Frequently Asked LASIK and Laser Eye Surgery Questions
 FAQ's
What is Laser Eye Surgery?
Laser eye surgery for refractive errors like nearsightedness, astigmatism, and farsightedness has been approved in the United States since 1994, helping millions of people achieve a better level of vision. The original, FDA-approved procedure is called photorefractive keratectomy, or PRK. This procedure has been modified to be performed under a protective flap that is called laser in-situ assisted keratomileusis, or LASIK. Our doctors perform both procedures and will discuss your surgical options with you at the time of your consultation, and both procedures have been very effective at reducing or eliminating patients' need for glasses or contact lenses. Both PRK and LASIK use an excimer laser to change the shape of the cornea, the front surface layer of the eye. This laser uses a cool beam of ultraviolet light to precisely remove a very thin layer of the cornea, typically less than one-third of the thickness of a human hair, thereby changing the curvature of the cornea to change the vision. Contact our practice today about the laser eye surgery options available, including Custom LASIK. Serving Santa Monica, Beverly Hills, and the Los Angeles area, the Beverly Hills LASIK Center is qualified to meet your eye care needs.
Advances in laser eye surgery have made LASIK safer with the use of a laser (the Intralase) to create the flap (IntraLASIK), and have made LASIK and PRK safer and more precise with Wavefront-guided laser vision correction.
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Who is a
candidate for laser eye surgery?
Laser vision correction can be used to correct up to -12.00 diopters of myopia (nearsightedness) with up to six diopters of astigmatism. The Beverly Hills LASIK Center is also able to offer laser eye surgery to patients in Beverly Hills, Santa Monica, and Los Angeles for up to +6.00 diopters of hyperopia ( farsightedness), with up to +6.00 diopters without astigmatism. We can provide most patients over the age of 18 who have vision imperfections with a surgical option that will reduce or eliminate their need for glasses or contact lenses. If your correction is outside of this range, there may still be some other options, such as Phakic IOL or Clear Lens Extraction, available to you.
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What is
the goal of laser eye surgery?
The goal of standard and wavefront-guided laser procedures like LASIK or PRK is to improve patients' vision to a level that is stable, predictable, and long lasting. Results of standard laser eye surgery treatment show that both LASIK and PRK can correct up to six diopters of astigmatism, as well as myopia and farsightedness. In addition, more than 99 percent of patients with less than -6.00 of myopia achieve a legal driving vision of 20/40 or better after undergoing laser eye surgery. Despite such promising results, patients who decide to undergo refractive surgery should have realistic expectations about the success of the procedure. A dramatic improvement in vision, the chance to participate in sports, drive, or function in an emergency, without glasses are all realistic expectations of PRK and LASIK laser eye surgery
for our patients from locally in Santa Monica, Beverly Hills and Los Angeles as well as from all over the world.
However, if you define success as achieving absolutely perfect 20/20 vision (without glasses) at all times, then you may be disappointed
– not 100% of patients achieve this level of vision. In our practice, with a wavefront Intralase procedure, the chance at your result being 20/20 after the procedure is dependent on your original correction, but the chance at getting 20/20 vision for most patients in the mild to moderate nearsighted or farsighted range is typically between 90 and 96 percent.
If you are significantly nearsighted, between -7.00 and -12.00, or significantly farsighted, between +4.00 and +6.00, your results are less predictable. Studies on these patients show that they can expect to achieve 20/40 vision over 95 percent of the time. Overall, the chances for visual success are even higher with Wavefront-guided laser eye surgery.
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What about reading glasses?
(Please read this section carefully if you are over 35 years old!)
If you are over the age of 35, you need to consider the options of laser
eye surgery seriously, especially when you consider that most people your age will develop or already have developed an eye condition called presbyopia. As people age, the eye's lens loses its ability to quickly focus from viewing things at a distance to viewing things close up -- this is called presbyopia. Presbyopia is the reason why people over the age of 40 generally need reading glasses. The good news is that if you never really needed glasses to see from far distances, you may only need reading glasses when you develop presbyopia. In such cases, most people use a "Ben Franklin" style half-glass with magnification.
There are some surgical options to reduce the need for reading glasses, including monovision (see below), Conductive Keratoplasty and Refractive lens exchange with the Crystalens, Restor or Rezoom intraocular implant lens. Contact the Beverly Hills LASIK Center today to see what refractive surgery treatment options our Los Angeles, Beverly Hills, Santa Monica, and surrounding area patients have available to them.
Over the age of 40, laser eye surgery patients all need reading glasses, unless they want to try monovision. Monovision is a very important concept for all patients over 40 to understand. For your convenience, we explain it in the next section. If you are nearsighted, you know that you can read without your glasses, although if you are very nearsighted, you may have to hold objects rather close in order to see them. If you are over the age of 40 and undergo laser vision correction, you will no longer be able to see objects close-up without reading glasses, unless you choose to have monovision correction.
If you are mildly nearsighted and love to read without glasses, then laser eye surgery may not be a good option for you, unless you choose monovision. Some patients may get rid of distance glasses but need new reading glasses. For many people, the ability to see clearly at a distance is worth the loss of uncorrected reading vision. If you are farsighted, then you already know that you need glasses to see clearly in the distance as you have gotten older, and even stronger glasses for reading. You will have two options, either to correct both eyes for distance and wear reading glasses, or consider a monovision correction.
