The LaserVision Correction Blog

Some people are under the impression that LASIK is an expensive luxury. However if you compare the cost of LASIK to the cost of the alternatives, specifically glasses or contact lenses, it is clear that LASIK is a very good value and actually saves money in the long run.

Here is an average breakdown of eye care over the span of 10 years:

Glasses

• Eye Exam $150 (every 2 years)
• Frames $450 (every two years)
• 10 Year TOTAL: $3000

Soft Disposable Lenses and Back-Up Glasses

• Initial exam with lenses $225
• Contact Lenses (each year) $200
• Eye Exam (each year) $150
• Solutions (each year) $200
• Frames (every 2 years) $450
• 10 Year TOTAL: $7975

Rigid Gas Permeable Lenses and Back-Up Glasses

• Initial exam with RGP lenses $300
• Eye exam (each year) $150
• RGP contact lenses $400
• Solutions (each year) $200
• Frames (every 2 years) $450
• 10 Year TOTAL: $6450

LASIK may seem expensive in the short-term,but when you calculate how much you are paying for your current eye care over the long run, LASIK is clearly the better value.

The cost of LASIK varies for each person and heavily depends on the surgeon and technology they use. As with most things in life, to a large degree you get what you pay for! If you compromise on price then you will be compromising on quality. When it comes to eye surgery, quality is not something on which you should compromise!

One great thing about clinics like ours, LaserVision Correction in Omaha, is that we offer a variety of financing options to make eye surgery affordable for anyone. If you think you are ready to take the next step into finding a better solution for your eyes, do not let finances be an obstacle. Contact our clinic today for a free consultation.

A vital factor for ensuring an effective surgery is the technology used in pre-operative screening and surgery. With LASIK advancements improving technology and procedural success, visual acuity achieved through surgery has never been better.

Wavefront technology is one of the most recent innovations to allow for decreased night glare, halos and high order aberrations. The Allegretto Wave EyeQ Excimer Laser was designed specifically for laser vision correction using “PerfectPulse” technology to control and ensure precision in every single laser pulse. By creating an aspheric corneal surface, it is the only laser to take into account the specific curvature of the patient’s eye, providing a customized procedure. Combined with topography-guided ablation profiles, data from a corneal topography scan allows for a guided and accurate laser treatment.

In almost all surgical cases at LaserVision Correction, thin-flap LASIK is used. Also known as SBK (sub-bowman’s keratomileusis), this technique increases residual stromal bed following LASIK, meaning less risk of long-term complication.

Technological advancements have recently catered to people who wear bifocals. Presby-LASIK technology has led to improved vision at a distance and at near in patients over age 40 who wear bifocals.

When choosing an eye center to perform your LASIK surgery, consider the latest surgical advancements and equipment that can promote an effective surgery with a smooth recovery. Learn more about how the latest technology can improve your LASIK results.

With our sight being one of our most cherished senses, it comes as no surprise that some patients feel apprehensive before undergoing laser eye surgery. For more than 20 years, LASIK has been a successful vision correction procedure for over 16 million people.

From famous athletes to professionals that rely on having excellent sight for their careers, LASIK has remained one of the most popular low risk surgeries for long-term vision correction. A recent study was published by the Army Warfighter Refractive Eye Surgery Program (WRESP), which was established by the US armed forces to reduce the limitations posed by corrective eyewear in combat situations. The study looked at the outcome and satisfaction rates of 16,111 armed service members who had undergone laser vision correction and concluded that excellent outcomes have enhanced the overall readiness of armed forces. Reports of night vision difficulties, surgical complications, and dry eyes were infrequent, and did not seem to have a significant negative impact on military operations or individual readiness. (Source: Ophthalmology; Volume 112, Issue 2, Pages 184-190.e2)

Although a recent study of over 2,000 patients confirmed that more than 95 percent of LASIK patients are satisfied with their results, one of the most common questions we are asked about LASIK is whether there are adverse long-term effects. With proper patient evaluation using corneal imaging systems, we are able to determine which procedure would be best for a patient’s individual needs and if LASIK would yield favorable results in each case.

