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   LASIK Laser Vision Correction by Robert Cykiert, M.D.
   New York's leader in LASIK & Laser Vision Correction

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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