PRK / LASIK ~ LASIK, PRK, laser vision correction, eye care, hyperopia - farsightedness, myopia - nearsightedness, astigmatism and excimer laser information.

THE LASER VISION CORRECTION (LVC) EXPERIENCE

Before the procedure:

Before you proceed with laser vision correction, you must have an initial exam with one of the Doctors at Grendahl Eye Associates.

The primary objective of this exam is to determine whether you are a candidate for laser vision correction, and if so, which procedure would be most appropriate for you. If you schedule an exam, there is no obligation to move forward with the procedure.

In general, to be a candidate for laser vision correction you should:

Be at least 18 years of age or older
Have stable vision for a year prior to the procedure
Be free of certain diseases of the cornea and retina
Be in good general health

Aside from these general requirements, we recommend you have a number of visual tests to determine whether you are a candidate.

It is important for you to realize that even if it is determined that you are not a candidate today, it does not mean that you will not be a candidate in the future. However, laser vision correction is not for everyone, and some patients (for example, those with certain diseases of the eye involving the cornea or retina) will never be candidates. The best way for you to find this out is by having a thorough examination with one of the surgeons at Grendahl Eye Associates or with your family eye doctor, the optometrist.

A thorough eye exam includes: visual acuity, a refraction to determine your refractive error (this is what we use to base our treatment with the laser on), eye muscle movement and balance testing, pupil tests, visual fields, and a dilated eye exam. The eye exam includes microscope evaluation of external and internal eye structures for cataracts, cornea disease, retina disease, and glaucoma. In addition, two different corneal topography machines are used to give us a full computer analysis of the front and back curvatures of the cornea. The Orbscan also measures the thickness of the cornea and gives true elevation information used in the surgical planning for the LASIK procedure. Most doctors use the older placedo disk technology, however we feel it is imperative that we use the scanning slit technology as well. Our Orbscan unit is the only one in the State of Alaska. Both computer analysis units create a map of the surface of your eye. Over 6,000 separate points on the eyes are measured. These two corneal topography units help us sort out which people should not have laser vision correction and who should not have LASIK.

Please plan approximately two to three hours for your eye exam, which will include dilation, patient education, and counseling. Some patients may require longer visits and/or follow-up appointments.

The eye health exams include pupil dilation, which allow the doctor a full view of your internal eye structures. In most cases, strong dilation drops are used which temporarily blur your near vision (2-3 days). During the dilation process we use a drop called Cyclogel. It temporarily paralysis your ciliary muscle making it blurry for you to read, we then perform a cycloplegic refraction. This is done for the purpose of detecting over minusing. This test helps prevent over corrections after laser vision correction. Length of dilation varies between patients depending on individual body chemistry and sensitivity. Distance driving vision is rarely altered, but there are some exceptions. Dilation temporarily prevents pupil constriction; thus, it is normal to experience light sensitivity. Sunglasses are provided to make your drive home more comfortable.

What to bring to your initial exam:

Prescription glasses
Prescription sunglasses
Please DON'T wear your soft contacts for two weeks prior to the exam.
Don't wear hard or gas-permeable lenses for four weeks prior to the exam.
List of all medications
List of medical and general allergies
Records from your previous eye doctors. (Old prescriptions)
Working distance measurements for custom glasses (i.e. computer, crafts, piano)
Insurance information

All of your important follow-up care can be provided by one of the surgeons at Grendahl Eye Associates or by your optometrist. Co-management is when you choose to have your follow-up care done by your optometrist.

Your optometric physicians role is to:

Educate you about the laser and your other vision correction alternatives
Provide your post-procedure follow-up care (when or if you can't come to Grendahl Eye Associates directly)
Prescribe glasses or contact lenses for any visual problems not treated (e.g. reading glasses for presbyopia), or those needed between treatments
Monitor the health of your eyes, on an ongoing basis

We will work very closely with your co-managing eye doctor to provide you with the highest level of care and results.

Our continuing education offers Grendahl Eye Associates affiliated co-managing optometrists a complete patient-care training program for the pre and post-procedure stages. This program is among the most extensive and practical in the field. We will follow your progress through every stage of your procedure by maintaining ongoing communication with your co-managing eye doctor.

The secondary objective of the consultation is to educate you regarding all aspects of laser vision correction.

Learning everything you can about your options is the key to making an informed decision. The consultation process will help you to understand what you can reasonably expect from the procedure.