In a study published in the Journal of Refractive, patients were spoke to after 12 years of experiencing the benefits of laser vision correction and found that “Almost 90% of eyes recalled for 12-year follow-up maintained or improved best corrected visual acuity.” (Source: Journal Of Refractive Surgery 2006; 22:871-877, Ocular Surgery News; January 1, 2007 p.34) Another Study published in Ocular Surgery News followed 800 eyes for 10 years. According to this article, efficacy, safety and predictability were maintained throughout the study in eyes requiring low, intermediate and high levels of correction. (Source: Ocular Surgery News; January 1, 2007 p.36)

From consultation to post-operative follow-up, Dr. Kugler and Dr. Schlichtemeier are committed to excellent patient care. It is important to keep in mind that despite positive reports, laser vision is a medical procedure that carries certain risks. Keeping this in mind, it is critical to seek a skilled and conscientious surgeon. Proper patient evaluation, an accurate creation of the LASIK flap, state-of-the-art laser technology and proper post-operative care all go into ensuring a safe and successful surgery. By finding an excellent surgeon and a supportive eye center that is compassionate to your needs, you can eliminate your fears and enjoy the benefits of LASIK.

Eye infections are a burdensome complication that no one enjoys. For this reason, many people are hesitant about undergoing surgery. Believe it or not, choosing corrective vision lenses over LASIK eye surgery can actually put you at a greater risk for infection. A study published in the Archives of Ophthalmology found that the cumulative annual risk of infection with contact lenses was 180 times greater than the risk of infection following LASIK. In fact, only about 0.05% of LASIK patients will experience infection after surgery.

While patients are often under the assumption that contact lenses are safer than LASIK, studies suggest daily wear of contacts can lead to further complications than laser vision correction surgery. In the United States in 2007, there were 55 corneal transplants for infections related to contact lens wear, in comparison to only 2 for infections following LASIK, according to the Cornea Clinical Committee of the American Society of Cataract and Refractive Surgeons.

Many people opt for contacts as an alternative to glasses or surgery, but the burden of ensuring sterile insert, removal and storage, plus the added risk of infection can make them an undesirable long-term solution. See if you’re a candidate for a low risk LASIK procedure and experience a life without contact lenses.

As with any popular procedures, the lines of myth and truth are often blurred. While we encourage every potential LASIK patient to seek answers through a consultation with a surgeon, we’ve dispelled the common misconceptions that may be weighing on your mind:

Myth #1: LASIK comes with high risks of complications and side effects, such as night glare and dry eyes.

Truth: Clinical studies of LASIK have documented that the risk of having a serious complication are extremely low. As with any surgery, there are some associated risks that Dr. Kugler or Dr. Schlichtemeier will inform you of before your procedure. If a complication does arise, it can most often be treated if diagnosed early on in your follow-up visit with your physician. While glare and dry eyes can be common side effects immediately following surgery, these typically subside within the first few months. With proper pre-operative testing, surgeons have a better opportunity to identify patients that may have increased risk of long-term complications. Patients are often under the impression that contact lenses are safer than LASIK surgery, but recent studies suggest the opposite. On the contrary, patients wearing contact lenses are 180 times more likely to have a serious infection than patients who have LASIK, and are more likely to require a corneal transplant later in life. Click here to read more about safety regarding laser eye surgery.

Myth #2: I am “too old” to have LASIK

Truth: Believe it or not, LASIK has been successfully performed in people in their late 90’s. As a relatively low risk surgery, LASIK can be performed at any stage of life and your numerical age alone will never prevent you from being a candidate for LASIK. However, it is true that if you are experiencing age-related eye problems or approaching the age of cataracts, other surgical solutions may be a better long-term fit, such as a lens implant or cataract surgery. It is important to remember that you are never too old for vision correction; it is just a matter of finding the right fit for your particular condition. By choosing a surgeon that is capable of performing a full-range of procedures, you will be able to assess and choose from a variety of options ideal for your eyes.

Myth #3: All the outcomes of LASIK are the same, so the cheapest surgery is no different from an expensive one.

Truth: When considering something as crucial as your vision, it is advisable to not compromise the health of your eyes by settling for a discount center. In the long-term, seeking a recommended and reputable surgeon is worth the investment. Cheaper clinics may not have the resources to keep up with the latest technology, patient screening, and follow-up care needed to ensure a successful procedure. “You get what you pay for” is one saying that can be aptly applied to LASIK surgery. Patients are encouraged to thoroughly compare and research. Learn more about how to choose your LASIK surgeon.

Myth #4: LASIK will only last until I am 40, then I will need glasses again.

