Frequently Asked Questions (FAQ) About Refractive Services

On this page, you will find a range of Frequently Asked Questions (FAQs) answered by our very own Refractive Experts.
To jump to a certain Procedure, click below:

Jump to LASIK Procedure FAQs
Jump to LASIK Procedure Video FAQs
Jump to CXL Procedure FAQs

FAQ – The LASIK Procedure With Dr. Randleman

I HAVE AN ASTIGMATISM. AM I STILL A CANDIDATE FOR LASIK?

Astigmatism

 

I AM NOT A GOOD LASIK CANDIDATE. DO I HAVE ANY OTHER OPTIONS?

Candidate

 

IS LASIK DANGEROUS?

Safety

 

IS LASIK PAINFUL?

Pain

 

WHY DOES LASIK SEEM SO EXPENSIVE?

Cost

 

IS IT REALLY IMPORTANT WHICH DOCTOR PERFORMS MY LASIK SURGERY?

Which Doctor Performs Surgery

 

WHAT EQUIPMENT IS USED DURING THE LASIK PROCEDURE?

Equipment

 

WHAT DOES THE LASIK CONSULTATION CONSIST OF?

Consultation

 

I HAVE DRY EYE, DOES THAT EXCLUDE ME FROM HAVING LASIK?

Dry Eye

 

Additional FAQ – The LASIK Procedure

I HAVE ASTIGMATISM. AM I STILL A CANDIDATE FOR LASIK?

LASIK (and PRK) can effectively treat near-sightedness, farsightedness and high astigmatism. LASIK is able to treat more than 95% of all refractive errors.

 

I AM NOT A GOOD LASIK CANDIDATE. DO I HAVE ANY OTHER OPTIONS?

The surgeons at USC Laser Vision provide the full spectrum of refractive surgical options including PRK, phakic lenses and refractive lens exchange. We provide extensive screenings to determine the best procedure for you.

 

IS LASIK DANGEROUS?

While there are possible complications with any surgery, the risk of poor outcomes is significantly low with LASIK for good candidates. In fact, many recent studies have found the risks of LASIK are less than those for extended contact lens wear, especially the risk of infection.

The US Food and Drug Administration, which is responsible for protecting the American public by requiring vigorous scientific testing of new surgical technology, oversaw tests within a 10 year period and approved the excimer laser in 1995. The website www.FDA.gov has information about the most current and safest laser technology.

According to the US Food and Drug Administration, there have been no reported cases of a patient going blind due to LASIK and none of my patients have ever lost vision. Complications that may diminish vision may be avoided by adhering to all of your eye surgeon’s post-surgery instructions for hygiene, exercise and follow-up appointments.
 

IS LASIK PAINFUL?

LASIK is generally a pain-free procedure. The process can seem intimidating before treatment begins. Before surgery, numbing drops are placed in the eyes to prevent discomfort. There are a few moments of pressure during surgery. The procedure usually takes a few minutes. After surgery, the eyes may burn, itch or feel like there is something in them for several hours. Eye drops and a mild pain reliever usually provide relief.

There is no pain during the LASIK procedure because the eye is numbed with drops before the procedure. You will feel slight pressure on the eye but it is not uncomfortable. If there is any discomfort after LASIK, it is usually minimal and can be treated with your usual over-the-counter pain medication. Wetting drops may be used to alleviate dryness or itching.
 

WHY DOES LASIK SEEM SO EXPENSIVE?

For most patients who wear glasses and contact lenses, the cost of LASIK is significantly less expensive over a short period of time when compared with the cost of glasses, contacts, solutions, and trips to the doctor to get your prescription checked. Many people find that LASIK and similar procedures qualify for their medical spending accounts, which further reduces the final cost.
 

IS IT REALLY IMPORTANT WHICH DOCTOR PERFORMS MY LASIK SURGERY?

Experience counts. When considering a surgeon, look for the proper credentials, including state licensing, board certification and subspecialty training in refractive surgery. Ask questions such as “How many procedures have you done?” and “What is your complication rate?”. Also make sure the doctor is comfortable and experienced with several types of eye surgery so all options are considered to provide the best outcome.

LASIK is a serious medical procedure and you want to choose a physician who is well-trained with exceptional experience. I am certified by the American Board of Ophthalmology and have years of experience performing microsurgery of the eye. I completed sub-specialty training in refractive surgery and corneal transplantation and am certified in the use of excimer laser and other refractive surgery Techniques.
 

WILL I SEE 20/20 AFTER HAVING THE LASIK PROCEDURE?

The chances of seeing 20/20 depend on many factors: your uncorrected prescription prior to surgery, your healing process and your physician’s knowledge and skill, just to name a few. You will need to be evaluated by your eye doctor to determine if you are a candidate for LASIK. Results vary from patient to patient; however, most patients experience improved vision after the procedure. Some patients attain vision that is better than 20/20 after LASIK, while some have a reduced need for glasses or contact lenses for many activities.
 

HOW LONG DOES THE CORRECTION LAST?