There are surgical options to reduce the need for reading glasses. The best procedure available today for patients between 45 and 60 who have good distance vision without glasses is conductive keratoplasty, which is an FDA approved procedure that creates a mild form of monovision with an excellent safety profile.
Other procedures involve going inside the eye for a refractive lens
exchange, whether with the Crystalens®, Restor® or Rezoom implant
lens. These procedures are generally better in the age group over 55 who need some glasses for distance vision or have some cataract formation. Nonsurgical options are monovision with contact lenses or reading glasses.
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What is
monovision, and why might I want it?
As described in the last section, people over the age of 40 may need two separate glasses prescriptions to see clearly -- one at the distance, and a different one for reading. The only options for laser vision correction are to either correct both eyes for good distance vision and wear reading glasses, or to have a monovision correction at the Beverly Hills LASIK Center. In a monovision correction, your dominant eye is corrected for distance vision, and your non-dominant eye is corrected for reading or intermediate vision. Monovision does not work for everyone, and it is always best to try it in contact lenses before doing it surgically. If it does work, it generally allows that person to function without glasses for most distances, although some patients will want "night driving" glasses or "sewing" glasses, and many will eventually have to wear some reading glasses as they continue to age.
Monovision can also be achieved with conductive keratoplasty surgery, and the monovision from this surgery is interesting in that the distance vision is generally much less compromised then it is with monovision with contact lenses or laser vision correction. This is the reason, in addition to the safety profile, that conductive keratoplasty is usually the best procedure for someone with good distance vision without glasses who want to get rid of their dependence on reading glasses.
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Does laser
eye surgery hurt? What is involved in laser eye surgery?
Both of our laser eye surgery procedures -
LASIK and PRK – are performed as outpatient procedures in the Laser Eye Associates suite on La Cienega Blvd just south of Wilshire Blvd. . Patients can expect the doctor to perform the procedure with the Alcon
LADARVision laser,
the Allegretto laser,
or the CustomVue™ VISX® Smoothscan laser.
The flap is almost always created with a Intralase laser.
Both
the PRK and the LASIK
procedures run about 15 minutes in length, where the laser is turned on for less than 90 seconds. The actual surgeries are painless, although there can be some discomfort during the recuperation period, which is longer for PRK. Patients can take some comfort in the fact that our qualified surgeons perform all procedures, and the doctor himself does all follow-up examinations and preoperative care. At the Beverly Hills LASIK Center, we have performed thousands of laser eye surgery treatments on patients who come to us from locally in Beverly Hills, Santa Monica and Los Angeles, as well as on patients who travel to see us from across the country including New York, San Francisco and Chicago, and international patients who have come to us from places like Japan, Indonesia, England, Hong Kong and Germany.
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What are the
differences between the two types of laser eye surgery: PRK versus LASIK?
PRK was the first laser procedure to use the excimer laser for reshaping the surface layer of the cornea. PRK was approved by the FDA in 1994 but has actually been used on the surface of the cornea since 1988. It is considered to be a stable and predictable procedure. Because the very surface layer of the cornea, the epithelium, is an irregularly thick layer, it must be removed before a laser can be applied to the surface of the cornea. After the laser eye surgery procedure, it takes usually about three to seven days for the epithelium to resurface the cornea. During this time, the patient's vision is not very good, and the eye is somewhat uncomfortable (it may feel like there is a grain of sand in the eye). Modern variations to this technology -- including cold application, the newer, smoother lasers, and LASEK -- have dramatically decreased the discomfort associated with PRK-related recovery. Still, healing time remains at about a week, with patient's vision rapidly improving over the next few weeks. You may elect to do both eyes the same day or wait two weeks before doing the second eye.
LASIK is a newer laser eye surgery procedure (1995) that involves lifting the protective flap of the cornea with a mechanical instrument called a microkeratome, or a newer, femtosecond laser called IntraLase®. The excimer laser treatment is carried out just as it is in PRK, on the bed of the cornea, where then the flap is repositioned onto the cornea. Because of this protective flap, the epithelial surface layer of the cornea is left intact, so LASIK's healing time is faster and less uncomfortable than it is with PRK. However, the process of making the flap adds a surgical risk to LASIK that is not present with PRK. To complicate matters, PRK carries an additional small risk of the complication of haze, a complication only rarely seen with LASIK. Confused? The next section will help you understand the relative risks and benefits of LASIK and PRK, so that you can decide which procedure is best for you.
If you are interested in finding out if you would be a good candidate for LASIK or another laser eye surgery procedure, and live in Santa Monica, Beverly Hills, the Los Angeles area or anywhere else and can come to our office for a complementary consultation, contact us to schedule a consultation with the Beverly Hills LASIK Center today.
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What are the
risks and complications of PRK and LASIK?
