Yes! Morris Eye Group uses the VISX S4 eximer Laser with CustomVue™ Wavefront guided technology. Prior to the patient’s surgery the doctor will map the focusing errors of their eye with a WaveScan® using wavefront analysis. WaveScan® projects a pattern of light into the eye. The camera sensor pinpoints the location of tiny imperfections throughout the entire visual system by measuring the way light reflects through their individual eye. CustonVue™ LASIK/PRK then corrects for both general refractive errors and more complex higher order aberrations that are unique to each individual.
At Morris Eye Group, we take pride in the fact that we have our own VISX™ CustomVue™ Laser in our Encinitas office.
Morris Eye Group calibrates our VISX™ CustomVue™ Laser in between every single patient, as well as periodic random calibration tests when the laser is not being used to make sure everything is working properly. Furthermore, our doctors are the only ones to use the laser, so we know that it has been calibrated most recently and properly. Unfortunately, many facilities calibrate their laser in between every other patient, or even less often than that.
According to the FDA, there have been no reported cases of a patient going blind due to Laser Vision Correction. In fact, the risk of facing serious complications after surgery is less than 1%, and the risk of suffering from a less serious complication is 3%. It is also very rare for a patient’s vision to become worse after Laser Vision Correction surgery. Should that occur, the surgeon will inform the patient as to the best way to correct the problem.
YES! We offer several other options for patients who are not candidates for Laser Vision Correction. In addition to traditional glasses and contact lenses, we also offer the Implantable Contact Lens (ICL) for patients with extreme myopic (nearsightedness) prescriptions. If you have signs of cataracts, or are simply deemed not a candidate for Laser Vision Correction, you may also be a candidate for Refractive Lens Exchange (Smart Lens) which will correct your near, intermediate, and distance vision. Your physician will discuss all of your options during your consultation.
LASIK: You should be able to drive yourself to your first post-operative appointment the day after your procedure; however, if you do not feel comfortable driving or feel like your vision is not good enough to drive, have a friend or family member drive you to and from your visit.
PRK: You will need a driver for the first post-operative appointment, and depending on how quickly your eyes heal, you may need a driver for your second appointment as well.
Depending on the natural shape of the cornea and size of your eye, there is an intrinsic power or lens “prescription” that will focus light onto the most sensitive part of the visual system, the macula. Glasses and contact lenses work by changing this focus of light to correct for nearsightedness (myopia), farsightedness (hyperopia), and astigmatism. Your glasses prescription is your “refractive error”.
An ophthalmologist is a medical doctor. He or she attended four years of college, four years of medical school, four years of residency, and sometimes 1-2 more years of fellowship training.
An acronym standing for Laser-assisted in-situ keratomileusis, this is the laser eye surgery that people get to remove the need for glasses and contact lenses. It was first FDA approved in 1998, and has since undergone numerous revisions and generations of laser technology since. It is performed only by trained ophthalmologists. Two different types of lasers are used, sequentially, to sculpt your prescription onto the cornea (the clear,round, front-part of the eye). LASIK does NOT involve going INTO the eye, this is a surface treatment only. Step 1: A femtosecond laser is used to create a flap in the cornea Step 2: The surgeon folds the flap backwards, an Excimer laser sculpts your custom wavefront-guided treatment into the cornea, then the surgeon folds the flap back into its original place.
For many years the only way to perform the first step of LASIK was with a steel microkeratome blade. Although millions of patients around the world had successful LASIK with this technology, there were added risks to using the blade and a number of serious complications that we no longer see thanks to advancements in technology. How deep the blade cut was dependent on the level of suction power of the device on the eye, and the shape of the cornea. While surgery was highly reproducible in normal eyes, if you happened to have an unusually large or small eye, or an unusually steep or flat cornea, you could be at risk for free caps and buttonhole complications.
At Morris Eye Group, we have the latest in femtosecond laser technology. The laser allows the surgeon to make a flap that is customized to the unique shape and size of YOUR cornea, not the one-size-fits-all blade of the past. Each cornea flap is monitored by active OCT-guided imaging (ocular coherence tomography) so that the surgeon can safely identify and fix issues BEFORE they become complications.
This is arguably the single biggest advancement in LASIK surgery in the last 10+ years, although rarely appreciated. Our understanding of who is the best candidate for LASIK and who is the worst candidate has evolved with decades of peer-reviewed published clinical research. At Morris Eye Group our surgeons have the experience and training to identify the clinically-proven risk factors for post-LASIK complications, some of which don’t occur for 5-10 years after the surgery. This is why Morris Eye Group surgeons employ the power of the PENTACAM scheimpflug scanner, the most advanced method of detecting even the most subtle risk factors for post-LASIK ectasia complications. When choosing a LASIK center, you want a surgeon that not only has the experience and training to perform the surgery, but has the knowledge and technology to accurately determine if you are a good candidate.
