LASIK and IntraLASIK – Frequently Asked Questions
Learn more about intraocular lens implants and what to expect before, during, and after the lens replacement procedure:
What is the WaveLight® Refractive Suite? Why is it Important?Dr. Tylock and Dr. George are the first LASIK Surgeons in the state of Texas to perform IntraLASIK and PRK with the WaveLight® Refractive Suite. This represents the most advanced state-of-the-art technology available anywhere in the United States (as of August 2013). The WaveLight® Refractive Suite combines the integration of two different lasers: • WaveLight® FS200 Femtosecond Laser (Left)–utilized in the first step of the IntraLASIK procedure to make the flap • WaveLight® EX500 Excimer Laser (Right)–used in the second step which reshapes the cornea, correcting the patient’s nearsightedness, farsightedness, and/or astigmatism These two lasers have been ergonomically combined and optimized into the WaveLight® Refractive Suite to give the patient, doctor and his staff exceptional comfort and efficiency in performing vision correction procedures. The WaveLight® Refractive Suite offers unprecedented levels of patient safety, accuracy and comfort, above and beyond any prior laser system used in the United States. It also has the shortest treatment times available anywhere in the world both in making the corneal flap and reshaping the cornea to its’ optimal focusing power. This advancement in speed minimizes patient treatment times, fatigue and anxiety, while providing the most favorable conditions for corneal refractive treatments.
What areThe ReSTOR®, TECNIS® Multifocal, ReZoom® or Crystalens®, are all "Advanced Technology Intraocular Lens Implants" that Dr. Tylock and Dr. George use for their patients, allowing for an extended range of vision at near and distance beyond conventional lens implants. Unlike conventional intraocular lens (IOL) implants, our Dallas / Fort Worth area practice in Irving, Texas offers "Advanced Technology Intraocular Lens Implants" to restore a much expanded range of functional vision, and minimize or eliminate the need for glasses and contacts for everyday tasks, allowing patients to see well and to look their best. With these Advanced Technology Intraocular Lens Implants, for the first time patients will have the opportunity to potentially experience the freedom of seeing well at all distances without glasses.
What is LASIK’s history? What about long term side effects?LASIK eye surgery is a form of lamellar (layered or flap like) refractive surgery which has been performed since 1949. Patients who have undergone these earlier and more invasive procedures over 60 years ago have not had any unusual problems. The Excimer laser has been used since 1985 to correct vision. Well over 25 million LASIK procedures have been performed worldwide.
What is the difference betweenThe ReSTOR®, TECNIS® Multifocal, ReZoom® or Crystalens® AO, are all "Advanced Technology Intraocular Lens Implants" which allow for continuous vision up close, far away, and at all distances in between, in many cases with patients experiencing the same vision they had when they were younger, without the inconvenience of corrective lenses. In contrast, standard "Conventional Intraocular Lens Implants" provide vision at a fixed distance and do not have the ability to provide a full range of near, intermediate, and far vision. Most people with "Conventional Intraocular Lens Implants" must wear glasses for near vision and may need to wear glasses for intermediate/arm’s length vision as well. People with "Conventional Intraocular Lens Implants" may even need weak glasses for distance. Bottom line, with "Advanced Technology Implants" you may eliminate or will be much less glasses dependent postoperatively than you would with "Conventional Lens Implants." Please ask our patient counselors or doctors to explain this further if you have any questions about this most important question.
Will having LASIK prevent me from getting other eye disease?No. LASIK does not cause, nor prevent cataracts, glaucoma, macular degeneration or any other eye diseases. Ophthalmologists term LASIK as a disease neutral procedure. Again, LASIK does not cause disease; it does not prevent disease, and it does not prevent diseases encountered in the future from being treated.