Since both PRK and LASIK employ excimer laser technology, patients that undergo these laser eye surgery procedures will face similar risks. The risks include overcorrection, under correction, regression, irregular healing (including decentration, corneal islands, and irregular astigmatism, with possible loss of best corrected spectacle visual acuity), glare, nighttime halos, with possible increased difficulty driving at night (especially if there are large pupils or a high level of astigmatism). The most common risk is overcorrection or undercorrection, which occurs when a refractive error develops or persists in the eye after it has healed. Although laser correction can improve every patient's vision, there is a range for how much each patient responds to the procedure. For the most part, the results depend on the patient's prescription. Lower corrections, such as less than -6.00 diopters of myopia or +4.00 diopters of hyperopia, do very well, with over 99 percent achieving 20/40 or better vision (without glasses) with standard LASIK or PRK, and even better results with Wavefront-guided correction. Higher corrections, however, are less predictable. Both PRK and LASIK appear to give the same results for overcorrection and undercorrection, i.e. the predictability of the procedure. Contact the Beverly Hills LASIK Center if you would like to learn more about laser eye surgery, and live in or can travel to the Beverly Hills, Santa Monica, or the Los Angeles area.
If your vision is not as good as you expect it or want it to be, most patients can elect to have a retreatment or enhancement done to improve their vision. A small percentage of patients may experience some regression of the effect of their procedure and can usually undergo a retreatment.
Glare and halos, which are generally seen at night, are some examples of the unwanted optical side effects of laser eye surgery. These problems were much more common in the early years of laser vision correction, when less sophisticated lasers and smaller optical zones were used. Today, the current lasers have smoother treatments and larger treatment zones, making side effects like significant glare and halos less common. Patients with larger than average pupils in dim light or high levels of correction will be counseled about their relative risk for glare and halos. Wavefront-guided or wavefront optimized laser vision correction is often the best solution to lower the risk of glare and halos with the original treatment, and can often be used as a retreatment if needed to treat persistent glare and halo symptoms in those individuals that still develop the symptoms. Irregular astigmatism can rarely occur, resulting in a warped shape to the cornea. It can uncommonly lead to a decrease in best-corrected visual acuity, and may be corrected with wavefront-guided retreatment.
Infection is a risk that can occur with either PRK or LASIK, but PRK infections are
more common, but also
easier to treat than those from LASIK. The reason is that PRK infections develop on the surface of the eye, whereas a LASIK infection is generally located in the deeper section of the cornea -- making it difficult to treat and more likely to scar. Studies show that LASIK infections occur in less than one in 1,000 cases.
When choosing between the laser eye surgery PRK and LASIK, most of our Santa Monica and Los Angeles area patients elect LASIK if they have no additional problems with their eye, such as a thin cornea, an irregular cornea, a corneal scar, or have an occupation or sports, or an interest that places them at extra risk for eye injury.
PRK carries the additional primary risks of a longer recovery period of three to seven days and the development of a rare complication called haze. Haze occurs because the cornea surface heals in a fashion that is no longer crystal clear, causing a patient to have foggy vision with increased light sensitivity and glare. Haze can occur in the early postoperative period. It has also been reported to develop up to a year later, especially if there has been exposure to bright sunlight without ultraviolet blocking sunglasses being used. Haze typically is mild, with an average decrease in best-corrected vision of one or two lines, and clearing of the haze in two to six months. Rarely, a more severe haze can significantly decrease the vision, and can take up to two years to clear, although retreatment for haze is also a possibility. Fortunately, haze is now very rare in PRK; this is primarily because of the smoother laser treatment and cold techniques used in modern PRK. There is some evidence that Vitamin C taken before and after PRK may lower the risk of haze.
LASIK offers patients multiple benefits, including faster recovery of vision, less pain, and virtually no haze. In the early years of LASIK (1995 to1996), the microkeratomes used to make corneal flaps had an unacceptable complication rate, in our opinion. For instance, in 1997, complication rates were reported at nine percent using the best microkeratome available at that time. Furthermore, there were rare reports of catastrophic events resulting in blindness because of the design of the microkeratome. In January 1998, a new microkeratome (the Hansatome) became available that solved many of the design problems, including the catastrophic ones, by allowing the flap to be located on the superior edge of the cornea, a technique also known as “Down-up LASIK.” Even with this new microkeratome, because of the mechanical preparation of the corneal flap, there are additional risks with LASIK that are not seen with PRK. These complications include problems in preparing the flap (incomplete flaps, irregular flaps, free flaps, flap buttonholes, bleeding around the flap), most of which require a delay in the laser eye surgery of four months but can cause problems with vision and postoperative flap complications (slipped flaps, epithelial ingrowth under the flap, flap folds or wrinkles, flap shrinkage, flap interface debris, or inflammation). Most of these complications can be managed with additional laser eye surgery, but some can lead to a permanent decrease in vision. A reasonable estimate of the frequency of these flap complications is about two percent, and that is the same regardless of the amount of correction attempted. Newer technological advances have allowed us to make the corneal flap with a femto-second laser (IntraLASIK using the Intralase laser), which has significantly lowered the incidence of flap-related complications. Many LASIK patients experience an increase in dry eye symptoms in the weeks and months following LASIK, and usually need more lubricating drops, at least for the first six to eight weeks. There are rare reports of progressive thinning of the cornea (called kerectasia), usually in patients with thinner corneas and high corrections, where the corneal stromal bed after treatment was less than 250 microns. It is very important that your corneal thickness be measured before LASIK. If your cornea is thinner than average, you may need to have an IntraLASIK procedure (using the Intralase laser to create a thinner flap, or even may need to do a PRK. The most serious complications of LASIK -- such as progressive thinning of the cornea, or severe scarring following infection, inflammation, or flap damage -- can usually be fixed with a corneal transplant surgery. Although significant, corneal transplant surgery is highly successful. The chance at having a complication that could lead to the need for a corneal transplant is about one in every 20,000 surgeries. There are very rare reports of patients who have lost vision from severe infections following LASIK. The chance of this appears to be about one in a million. If you would like to learn more about the laser eye surgery LASIK and live in (or can come to) Santa Monica, Beverly Hills, or the Los Angeles area, contact the Beverly Hills LASIK Center today.