LASIK surgery is designed to be permanent. If your prescription were to change dramatically over time, which is very rare, retreatment may be possible. Also, vision diminishes as you reach middle age—known as presbyopia—and you may require reading glasses for crisp up-close vision. Other diseases affecting vision such as glaucoma, macular degeneration or cataracts can still occur.
 

WHAT ARE THE RISKS ASSOCIATED WITH THE PROCEDURE?

Like any medical procedure, LASIK does have potential risks and side-effects. The major risk is infection. Following your procedure, you are given antibiotic eye drops to use and will have follow-up visits to check your healing. Some patients see halos and glares, especially during the night. This usually diminishes over time. I give patients detailed information regarding risks and complications prior to the procedure. I also discuss health conditions that might increase the risks associated with LASIK or possibly recommend against having the procedure.
 

DOES HEALTH INSURANCE COVER LASIK SURGERY?

In most cases, health insurance companies consider LASIK to be cosmetic and medically unnecessary surgery so they don’t cover the procedure, but you need to check your specific company for coverage details. Your employer may offer a flexible spending account, which can be applied toward LASIK or other procedures. It is best not to choose an eye surgeon to have LASIK based on cost alone.
 

FAQ – The CXL Procedure

IS CORNEAL CROSS-LINKING (CXL) A NEW TREATMENT?

CXL was recently approved in the United States in 2016 based on randomized clinical trials performed in the US in 2008. However, CXL was introduced in Europe more than 15 years ago where the procedure was pioneered. There are many long-term studies that demonstrate the efficacy and safety of the procedure.
 

WHAT IS THE MAIN GOAL OF CXL?

The purpose of the treatment is to prevent progressive bulging and thinning of the cornea that can interfere with vision. With a stronger and more stable cornea the risk of requiring a corneal transplant is reduced. What is the success rate of CXL The success rate at preventing progressive bulging and thinning is 98 percent. Many patients have seen some modest regression of their corneal bulging, which can improve proper contact lens fitting and provide better vision with glasses than before treatment.
 

CAN CXL BE REPEATED?

In rare cases (less than 2 percent) where CXL is not successful in stabilizing a cornea, a repeat treatment can be performed. Since very few patients have ever required repeat CXL, less is known about the efficacy of a repeat treatment, but it has been shown to be equally safe as initial treatment.
 

ARE CERTAIN PATIENTS NOT GOOD CANDIDATES?

Patients must have sufficient corneal thickness for the procedure to be performed. Your doctor will perform measurements to confirm adequate thickness. CXL is not a good treatment when corneas have significant central scarring that interferes with vision.
 

IS THERE AN IDEAL AGE FOR CXL TREATMENT?

Usually, the younger the patient, the greater the chance of preserving vision with CXL, but patients at any age may benefit from CXL, especially if they have worsening keratoconus or if they have diminished vision correction with glasses or contact lenses. Patients with advanced disease can have CXL, but vision may be less than ideal with glasses or soft contact lenses necessitating the use of rigid contact lenses.
 

Why does the ultraviolet light treatment time vary from clinic to clinic?

The original treatment protocol in Europe was the use of ultraviolet light for 30 minutes at an energy level of 3mw/cm2. This is the only treatment protocol that is currently FDA-approved in the US, but some practitioners use different treatment protocols.
 

CAN VISION BE IMPROVED WITH CXL?

Although the main goal of CXL is to stabilize the cornea, 60 percent of patients have a mild improvement in their vision. This is a result of the corneal surface becoming more regular after CXL.
 

CAN THE CORNEAL EPITHELIUM BE LEFT INTACT OR DOES IT HAVE TO BE REMOVED?

Clinical studies have shown that best results are obtained when the epithelium is removed prior to treatment. Early research on leaving the epithelium intact has been positive, but long-term results are still needed.
 

WHAT IS REQUIRED AFTER THE TREATMENT?

After CXL a soft bandage contact lens is worn for 5 to 7 days. This promotes healing of the corneal epithelium. An antibiotic drop and a steroid drop are used for 1 to 2 weeks after surgery. Artificial tears can be used as needed for comfort.
 

IS VISION BETTER IMMEDIATELY AFTER THE PROCEDURE?

Usually vision is slightly blurrier during the first month and then gradually improves. The blurred vision is related to the healing of the corneal epithelium.
 

HOW DO I KNOW IF THE TREATMENT IS SUCCESSFUL?

Repeat corneal mapping is performed to determine corneal stability or flattening. The mapping is typically performed at 3 to 6 months after treatment and then at regular intervals.
 

WHAT ARE THE POTENTIAL COMPLICATIONS?

The complication rate and risk of infection is extremely low with CXL. Occasionally the healing of the corneal epithelium is slow, which can delay the return of best vision.
 

WHEN CAN I START WEARING CONTACT LENSES?

Your physician will determine when you can begin wearing contact lenses. Average wait time is usually two weeks after the procedure. If you have never worn contact lenses or need a new fitting, consult with your ophthalmologist about how long to wait before having lenses fitted.
 

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The information available on this web site is provided for informational purposes only. This information is not intended to replace a medical consultation where a physician's judgment may advise you about specific disorders, conditions and or treatment options. We hope the information will be useful for you to become more educated about your health care decisions.