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LASIK
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LASIK
Laser Vision Correction by Robert Cykiert, M.D.
New York's leader in LASIK
& Laser Vision Correction
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What is Laser Vision
Correction?
LVC
or Laser Refractive Surgery as it used to be called, is
a way to reshape or remold the surface of the cornea to
eliminate eye refractive errors such as nearsightedness
(myopia), farsightedness (hyperopia) and astigmatism. LVC
uses a cool Laser called an Excimer to accomplish this.
There is virtually no heat generated by this laser so that
other eye tissues are unaffected by it. The Excimer laser
is an extremely precise tool that was originally invented
by IBM in about 1980 to carve Silicon Chips for computers.
The laser was adapted for use on human corneal tissue in
the mid 1980’s and has been used on humans for over
eleven years internationally, and over seven years in the
USA. In essence the laser very precisely reshapes the cornea
to the power or prescription needed to correct the eye’s
refractive error. TOP
What is LASIK?
LASIK
is a technique which utilizes the incredibly precise, computer
controlled and physician operated Excimer Laser to reshape
the Cornea and change its curvature. This is done by the
Ophthalmologist first creating a small flap on the surface
of the cornea using a device known as a microkeratome. The
flap is gently folded back and the internal part of the
cornea is lasered an exact amount in order to eliminate
nearsightedness, farsightedness and astigmatism. The corneal
flap is then put back in proper position and adheres to
the rest of the cornea almost immediately. The entire LASIK
technique takes less than 5 minutes and is completely PAINLESS.
It is an office procedure which requires only eye drop numbing
anesthesia. No sedation is needed. There are no injections
given and there are no stitches used. The vision after LASIK
is improved immediately so that the patient can go home
within 15 minutes after the end of the procedure. There
is minimal or often no discomfort at all after LASIK. The
other incredible thing about LASIK, besides the fact that
it is very quick and painless, is that the vision often
recovers to 20/20, or near 20/20 within 24-48 hours! For
obvious reasons, LASIK has become extremely popular and
in 1998 it is estimated that the majority of Laser Vision
Correction (LVC) procedures performed in the USA were of
the LASIK type. In 1999 about 90% of all Laser Vision Correction
procedures in the USA were of the LASIK type. In 1999 approximately
1million Laser Vision Correction procedures were done in
the USA!
Time
magazine recently had an issue about LASIK and Laser Vision
Correction. The cover of the magazine was devoted to this
procedure. Click on Time to view the excellent graphics
detailing the LASIK procedure. TOP
Here
is a photo of Dr. Cykiert performing Laser Vision Correction:
What is the Cornea
of the eye?
The
Cornea is the most front part of the eye. It is transparent
and has a dome shape, similar to the top of a basketball.
It focuses light that enters into the eye. For those familiar
with contact lenses, the contacts sit on the surface of
the cornea. See the diagram below which shows a cross section
of the eye for details of eye anatomy. TOP
What are Nearsightedness,
Farsightedness and Astigmatism?
These
are conditions of the eye that are inherited in a complex
pattern from both parents, but sometimes generations may
be skipped so the inheritance pattern is not necessarily
predictable. There may also be some environmental factors
that contribute to them. In nearsightedness the corneal
curvature and focusing power does not match the size of
the eye, which is usually too long, and in farsightedness
the eye is too short. In astigmatism either the cornea or
other parts of the eye have an oval, rather than round shape,
thus the focusing of the cornea is distorted. Nearsightedness,
farsightedness and astigmatism are almost always correctable
with glasses and/or contact lenses. TOP
 
Is it necessary to
have Laser Vision Correction?
Do you
play tennis or golf? Do you drive a car? Do you swim, jog
or work out in a gym? Do you go to the movies, theater,
or watch TV? Do you wear glasses or contact lenses and find
that they get in the way of performing the activities above
or any other important activities that you participate in?
If the answer is "YES" to any of the questions
above then you have very good reason to consider having
LASIK or Laser Vision Correction. LVC is a completely elective
procedure, but for people who are unable to wear glasses
or contact lenses comfortably for professional, social or
convenience reasons, LVC is a perfect alternative and solution
to their problems. Many people consider contact lenses and
glasses to be a crutch or appliance that is usually very
helpful, but often is cumbersome and gets in the way of
certain work, recreational or social activities. If you
would like to wake up in the morning and see your alarm
clock, without first groping for your glasses, then Laser
Vision Correction is something you should consider. TOP
Are there other
operations available to correct vision?
Since
the late 1970s there was a procedure called Radial Keratotomy
(RK) which used a sharp diamond knife to make deep cuts
in the cornea to correct certain types of refractive errors.
In the last few years RK has become a thing of the past
since LVC is safer, more accurate, more predictable, more
reliable and has a greater range of Vision Correction.