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Which procedure is
best for me, PRK or LASIK?
All patients have the option of either PRK or LASIK at all of these ranges, and the issue will be discussed with you in your consultation with our doctors. As previously stated, both PRK and LASIK share certain risks with the excimer laser, including overcorrection and undercorrection. The primary differences between PRK and LASIK are related to the differences in the risks, complications, and the recovery process. Most patients select LASIK for most corrections based on the more comfortable and faster recovery.
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What occurs
during the LASIK procedure and recuperation?
The different stages of a patient's LASIK procedure can vary depending on which laser is used for the procedure. Your doctor will both recommend and discuss with you which laser is the best for your eyes. You will need to be out of your contact lenses for some time before the LASIK procedure--generally seven days for soft contact lenses, and at least three weeks for rigid, gas permeable contact lenses.
With either laser, you will arrive early at the Laser Center, and drops will be placed into your eyes. If you are being treated on the Autonomous LADARVision laser, you will arrive one hour ahead of time to have photographs taken of your eyes, so the tracking laser can function. If you are being treated on the Alegretto or VISX® Smoothscan laser, you will arrive 30 minutes before your procedure.
Because the Beverly Hills LASIK Center offers numerous options for your LASIK treatment, the exact sequence of events on the day of your laser eye surgery procedure may vary. If you are having your flap created with the Intralase laser (IntraLASIK), that portion of the procedure will take about five minutes. You will be instructed to lie down on a chair and look straight up into a fixation light. A gentle suction ring will be placed on the eye, and the laser will create the flap in about 20 seconds.
If you are having Wavefront LASIK, a wavefront picture may be taken before your flap is made. If you are being treated with the LADARVision system, dilating drops will be placed in your eyes, and you will wait about 40 minutes for them to work. Next, your doctor will center you under the laser and put some anesthetic eye drops in your eye. The other eye will have a patch covering it, so you will only be able to see out of the operative eye. Sterile drapes will be placed over your eye, and an instrument placed to keep you from blinking your eyelids.
If you have not already had your flaps created by the laser, then an instrument will be placed over your eye and a suction will be applied to your eye. During this portion of the laser eye surgery procedure, you may experience a pressure sensation, and your vision will probably fade to gray or become lost temporarily. The microkeratome will be placed on the suction instrument, and the flap will be created. After the flap is made, the instrument will then be removed from your eye.
It is important that you think about the LASIK procedure as two separate steps; the creation of a perfect flap, and then the laser treatment. If the flap is not perfect, then it will be repositioned and the laser treatment not performed. Typically, your vision will be back to what it was before the procedure on the next day and laser eye surgery will be rescheduled for about four months.
If the flap is perfect, then the flap will be lifted to the side and the LASIK treatment performed. The laser is activated, and you can expect to hear a clicking sound and to experience some blurring of the vision. The fixation light will be visible, and it is extremely important that you look at the light directly for the laser treatment, which lasts between 15 and 90 seconds. If you would like to find out if you would be a good candidate for laser eye surgery, and live in the Beverly Hills, Santa Monica, or Los Angeles area
, or can travel to Beverly Hills,
contact the Beverly Hills LASIK Center today.
If you are being treated with the Allegretto or Alcon LADARVision laser, the device is much quieter, and although it is still important to look at the light, the tracking technology makes up for any small movements of the eye. There is no pain with the laser. At the end of the LASIK treatment, the flap will be repositioned and fluid irrigated over the eye. The doctor will then give you eye drops and clear goggles or a plastic shield to cover the eyes.
Most patients will use eye drops for about a week and have improved vision within hours of laser eye surgery. Some patients experience some mild, scratchy discomfort usually for about two or three hours. Our doctors recommend that patients take a nap during this time, thereby keeping the eyes gently closed for the first few hours after the procedure. Patients are advised to be careful about rubbing the eye after LASIK, and to wear protective goggles for sports like basketball. It is your choice whether you want to do both of your eyes on the same day. Treating both eyes on the same day is an option for you. Although the risks of bilateral surgery are low, we want to try and offer you every possible margin of safety possible. Usually, one day between the two eyes is enough time to wait. The Beverly Hills LASIK Center has the best laser eye surgery technology
available today and we are prepared to meet the needs of our local patients from Beverly Hills, Los Angeles and Santa Monica as well as patients who travel to our office from all over the world. Contact our practice today for a consultation.