Patients often tell us that although never formally evaluated for LASIK, their doctors recommended AGAINST it due to their “astigmatism.” Astigmatism has to do with the shape of the cornea, the front part of the eye. If it’s perfectly round like a basketball, you have no astigmatism. If it’s shaped like a football, you have astigmatism. But without being evaluated by a LASIK surgeon that keeps up with the technology and literature, you are doing yourself a disservice. In fact, LASIK is FDA approved for very high levels of astigmatism with fantastic results. You owe it to yourself to get a free consultation with a reputable surgeon before crossing it off your list.
Other broad requirements include being at least 18 years of age, not pregnant or nursing for greater than 3 months, and having a stable glasses or contact lens prescription for 1-2 years.
PRK (photorefractive keratectomy) is an excimer laser vision correction surgery that was FDA approved 1-2 years ahead of LASIK. The laser that sculpts your prescription into the cornea is the exact same laser as that used for LASIK. The endpoint visual results are essentially identical to that of LASIK.
There are several aspects of PRK that distinguish it from LASIK. In LASIK, a corneal flap is created and folded back while the excimer laser applies the wavefront guided treatment. The flap is then put back in place with rapid visual recovery. In PRK, there is no flap. The wavefront-guided excimer laser treatment is applied directly to the surface of the eye. The visual outcomes are essentially identical. The time to recovery is the big difference. The recovery with PRK is a little more uncomfortable, requiring a contact lens that remains on your eye for one week, and narcotics for the first 2 days. Visual rehabilitation takes on the order of weeks. Every week that goes by vision improves, with a majority of vision achieved at 3-4 weeks.
LASIK essentially took off as the “sexier” version of laser vision correction because of its rapid recovery and minimal discomfort. With LASIK, a majority of vision is achieved in the first 24 hours with very little discomfort.
PRK is typically reserved for those patients that don’t qualify for LASIK. Many people that don’t qualify for LASIK can safely have PRK. But that isn’t a blanket statement. There are certain PRK treatments that actually have increased risk for scarring and other complications. Some surgeons only offer PRK because it’s a safe alternative to LASIK without the need for the surgeon to purchase an additional $200,000-$400,000 laser that requires regular factory maintenance. But again, when faced with the choice, most patients tend to choose the quick recovery and minimal discomfort seen with LASIK.
Patients that engage in mixed-martial arts (MMA) fighting or athletes with significant physical contact with other athletes, like Rugby players and wrestlers, are more likely to choose PRK because there is no concern about a flap being dislodged with trauma directly to the eye. There are certain divisions of our armed services (Army, Navy, Air Force) that have restrictions on LASIK (special forces/aviation/HALO units).
Morris Eye Group have the latest technologies at their disposal and are pleased to offer both procedures for their patients, because the needs of every patient are unique.
Both surgeries take about 5-6 minutes per eye. It tends to take more time to get you set up, cleaned, and prepped for surgery than it does to actually perform the treatment!
During the first part of the LASIK procedure, the flap-making process, you may feel a pressure sensation on your eye. You can simulate the sensation by closing your eyelids and pushing on your eye slightly. It lasts about 30 seconds and you’re done with the hardest part! You certainly won’t feel any sharp pain. The rest of the procedure is painless and is over within minutes. And to help take the edge off, most of our patients elect to take Valium.
Some patients with high prescriptions start to see even immediately after the procedure! Typically, though, the eye tends to be a little irritated and sensitive to light the first 4 hours after surgery. This is why we tell patients to go home and take a nap. After this period of time, most patients feel significantly better. While a far majority of patients that undergo custom wavefront-guided LASIK can see 20/20 or better by the next day, it may be a little blurry or foggy. You have functional vision though, and 99% of nearsighted patients can drive, return to work the next day, and resume activities of daily living. The total stabilization period of vision for anyone undergoing laser vision correction anywhere in the world is 3-6 months.
None of your post-op visits in the first year require out of pocket expenses to be seen. You are seen 1 day, 1 week, 1 month, 3 months, and 6 months after the day of your surgery. At Morris Eye Group, your surgeon will take the time to see you himself before eventually having other doctors assist in your postoperative care. This is unique to our center, as many laser centers in town designate your postoperative care to a doctor that was never involved in the treatment process. Every eye heals differently and it’s our belief that only a trained, experienced surgeon should see you in the first month after your surgery.
Your follow-up at our center is important to us not only to monitor your progress, but because your surgical results are logged and used to adjust nomograms at our center for future treatments. Ensuring the best visual outcomes have been critical to our success.
Any subsequent laser vision correction surgery that occurs after your initial surgery, even years later, is referred to as an “enhancement.” It’s called an enhancement and not a “re-treatment” because the residual refractive error needing correction, if at all, is very tiny. It is difficult to predict who will need an enhancement in their lifetime. This not only depends on the unique way you heal, but also on the size of your initial treatment and on your age at the time of the treatment. There are natural changes to the inner-workings of the eye as we age that isn’t impacted by the LASIK procedure. Many treatments last well over a decade, and even with a little regression 10-15 years later, many patients don’t want the enhancement because they appreciate the near vision that they’ve regained. In fact, most patients needing enhancements after 10 years or more typically only want one eye sharpened up (see monovision discussion below).
