ANSWERS
 

Does the surgery hurt?

The procedure is done under topical anesthesia so the patient does not feelanything during the procedure. The only slight discomfort that may be felt is from the lid speculum which keeps the eye open and stops you from blinking since the lids cannot be anesthetized. It is also common for patients to feel a pressure sensation while creating the flap with the
microkeratome.

Can I go blind from the procedure?

We are not aware of any patients that have ever gone blind from the procedure and certainly none of our patients have gone blind from any refractive procedure we have ever performed.

What is the worst possible complication?

A serious infection with an ulcer in the center of the vision. This will only normally happen to patients who do not follow their instructions and are not compulsive about seeing their doctor after surgery. Most infections when caught early are easily treated with minimal consequences. In the case of a permanent central scar, a cornea transplant can be performed to restore
vision. Dr. Rabinowitz is a very accomplished Corneal Transplant surgeon and has demonstrated an excellent success rate with this procedure. We have never had to perform a cornea transplant on any of our refractive patients in the past 10 years since commencing practice.

What kind of vision can I expect from the procedure?

The results are variable and is different for each person. However, based on all the LASIK procedures done to date at our institute, the results are as follows:

100% - 20/40 or better
95% -   20/30 or better
85%     20/25 or better
75%     20/20

The lower your correction and the less astigmatism you have the better chance you have of achieving a better result.

Are there any negative long term effects?

Eye laser surgery has been around for 10 years and lamellar surgery i.e cutting a flap has been around for 35 years. We can only speak for the future by assessing data from the past. All data to date demonstrates a very positive healing response and after healing the eyes with lamellar surgery have not shown us any negative effects giving us confidence that the eye will be healthy in the future following lamellar laser refractive surgery

What are the risks and side effects of LASIK?

For detailed information about all the risks and side effects please read the consent form prior to surgery.

In general the risks involve:

1. creating a free cap, this has not happened at all with the new Chiron Hansatome at our Institute since there is a mechanism to safeguard against this, this may however occur more commonly with the Automatic Corneal Shaper(ACS) which creates the nasal flap. 
2. Mechanical failure of the keratome- if this occurs the case is aborted and the procedure rescheduled 8-12 weeks down the road with almost no long term consequences.
3. Infections - these are extremely rare and may be controlled with medication. 
4. Dislocating the flap - this also occurs rarely with the
Hansatome, but if it does occur the flap can easily be repositioned in place usually with minimal consequences if the patient sees the doctor early enough. 
5. Growth of epithelial tissue under the flap - this can be treated
by lifting the flap and removing the epithelial tissue.

Side effects which occur more commonly, include:

1. Increased sensitivity to light. This is only for the first couple of days and then resolves. 
2. Glare mainly at night this resolves in over 90% of patients within the first couple of months.
3. Fluctuation in vision - this tends to stabilize within 2
to 6 weeks 4. Under or overcorrection - this can usually easily be fixed at 8 weeks with a "touch up' or "enhancement".

What are enhancements(touch ups)?

At 8 weeks after your procedure your vision will either be spot on or a little under or over corrected. This can be fixed or tuned up with a simple procedure called an enhancement or touch up. This is a minor laser procedure to correct your residual refractive error and takes only a fraction of the time of the original procedure. The doctor does not normally charge you for this but there may be a small facility fee.

How do I know I have chosen the best Laser Center?

Reputable institutions normally have excellent quality control and will not expose any patient to a risky Laser. Firstly you should inquire whether the Laser that is being used is FDA approved? Has the center or the Doctor ever used a non FDA approved Laser? Has the center been involved in any
investigative trials to improve the procedure?  Fortunately Laser Eye Associates, Cedars-Sinai Medical Center, Mark Goodson Building meets all these criteria, they have only used FDA approved lasers, they have the best state of the art laser and software available and they have been involved in over half a dozen clinical trials since 1990 to perfect laservision correction.
Currently we have the VISX Star S2 with the seven beam smoothing software as well as the Autonomous Techonologies Laser that tracks the eye like a radar(LADARVISION).

How do I know I have chosen the best Doctor?

Often the best source of referral is from a friend who has had a good experience with the doctor. There are other factors that are important as well. It is important that the doctor has had a lot of experience and does a regular number of cases a week. While he does not have to be a factory, doing 10 or more cases a week allows him to keep his skills honed. If the doctor is a cornea specialist he will normally have an edge since lamellar surgery is corneal surgery and a fellowship trained corneal surgeon will have seen in his one year of training what the average eye doctor sees in 30 years of practice. Lastly does the doctor do research and is he academically oriented, such doctors tend be more conservative and less driven by financial incentives to perform surgery. Ask the doctor for his curriculum vitae? Ask him for a referral of a patient he has performed surgery and also ask him if he has ever been sued by a patient who has had refractive surgery?

Dr.Rabinowitz's curriculum vitae is available on this website, he was one of the first doctors to perform the new down-up LASIK procedure and performs approximately 20 of these a week. He has never been sued in 10 years of practice and there are large lists of patients available who have had the procedure and who would be happy to provide testimonials.

How long will the correction last?

Probably for the rest of your life. The cornea is a very stable tissue. Medical experience shows that once the cornea has been modified, it tends to stay modified permanently. There are rare cases of regression, which may be corrected with further surgery, but the vast majority of corrected eyes continue to stay in focus.

What happens to my reading vision after surgery?

This depends on your age. If you are under age 45 your reading vision will not be affected. If you are over 45 you will need glasses for reading, if you have your distance vision fully corrected. The only alternative to not needing reading glasses is monovision.

What is monovision?

With this procedure the dominant eye is corrected fully for distance and the non dominant eye is corrected for near. This works extremely well for most patients in that when they look in the distance the brain ignores the near eye and when they read the brain ignores the distance eye. The advantage of monovision is that you will not need reading glasses for 5 to 10 years. The
disadvantages are that there is some slight loss of depth perception and some people have may still need glasses for night driving only. If you are interested in this ask your doctor to demonstrate it to you with glasses prior to surgery.

When can I drive?

You need 20/40 vision for driving. Most patients can drive the next day if the surgery goes well.

When can I return to work?

Depending on the kind of work they do most patients can return the next day.

How long will I stay on drops?

Approximately 6 weeks.

How often do I see the doctor after the surgery?

The next day, at 1 week then at 6 weeks and 6 months if necessary.

If I need to, can I wear contacts after LASIK?

Depending on the condition of their eye most people can still wear contacts after LASIK if they so desire.

Have any eye doctors had LASIK?

Many eye doctors throughout the world are having LASIK performed on their own eyes everyday. Dr. Rabinowitz is one of the few eye doctors to have performed LASIK on other eye doctors. He is fortunate in that he has been blessed with excellent vision and has not had to have the procedure done on
himself,  but he has done it on virtually all the staff in his office
including the eye doctors who work for him. If you visit his office, ask them about it. 

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