In recent
months a new procedure using plastic inserts surgically
placed into the cornea has been approved. The implants,
known as Intacs, can correct small degrees of nearsightedness
(unlike LASIK which can correct large amounts of nearsightedness)
and cannot correct farsightedness and astigmatism. The results
thus far look very promising. TOP
Are LASIK and Laser
Vision Correction safe?
The
United States Food and Drug Administration (FDA), a very
conservative organization when it comes to approving new
drugs or devices for human use, approved the PRK technique
with the Excimer Laser for use on humans in 1995, after
an extensive three year long study, and evaluation of other
studies internationally. This indicates that LVC is safe
and effective. During the first year that the Excimer laser
was approved approximately 100,000 procedures were performed
in the USA. During the second year it was 200,000, and in
1998 approximately 450,000 procedures were done with this
laser. In 1999, close to a million Laser Vision Correction
procedures will be done in the USA, primarily using the
LASIK technique! Internationally, several million people
have had this procedure done in the last decade. Several
hundred Ophthalmologists in the USA and internationally
have had LVC performed on their own eyes with excellent
results. (I personally have performed LVC on colleague physicians
and surgeons, dentists, attorneys, engineers, architects,
airplane pilots, firemen and other people who depend on
excellent vision for their career and livelihood. Fortunately
I was blessed by not needing glasses to see. However if
I did need glasses I would not hesitate to have LVC done
on my eyes at this point in time). The FDA has approved
two Excimer lasers specifically for LASIK. TOP
What is the PRK
technique and how does it compare to LASIK?
The
procedure that was originally approved by the FDA is called
PRK. This technique reshapes just the surface of the cornea
to correct almost any type of refractive error of the eye.
The LASIK technique lasers the internal part of the cornea
after a small thin flap is created on the surface of the
cornea using a cutting device called a microkeratome. After
the laser procedure is completed the flap is put back in
place to cover the lasered area of the cornea. LASIK was
recently approved by the FDA for two different excimer lasers.
It is expected that all available lasers will be approved
for LASIK in the near future. TOP
What are the pros
and cons of LASIK vs. PRK?
LASIK
usually provides a much quicker recovery of vision to an
excellent level – usually within 12-24 hours in most
cases. Many patients have 20/20 or better vision the day
after LASIK. PRK may take 5-14 days to accomplish the same
level of vision. In the long term both procedures result
in similar excellent vision, but PRK is not as effective
in traeting higher degrees of nearsightedness. LASIK usually
causes no pain or discomfort at all, but a very small percentage
of people will have very mild scratchiness, tearing and
light sensitivity for 12-24 hours. PRK may cause moderate
to severe pain and discomfort for 24-48 hours only. LASIK
also works better for higher degrees of nearsightedness,
resulting in less chance of haziness or scarring of the
cornea. LASIK has a 6 year track record whereas PRK has
demonstrated its safety after almost a decade of use internationally.
LASIK requires creating a corneal flap with a microkeratome
device prior to actually lasering the cornea. This step
is painless, takes about 30 seconds to perform, and has
very low risk when performed by an experienced LASIK surgeon.
Your Ophthalmologist can discuss the pros and cons and benefits
and risks of PRK and LASIK with you, and help you decide
which one is best for your eyes. Most Ophthalmologists now
prefer LASIK. TOP
How good is the
vision after LASIK & Laser Vision Correction?
With
PRK the data shows that 98% of people achieve 20/40 or better
vision – which is good enough to pass a driver’s
test and drive without glasses. About 80% achieve perfect
20/20 vision. The results with LASIK are very similar, but
with LASIK the vision can recover to an almost perfect level
over night, whereas with PRK it can take days to weeks.
The results in people who have very high degrees of Refractive
Error may be somewhat less, but still excellent. There is
no guarantee that you won’t need any glasses after
LVC. Some people (a small percentage) still need glasses
for night time driving on dark roads or for other unusual
activities – but this is relatively rare. If you are
over 40-45 years of age, if you currently wear bifocals
or reading glasses, then you will need glasses for reading
and close work after LASIK and laser Vision Correction.
Everyone should wear sunglasses with UV block on sunny days
to protect the eyes from the harmful rays of the sun. TOP
Are LASIK and Laser
Vision Correction free of risk?
The
risks and complications from PRK or LASIK are generally
very rare and when they do occur are usually relatively
mild. You should discuss the details of risks and complications
with your Ophthalmologist prior to having LVC. You should
also be given some literature and consent forms prior to
LVC which also discuss these topics in detail and present
an opportunity for you to discuss the specifics of your
eyes with your surgeon. TOP
Does LASIK laser
Vision Correction hurt?
LVC
takes just a few minutes to do and there is minimal, or
in almost all cases no discomfort at all. Both PRK and LASIK
are office procedures that use only eye drop numbing anesthesia.