Will I be able to read in all light conditions withThe ReSTOR®, TECNIS® Multifocal, ReZoom® or Crystalens®, are all "Advanced Technology Intraocular Lens Implants" take the place of the natural human crystalline lens. Every individual’s vision is reduced in dim light conditions. It is also influenced by the overall health of your eye and by the condition of the light photoreceptors in the retina. As we age, our ability to see in low light conditions decreases. Certain lenses such as the ReSTOR®, TECNIS®, and ReZoom® lenses may make dimly lit reading more challenging, but not impossible. It is best to read in optimal light conditions.
Who is a candidate for LASIK Vision Correction?A good LASIK candidate must be at least 18 years old and have a stable prescription. You must also myopia up to -12.00 or hyperopia up to +6.00. Your level of astigmatism may be as high as 6.00 diopters. You should not be pregnant or have any unstable medical condition, or any uncontrolled eye diseases.
What are the chances that something could go wrong with the intraocular lens implant surgery?The contemporary treatment for cataracts is to remove the natural crystalline lens in the eye and replace it with an artificial lens. The ReSTOR®, TECNIS® Multifocal, ReZoom® and Crystalens® intraocular lens implants available at our Texas practice in the Dallas / Fort Worth area represent the state-of-the-art in "Advanced Technology Intraocular Lens Implants" design and are the result of more than 50 years’ evolution in the treatment of cataracts. We are proud to offer these intraocular lens implants at our Irving office serving the Dallas / Fort Worth, Texas area. The medical procedure to implant these "Advanced Technology Intraocular Lens Implants" is the same safe, proven cataract surgery performed annually on more than seven million eyes globally. More than 40 million procedures have been done in the last 30 years. Since it is surgery, it is not completely risk-free. Complications of cataract surgery range from minor, usually temporary side effects, to sight-threatening complications. Fortunately, significant sight-threatening complications are extremely rare since cataract surgery is one of the most common and safest procedures in all of medicine. You will have a thorough examination prior to your surgery and be fully informed of any increased risk you may have.
Who can LASIK benefit?LASIK can benefit a great number of people with myopia, hyperopia and astigmatism. Candidates should have a strong desire to be less dependent on corrective lenses, have established realistic expectations, and understand the risks associated with the surgery.
When will I be able to return to normal activities after aTypically you will be able to return to normal activities within several days after the intraocular lens is implanted, with some limitations. Your eye may be sensitive to touch and bright light, but you should be able to drive and return to work in two to three days. Your doctor will provide you with medications to prevent infection and decrease inflammation, and may provide a protective shield to cover your eye while sleeping the first five days. A pair of plastic, disposable sunglasses will decrease your sensitivity to light, as well as provide protection during the day. It is important that you follow the post-operative instructions that are given at our office serving the Dallas / Fort Worth, Texas area. You also must avoid lifting heavy objects, as well ass rubbing or pushing on your eye. You should refrain from activities that could increase your chances of getting hit in the eye, especially in the immediate post-operative period.
Can anyone have laser vision correction (LASIK) done?Laser vision correction is exciting, but it isn’t for everyone. We like to make sure that everyone undergoing a procedure has healthy eyes and have been determined to be a good candidate after a complete eye examination. It is important to discuss your goals with the doctor and have realistic expectations. Generally speaking, anyone who sees well with glasses or contacts but is not happy with their eyesight without optical devices is probably a good candidate for laser vision correction.
Will a laser be used to remove my cataract?Despite popular belief, most cataracts are not removed by lasers. After your initial cataract surgery, the membrane that is left in place to support the intraocular lens (IOL) may become cloudy. To restore your normal vision, Dr. Tylock will use a YAG laser to create a tiny opening in the membrane. This takes only a few minutes in the office, is painless, and does not require any incisions.
What does LASIK cost?Tylock Eye Care & Laser Center has a tiered pricing system which means that the cost of LASIK is based on the individual’s amount of correction. Pricing can vary from patient to patient depending on the patient’s prescription, their choice of procedure, and the agreed decision between the doctor and patient on what will give the patient their best personal vision. Please contact one of our Patient Counselors for more information on the cost of your procedure.
