LASIK is a remarkable advancement in refractive surgery for nearsightedness, astigmatism, and farsightedness. LASIK vision correction evolved from a long line of refractive surgical procedures and combines the precision of two established procedures that have long been performed by ophthalmic surgeons:
The creation of a corneal flap by a procedure known as keratomileusis.
The use of an excimer laser to precisely reshape the corneal tissue beneath the flap. This enables light rays to be more accurately focused on the retina at the back of the eye, thereby improving vision. The flap is then returned to its original position.
It is the first and only system that combines both corneal topography measurements and wavefront analysis. This enables us to obtain the most accurate assessment of your visual system, which Dr. Mandel utilizes to customize your surgical treatment.
Mandel Vision is the only practice in NYC to offer this exciting new technology. Click here to read more.
There is a new player in the refractive surgery world called SMILE. If LASIK and PRK were not available, it would be a fantastic option. However, as usual for any new procedure, there is hype and then the reality.
So, why are LASIK and PRK still favored over SMILE?
It begins with how you correct the prescription on the cornea. The correction with LASIK and PRK is achieved with an excimer laser, whereas a femtosecond laser is used for the SMILE procedure. Simply put, the excimer laser is more precise because it utilizes customized wavefront technology integrated with topographical analysis, something SMILE and the femtosecond laser cannot do. Dr. Mandel uses the iDesign Refractive Studio, which is the only system with this proprietary technology. In addition, patients see better sooner with LASIK than with SMILE.
At Mandel Vision, we always keep our eye on all new developments in laser vision correction. However, for now and the foreseeable future, LASIK and PRK are still your state-of-the-art options in refractive surgery.
Imagine if you were in need of surgery in any other place in your body. Say, for instance it was your heart. Would you say “It doesn’t matter which surgeon performs my procedure, as all cardiac surgeons are the same.” Of course not. LASIK and PRK laser vision correction are both surgeon-dependent procedures. The best equipment does not produce optimal results in just anyone’s hands. The skill of the surgeon, during both LASIK and PRK, is just one of the factors in optimizing results. Choosing what prescription or wavefront aberration to choose, and how to customize it, are critical components in achieving optimal results. This is also surgeon-dependant and requires experience and attention to detail. Proper medication choices post operatively, especially with PRK, are essential for optimization. You want to make sure that your surgeon not only personally evaluates, examines you and performs your procedure, but also does most, if not all, of your post-operative care. Click here to learn some important factors in choosing a LASIK surgeon.
A thorough eye examination is performed to assess the health of the eye. The corneal contour and thickness are precisely measured in order to rule out any unseen abnormalities. New York LASIK surgeon Dr. Eric Mandel personally answers all of your questions and reviews all of your options. The results of this evaluation will help Dr. Mandel customize the treatment for your specific procedure. Schedule a consultation with our New York LASIK practice to find out if you are a good candidate for LASIK surgery or another vision correction procedure.
Wavefront Technology is one of the most revolutionary advancements used to analyze your eyes. This technology can now create a unique fingerprint of your eye’s unique visual aberration. Wavefront sensors measure thousands of light rays from your eyes to detect changes that were never seen before. It is used as a diagnostic and therapeutic tool to enhance our abilities to measure your eyes with an accuracy that was previously unattainable. Learn more about wavefront technology here.
Being scared is a NORMAL response to having an elective procedure performed upon your eyes. But be assured, at Mandel Vision we turn many patients away who are not appropriate candidates for laser vision correction. So, if you are selected as a good candidate, you can feel confident that we have carefully reviewed all of your diagnostic tests. Discomfort during either PRK or LASIK is usually not significant. Most patients report a “pressure” feeling during the procedure, rather than pain. The vast majority of our patients only require numbing drops to perform the procedure. For those patients that need a little help relaxing, valium is an option. The most important criteria to allay your fears should be the experience of your surgeon.