At Morris Eye Group, we offer patients lifetime enhancements free of charge (exclusions apply). This way you won’t have to roll the dice and concern yourself with whether your surgery will last 20 days or 20 years. Rest assured that when you get your LASIK at Morris Eye Group you will remain a part of our LASIK family forever.
LASIK is extremely safe. If was first approved by the FDA in 1998 only after having been performed outside the U.S. for many years prior. The FDA process is extremely stringent and painstaking, designed to ensure only the safest procedures are performed here. There are numerous organizations that call for a less stringent process, however, because the current process keeps new technologies and drugs from entering our markets until many years after global penetration. That said, LASIK has passed all benchmarks for safety and is far safer today than it was over 10 years ago. In fact, you have a higher lifetime risk of death as a passenger in a car accident or death by a firearm than you do to lose at least one line of best corrected visual acuity.
A study out of the Oregon Health Sciences University (OHSU) found that LASIK is safer than wearing contact lenses. Contact lens wearers have a 30-year risk of bacterial keratitis (a corneal infection) of 1 out of 100, and a 1 out of 1000 risk of developing an Acanthamoeba infection. Either of these infections can result in devastating visual loss or total blindness.
The lasers are actively tracking your eye’s micro-movements. If your head moves or you cough/sneeze, the laser stops immediately. Not a single pulse of energy is emitted unless the eye is in the proper position.
Yes. Most patients prefer to get both eyes done on the same day so the time spent away from work is minimized. But we are happy to customize treatments to your schedule.
We are born with an incredible ability to control the muscles within the eye giving many the ability to see both distance and near. This is called your ‘accommodative amplitude’. We actually lose a little every single year of life, but you hit a critical threshold in your mid 40s to early 50s. You will know that you crossed this threshold when putting in your contact lenses or throwing on your prescription sunglasses gives you excellent distance vision, but suddenly you can no longer read text messages on your cell phone! Congratulations, you are now a “presbyope”. Correcting both of your eyes for distance with LASIK will give you fantastic distance vision, but depending on your age and the status of your muscles, you will likely need over-the-counter readers to help for up-close reading. Your surgeon will review the surgical options with you, because the needs of every patient are unique. You will either be corrected for distance in both of your eyes, get a Blended Monovision treatment (see below), or you may be a candidate for a near vision Raindrop Corneal Inlay. Dr. Lee Katzman is the first surgeon in all of San Diego to implant the Raindrop Inlay, which gives you the ability to see both distance AND near vision in the same eye.
Monovision is a term used to describe the phenomenon where one eye is targeted for clear distance vision while the other eye is targeted for good near vision. It is based off of the science of ocular dominance, where one eye is actually preferred over the other due to neuro-development. No different than preferring one arm/hand or leg over the other, most of us are born with a preference for ONE eye over another. Think about which eye you would use to take a picture through a disposable camera (not a digital camera where you look at the screen in front of both eyes). The eye you chose is almost always your dominant eye. THIS is the eye that must have great quality distance vision for you to be happy. The other eye is then made good for near vision at the slight expense of its distance quality.
This is not a solution for everyone, but millions of Americans over 45 are walking around today with monovision whether they were born with it, they’re prescribed it by their optometrist, or their surgeon planned it with cataract surgery. You may be very surprised to learn that your current contact lenses are giving you a mini-monovision! Optometrists and Ophthalmologists prescribe contact lenses with this phenomenon in mind for all patients over 40, even if the patients don’t realize this is occurring. That’s why we always ask you if you are happy with your contact lens prescription! We want to make sure you are getting good enough quality distance without losing too much near vision.
Your LASIK surgeon at Morris Eye Group will go over the options and help you decide which treatment is best for your lifestyle.
Because LASIK is considered an elective surgery, you are unlikely to find a plan that will pay for your surgery in its entirety. There are some insurances that offer discounts towards LASIK that we honor, so don’t forget to bring your insurance information to your initial consultation. On occasion we find some companies offering certain LASIK insurance coverage as a perk for employment at their place of business, but it is rare.
The most common side effects are usually temporary and short lived. Dryness of the eyes, sensitivity to light and halos/glare at night. Most patients that get dry eyes, which is a minority, typically respond very well to additional drop therapy and resolve after three months. Close to 99% of patients get full resolution of dry eyes at 6 months, and this is corroborated in the literature. I treat dry eyes aggressively in all of my patients whether they are at risk or not, which keeps symptoms at a minimum and vision clear.
New glare and halos at night typically resolve at 30 days after your procedure. It is important to realize that some visual symptoms at night can be noticed even before your surgery. If you experience these visual phenomena at night in your contacts or glasses, you may still experience this after surgery. These “aberrations” are likely something you were born with. Your Custom All-Laser Bladeless LASIK at Morris Eye Group works to minimize these aberrations with cutting edge technology, and many people report better night vision than when in contact lenses. A recent large scale study by Frank Price, M.D. confirmed these findings. A recent FDA study on LASIK also confirmed that the visual disturbances many experience before surgery are reduced. You can ask your surgeon for more details about these studies and to discuss your risks for the above mentioned side effects and others, including over- and under-corrections which are highly dependent on the size of your particular treatment.
Please visit our LASIK Steps page for the details.