What is Monovision?Monovision is a situation where a patient has one eye corrected for distance and the other eye for near. This may be done using contact lenses, LASIK, or cataract surgery. Not all individuals are capable of adjusting to monovision because it requires the brain to comfortably change as one transitions from their distance image with one eye then to the near image with the other eye.
Does LASIK hurt?Before the LASIK procedure begins, your eyes will be made thoroughly numb by anesthetic drops. While you may feel a pressure sensation as the corneal flap is being made, actual pain is rare. Any discomfort you may feel subsequent to the LASIK procedure is typically minimal and lasts only a few hours. Sleep and lubrication, as well as Tylenol or Ibuprofen, are usually enough to counteract any discomfort.
How do the ReSTOR® and TECNIS® MultifocalThe ReSTOR® and TECNIS® Multifocal "Advanced Technology Intraocular Lens Implants" act like two lenses in one. One is a refractive lens that is for distance vision, the other focuses near vision by using a special set of graduated rings in the implant. This gives a much wider expanded range of vision compared to "Conventional Intraocular Lenses". These "Advanced Technology Intraocular Lens Implants" allow people to enjoy activities like reading, writing, and playing cards all without the hassle of reading glasses, bifocals, progressive lenses or contact lenses. Because the ReSTOR® and TECNIS® Multifocal implants do not work with the muscles of the eye, it is not dependent on a mechanical process or the movement of the lens to give clear vision. To find out if you would be a good candidate for the ReSTOR® and TECNIS® Multifocal "Advanced Technology Intraocular Lens Implants", contact our vision correction center serving the Dallas / Fort Worth, Texas area.
Should I have LASIK done on both eyes on the same day?The vast majority of LASIK patients elect to have both eyes done at the same sitting. The results are predictable and the procedure is safe enough that most people undergoing LASIK surgery prefer to have both eyes done on the same day. However, if they wish, a patient may correct one eye at a time.
How does the Crystalens® intraocular lens implant work?The Crystalens® works by using a pair of hinges, one on each side of the central optic, the focusing part of the implant. These two hinges work naturally with your eyes’ muscles allowing the implant optic to move forward and backward, or accommodate focusing on objects near, far, and may correct all distances in between seamlessly. This design mimics the eye’s natural lens process of accommodation. This accommodation process is practiced by the patient in the ensuing months post operatively to enhance and fine tune their near vision capabilities. If the patient is able to achieve this full range of movement with the Crystalens®, it allows for the kind of vision patients enjoyed when they were younger. Typically after implantation of the Crystalens and subsequent enhancement procedures, patients will see excellent at distance, as well as their computer range without any correction. They most often will need glasses for reading fine print. It is certainly possible to target more of a monovision in each eye for selected patients that is more likely to give greater independence of glasses. It is important to have this discussion with your doctor preoperatively to make sure that your expectations are realistic.
How accurate is the excimer laser?The excimer laser is very accurate. The laser removes .25 microns of tissue with each pulse. We never had this kind of delicate and accurate control in corneal surgery before the development of the excimer laser…in fact the excimer laser could engrave your initials in a human hair without destroying its structure.
Can my vision be corrected to 20/20, for both reading & distance?The ReSTOR®, TECNIS® Multifocal, and Crystalens®, are all "Advanced Technology Intraocular Lens Implants" that have been designed to focus your eyes at all distances after cataract surgery. While virtually everyone will experience a significant improvement in their uncorrected vision after intraocular lens implant surgery, some patients will not see 20/20 at all distances. It is interesting to note that many people who have not had surgery are not able to see 20/20 at both near and far even with glasses or contact lenses. This is due to a variety of ocular and physiological problems, as well as lifestyle preferences--yet most of these people function quite normally despite reduced vision. After undergoing intraocular lens implant surgery Dr. Tylock or Dr. George may perform LASIK or PRK to further fine-tune your vision, adjusting the power of your eyes for the most optimal vision. These enhancement procedures, LASIK and PRK are performed at our Irving office which serves Dallas, Fort Worth, and surrounding areas.