The only choice that has no risk is wearing glasses. Soft contact lenses have risks including a permanent decrease in vision. Click here to learn more about soft contact lenses and your eye health in our LASIK blog: Eyes on a Clearer World.
The short answer is yes. However, due to the fast nature of the procedure – it typically lasts less than 5 minutes per eye – most patients do not need to take valium, so we don’t stock it in the office. So, if you think you’ll need a little extra help to relax on the day of your surgery, and our relaxation room equipped with massage chairs isn’t enough to do the trick, just ask us ahead of time and we’ll be happy to e-prescribe valium to the pharmacy of your choice. We just ask that you don’t take it prior to your arrival. Instead, bring it with you on surgery day and we’ll tell you when you can take it. There are some measurements that we repeat on the day of surgery and we want to complete those tests BEFORE you take your valium.
LASIK surgery lasts less than five minutes per eye.
We recommend not wearing eye makeup for 1 week after LASIK surgery. During the first week we ask our patients to avoid makeup which can harbor irritants and bacteria, and also so that the eyes aren’t traumatized during the first week healing period. After one week eye make-up can be applied, but we instruct our patients on how to remove the make-up to avoid irritating their eyes.
There are no restrictions regarding air travel after LASIK. Once you’ve completed your 1 day post-operative check-up with Dr. Mandel, you’re free to fly right away. Since airplanes are particularly dry environments, it’s recommended that you increase the use of (preservative-free) lubricating drops to every 20-30 minutes during your flight. This can help keep your eyes more comfortable.
- Rapid recovery
- Both eyes can be safely treated at the same time
- Much less discomfort than with older/other refractive procedures
- Better anatomical location
Results vary according to the surgeon performing the laser eye surgery. Under the care of Manhattan LASIK surgeon, Dr. Mandel, over 95% percent of patients achieve eyesight within one line of 20/20 and at least 99 percent of patients are able to pass a driving test without glasses or contact lenses.
In the hands of a skilled LASIK surgeon who has performed thousands of procedures, LASIK is a very safe procedure. To learn more, contact our Manhattan LASIK center in New York to schedule your LASIK vision correction consultation.
The VISX® Star S4 laser is FDA approved to treat nearsightedness, farsightedness and astigmatism. New York LASIK expert Eric Mandel, M.D. has extensive experience using the VISX® Star S4 Laser System.
Generally patients will see better, albeit blurry, immediately following the LASIK surgery. More than 99 percent of our nearsighted patients are able to drive, return to work, and resume most of their normal daily activities the very next day. *If you choose Monovision LASIK, Dr. Mandel recommends driving glasses for the first year.
Read more about what to expect after LASIK surgery in our blog post: What Can I Expect After My LASIK Eye Surgery at Mandel Vision?
Just about everyone who sees distance clearly out of each eye, will need reading glasses starting as early as 40 years of age. Most people will need some reading help between 42-46 years of age. This happens in patients whether they require distance glasses or not, and with or without LASIK or PRK laser vision correction. This is a natural, aging process called presbyopia. When this develops, if you wear glasses, you usually need bifocals or a progressive reading lens. If you wear contact lenses, you will need to wear reading glasses over your contact lenses. You can also consider bifocal contact lenses or monovision, where one eye is focused for distance and the other for reading. LASIK and PRK laser vision correction does not bring on presbyopia (the need for reading glasses). This happens naturally with age. However, if a nearsighted (myopic) individual, who is over age 40, chooses to have both eyes corrected fully for distance, they will no longer be able to see up close without their glasses, as they are not nearsighted anymore. Therefore, reading glasses will be needed, starting at some point in their 40’s. One option to minimize the need for reading glasses after the procedure is to choose monovision, where one eye is focused up close and one is focused in the distance.
