Am I a good candidate for Lasik?
What results can I expect from Lasik?
Will I be able to eliminate my glasses or contact lenses?
Is the treatment painful? Will my eyes hurt afterwards?
How safe is the Lasik procedure?
Are all excimer lasers the same? Do they all use the same
Will I need reading glasses afterwards?
What is monovision?
Will my eyes look or feel any different after Lasik?
What are the long term results? Is the treatment permanent?
What is "Wavefront guided Custom Cornea"?
What is "All Laser Lasik"?
What if I move or close my eye during the procedure?
Am I a good candidate for laser vision correction?
Lasik effectively treats myopia (nearsightedness), hyperopia
(farsightedness), and astigmatism (corneal irregularity). If you are
presently wearing glasses or contact lenses there is an good chance that
you are a candidate for laser vision correction.
There are however, correction limits, and various
contraindications to Lasik, and thus, an evaluation by Dr. Ullman would
be required to determine your suitability. As a courtesy, we provide a
free consultation to determine whether Lasik is right for you.
Contraindications to Lasik include the following: If
you are under the age of 18, because your refractive error may not have
stabilized. If you have fluctuating vision or an unstable refraction
within the six month prior to considering Lasik. If you are a female and
are pregnant or nursing. If you have eye pathology such as cataracts or
macular degeneration. Lastly, although our results are excellent with
Lasik, if you are a perfectionist and have unreal expectations, Lasik
may not be right for you. We will only perform Lasik on people who are
good candidates. We turn away approximately 35% percent of those
requesting the procedure because they are not ideal candidates. To
insure the best results under the safest conditions, we are very
discriminating about those we select for Lasik treatment.
2. What results can I expect from Lasik? Overall 97%
to 99% of patients will see well enough to pass their drivers license
exam (20/40 vision), without their glasses or contacts. Depending on the
technology used, (see Wavefront guided Custom Cornea below), as high as
90% of patients may achieve 20/20 vision. As a rule the smaller the
refractive error, the higher the percentage of 20/20 outcomes.
3. Will I be able to eliminate my glasses or
contacts? The goal of all refractive surgery is to eliminate
dependence on glasses or contact lenses. Virtually all of those patients that Dr. Ullman has
performed Lasik on are able to drive and perform most other tasks
without glasses or contacts. Those over the age of 40, who didn't choose
"Monovision", (see below), usually will require reading
glasses only. A few people may desire a small prescription for night
driving, but this is the exception, not the rule.
4. Is the treatment painful? Will my eyes hurt
afterwards? The Lasik treatment, which usually takes a few
minutes per eye, is relatively painless. Anesthetic eye drops are used
during the procedure to eliminate any discomfort. No further anesthesia
or sedation is usually required. Afterwards, some patients may feel a
foreign body sensation for one to two hours. Lubricating eye drops are
given to alleviate this sensation. Rarely, does anyone complain of
significant discomfort during or after the procedure.
5. How safe is the Lasik procedure?
As with any surgical procedure, there are a few
risks associated with Lasik, however, in the hands of a skilled and experienced surgeon
like Dr. Ullman, the risks are very low. Careful patient screening, meticulous preoperative
evaluation, planning on a case to case basis, and use of the best lasers with the
latest technological advancements and safety features, further helps
keep our risk of complications to a minimum. Potential risks include the following:
* Under and over corrections- In a few cases we may
not achieve the full correction, or conversely, we may get a slight overcorrection. In
such cases there will be a significant visual improvement, but a slight haze or blur might
remain. Usually all that is required in these cases is an enhancement with the laser. We
literally do a few second "touch-up" with the laser to eliminate the residual myopia,
hyperopia, or astigmatism. Enhancements are performed in approximately 5-10% of our
patients. We perform them up to one year after the initial Lasik procedure, at no additional
* Halos - It is not uncommon to notice halos
,starbursts, or glare around lights in the immediate post-op period.
These symptoms usually resolve spontaneously over the first few days or weeks in the majority of
patients. During the pre-operative evaluation, we will determine whether you are at
high risk for seeing halos after Lasik. Large pupils that dilate beyond the treatment zone
is a major risk factor for postoperative glare or halos. Your pupils
will be measured prior to the procedure and if they are found to be
large, the LADARVision laser will be chosen for the treatment because it
has an adjustable treatment zone which can enlarge to exceed the pupil
diameter, thus greatly diminishing the incidence of postoperative glare
* Dry Eyes- People who have dry eyes necessitating
the use of artificial tears may find that after Lasik their dry eye
symptoms are worse. An inadequate tear film can cause a foreign body
sensation and also intermittent blurry vision. This can last several
weeks to several months. During your consultation, we can identify
whether dry eye is a problem, and we can prepare for the appropriate
post-op treatment, which usually means frequent use of ocular lubricants
or perhaps temporarily plugging the tear ducts with silicone plugs to
allow natural tears and administered artificial tears to lubricate the
eye longer. Some cases of extreme dry eye may not be suitable for Lasik.