No sedation, injections or pills are required. Most people
can go home within 15-30 minutes of the end of the procedure
and return to their normal activities and work the next
day. PRK requires wearing a soft protective contact lens
for several days after the procedure to reduce the pain
and speed up the healing. LASIK does NOT require any contact
lens wear after the procedure since the corneal flap immediately
covers and protects the lasered part of the cornea and usually
prevents any pain. Swimming should be avoided for 1-2 weeks
in both PRK and LASIK. TOP
Does laser Vision
Correction weaken the eye?
Unlike
RK, which did permanently weaken the cornea and made it
more susceptible to serious injuries, neither LASIK nor
PRK do this, with extremely rare exceptions. Therefore LVC
can be performed on all professions with rare exceptions.
Many professional Baseball players, Hockey players, Football
players and Golfers have had LASIK Laser Vision Correction.
People who are very prone to direct eye injuries should
take special precautions after eye surgery. You should discuss
this with your Ophthalmologist. TOP
Can every one have
Laser Vision Correction?
There
are certain medical conditions and other eye conditions
that interfere with the safe healing of the cornea after
LVC. Your Ophthalmologist will evaluate you fully and will
make sure that you are a good candidate. LVC should also
be avoided in people under 18 years of age, in pregnant
or nursing mothers, and in anyone who demonstrates a frequently
changing eyeglass or contact lens prescription. TOP
Is LASIK Laser
Vision Correction expensive?
If you
figure out what you spend over the years in glasses, contact
lenses, and contact lens supplies, LVC is actually relatively
cheap. PRK and LASIK generally cost between $2000 to $2500
per eye. Unfortunately insurance companies do not cover
the cost of LVC since they consider it to be a non-essential
medical procedure similar to plastic surgery. However, most
employee flexible spending medical plans do allow payment
for LVC. TOP
Are you a candidate
for LASIK Laser Vision Correction?
If you
want to have LASIK or Laser Vision Correction you need to
have a thorough eye exam by Dr. Cykiert prior to having
the procedure performed. During this exam Dr. Cykiert will
take some very precise measurements of your Corneas and
Eyes. These measurements are then used to program the computer
that controls the Laser. In order to make sure that the
measurements are accurate you must not wear soft contact
lenses for at least 5 days prior to the exam. Hard or Gas
Permeable contact lenses must not be worn for at least 3
weeks prior to the exam. Contact our office by phone (212-922-1430),
fax (212-922-1436), or send an email to LaserDoc@LasikGo.com
to make an appointment, or for additional information.
If you are interested in having LASIK or Laser Vision Correction
but are not sure if you are a candidate, or if you would
like some additional information arrange for a convenient
FREE LASIK - Laser Vision Correction evaluation by calling
(212-922-1430), faxing (212-922-1436), or by sending an
email to LaserDoc@LasikGo.com TOP
What type of doctor
performs LASIK & Laser Vision Correction?
Only
Ophthalmologists, Eye MDs, are allowed and licensed to perform
surgery of the eye and Laser Vision Correction, LASIK and
PRK. Optometrists can evaluate you to determine if you are
a good candidate, but refer to an Ophthalmologist for performing
the procedure. Many Optometrists have been trained and are
qualified to perform the postoperative management of Laser
Vision Correction patients. Generally, Ophthalmologists
with subspecialty or fellowship training in Corneal Surgery
have a greater aptitude for performing LVC and managing
the postoperative care during the healing of the corneas.
This was mentioned in the Time magazine article as well.
However, many general Ophthalmologists perform LVC as well.
TOP
Does health insurance
pay for Laser Vision Correction?
Unfortunately,
Insurance companies and HMOs do not usually pay for LVC
because they consider it to be a non-essential medical treatment,
similar to cosmetic surgery. Most people pay for LVC using
checks or credit cards. Other financing plans are also readily
available. When considering the cost of LVC, keep in mind
that it is less expensive than what many people pay for
glasses and contact lenses in the long run. TOP
What is Dr. Cykiert's
experience with Laser Vision Correction?
He was
one of the first surgeons in New York to perform LVC when
it was approved by the FDA in 1995. Since then he has successfully
treated many happy and extremely satisfied patients including
physicians, surgeons, dentists, attorneys, architects, pilots
and other people who depend on their vision for their livelihood
and career. He has also trained many other Ophthalmologists
in LVC techniques over the last few years. Dr. Cykiert has
lectured on LVC procedures in several hospitals and Medical
Centers in the USA and Canada. Dr. Cykiert also has the
advantage of being a Fellowship trained Cornea Specialist
and Surgeon since 1981, thus being very comfortable and
used to performing surgery on the cornea. Dr. Cykiert also
is a consultant for other Ophthalmologists on Laser Vision
Correction issues. TOP
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