As you age, the focusing lens in your eyes hardens, and this decreases your ability to focus up close. This phenomenon is called presbyopia and begins visually in your early 40’s and continues to worsen through your mid 50’s, at which point it generally levels off. If you see clearly in the distance with both eyes with either glasses, contact lenses or laser vision correction, you will need magnifying reading glasses to see up close. Another way to say this is that if you see clearly in the distance with each eye at age 55, you will almost surely need reading glasses to see things up close. There is one tried and true alternative called monovision that helps many people see both far and near, in this age group, with the laser vision correction procedure.
Monovision means simply that one eye is corrected for distance vision (usually your dominant eye), and the other eye is corrected for reading vision (your non-dominant eye). Your vision with one eye alone is not as clear as with both eyes, but this is a compromise that many people are motivated to make so that they are less dependent on glasses or contact lenses for both distance and reading. For most people, monovision works very well if they have realistic expectations. Monovision works well with contact lenses and with laser vision correction, but not typically with glasses.
Click here to read more about monovision in our Mandel Vision Blog: Eyes on a Clearer World.
New York LASIK surgeon Eric Mandel closely monitors the healing process in order to ensure optimal visual improvement. Unlike some other/older refractive procedures, patients usually do not need to wear a bandage or a contact lens after LASIK. Instead, we recommend that you wear your sunglasses or goggles home from the office and while you sleep that evening. Patients use medicated eye drops for approximately one to two weeks following the procedure. All patients then continue with rewetting drops and other lubricants for approximately three to six months.
Read more about post LASIK care.
Almost all patients have some form of astigmatism, which is corrected by laser vision correction.
Astigmatism is one of the most common conditions that can be treated with LASIK or PRK laser vision correction. To know if your type of astigmatism is treatable with our advanced wavefront custom laser system and to find out if you are a candidate, you need to come in and have your eyes evaluated by Dr. Mandel. During your free laser vision consultation, the curvature and thickness of your corneas will be measured using our Atlas topography system and our Pentacam tomography technology to determine your candidacy. In addition, Dr. Mandel will personally examine your eyes.
The vast majority of patients do not need a second procedure. There are occasionally some patients who will need an upgrade in the future, and if they are still a candidate for laser vision correction, they generally do very well. Patients fully corrected for distance will need reading glasses in their 40’s. This is a normal aging change that occurs with or without laser vision correction. For example, if you continue to wear contact lenses or glasses instead of having LASIK or PRK, you will need to do something to correct your reading vision after age 40. This condition is called presbyopia. The options for this condition are: bifocals, progressive lenses, multifocal contact lenses or monovision contact lenses. For our patients seeking LASIK or PRK who are already over age 40, monovision laser vision correction may be an option. Click here to read more about monovision LASIK and PRK in our LASIK blog: Eyes on a Clearer World.
If the results of your procedure were solely dependent upon just using any laser system, then the fees for laser vision correction could be more uniform. But in reality, the experience of the laser surgeon is critical for an optimal result. There are many factors to be considered before during and after the procedure that make laser vision correction extremely surgeon dependant. Some of those factors are:
- Determining that you are a safe candidate
- Designing the laser parameters to correct your unique visual aberration
- The skill of the surgeon during the procedure
- The decisions the surgeon makes during your post-operative care
This is your only pair of eyes, choose your surgeon wisely.
Fortunately, significant complications are rare after laser vision correction. This should not be confused with glare and halo, or dryness, two side effects that almost everyone experiences for a time after laser vision correction. Advanced 21st century screening and procedure techniques have dramatically decreased complications. The combination of topography, corneal thickness measurements (pachymetry), an extensive examination, counseling, and Pentacam technology, afford us excellent candidates for our procedures, yet we must turn away about 20% of those seeking laser vision correction. For BOTH LASIK and PRK we try to minimize the chance of complications. For LASIK, our goal is to avoid weakening the cornea. The all- laser, blade-free iLASIK technique we have exclusively used for many years for our LASIK patients has reduced the chances of weakening the cornea, because the creation of the laser flap is much more predictable compared to microkerotomes (bladed systems). In PRK, we want to decrease the chance for any inflammation and haze. We have drastically decreased this by the combination of very fast and smooth lasers, as well as mitomycin applications for a few seconds at the end of the PRK procedure for patients with moderate to high prescriptions.
