Determining whether LASIK is the right surgery for you

Lance Kugler, MD — Fri, 18 May 2012 10:30:11 +0000

Every year, millions of Americans experience the life changing benefits of LASIK.

The excellent success rate of laser vision correction can partly be attributed to the detailed patient screening conducted prior to a LASIK procedure. Though many interested patients are ideal candidates for refractive surgery, there are a few important factors to consider before seeking approval.

1) Vision should be stable for at least a year
Stable vision means there has been minimal change in the glasses prescription for at least one year. Ideally, eyes should also be free of injuries and infections, including retinal diseases, eye inflammation and herpes of the eye.

2) Eyes should be fully developed
Maturation of the eye depends on the individual. LASIK is best performed when young adult eyes are fully developed at approximately age 18.

3) Patients should not be pregnant or nursing
Pregnant or nursing women may undergo hormonal changes that could affect their vision stability and success of LASIK.

4) Patients should not have an autoimmune disease
Some autoimmune disorders, including Multiple Sclerosis, Lupus, Crohn’s Disease or Rheumatoid Arthritis, may interfere with a patient’s ability to heal after LASIK. In these cases, other surgical options are best.

5) The cornea is healthy and has sufficient thickness
Creation of the corneal flap and reshaping of the cornea may be affected if the cornea is abnormal or scarred. A scarred cornea is often the result of Keratoconus, a degenerative disorder that causes the eye’s structure to change and the cornea to thin and become conical shape. There are several alternative vision correction options to accommodate patients with a thin or abnormal cornea.

Dr. Kugler and Dr. Schlichtemeier perform a very thorough evaluation and will customize the treatment plan to fit each patient’s unique needs. Discover if you’re a possible LASIK patient by taking a Candidate Self Test online.

What are Cataracts and how can they be treated?

Lance Kugler, MD — Fri, 04 May 2012 10:30:11 +0000

One of the main structures in the human eye is the crystalline lens, which refracts light to focus images on the retina. It is mostly made up of water and protein, both arranged in a certain way to keep the image sharp and let light pass smoothly through it. Sometimes, the protein and water can clump together and start to cloud a small area of the lens, making it difficult to see clearly. The cloudy spots are called cataracts.

Cataracts start out small with little effect on your vision, but progress over time resulting in blurred, hazy or darkened vision. While the most common cause of cataracts is age, they may also occur because of diabetes, trauma, genetics, certain medications (i.e. steroids), long-term exposure to sunlight, previous eye inflammation or injuries. Cataracts can develop in both eyes at the same time, but it is not uncommon for one to be more severe than the other.

According to last year’s Eye Health Statistics, cataracts affect nearly 22 million Americans who are 40 and older. By age 80, more than half of all Americans have cataracts. While many learn to live with the blurred vision, once the cataract progresses to the point where it’s difficult to perform every day tasks like driving, reading, watching TV or using the computer, cataract surgery may be recommended.

The best option for people suffering with cataract is to see a cataract specialist for a complete eye examination to determine whether surgery is needed. Drs. Kugler and Schlichtemeier in Omaha, Nebraska, specialize in cataract surgery and use the most advanced technology available to remove cataracts.

Cataract surgery is known to be one of the safest surgeries performed in medicine, and is normally quick and painless. For more information about the options or to book a consultation, contact LaserVision Correction in Omaha.

More information is available about cataracts here.

Choosing your LASIK surgeon

Lance Kugler, MD — Fri, 20 Apr 2012 10:30:24 +0000

Your eyes are important and so is the serious consideration of the surgeon performing your refractive surgery. Choosing a qualified doctor should involve more than visiting the nearest laser vision correction clinic or picking the cheapest option. The process of discriminating between surgeons can be confusing for patients who have never “shopped” around for medical services. However, here are some important factors every patient should investigate while selecting their LASIK surgeon:

Check their credentials: Validate your LASIK surgeon’s license by contacting your state licensing board. Credentials can also be checked through the National Practitioner Data Bank. Find a surgeon that is board certified by The American Board of Ophthalmology. Board certification is the gold standard of a surgeon’s competence and involves a two-part examination to assess the practitioner’s knowledge, skills and experience.
Consider reputation and experience: Find a surgeon with real and respected testimonials. These may be available on the clinic’s website. Choose a surgeon that has experience in several procedures, such as Conductive Keratoplasty (CK), Refractive Lens Exchange, PRK or the Visian Implantable Collamer Lens (ICL) procedure. LASIK may not be ideal for everyone and your surgeon should be versatile in assessing your needs and offering alternative options.
Ask the right questions: Clarify the essentials in your initial consultation, including the clinic’s outcome statistics, complication rates and billing policies.
Make sure you are comfortable: Choose a surgeon and eye care center that makes you feel assured and comfortable. The staff should be friendly, courteous and willing to address your questions and concerns every step of the way.

Dr. Kugler interviewed for UNMC “Ask the Expert”

Lance Kugler, MD — Tue, 17 Apr 2012 15:12:39 +0000

Dr. Kugler serves as the Director of Refractive Surgery at the University of Nebraska Medical Center department of ophthalmology. He was recently interviewed for the University’s “Ask the Expert” segment. Here is the video:

Is LASIK painful?

Lance Kugler, MD — Fri, 06 Apr 2012 10:30:50 +0000

People often cringe at the idea of LASIK, as it may sound like a painful procedure during and after surgery. Almost every patient that comes into LaserVision Correction in Omaha asks us, “Is LASIK painful?” And we assure them that if a proper evaluation has been done and the surgery is completed successfully, it is relatively painless.

LASIK is considered to be the most established and safest refractive surgery procedure. It is performed with the patient awake, but before the surgery begins, your eye is numbed by anesthetic drops. LASIK is performed under a flap of corneal tissue, which is created with a precise and sophisticated laser called a Femtosecond laser. While you may feel a little bit of pressure on the eye as the corneal flap is being made, there is no real pain.

After the corneal flap is created, it is then folded back so the excimer laser can reshape the underlying tissues to correct any vision abnormalities. The corneal flap is replaced over the treated area.

Patients may experience discomfort or irritation during or after the procedure, but that can be soothed with lubricating eye drops and Tylenol or ibuprofen. The eyes usually have mild soreness for a few hours after LASIK surgery, but significant pain is rare.

It is important to find a LASIK surgeon whom you are confident in and comfortable with. LASIK surgery, as well as other forms of laser vision correction, can be performed smoothly and successfully provided you are getting it done with a professional and experienced surgeon who uses the best technology.

Our doctors are specialty trained laser and cataract surgeons who have more than 30 years of experience. Contact LaserVision Omaha today to book a free consultation.

Preparing for your LASIK appointment

Lance Kugler, MD — Fri, 23 Mar 2012 10:30:12 +0000

Patients often feel excited or anxious prior to their LASIK procedure. While these emotions are completely normal, being prepared can help put your mind at ease during the lead up to your big day. Here are a few tips to help you get ready:

1. Ask questions and express your concerns
During your consultation and pre-operative appointment, consult with your doctor about any questions that may be weighing on your mind. We encourage patients to familiarize themselves with the procedure, technology and health care professionals. Clearing up your concerns will help you feel more confident going into your surgery.

2. Be up-front
Advise your doctor about any health history concerns or medications you are taking. A two-way flow of communication can promote a smooth procedure and recovery.

3. Stop wearing contact lenses during the period of time advised by your doctor.
Adhere to the contact lens guidelines provided by your doctor. To ensure the shape of your eye is optimal for LASIK, you must stop wearing contact lenses a few days or weeks before your surgery. Be sure to confirm when you need to stop wearing your contacts and follow these instructions accordingly.

4. Lose the cosmetics
On the day before surgery, stop using make-up, lotions, perfumes or other cosmetics that may interfere with the procedure. These substances can cause debris, which may get in your eyes during the procedure.