Truth: While the effects of laser vision correction last a lifetime in most patients, LASIK does not prevent the onset of age-related eye conditions. As we enter our 40’s, everyone develops a condition called “presbyopia” [http://www.lasikomaha.com/near-vision/overview/]. Regardless of whether someone has had LASIK, they will need reading glasses for particular circumstances. Presbyopia is not worsened by LASIK and the effect of distance vision remains the same as someone enters their 40’s. There are some surgical procedures, such as CK that can reduce the need for reading glasses after LASIK.

Myth #5: LASIK is so new that no one knows the long-term side effects.

Truth: Successful LASIK eye surgeries have been performed for more than 20 years. Since the early 1980s, over 16 million people have had LASIK worldwide, allowing for ongoing advancement of technology and procedural development. Countless studies of long-term safety and stability have been well documented. A study published in Ocular Surgery News followed 800 eyes for 10 years. According to this article, effectiveness, safety and predictability were maintained throughout the study in eyes requiring low, intermediate and high levels of correction. (Source: Ocular Surgery News; January 1, 2007 p.36) Click here to learn more about the history of refractive surgery.

Myth # 6: Myth: Anyone who wants to have LASIK is a candidate.

Truth: To ensure safety and high rate of success following LASIK surgery, patients are stringently evaluated to determine if they are ideal for the procedure. While not everyone is a candidate for LASIK, there are other vision correction options available. The best way to determine if you are appropriate candidate for LASIK or another treatment is to meet with Dr. Kugler or Dr. Schlichtemeier for an initial screening. Screenings are important for preventing complications and addressing questions and concerns.

Myth #7: I have astigmatism so I can’t have LASIK

Truth: Although this misconception was true when LASIK technology was in its infancy, it is no longer the case. Modern laser systems can effectively treat astigmatism with excellent results. At LaserVision Correction in Omaha, we specialize in astigmatism and use Vector Analyisis to ensure that astigmatism treatment is effective. Dr. Kugler is one of the few surgeons in the world who is expertly using vector analysis for appropriate correction of astigmatism. Click here to learn more about Astigmatism Analysis and treatment with LASIK.

Myth #8: LASIK is still being developed, and every year there is something new. Patients should wait until doctors find the best technology.

Truth: A recent study of over 2,000 patients confirmed that more than 95 percent of LASIK patients are satisfied with their results. Technology and procedures will continue to advance to refine vision correction results, but the current technology is so good that waiting for the newest developments are not necessary for most patients.

Myth #9: All the lasers used for LASIK are basically the same

Truth: There are a variety of lasers that can be used for LASIK and they are not all equal. While some clinics use dated technology from the 1990s, others are focused on implementing the newest tools for optimal laser vision correction results, such as the Allegretto Wavelight EyeQ laser system. With impressive speed, precision and accuracy, this state-of-the-art technology offers eye tracking and wavefront mapping for a custom and more effective procedure. To learn more about how laser technologies can make a difference in your procedures, click here.

Myth #10: It does not matter which doctor performs the procedure because the laser does the work.

Truth: Just as technology matters, so does the surgeon’s application of skill and level of expertise. Laser systems are sophisticated and must be properly programmed to deliver customized treatment to each individual eye. An eye surgeon’s level of experience and care before, during and after surgery are critical to the success of a procedure. As a patient, it is important that you feel comfortable and confident in the surgeon performing your procedure. To learn more about how to choose a surgeon that is ideal for your needs, read more here.

The decision to explore the life changing benefits of LASIK eye surgery can often lead to an exacting weighing of pros and cons. One common misconception that is often relegated to the wrong list is the myth that LASIK effects eventually “wear off.” On the contrary, most patients enjoy the benefits of laser vision correction for a lifetime. In fact, only a small percentage of people (3-5% in our practice) require an enhancement surgery at some point after LASIK. Knowing this, it is easy for many patients to justify investing in a one-time surgery that will most likely change their lives forever.

A study published in the Journal of Refractive Surgery followed patients over 12 years after having laser vision correction and found that “Almost 90% of eyes recalled for 12-year follow-up maintained or improved best corrected visual acuity.” ( Source: Journal Of Refractive Surgery 2006; 22:871-877, Ocular Surgery News; January1, 2007 p.34)

Of course, LASIK does not magically stop the aging process. As the eye matures, reading glasses are needed after age 40, as they are in everyone regardless of whether they have had surgery. However, many only rely on eyeglasses for particular circumstances, such as reading fine print. In addition, if cataracts develop later on, it is important to consult with a surgeon that specializes in cataract surgery in LASIK patients.