What will my vision and post-operative course be like after surgery with the Crystalens®Most often your distance vision will usually be very good within a day or two after surgery. Your intermediate vision will improve next, followed by your near vision weeks to months later as you learn the process of focusing up close with your Crystalens®. As it is standard with all cataract surgery, you will also take antibiotic drops for one week. You will take your anti-inflammatory drops five to six weeks in your operated eye. The recommended eye exercises are important to develop and refine your near vision capabilities. About a week after your intraocular lens implant procedure, you will notice that your intermediate (arm’s length) vision is improving and your near vision is also starting to get better. It is important that you stop the use of the reading glasses at this time so that you strengthen the focusing muscle of your eyes in use with the Crystalens®. Most patients have their second eye done about two to four weeks later, depending on their schedule and other factors. It may take several months for your eyes to reach their full near focusing potential. The more you discipline yourself and attempt to read without reading glasses, the quicker you will be able read without them. You may notice a variation in your vision from one eye to the other after your eyes heal. This is normal. A Crystalens® patient’s focusing ability up close may differ from one patient to another. Most people will be able to see clearly in the distance and have excellent middle vision. Near vision with the Crystalens® may be more challenging, as some patients will be able to read a newspaper without glasses, while others may be more comfortable with near correction, particularly for fine print or in dim light. If your vision is less than optimal at a distance or near, or you have astigmatism after intraocular lens implant surgery, Dr. Tylock or Dr. George may perform LASIK or PRK to further fine-tune your vision. While virtually everyone experiences improved vision, as well as a much greater range of vision after "Advanced Technology Intraocular Lens Implant" surgery, some people will have better uncorrected vision than others. It is also important to remember that intraocular lens implant surgery cannot resolve pre-existing visual issues such as floaters, flashes, or visual field loss that are a result of conditions of the eye and not related to the lens implant. To find out more about post-operative care following intraocular lens implant surgery, contact our office, which serves the Fort Worth / Dallas, Texas area.
What if I move my eye during the laser treatment?With the WaveLight® EX500 Excimer laser you do not have to worry about eye movement since the laser’s sophisticated tracking system is dedicated to following your eye movements. This brings peace of mind to the patient. The EX500 Excimer laser’s infrared camera monitors and tracks the pupil at 1050 times per second and makes adjustments for any movement at 500 times per second (latency period) or every 2 one-thousandths of a second. This extremely fast tracking and short latency period far exceeds any other Excimer laser ever released in the United States before. This technology establishes a much higher industry-standard for safety, accuracy and end result for the patient. This is why Dr. Tylock and Dr. George are so proud to be the first to perform LASIK and PRK in the state of Texas with the WaveLight® Refractive Suite.
What will my vision and post-operative course be like after surgery with the ReSTOR®Your distance vision will usually be very good within a day or two after cataracts treatment, followed by your near vision a few days to a week later. There may be a short adaptation period in getting used to your near vision since this will be new to you. As it is customary with all cataract surgery, you will take an antibiotic drop for one week and an anti-inflammatory drop for three to four weeks in your operated eye. Your near vision with the ReSTOR® intraocular lens implant will be intact much more quickly than the Crystalens®. Since the ReSTOR® lens works differently than the Crystalens®, there will be no need to take dilating drops in the post-operative period and it will not be necessary to perform eye exercises to further improve your near vision after surgery. Most patients have their second eye done with the ReSTOR® implant about two to four weeks later. Having the second eye done makes patients feel much more comfortable with their near and distance vision since the eyes are working again in synchrony as a pair with the same type of optics. If your vision is less than optimal at a distance or near or you have astigmatism after implant surgery, Dr. Tylock or Dr. George may perform LASIK or PRK to further correct your vision. This will be done about four months or later after your initial "Advanced Technology Intraocular Lens Implant" procedure. While virtually everyone experiences much improved vision, as well as a much greater range of vision after "Advanced Technology Interocular Lens Implants" surgery, some people will have better uncorrected vision than others. It is also important to remember that intraocular lens implant surgery cannot resolve pre-existing visual conditions such as flashes, floaters, or visual field loss that are a result of conditions of the eye and not related to the lens. Not all patients have the same vision potential. To find out if you would be a good candidate for an intraocular lens implant, contact the Tylock Eye Care & Laser Center, serving the Dallas / Fort Worth area of Texas today.
