a certain level of correction regardless of an individual’s needs. In the FDA study 98% if patients saw 20/20 or
better, 100% could pass a driver’s test, 70% could see better than 20/20. VISX CustomVue can measure and
address the unique imperfections of each individual’s vision and provide them with the potential to experience
better vision than is possible with glasses or contact lenses…their Personal Best Vision.



                    Are you a candidate for LASIK? Find out!
                  For a free screening call 1-877-963-EYES (3937)

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A note from our surgeons:
Remember, your vision is precious and although you want to be able to afford laser vision correction, it is
important that the surgeon is the best one for you.

Temptation is always there to select your LASIK surgeon based on pricing alone, but keep in mind, it is
always best to choose the most qualified physician, then worry about the price. We believe the value of
your eyesight is immeasurable. The more education you have about the LASIK procedure, the better to
make an informed decision about having it.

Novus Clinic has financing available to you through CareCredit.                You can apply on-line at
www.novusclinic.com. Nationally, fees range from $2000-$5,000 for both eyes. Don't be fooled by
misleading marketing. Laser vision correction is still a surgical procedure, and is dependant on the skill of
the surgeon.

The fees for LASIK depend on the type of procedure, your geographical area, and the surgeon.

What about those low-priced ads you have seen in the paper?

We know there are many "low-cost centers” who would like you to assume that the laser alone corrects
your vision. If you encounter a LASIK provider with a low price that seems too good to be true, it probably
is.

There are a slew of details that must be considered that allow “low-cost centers” ways to "bait-n-switch”.
Be sure to ask what is included in the fee. Be cautious of centers that offer very low fees per eye. With
more exploration, you may find this fee is only valid for individuals with a very minimal prescription to begin
with. The higher the prescription, the higher the fee is -in most cases. Be sure to ask if the surgery will be
performed locally. Many low cost centers require you to travel to Cleveland, Columbus or even out of
state. You may discover that a fee of $299 does not include the facility fee or the surgeon's fee. Also,
keep in mind that there are many different types of lasers being used for LASIK. Not all lasers are created
equally and they do not all have the same level of success. Consider LASIK to be affordable and cost-
effective when compared to the 10-20 year expense of glasses, contact lenses, and lens care. Laser
vision correction will be one of the most rewarding decisions you will ever make. This is a true lifestyle
investment and should be considered carefully. If you have any questions at all, please feel free to contact
us at 1-877-963-EYES (3937).




Dr. Todd Beyer

Dr. James L. Johnston, Jr.


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