Frequently Asked Questions
Click on the questions below to view the answers:
I’m not sure I understand the difference between LASIK and ASA?
Both LASIK and ASA utilize an excimer laser to reshape the cornea. The laser is so precise that it takes several pulses of light to remove a single cell. In ASA, the laser is used on the surface of the eye, which requires a slightly longer healing time, with most patients able to drive in 24-48 hours. LASIK involves creating a thin flap of tissue, retracting the flap, and applying the laser underneath the flap. The flap is then replaced, and it adheres very quickly on its own. Discomfort with both procedures is typically mild.
What is Intralase LASIK?
Intralase LASIK involves the use of a femtosecond laser instead of a blade to create the corneal flap.
For additional info on Intralase LASIK vist: www.intralasefacts.com
What are the advantages of Intralase LASIK over Traditional LASIK?
In certain patients, the Intralase may provide an even more precise result with better vision and an increased margin of safety. Dry eye symptoms after surgery may be less significant with the Intralase as well. Not all patients are candidates for Intralase LASIK. In a research study of patients treated with one eye using Traditional LASIK, and the other eye using Intralase LASIK, patients stating a preference preferred the vision in their Intralase eye 3 to 1 over the Traditional LASIK eye. Which is best for you? Dr. Dell will provide a recommendation based upon the individual characteristics of your case.
Can Intralase LASIK be combined with Custom Wavefront Treatment?
Yes. In fact, Intralase combined with Custom Wavefront treatment has produced some of the best results ever achieved with laser vision correction. This combination of advanced technology is called iLASIK.
What is iLASIK?
iLASIK is a highly advanced, state-of-the-art form of laser vision correction. iLASIK specifically refers to using the IntraLase femtosecond laser to create the exquisite iLASIK flap combined with the Advanced CustomVue Wavefront-Guided excimer laser technology. This combination of two advanced technologies in iLASIK has produced some of the best results we’ve ever seen in laser vision correction.
I’m considering LASIK and ASA. How do I know which procedure is right for me?
Both LASIK and Advanced Surface Ablation (ASA) produce excellent results for most patients. LASIK offers the advantages of very rapid recovery of vision, minimal or no discomfort, and excellent accuracy. There are some patients who are better candidates for ASA however. Generally speaking, these are patients with very thin corneas, or corneas with certain types of surface abnormalities. Additionally, a few patients with very large pupils may also be better candidates for ASA, but this is determined on an individual basis. Some patients prefer the option of ASA simply because it produces results comparable to LASIK, but involves a completely blade-free approach to surgery. A complete eye exam with one of our doctors can identify the best options for you.
Dell Laser Consultants provides a very extensive pre-operative work-up, utilizing technologies unavailable at most laser clinics. Most clinics simply measure the curvature of the front surface of the eye. We use a sophisticated device called an Orbscan II to measure the front and back curvature and elevation of the cornea, as well as the thickness of every point on the cornea. We also perform advanced wavefront analysis of the entire optical power of the eye, from the front of the cornea all the way back to the retina. Next we perform a sophisticated infrared measurement of your maximum pupil size in near total darkness using the Procyon Pupillometer. These instruments help us customize the best treatment options for your individual situation.
For more information on our equipment please check out our technology section.
What is Custom-LASIK and Custom-ASA?
No two eyes are alike, and like your DNA or fingerprint, your vision is unique. For hundreds of years, glasses have been used to correct vision by eliminating one or more of the three basic elements of blurring; nearsightedness, farsightedness and astigmatism. However, advances in optics have demonstrated that these three basic elements are only part of the picture. There are tiny imperfections or distortions in every eye, even when the perfect glasses or contact prescription is used. To understand this further, imagine two people who visit the eye doctor and obtain exactly the same glasses prescription. Using standard laser correction, those two individuals would be treated with exactly the same laser treatment plan, despite the fact that their eyes each have a unique set of naturally occurring tiny imperfections and distortions. And while we have achieved excellent results by treating only these three basic elements (nearsightedness, farsightedness, and astigmatism), we can now offer even more.
Dell Laser Consultants offers the technological advantage of Custom wavefront-guided laser vision correction. Custom laser correction involves a diagnostic device that maps the entire optical path of your eye, including the tiny distortions and imperfections naturally present in all eyes. This is effectively a unique “fingerprint of your vision,” and provides us with extremely precise and detailed information about your vision. The technology involved is highly complex, and it is based upon mathematical techniques used to improve the performance and image quality of deep space telescopes. This customized unique map of your eye is then loaded into the computer of the excimer laser, which generates a wavefront customized treatment appropriate for the individual “fingerprint” of your eye.
Results of an FDA clinical trial of this technology demonstrated that an incredible 94% of patients treated were able to see 20/20 or better without glasses. Four times as many people in the trial were very satisfied with their night vision after LASIK, compared to their night vision before with glasses or contacts. These results are superior to those obtained with standard laser correction, and the dramatic improvement in night vision may be the greatest single advantage of Custom laser correction. Custom correction can be applied to both LASIK and Advanced Surface Ablation treatment.
You are probably already familiar with one application of wavefront-guided optical technology. In December 1993, Space Shuttle Mission STS-61 installed the COSTAR (Corrective Optics Space Telescope Axial Replacement) upgrade to the Hubble Space telescope to correct a spherical aberration in the lens system of the telescope. Spherical aberration is one of the main phenomena corrected by Custom wavefront guided laser correction.
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Is the surgery painful?
he surgical procedure itself is essentially painless. Most LASIK patients tell us they have no discomfort following the procedure, and they generally feel comfortable returning to work the following day. Advanced Surface Ablation patients are fitted with a temporary soft contact lens for a few days after the procedure, so they will typically describe a sensation of having the lens in their eyes. Some ASA patients schedule a day off from work on the day following surgery.