What holds the flap in place after LASIK surgery?There are four natural forces that cause a newly made corneal flap to re-adhere to the cornea: Tissues like to stick together. Within seconds hydrostatic forces between the flap and the corneal stroma create a seal between the two tissues, causing the flap to begin to re-adhere. Endothelial cells are constantly pumping fluid out of the cornea. This pump function maintains corneal clarity and creates a natural vacuum that holds the flap down. This process begins working in a matter of minutes. Within hours the epithelial cells grow over the edge of the flap. This process helps to glue down the flap and takes just a few days to complete. Eventually, the internal healing process with collagen bonding allows for the flap to be permanently glued down. The corneal flap is most vulnerable during the first twelve to sixteen hours immediately after surgery. With each passing hour it grows more and more stable until it is fully re-adhered.
How do I know whichDr. Tylock and Dr. George offer the Crystalens®, ReSTOR®, ReZoom® and TECNIS® Multifocal "Advanced Technology Lens Implants" because they are proven technology whose design is the result of more than 50 years’ evolution in the treatment of cataracts. Although these intraocular lens implants restore a full functional range of vision, they work by different methods. It is always necessary for you to have a pre-op eye surgery exam and evaluation before any surgery. At that time, depending on your eyes, work needs, recreational activities, expectations and other factors in your profile, it will be determined which intraocular lens implant is best for you. Contact our office serving the Dallas / Fort Worth areas today to schedule your consultation!
Will dry eyes affect my LASIK surgery?Patients are tested for dry eyes in their complete LASIK evaluation. If a patient is diagnosed with having dry eyes, the doctor may recommend that the patient have IntraLASIK. Several advantages of IntraLASIK help reduce dry eye symptoms as the surgeon can create a custom flap on these patients. This will be discussed with the LASIK eye surgeon at your LASIK evaluation.
Has anyone ever gone blind from LASIK?After performing more than 55,000 LASIK surgeries, Dr. Tylock has not had any of his patients go blind from the procedure. However, as with any surgery, there are risks involved which you need to be aware of prior to having your surgery.
How fast does my vision improve after the procedure?This depends on the type of treatment you have. LASIK patients often have legal driving vision (better than 20/40) the next day and are ready for work and other daily activities. A lot of improvement will be noticed the next day though gradual improvement is still noted for the next few weeks.
Can LASIK help me get rid of reading glasses?As we age, our eyes lose the ability to focus on images up close. We continually move an image, such as a book or newspaper, farther and farther from our eyes in order to bring it into focus. This condition is called presbyopia. When presbyopia progresses to the point where our arms are not long enough, we need reading glasses or bifocals. Everyone will experience presbyopia, whether they started with corrective lenses or not. Presbyopia is simply an aging process of the internal lens of the eye and typically begins around the age of 40 to 45. Patients in their forties or older who are experiencing difficulty with their reading vision, it is possible to treat one eye for near vision and the other for best distance vision, therefore decreasing the necessity for both near and distance glasses. If you are considering this process, called monovision, it is advisable to try it out with contact lenses before proceeding directly to LASIKor PRK surgery. If you have already been successful with monovision in contact lenses, you will most likely enjoy this type of correction through PRK or LASIK. If you are in your late 40s and hope to avoid glasses altogether you can also choose to restore your vision at all distances with one of the "Advanced Technology Intraocular Lens Implants" such as the ReSTOR®, TECNIS® Multifocal, or Crystalens®.