If you are a nearsighted laser candidate, then monovision may be for you. Monovision is a technique in which your Grendahl Eye Associates surgeon fully treats one of your eyes, usually your dominant eye, for distance vision. The surgeon then either undercorrects your non-dominant eye, or does not treat it at all (if it is only mildly nearsighted). This leaves the eye slightly myopic for improved reading vision. Monovision lets you maintain your reading vision in one eye, which may help you to avoid reading glasses once you develop presbyopia. As always, you must give up a little distance sharpness to gain this near vision. During your consultation, you can discuss this option with one of the surgeons at Grendahl Eye Associates or your optometrist and, together, you can decide what the best choice is for you.

What Happens on the Day of the Procedure?

On the day of your procedure, you should arrive at the Alaska Surgery Center as rested and relaxed as possible, and should allot approximately four hours for the entire process. You will go through a complete preparation process including a medical history, counseling, and the administration of mild eye drops. After this, you will enter the Laser Suite for treatment, which will only last 15-20 minutes for PRK and 20-40 minutes for LASIK.

The most natural response prior to your procedure is a mixture of both eager anticipation and nervousness. Most laser patients describe similar feelings before their procedure, so be reassured this is extremely normal. In fact, Some patients are even more nervous with their second eye, for fear that it will not work out as well as their first eye did. The nurses, technicians, and surgeon will talk your through the entire procedure. A nurse will be at your side holding your hand and reassuring you.

Your GEA Surgeon's Role

All GEA surgeons have been extensively educated in all aspects of laser vision correction by completing a hands-on training and certification program offered by GEA and VISX. GEA and VISX's training program prepares each doctor for performing laser vision correction procedures safely and effectively. The information from your eye exam is used to program the state-of-the-art computer software, which calculates the required corneal change and then helps the laser make this change. Your GEA surgeon programs and operates the laser, maintaining control throughout your procedure.

Both the LASIK and PRK procedures are very laser dependent. We have chosen the VISX Star S-4 Excimer Laser to use on your eyes. This is the best laser available in the U.S. today. The LASIK procedure is very surgeon and microkeratome dependent. We have chosen the most advanced microkeratome on the market in the U.S. today. We use the Moria Barraquer-Carriazo and the Chiron ACR. The bottom line is know your surgeon and know the laser. Both are equally important and critical to the successful outcome of your laser procedure.

Our primary objective is to provide you with the most advanced technology available to achieve the best results in the safest way.

After the Procedure

Once your procedure is complete you will be able to go home almost immediately to rest. Additional drops will be placed in your eyes and medication may be given to you to use over the next few days.

If you have PRK, a bandage contact lens will typically be placed in your eye. It is a very thin, clear lens which along with the eye drops used dramatically reduces any discomfort you may feel following the procedure. Even if you have never used contact lenses before, do not be concerned, as our staff will insert and remove the lens for you.

If you have LASIK, you will not receive a contact lens, but rather an eye shield that will be placed over your eye. You should use the shield for the first day to protect your eye while you are sleeping or as directed by your doctor.

You will typically notice dramatic visual results within the first few days following the procedure. By the end of the third day, you will usually be able to resume all or your regular activities.

It is important for you to remember the following during this period:

We recommend that you rest as much as possible following your procedure as sleep helps to speed up your recovery tremendously.
You may find that placing a cold compress over your eyes while resting is very comfortable and soothing.
You should avoid swimming, hot tubs, or whirlpools for one week.
Showers and baths are fine, but try to keep your eyes closed in the shower and avoid getting water and shampoo in your eyes for the first few days.
We recommend you avoid eye makeup, gardening and dusty, dirty environments for one week. Smoking is allowed, but you may find that smoke will be quite irritating.
Watching TV and reading will strain and irritate you eyes for a few days. These activities should be done in moderation.
We recommend that you avoid driving for the first five days following PRK, and two to three days following LASIK. You may experience blurred vision and the loss of depth perception. Your eye doctor will let you know when you are able to safely resume driving.
If you are planning to have both your eyes treated on the same day, we recommend you allow four to five days recovery following your PRK procedure, and two to three days recovery for the LASIK procedure.

If you follow these guidelines, your post-procedure healing should be smooth and trouble-free, and you should expect to enjoy improved vision shortly following your procedure.

It is important for you to understand that follow-up care is as important to your results as the actual procedure. This follow-up care will be provided by your surgeon or your optometrist.

Laser Vision Correction will reduce your dependence on glasses and contact lenses, the degree of improvement may vary from individual to individual. Results cannot always be predicted and can never be guaranteed. We tell people they will be 20/happy.

At GEA, we recognize that all patients are unique. Each starts off with a particular prescription, a unique healing profile, and personal expectations for the procedure. It takes experience with many patients to effectively plan and forecast the visual results, as well as to counsel patients about what they can expect.

Overwhelming majorities of our patients tell us about the dramatic impact the procedure has had on their lives, enabling them to enjoy everyday activities in a way they could not before laser vision correction.

Meeting your expectations is our most important measure of success.