What will my vision be like the day after the surgery?
LASIK and Advanced Surface Ablation patients generally see well enough to pass the driver’s license examination on the first day after the surgery. Many are 20/20 only hours after their surgery, while others take a little longer to achieve that result. ASA patients typically recover a bit more slowly, although patients can usually drive in 24-48 hours. Some patients, particularly those who are older, will heal a bit more slowly.
What if I move or jerk or do something to create a problem during the actual surgical procedure?
This is probably one of the greatest concerns that many patients have when contemplating laser eye surgery. We understand that this procedure may be routine for us, but it is a life changing event for you. It is perfectly normal to be apprehensive. Our first goal is ensure that you are made comfortable before you enter the laser suite by giving you a sedative. During the actual treatment, many patients worry that they will move their eyes too much and cause a problem. All of the lasers that Dr. Dell uses are equipped with automated eye tracking devices. The laser is able to follow the movements of your eyes, and keep the treatment properly aligned, even if your eyes are in motion.
Will I have glare at night?
All LASIK patients will experience some degree of temporary night glare for about 6 weeks post-op. This is due to microscopic swelling in the flap which goes away. Many describe it as comparable to their vision at night with a soft contact lens. ASA patients can experience similar temporary glare as the surface of their eye heals. With Dr. Dell’s technique of measuring the pupil size in near total darkness using an automated infrared pupillometer, adjusting the excimer beam size to suit the pupil, and using sophisticated eye tracking technology, night vision complaints are very unusual. Many of our patients tell us that their night vision is superior after surgery to anything they had prior to surgery.
I’ve been told I have astigmatism. Can you treat that?
All of the lasers Dr. Dell uses are FDA approved to treat astigmatism, and astigmatism can be treated using either LASIK or Advanced Surface Ablation. Astigmatism correction generally adds only a few seconds to the overall treatment of the laser.
Can the laser treat farsightedness?
The FDA has approved the treatment of farsightedness, both with and without astigmatism. Dr. Dell conducted one of the original FDA trials for farsightedness correction with LASIK.
Do you treat both eyes at the same time?
Dr. Dell typically treats both eyes on the same day. Some patients elect to have their eyes treated on separate days for financial or other reasons.
Can I have LASIK if I have dry eyes?
Yes. Typically, we only treat patients with monovision (one eye for near, and one eye for distance) who have previously successfully worn monovision contact lenses. If appropriate, we will discuss this option with you at the time of your consultation.
Will the results of my laser surgery last?
Long term results have demonstrated that the treatments performed with the laser years ago are permanent; in fact some patients are now over ten years post-op with stable results. LASIK and ASA will not accelerate other aging changes in the eye such as cataract formation, or the development of presbyopia (the need for reading glasses). On the other hand, laser vision correction will not protect you from these natural aging changes in the eye. A yearly eye exam is still recommended following your laser treatment.
Why do you have so many different lasers when most clinics only have one?
If you ask most surgeons what the best laser in the world is, they may very well tell you that it is the laser they happen to own. Dr. Dell serves as a consultant to a number of different ophthalmic companies, and he is heavily involved in clinical research, physician education, and product development. Excimer lasers are incredibly expensive devices, with some costing several hundred thousand dollars each. His consulting relationships allow us access to many different lasers and other sophisticated technologies that would otherwise be impossible to obtain. In some cases, Dr. Dell has access to these technologies years before they are otherwise available. Each laser has its own subtle advantages, and Dr. Dell selects the best laser for each individual case. As a patient, you benefit from this incredibly wide array of treatment options.
For more information on our equipment please check out our technology section.
Why is it important to choose a good surgeon?
Laser vision correction is possible because of tremendous advances in medical technology; however the role of the surgeon is more critical than ever. While complication rates with laser vision correction are very low, Dr. Dell spends a good deal of his time providing second opinions for patients who have experienced complications related to laser surgery performed elsewhere. Very often it is possible to correct these problems, but these complex cases underscore the importance of selecting the right surgeon the first time. Eye doctors in Austin certainly know this, and more of them have selected Dr. Dell for their own surgery than any other surgeon.
Do you have financing plans?
Dell Laser Consultants offers a variety of financing plans, and we will work with you to develop a plan to meet your needs. All financial arrangements must be completed prior to the day of surgery.
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Does insurance cover laser vision correction?
Generally, health insurance does not cover laser vision correction; however, a few health plans provide a small contribution to the total cost of the procedure. We are happy to investigate this possibility for you. Many corporate cafeteria plans allow pre-tax dollars to be used toward laser vision correction.
Is laser vision correction tax deductible?
YES, a new ruling from the IRS allows many patients to deduct the cost of laser vision correction. See the IRS website for further details.
What is Refractive Lens Exchange?
Refractive Lens Exchange is a procedure that is essentially identical to the procedure used to treat cataracts. Patients who have some degree of cataract formation may actually benefit from having their cataracts removed as a method of eliminating their glasses prescriptions. The reason for this is that at the time of cataract removal, an implant lens can be placed which has the prescription power necessary to reduce or eliminate the need for glasses. The recovery period for this procedure is similar to LASIK; however, only one eye is treated at a time. This procedure is occasionally used for some younger patients with extremely high prescriptions, well outside the range of LASIK or ASA. During our evaluation of your eyes, we can determine if this option is appropriate for you.
What about pregnancy?
Although significant, permanent change is rare, a woman’s eyes can change during pregnancy. We recommend women planning motherhood wait a minimum of one month after laser vision correction before trying to conceive. Likewise, we recommend women who are pregnant or nursing, wait a minimum of three months after childbirth and/or the end of the nursing period before pursuing laser vision correction.