5. Have a light meal
Eating a light meal before your surgery is acceptable and encouraged!

6. Arrange alternate transportation
Driving is not advised immediately following your procedure, so you will need a driver to take you home. Most LASIK patients are able to drive the next day, however!

7. Dress for comfort
Wear comfortable clothing to your surgery. Avoid wearing bulky clothing or lint shedding material like wool or mohair. For comfort, steer clear of hair accessories that may interfere with the position of your head under the laser.

8. Relax!
Your health care professionals will cover any additional instructions and address any concerns or questions you may have. Relax, you’re on the road to a lifetime of clear vision!

Can LASIK correct astigmatism?

Lance Kugler, MD — Fri, 09 Mar 2012 10:30:59 +0000

Astigmatism is a refractive error that results in impaired eyesight due to irregular conformation of the eye, meaning the eye is not perfectly round but more ovular. It often occurs early in life and usually in children between the ages of 5 to 17 years old. Astigmatism can last a lifetime if it isn’t treated properly.

Many believe that astigmatism cannot be treated with LASIK surgery, and although this was true years ago, modern laser systems can now treat astigmatism very well.

Laser vision correction can now change the shape of the front surface of the cornea, which is most responsible for astigmatism. However it cannot change the shape of other parts of the eye, such as the posterior surface of the cornea or the crystalline lens, which are also contributing factors.

If astigmatism lies in the front surface of the cornea, the surgery can be completed successfully, but if it is anywhere else in the eye, then most laser systems try to reverse the astigmatism by reshaping the cornea, even if there is nothing wrong with it. This form of correction results in good vision for patients temporarily, but may actually cause poor quality vision long-term. It could also reduce the success of cataract surgery for the patient in the future.

There are only a handful of clinics, ours being one of them, that can avoid this long-term astigmatism problem by using vector analysis software for all of their LASIK patients with astigmatism. This analysis outlines patients who may be at risk for long-term astigmatism problems, and allows doctors to address them at the time of surgery or recommend another type of vision correction.

If you suffer from astigmatism, the best way to check if you are suitable for laser vision correction is to book a consultation with an eye doctor that specializes in LASIK for patients with astigmatism.

Contact our clinic today to book an appointment with Dr. Kugler and Dr. Schlichtemeier.

LASIK after age 65

Lance Kugler, MD — Fri, 24 Feb 2012 10:30:09 +0000

LASIK eye surgery is increasingly becoming a clear option for patients over the age of 65. With more seniors turning to laser vision correction to treat aging vision problems like myopia and astigmatism, “too old for LASIK” has become a belief of the past. Believe it or not, Rolling Stones guitarist Keith Richards recently underwent laser eye surgery to correct his deteriorating vision. According to an article in the Times Colonist, The 68-year-old rocker is reportedly “doing very well” following the procedure.

Though vision problems often come with the aging process, quality of life need not be compromised in your golden years. While other treatment options may be a better long-term fit for patients with cataracts, glaucoma or retinal disorders, you are never too old to be considered for LASIK or vision correction alternatives.

A recent study in the Journal of Ophthalmology reported that the safety and efficacy of LASIK procedures in patients over 70-years-old has greatly increased in recent years, including the complication rate decreasing to 1%. Depending on your condition and lifestyle, cataract surgery, corneal replacement surgery or a lens implant may be a better option. Above all, visiting an eye center specialized in offering a variety of treatments is always recommended. It is advised that older patients have a complete eye exam with a vision care specialist every 1 to 2 years to check for early signs and symptoms of diseases and test for glaucoma. Patients should also monitor and regularly check for diseases that may cause eye problems, such as diabetes.

If you think you’re too old for vision correction, think again. LASIK is just one of the possibilities for visual acuity after age 65.

The affordability of LASIK

Lance Kugler, MD — Fri, 10 Feb 2012 10:30:29 +0000

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.

Recent advancements in Laser Vision Correction

Lance Kugler, MD — Fri, 27 Jan 2012 10:30:42 +0000

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.