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What occurs during
the PRK procedure and recuperation?
As in LASIK, you will need to be out of your contact lenses for some time before laser eye surgery is performed. We advise patients to remove their soft contact lenses for approximately seven days before surgery, and their rigid, gas permeable contact lenses for at least three weeks. If you are having a Wavefront-guided treatment, Wavefront pictures may be taken first, and then your doctor will center you under the laser and put some anesthetic eye drops into your eye. The other eye will have a patch covering it, so you will only see out of the operative eye.
After you have been centered, and have received a cold treatment, an instrument will be gently placed on the eye that will momentarily block your view of the fixation light. Next, a solution will be placed in this instrument for 20 to 40 seconds that will soften the very surface layer of the eye. These softened surface cells that are an irregular thickness will then be wiped away with a sponge, or slid to the side with LASEK, which is completely painless. Next, a laser will be activated -- you can expect to hear a clicking sound and to experience some blurring of the vision. The fixation light will be very easy to see, and it is extremely important that you look at the light directly for the laser treatment, which will last between 15 and 90 seconds. You will experience no pain from the laser. At the end of the laser eye surgery treatment, your doctor will apply a cold treatment again, and give you more eye drops and a thin bandage contact lens in your eye. The initial recuperation process usually lasts for three days, and occurs because the surface cells need to regrow in order for them to cover the surface of the cornea. Most patients describe the sensation in the eye as irritating, light sensitive, and tearing, like a grain of sand in the eye. Some patients have almost no sensation during this period, and some are very uncomfortable, requiring Vicodan or Tylenol with Codeine. Generally, patients are mildly uncomfortable in the eye, but with the use of drops and sunglasses can function, although they cannot see very well. The vision is not instant with PRK, and most patients start to see adequately on the fifth to seventh day, with continued improvement over the next weeks. Some patients take drops during the first six weeks after PRK, and many do not require any drops. All patients should be committed to always wearing UV blocking sunglasses, as everyone should anyway for the health of their eyes.
It is also a good idea to start Vitamin C 1000mg per day one week prior to PRK surgery and to continue it for a month afterwards in order to reduce the risk of corneal haze. If you would like to learn more about PRK, a laser eye surgery treatment available to patients who live in or can travel to Beverly Hills, Santa Monica, and the Los Angeles area, contact our practice today.
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What
are your LASIK Results?
Our office's LASIK results compare very favorably with national results published in scientific literature. Dr. Peter Cornell has been practicing laser eye surgery since it was approved by the FDA in 1994 and has performed thousands of LASIK procedures on his patients from Beverly Hills, Santa Monica, Los Angeles, and around the world. Dr. Stuart Stoll has been practicing laser vision correction since his fellowship in refractive surgery in 1999. Results from LASIK can be reported in a number of ways, and it is very important to understand that these results are the averages of a large number of patients. Your specific results may vary and are not guaranteed.
Beverly Hills LASIK Center's Laser Eye Surgery Results
Subjective satisfaction scores, scale of 1 to 10
(10 most happy): average score 9.7
Myopic patients with preoperative best corrected vision of 20/20 and distance target:
20/40 or better, 99%
20/20 or better, 92%
within +/- 0.50 diopter, 93%
Hyperopic patients with preoperative best corrected vision of 20/20 and distance target:
20/40 or better, 97%
20/20 or better, 90%
within +/- 0.50 diopter, 88%
Retreatment rates
Myopia, 3%
Hyperopia, 5%
Retreatments are performed at the patient's request, generally for small residual corrections.
Complications:
Irregular flaps < 1%
Flap wrinkles or folds < 1%
Significant Epithelial cell ingrowth < 1%
Significant night glare, halos, 1% (now rare with the new lasers, and even more rare with wavefront-guided technology)
Significant Inflammation (diffuse lamellar keratitis), 1/500
Infection < 1/1,000
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What are
my Laser Choices? Why do you offer three different lasers?
Our doctors have the option of performing laser eye surgery on your eyes using a number of different FDA approved lasers, including the Allegretto laser, VISX® Smoothscan S4 and the Alcon
LADARVision system for LASIK and PRK. The Allegretto, the VISX® and the LADARVision are all excimer lasers, and each has advantages. As part of your consultation, the doctor will examine your eyes and recommend a laser that will be best for your customized treatment. Our doctors recommend that almost every patient have the flap created with a laser rather than an blade, using the Intralase laser to create the flap.
The VISX® Smoothscan S4 with Active Tracker has performed most of the LASIK procedures
in the United States in the past few years. Our model is constantly upgraded with the newest software and is maintained by Laser Eye Associates.
The Alcon LADARVision system is a newer laser, and it combines several exciting features. It is a true scanning and tracking laser, tracking the eye position 4,000 times per second, so the laser compensates for any small movements of the eye during the laser eye surgery procedure. The laser beam is applied with a small “flying spot,” which results in a very smooth surface. The laser also allows us to treat a larger optical zone than in past years, allowing us to offer a lower rate of glare and night driving problems.
Our newest laser is the Allegretto, which offers a unique wavefront optimized treatment protocol with very low enhancement rates and blazing speed.