LASIK is not recommended during pregnancy for a few reasons. Hormonal fluctuations during pregnancy can change your prescription . It’s also better to avoid prescription eye drops during pregnancy as they pass through the naso-lacrimal system into the nose and mouth, get into the bloodstream, and can pass to the baby. Prescription antibiotics and anti-inflammatory (steroid) drops are used post LASIK, so this is another reason it’s best to wait until after your pregnancy to have LASIK. If you plan to breast-feed, it’s also recommended to wait until after you’re finished breast-feeding before having LASIK.
Although there are a handful of companies that offer insurance coverage for LASIK as an employment perk, the vast majority of insurance companies do not cover LASIK as it’s considered a cosmetic procedure. However, there are several insurance companies that Mandel Vision participates with that include discount programs for LASIK. Therefore, we encourage our patients to bring their insurance card with them for their free evaluations. Our LASIK consultants are happy to check benefits to see if a discount can be applied. Click here for a list of our discount programs.
- Extremely nearsighted patients, over 15 diopters, may benefit from intraocular implants.
- Collagen Crosslinking may stabilize eyes with keratoconus
- Intrastromal rings can correct for low degrees of nearsightedness, but are more invasive than LASIK and PRK surgery. They are indicated for unstable corneas and are not as accurate as LASIK and PRK.
- SMILE is a new procedure that is in evolution and the visual results are not as good as with LASIK and PRK.
PRK was the first approved laser vision correction procedure in the United States. It uses the same laser as in the LASIK surgery except that there is no corneal flap created. In PRK the excimer laser works on the surface of the cornea to reshape the eye and creates a surface abrasion. Patients wear a bandage contact lens for corneal healing for approximately one week.
PRK avoids all associated LASIK flap complications because no flap is created.
The current PRK procedure is a customized, advanced surface laser procedure that utilizes the same astronaut approved laser used in LASIK. PRK actually takes less time to complete than LASIK. The procedure creates an area on the corneal surface where the outermost layer of skin (epithelium) is gently removed. The excimer laser is then used to re-profile your cornea to correct your unique visual aberration, just as in LASIK. After the procedure is complete, a soft contact lens, without a prescription, is placed on the cornea to allow the first layer of your epithelium to heal. This usually takes about a week. Most patients do go to work the day after the procedure, but need to increase the font size on their computer and smart phone for the first 4 to 6 weeks. With Dr. Mandel’s customized post-operative regimen, discomfort is usually much less than in the original days of PRK in the 1990’s. Most of our patients have light sensitivity on day #2, more discomfort on day #3, and then a return to more comfort. Vision is slower to recover with PRK than with LASIK where most patients are near 20/20 the day after the procedure. The majority of our PRK patients appreciate improved vision the next day, but we usually recommend no driving for one or two weeks after the procedure. The results of PRK are equal to LASIK, and have the advantage of avoiding the creation of a laser flap. By 4 to 6 weeks most patients are satisfied with their vision, which continues to improve over the next few months.
Learn more about what to expect from PRK.
A refraction is the test performed to determine a patient’s refractive error, or prescription. More specifically, a refraction is used to determine the precise prescription needed to correct nearsightedness (myopia), farsightedness (hyperopia), astigmatism and presbyopia. This measurement can then be used to make eyeglasses and contact lenses. It’s also a component of Dr. Mandel’s customization process for LASIK and PRK eye surgery. The reason it’s called a refraction has to do with optics, which is the study of sight and the behavior of light rays. During the test, different lenses are introduced via a machine called a phoropter. These lenses refract, or bend, light rays from an object to bring them to a focal point directly on the macula, which is the part of the retina responsible for central vision. When light rays fall directly on the macula, a clear image is produced.