I’ve heard so much about astigmatism. What is it? Does LASIK correct it?Astigmatism refers to the curvature of your cornea. A "normal" cornea is round, like a basketball. If you have astigmatism, your cornea is shaped like a football. Astigmatism can occur alone or in addition to either nearsightedness or farsightedness and can be corrected with LASIK.
After LASIK and PRK surgery, can I have cataract surgery if I need it in the future?Yes, the surgical technique used will not change. However, your lens implant used during cataract surgery will be calculated using a different formula.
What is IntraLASIK and how is it different?General laser surgery for vision correction is really a two-step approach. First, a corneal flap (a hinged opening) is created and then folded back. Then, an excimer laser reshapes the inner cornea and the flap is folded back onto the eye. Corneal flap creation is considered the most critical step in vision correction surgery. A high quality, smooth fitting corneal flap is essential for an excellent result. Before IntraLASIK was introduced, the flap was created by cutting a thin flap along the top of the cornea with a surgical blade held by a device called a microkeratome. Refractive surgeons recognize that the microkeratome is frequently seen as the source of many complications as considerable skill and training are required to properly use it. In 2002 Dr. Tylock was one of the first surgeons in the United States to perform the more advanced IntraLASIK procedure that creates the corneal flap with a computer controlled femtosecond laser. Dr. Tylock and Dr. George custom program the parameters of your corneal flap based on the type of procedure and other measurements obtained during your examination(s) and studies performed. IntraLASIK makes your laser vision correction surgery truly all-laser.
Why is IntraLASIK safer?Although the use of surgical blades in vision correction has produced excellent results in most patients, the vast majority of serious complications involve the cutting of the corneal flap. The all-laser IntraLASIK approach eliminates the surgical blade and microkeratome. The use of the femtosecond laser to create the corneal flap is much safer and more precise. The all-laser approach bevels the edge of the flap so when it is folded back after the inner cornea is reshaped, the edges fit precisely and exceptionally well, virtually eliminating the complications associated with corneal flaps made by other methods.
Is IntraLASIK painful?Actually, the use of IntraLASIK is completely painless and patients are quite comfortable during and after the surgery with it. Patients will typically feel pressure, but experience no pain. You should feel relaxed and confident, knowing that you and your LASIK eye surgeon have selected the most advanced, safest approach to correcting your vision.
How long does the IntraLASIK portion of the procedure take to make the flap?The WaveLight® FS200 Femtosecond Laser is the perfect partner for the WaveLight® EX500 Excimer Laser, both comprise the WaveLight® Refractive Suite. The FS200 features the fastest flap creation times, approximately 6 seconds. Dr. Tylock and Dr. George are proud to have been the first surgeons in the Dallas / Fort Worth area to obtain this new state-of-the-art laser.
What can I expect after surgery with IntraLASIK?Immediately following the procedure the surgeon, Dr. Tylock or Dr. George will check you at the slit lamp in the operating room. After this, you can expect to stay with us for 20 minutes to a half-hour to rest with your eyes closed. This will allow the effects of the numbing solution to wear off. Your eyes will be checked again and you will be given postoperative instructions. You should ask any further questions if you have any and then you will be free to go home. It is especially important that over the next 12 to 16 hours that you turn off any ceiling fans and keep your eyes well lubricated. If your eyes feel the least bit dry, add the lubricating drops that were given to you in your packet. If your eyes water and tear a lot, that is good, because it will minimize the friction between your eyelids and your corneal flap. Remember that the flap adherence to the cornea is weak at first, and will increase every hour of the initial healing during this period. You’ll notice your vision will be improved immediately and your eyes should not be uncomfortable. Most patients say their eyes feel normal by the next day and you can return to your normal activities. You should feel secure that your LASIK eye surgeon has provided you with the most advanced, reliable and safest choice in vision correction surgery.
Following Wavefront Optimized IntraLASIK, will I see better than I do with contact lenses or glasses?Studies have shown approximately 50 percent of Custom IntraLASIK patients will see better than they did with their glasses or contact lenses. One needs to understand that although this vision improvement is possible, it is by no means guaranteed.