All lasers have Wavefront-guided or wavefront optimized treatments available for most patients, depending on the correction required. If you would like to find out if you would be a good candidate for laser eye surgery and live in Santa Monica, Los Angeles, or
Beverly Hills, or can travel to our office in Beverly Hills, contact the Beverly Hills LASIK Center today to schedule a consultation.
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What is “Down-up LASIK?”
Down-up LASIK refers to a LASIK procedure performed with a new model microkeratome, or the IntraLase®, that creates the corneal flap from the bottom of the eye with the hinge located on the top of the cornea. Older models of the microkeratome create the hinge on the side of the cornea. The hinge placement at the top of the cornea is a more natural location, allowing the natural blink of the eye to work in the direction of the flap, rather than at right angles to the flap. This technique has reduced complications from LASIK, and our doctors perform the down-up technique in all LASIK cases. The option of having all laser LASIK with IntraLase® allows us to control the hinge location, size, and parameters of the flap as never before.
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Why IntraLase®?
Traditional LASIK is a very good procedure. But while the risk of complication is very minimal, all laser eye surgery carries some degree of risk. Now, an advanced, computer controlled laser technology is available that significantly reduces the risk of complications. It is known as the all laser LASIK treatment with the IntraLase® laser.
The IntraLase® laser is uniquely safe, uniquely precise, and offers patients predictably better visual results. The advanced IntraLase® technology has given many patients more confidence when considering laser eye surgery. Our doctors use the IntraLase® FS laser because it provides micron level accuracy and significantly reduces the possibility of risk and unpredictable outcomes.
Our practice was one of the first in the country to use the Intralase technology, and we have been using to make our flaps since 2004. The Intralase allows your surgeon to control the flap thickness, location, size, orientation and design, and allow us to customize the flap to your eye’s needs. The Intralase is such a significant improvement over the mechanical blade microkeratome that the U.S. Navy has approved the Intralase LASIK procedures for Navy pilots in 2006.
If you would like to find out more about all laser LASIK or another laser eye surgery treatment, and live in Santa Monica, Beverly Hills, Los Angeles,
or can travel to our office in Beverly Hills,
contact the Beverly Hills LASIK Center today for a consultation.
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How is IntraLase® different from traditional LASIK?
LASIK is actually a two-step process. First, a flap of corneal tissue must be created and then folded back. The cornea is the transparent, dome-like structure that covers the iris and pupil of your eye. By creating a flap in the cornea, our doctors are able to perform the laser eye surgery on the inner layer of the cornea, which practically eliminates any patient discomfort and allows for a rapid visual recovery.
Traditionally, our doctors have created the corneal flap with a hand-held mechanical device, which utilizes a surgical blade. This method has worked well over the years; however, the performance of these devices can be unpredictable. And although LASIK complications are rare, this mechanical device is frequently the source for many of the reported complications.
With the IntraLase® laser, our doctors use the precision of a laser to create the corneal flap. The accuracy of the laser (100 times more accurate than a blade) is unparalleled by any other technology in laser eye surgery. This advanced technology allows the LASIK surgeon more control during the procedure, and even allows customization of the corneal flap for every individual patient. Because of its consistent accuracy, IntraLase® now makes it possible to treat many patients who were dismissed as candidates for laser vision correction due to thin corneas.
Is this the same as the customized LASIK procedure I have heard so much about?
Making the flap safely and predictably with the Intralase laser is the critical first step of the customized LASIK procedure. The second step is the use of a wavefront guided or wavefront optimized excimer laser treatment to change the shape of your cornea. There has never before been a combination of technologies that have allowed for this type of personalized vision correction. The most exciting part, is that while offering the ability to get the best results, we are doing it all with unprecedented safety and precision.
Every patient’s eyes are different, and therefore need to be evaluated independently and uniquely treated. Now, all steps of the laser eye surgery procedure may be customized to the individual: custom diagnosis (before the procedure), custom flap (to start the procedure), and custom treatment (to complete the procedure). If you would like to find out if you would be a good candidate for customized laser eye surgery and you live in Santa Monica, Beverly Hills, or the Los Angeles area, or can travel to our office in Beverly Hills, contact the Beverly Hills LASIK Center today.
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Is IntraLase® safer?
Most LASIK surgeons acknowledge that the main safety issues in laser eye surgery
are related to the use of the mechanical device used to create the corneal flap. Multiple studies, which compare the incidence of complications when using the IntraLase® laser during LASIK versus the microkeratome device, have shown a significant decrease in the events that adversely impact safety.
The IntraLase® laser provides a unique level of safety during the LASIK treatment because of its micron level precision. Clinical studies establishing the precision and accuracy of the IntraLase® FS laser have led researchers to proclaim IntraLase® technology as 100 times more accurate in creating the flap (the first step of the LASIK procedure) than the traditional approach with a surgical blade. The statement is founded upon comparative studies that report the likelihood of inaccuracy with the mechanical device as compared to that of the Intralase® FS laser.
This precision was also documented in studies conducted for the FDA clearance of the laser, where the accuracy of flap thickness was demonstrated at +/- 10 microns. Precise flap thickness is critical to a successful LASIK outcome, and this degree of accuracy is unprecedented in flap creation technology to date.