6. Are all excimer lasers the same? Do they all use
the same technology? No. Lasers differ in the size of the treatment
zone, eye tracking ability, and on whether they have modern Wavefront or
CustomCorneaź capability. The size of the treatment zone is very
important when dealing with pupils that dilate widely. A common cause of
halos or glare after Lasik, is when the pupil dilates beyond the
treatment zone. An active eye tracker is important in neutralizing the
small inherent movements the normal eye routinely makes. A laser with a
good eye tracker will yield a smoother treatment. Wavefront computer
analysis allows us to measure the higher order aberrations in the eye and
transfer the data to the laser allowing a more individualized and
At our laser center we have both the LADARVision
laser as well as the VISX laser. Worldwide, these two lasers are used more frequently
than any others. Both of our lasers are equipped with advanced Wavefront
technology. With Wavefront guided treatments we are seeing a higher
percentage of 20/20 or better visual outcomes, and we are seeing less
post operative glare or halos, and less difficulty with nighttime
vision. In addition, both lasers exhibit sophisticated eye tracking
devises to neutralize any small movements the eyes may make during the
treatment, facilitating a smoother more precise ablation. For those
candidates who have pupils that dilate widely, the LADARVision laser has
an adjustable treatment zone, which can be enlarged to accommodate large
pupils, further decreasing the risk of postoperative glare and nighttime
Our laser center is also one of the few centers in
southern California to have the new "All Laser Lasik" technology, IntraLase.
Intralase is a revolutionary computer assisted laser that creates the
Lasik flap using laser energy . This unique technology allows an unparalleled
level of safety and precision when compared to the
traditional method of cutting the flap using an automated steel blade.
Not all lasers are the same, and not all laser
centers have the same equipment. If you want to get the best results,
make sure you are getting the best laser and the latest technology.
7. Will I need reading glasses afterwards? As a
rule, people over the age of forty begin to lose the ability to focus on
near objects. This is called presbyopia. If you are older than forty,
chances are you will need reading glasses after Lasik, unless you choose
monovision (see below). If, however, you are under forty years of age,
Lasik will usually provide excellent distance as well as reading vision.
8. What is monovision?
Monovision is a refractive strategy for people in
the presbyopia age where one eye is fully corrected to obtain excellent
distance vision, while the other eye is under-corrected by a
predetermined amount to allow for reading vision. If you are over the
age of forty, we will give you a trial with contact lenses simulating
monovision, to see if it is right for you.
9. Will my eyes look or feel any different after
Your eyes will look exactly the same after Lasik.
You will have microscopic scars in the cornea outlining the edge of the
flap. They can only be seen under the high magnification of the slit
lamp. Over time many of these scars will become invisible. Your eyes
should also feel no different after the procedure. Some people will
experience dryness of the eyes in the first few days or weeks after
Lasik, but in most cases it will be temporary, and easily treatable with
10. What are the long term results? Is the treatment
The correction achieved with Lasik is permanent. In
the majority of cases stability will be achieved by three month after the treatment. As you
age the distance vision should remain clear.
11. What is "Wavefront-guided
Wavefront technology is a computer assisted program
that measures the higher order aberrations of the eye and transfers this
information to the laser to provide a more precise and individualized
Custom Treatment. Prior to Wavefront analysis, we could only measure the
lower order aberrations of the eye, for example the refraction or
prescription of the lenses in your glasses or contacts. With Wavefront
measurements, we are able to correct all the aberrations in the complete
optical system of the eye. This translates into a higher number of
people getting 20/20 or better visual outcomes, and perhaps more
importantly, less people having problems with halos and glare especially
with nighttime vision.
12. What is "All Laser Lasik"?
Intralase, is a new laser technology that allows the
surgeon to create the Lasik flap using laser energy instead of a steel-bladed
Creating the flap is the most delicate part of the procedure. With
Intralase, computer-assisted technology allows us a higher level of precision and safety
in creating the corneal flap. Complications with Lasik are often due to flap irregularities. With Intralase,
flap irregularities are much less likely.
13. What if I close my eye or move during the
A thin wire speculum is used to gently open the eye
during Lasik, making eyelid closure impossible. Small eye movements are
automatically neutralized by the active eye tracker technology of the laser. Larger movements are seen
on the video screen which alerts the surgeon to lift his foot off the
control pedal. Once the eye is re-centered the control pedal is
reactivated and laser treatment resumes; no harm done. It is unlikely,
however, to make large eye movements, because you will be continually
focusing on a colored blinking light.