Lasik & Phakic Iol | LASIK

General Guidelines for LASIK

Millions of people have successfully undergone refractive surgery to improve their vision. But LASIK surgery is not reversible and like every surgical procedure has risks and possible side-effects.

Below you will find a check list of basic guidelines for successful LASIK surgery but you are always welcome to call and ask about your particular situation.

Ask yourself the following questions:

  • Are you at least 18 years old with a stable prescription to ensure your eye structure and vision have developed fully?
  • Are you taking the prescription drug Acutane, which interferes with LASIK?
  • Are your eyes healthy and your prescription stable? If you are young and nearsighted, you may have to postpone LASIK until your prescription has stabilized, as nearsightedness may continue to increase in some patients until their early twenties.
  • Are you in good general health? LASIK is not recommended for patients with uncontrolled diabetes, rheumatoid arthritis, lupus, glaucoma, herpes infections of the eye or cataracts. You should discuss any and all health issues with our specialists.
  • Are you pregnant or nursing? These conditions may change the prescription. It is recommended you wait six months before or after pregnancy to schedule LASIK.
  • Are your expectations realistic?
  • Are you really unhappy wearing contact lenses or glasses?

If you are currently using correction in a bifocal or are approaching 40 years of age, remember that LASIK cannot correct presbyopia, a condition that creates the need for reading glasses or bifocals. Ask Dr. Anjali Pathak, Medical Director or Dr. Linda Tsai, if you’re a candidate for modified monovision, which can reduce your need for reading glasses after LASIK, by adjusting your correction in a way that sets the focus of your dominant eye (the eye you would choose while using a camera) for distance and your other eye for clearer near vision.

This solution is not for everyone; however, our specialists have had enormous success in helping patients reduce their dependency on reading glasses after LASIK If you are interested in having LASIK performed in this way a trial of this scenario can be given at the time of your screening.

Preparing for the Evaluation

If, after your screening, you are found to be a candidate and desire to proceed with refractive surgery, we will schedule you for a full evaluation with Dr. Anjali Pathak or Dr. Linda Tsai. This is usually performed within several weeks of your screening. If you wear contact lenses, they must be removed prior to your evaluation with the surgeon, so that the cornea is allowed to relax to its original curvature prior to contact lens wear.

Before the Operation - Screening

At your screening, measurements will be taken by the surgical coordinator or surgical technician, and the procedure will be explained in detail.

Computerized corneal topography (corneal surface maps) will be performed to measure corneal curvature. In addition, corneal thickness and pupil size will be measured, your prescription determined and your medical and eye history taken. Please bring a list of all prescriptions and OTC medicines you take regularly.

Any and all questions will be answered at this time, and your expectations will be reviewed. If you are a candidate for monovision (over 40 years of age and interested in preserving reading vision after LASIK), we will give you a trial of modified monovision.

Before the Operation - Full Examination

If you qualify as a candidate for laser vision correction and wish to proceed, we require a surgery evaluation by the corneal surgeon. We will review your medical history and conduct a complete eye examination, including dilation. During this time we will determine your degree of nearsightedness, farsightedness and/or astigmatism. We will confirm measurements taken at the time of your screening and check and recheck your prescription.

This detailed information is required to develop a treatment plan specifically for you. The cost of the evaluation is $210.00 and is covered by most insurance carriers as a complete medical eye exam. The evaluation will last up to two hours, and you will have an opportunity to have any and all questions answered.

Soft daily wear contact lenses should be removed 7 days prior, soft toric contact lenses should be removed 21 days prior and rigid gas permeable contact lenses should be removed three weeks per decade of year prior. This process, though inconvenient, is a critical step in preparing for LASIK. If the corneas are not allowed time to return to their original curvature before the procedure, they will continue to return to their original curvature after the procedure, possibly altering the results of the procedure. Our surgeons will verify that your cornea curvature is stable before proceeding. This is a critically important step in preparing for your procedure.

At the Washington University Refractive Surgery Center, we are interested in your well-being and will never rush to operate. This conservative approach is to your benefit.

You will be asked to stop wearing makeup, lotions or perfume the day of your surgery. These products can interfere with the laser treatment or increase the risk of infection.

During the Operation

The surgery should take less than 30 minutes. You will receive a small dose of Valium 40 minutes before your procedure. You will then be comfortably positioned in a reclining chair in our surgery suite in the office. The laser system includes a large machine with a microscope attached to it and a computer screen.

A numbing drop will be placed in your eye, the area around your eye will be cleaned, and an instrument called a lid speculum will be used to hold your eyelids open. You will be asked to stare at a bright red/orange light. This is a target for you to stare at during your procedure. A suction ring will be placed on your eye and very high pressure will be applied to create suction to the cornea. During this step, you will feel some pressure for approximately 20 seconds, while the flap is created. You will not see any light for this 20 seconds because of the microkeratome. As soon as the flap is created, and the microkeratome is removed, you will again be asked to stare at the red/orange light, and will continue to stare at this light during the remainder of your procedure.

The eye surgeon will then gently position the flap out of the way so that laser can been applied the surface beneath. The flap is about 1/4 of the thickness of the cornea, leaving 3/4 of it for reshaping.

When your eye is in the correct position, staring at the red/orange light, the surgeon will apply the laser beam to the surface. At this point you will be aware of a clicking sound. The pulse of the laser makes a ticking sound as it delivers the cool light beam.

To arrange for a screening or to request a brochure, please call the following phone numbers or you may send us an email:

Dr. Pathak, Medical Director
Jo Ellen, Surgical Coordinator
314- 996-3300

Dr. Linda Tsai
Wanda, Surgical Coordinator
314- 996-3300

For more information on LASIK surgery in the St. Louis area through Washington University Physicians or to make an appointment, please call 314-996-3300

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