Finally, greater flap stability was also demonstrated with the IntraLase® laser
in studies for the laser’s FDA submission. The assurance that the flap will be securely repositioned without incident provides added peace of mind for many patients. If you have questions about the laser eye surgery treatments available at our practice -including the revolutionary Custom LASIK procedure
procedure – and you can travel to our Beverly Hills location from locally in Los Angeles, Santa Monica or anywhere else in the world, contact the Beverly Hills LASIK Center today for all your eye care needs.
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Is
traditional LASIK unsafe?
No, but IntraLase® reduces the risk of complications reported with traditional LASIK, and we feel that it is very important for all patients. The advanced IntraLase® technology has given many patients more confidence when considering laser eye surgery. LASIK surgeons are recommending the IntraLase® FS laser for their patients because it provides greater precision and may significantly reduce the possibility of risk.
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Another
provider told me their technology is used more often. Who do I believe?
Leading LASIK surgeons nationwide are now adopting the IntraLase® laser, and approximately 300,000 eyes have now been treated with this advanced technology. IntraLase® has become the standard for excellent care in laser eye surgery practices.
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How
would you compare the visual outcomes using IntraLase® with those of traditional LASIK?
IntraLase® is rapidly becoming known as the key ingredient to optimizing results in laser eye surgery. Comparative clinical studies confirm that patients see better following LASIK with IntraLase® than with previous methods.
Our doctors now offer a new level of predictability to each patient in all parts of the procedure: custom diagnosis (before the procedure), custom flap (to start the procedure), and custom treatment (to complete the procedure). We believe that IntraLase® is one essential ingredient of this strategy to obtain your best vision while maintaining the highest standards for safety and patient care. Our laser eye surgery patients in Beverly Hills, Los Angeles, Santa Monica, and beyond know our practice will only offer the best technology that the vision correction field has to offer. Contact the Beverly Hills LASIK Center today to see how a customized LASIK treatment can change your life.
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I have seen
several advertisements for “All-Laser LASIK.” Is this IntraLase®?
Be sure to ask for IntraLase® by name. Only the IntraLase® FS laser can provide the computer controlled, laser precision required for maximum predictability. Our doctors can explain the difference between other laser eye surgery procedures that may be advertised as “all laser,” such as LASEK or PRK, which are surface ablations that do not require the creation of a corneal flap. These procedures generally require longer healing time and frequently involve more discomfort.
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Is IntraLase® more expensive?
LASIK surgery may be elective, but good vision is not. Advanced technologies are usually more expensive for the surgeon to employ in a practice. IntraLase® surgeons are frequently key opinion leaders who continually evaluate all advances in laser eye surgery technology. They have found that the IntraLase® computer-guided laser for flap creation is the most sophisticated and accurate system available today.
IntraLase® technology provides greater precision, safety, and predictability. IntraLase® surgeons believe that laser eye surgery enriched with IntraLase® is one of the most important advances in technology today. Because of its unique safety profile, these LASIK surgeons have invested in the technology in order to maintain their commitment to excellence in patient care. Because our practice is committed to only using the best technology available to treat your eyes, we only perform LASIK using the Intralase laser, except in very rare circumstances. As a result, there is not an extra charge for using the Intralase laser to make the flap. Our charge for custom wavefront guided or wavefront optimized LASIK using the Intralase laser to make the flap is typically $2800 for each eye.
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How much does
Laser Vision Correction cost? What is my next step?
The cost for standard PRK or Intralase assisted, LASIK is $2,600 for each eye, with an additional $200 per eye for Wavefront-guided or Wavefront optimized LASIK. The charge for LASERWave (IntraLASIK and Wavefront-guided) is $2,800 per eye. This is generally not a covered expense through any medical insurance carrier, although certain vision plans like VSP provide some coverage. Laser eye surgery is a deductible medical expense on your tax return. Zero interest financing is available through our office. These fees cover all of your preoperative and postoperative care, as well as all laser charges. Retreatments for overcorrection/undercorrection within one year are charged at $185. If you are interested, call the office of Dr. Peter Cornell and Dr. Stuart Stoll at 310-274-9205 to schedule a free laser vision correction screening. The free screening will include evaluation of your eye refraction, corneal thickness, pupil size, and corneal topography. It will also include a complete, personalized discussion directly with one of the doctors about the risks, benefits, and options available to you. Contact the Beverly Hills LASIK Center about laser eye surgery today. We serve Beverly Hills, Santa Monica, Los Angeles, nationwide and international clients and provide eye treatments that will change the way you live your life.
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What surgical vision correction options are available today?
Although vision imperfections can be corrected with glasses or contact lenses, many people choose to have laser eye surgery because they want to reduce or eliminate their need for glasses or contact lenses. Historically, the first major common procedure performed on patients was Radial Keratotomy. Radial Keratotomy -- helpful for the correction of mild to moderate myopia -- involved making incisions in the peripheral cornea to flatten the central cornea. The procedure is much better today than ten years ago, but still carries complications that include long term fluctuations in vision, nighttime glare, and structural weakening of the eye. Because of these problems, very few of these procedures are performed in the United States at this time. Instead, they have been replaced by the new laser eye surgery procedures, PRK and LASIK. Another type of incisional surgery, which is similar to Radial Keratotomy, is still used to correct some cases of astigmatism. This procedure, called Astigmatic Keratotomy, involves making incisions in the peripheral cornea to change the irregular shape of the cornea. Although most astigmatism today is corrected with the new laser techniques, Astigmatic Keratotomy is still sometimes a useful procedure, particularly when done in conjunction with cataract surgery. This is called limbal relaxing incision.