Once you have LASIK surgery and attend your post-operative follow-up, you should be fine to resume your normal life without additional LASIK surgeries. Regardless, it is important to see your eye doctor at least once a year to ensure your eye remains healthy.

LASIK does not protect the eye from UV damage or age-related eye conditions, but it does eliminate the burden of wearing contacts or eyeglasses for day-to-day tasks. While LASIK is not a preventative surgery, it often changes a patient’s life forever with an effective one-time surgery.

I was recently asked to answer the following question that appeared on the Quora website:  ”Which form of laser eye surgery removes the least amount of tissue?” Here is my answer:

For a given refractive error, the “amount” of tissue removed is roughly the same for the two primary methods of laser refractive surgery: LASIK and PRK. Both methods use an excimer laser to remove a given amount of tissue to better focus incoming light on the retina. The difference in terms of tissue removal is the effect that each technique has on residual stromal bed.

The residual stromal bed is the amount of tissue remaining after a laser procedure that contributes to the overall strength of the cornea. The first step in LASIK is the formation of the LASIK flap, using either a blade or a femtosecond laser. For the sake of discussion lets assume that the average flap thickness is 120 microns. Let’s also assume that the average corneal thickness is 535 microns.

If a patient has a refractive error of -3.00D, then the amount of tissue removed will be roughly 33 microns (this varies depending on the laser platform, but for the sake of this dissuasion let’s assume 11microns per D).

So if the cornea starts with a thickness of 535, then a 120 micron flap is made, we are left with 415 microns after the flap is made. Subract another 33 microns after the laser is performed, and we are down to 382 microns of residual stromal bed.

Let’s say the same eye had PRK, (also known as Surface Ablation). There is no flap made in PRK, but the outer layer of the eye, called the epithelium, is removed prior to laser. The epithelium is approximately 50 microns. So for the same eye:

535 – 50 (epithelium) = 485. 485 – 33 (laser) = 452.

So in this example, LASIK would leave the eye with 382 microns of RSB whereas PRK would leave the eye with 452.

There is much debate amongst LASIK specialists as to whether this difference matters clinically, but the general consensus is that it is best to avoid a RSB less than 250 microns.

For a more in-depth review of this subject, read here.

This question was posed on Quora, here is my answer:

A few years ago there was a lot of discussion amongst refractive surgeons about “super vision” or “super LASIK” which was supposed to correct people even better than the long-standard for “normal” vision of 20/20. Much of this talk has subsided, however, as we have learned how complicated the factors that lead to visual quality can be, and how difficult it is to predict who will and who will not achieve this level of vision.

There are many factors that enter in to a given individual’s ability to see. Certainly the refractive error, such as nearsightedness or astigmatism, is a major contributor. However, there are other parts of the visual system, including the retina and brain, that ultimately affect visual quality.

So if we are able to completely correct the refractive error in a given eye with LASIK, then the visual potential of that eye is now dependent upon the rest of the visual system.

For the average human retina and brain, this potential is around 20/12, but many eyes are not able to see that precisely, and some are able to see even better.

There is confusion amongst patients, and even many doctors, about the role that “Custom” correction plays in the LASIK world. Custom is another word (actually a trademarked term) for Wavefront-guided LASIK. Wavefront-Guided LASIK attempts to correct high-order aberrations (such as spherical aberration and Coma) as well as low-order aberrations (such as the myopia and astigmatism that are corrected by glasses). Although this is nice in theory, the reality is that it has some drawbacks. The biggest problem is that wavefront-guided treatments correct theentire sum of refractive aberrations on the anterior corneal surface, regardless of where the aberrations actually arise.

It is true that patients may see better than 20/20 after Custom LASIK, but that is also true of patients after conventional LASIK. The reason that the data seems to suggest a higher rate of 20/15 after custom lasik is partly because the laser manufacturers quietly upgraded the treatment patterns of low order aberrations when they added custom treatment to the laser software. In fact, if one looks closely at the FDA approval for one major laser platform, it says that high-order aberrations actually increased in patients after custom treatments. The key is, however, that they did not increase as much as conventional treatments on the same laser platform.

The best treatment technique, in my opinion, is Wavefront-optimized treatments which do not attempt to treat aberrations on the anterior corneal surface that did not arise from there, but rather attempt to decrease the creation of aberrations at the time of LASIK. These patients have tremendous results, and a high percentage of them achieve “super vision” or vision of 20/15 or better!