The two primary procedures in use at this time both use the excimer laser to change the shape of the cornea. They are PRK (Photorefractive Keratectomy) and LASIK (Laser in-situ Keratomileusis). A third laser eye surgery procedure, LTK, was approved by the FDA in 2000 for the treatment of mild farsightedness without astigmatism. It involves the application of the Holmium laser to the peripheral cornea to steepen the central cornea, but has not proven to be as good as LASIK, and is no longer performed.
There are several other technologies that are currently available or under investigation. Intracorneal Rings use a surgical technique to implant clear plastic ring segments into the peripheral cornea to change its shape. This surgery has some success in mildly nearsighted patients, but does not appear to have any major advantages over PRK and LASIK.
It is currently primarily used to stabilize unstable corneas in a disease called keratoconus. The Implantable Contact Lens (ICL) is another exciting refractive option that is an FDA approved procedure that is primarily used to correct very nearsighted patients. Conductive Keratoplasty (CK), involves using a probe to apply radio frequency waves to spots in the midperipheral cornea. These waves shrink the corneal collagen, causing it to contract and alter the shape of the cornea.
This procedure is approved for the treatment of presbyopia, which is the need for reading glasses. This procedure has become more accurate, safe and predictable in 2007 with the use of a template instrument that has improved the results.
Refractive surgery has entered a new era in 2004 with the FDA approval of the Crystalens® Intraocular Implant Lens , and subsequently the ReStor® Intraocular Implant Lens and the Rezoom® intraocular implant lenses. These lenses may be placed in the eye either at the time of cataract surgery, or during a refractive lens exchange. These lenses, sometimes combined with LASIK, may allow patients over the age of fifty the opportunity to be less dependent on both distance glasses and reading glasses. Our practice was the first in Beverly Hills to implant the Crystalens implant lens, and we use all three of these lenses in appropriately selected patients.
If you would like to find out if you would be a good candidate for laser eye surgery, LASIK, or another treatment, and you live in Santa Monica, Beverly Hills, or Los Angeles, or can travel to our Beverly Hills office, please visit the Beverly Hills LASIK Center today for a complementary consultation.
Other new techniques that are currently under investigation include a surgery to correct presbyopia by placing small plastic band segments around the front portion of the eye, or making incisions in the sclera with the Laser Assisted Presbyopia Removal (LAPR). LAPR both restores tension to the lens and restores the lens' focusing power. Initial results are encouraging, but it will take a few years to fully evaluate this technique. Another technique, the AcuFocus, uses a small inlay in the cornea under an Intralase flap to provide focusing for close up vision. Still more future techniques in the development pipeline involve the development of focusing lens implants, thermal lasers, and numerous other treatments to change how the eye focuses. All of these techniques are designed to clear up the blurry images caused by the refractive disorders of myopia, astigmatism, hyperopia, and presbyopia. That said, the best methods available today use laser vision correction.
If you would like to see if you would be a good candidate for laser eye surgery whether you are locally in Beverly Hills, Los Angeles, Santa Monica or live anywhere else in the world and can travel to our Beverly Hills office,contact the Beverly Hills
LASIK Center today for a free consultation.
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How does the
eye work?
To understand how laser eye surgery may help you see better and reduce or eliminate your need for glasses or contact lenses, it is helpful to understand how the eye works. In order to see clearly, the "normal"
eye is designed to focus images clearly onto the retina. This focusing power is a combination
of the front surface layer of the eye, the cornea, the lens of the eye, located inside the eye,
and the length of the eye. If these three elements are not in perfect relationship to each other,
then the eye may not focus images on the retina, leading to blurry vision. The four main reasons
that a healthy eye may have blurry vision are myopia, astigmatism,
hyperopia, and presbyopia.
Myopia, or nearsightedness, is the condition
when the distance between the cornea and the retina is too long, and the image formed by
a distant object falls into focus in front of the retina, causing blurred vision in the distance.
Myopia may be mild (-1 to -4), moderate (-4 to -10), or severe (more than -10).
Astigmatism occurs because the cornea is curved
more in one direction than the other direction, so that it is shaped like the back of a teaspoon.
With astigmatism, images at all distances will be blurry.
Hyperopia, or farsightedness, is the condition
when the distance between the cornea and the retina is too short, and the image formed
falls into focus behind the retina, causing blurred vision. Because the youthful lens inside the
eye can make up the additional power needed to focus images on the retina, many people who are
farsighted do not have blurry vision until their lens ages.
Presbyopia is the normal aging change
inside the eye whereby the lens inside the eye loses the ability to accommodate,
or to change focus from the distance to close up. Presbyopia is the reason that people
over the age of forty typically need reading glasses.
Contact the
Beverly Hills LASIK Center today for a free consultation about laser eye surgery today.
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