Ophthalmologist + Refractive Surgeon
Dr. Nicholas Lancaster
Dr. Lancaster is a Refractive Surgeon at SharpeVision Modern LASIK & LENS. He has lived all over the world and is fluent in Spanish.
Meet Dr. Nicholas Lancaster
Great results begin with a great process. We want you to know what to expect no matter which procedure you choose.
SharpeVision’s mission is to help you achieve your dream of clear, uncorrected vision while creating a medical experience better than any you’ve ever had. Our doctors of optometry and ophthalmic technicians will make sure you know everything you need and want to know about the procedure, as well as risks and benefits specific to your eyes, so that you can make the decision that is right for you.
Our Optometrists and staff of experienced ophthalmic technicians are an elite team who train continuously. They will guide you through the comprehensive exam and consultation, which is free of charge. At this 90-minute appointment, they will measure and examine your eyes, recommend and discuss treatment options, and answer any questions you have about the procedure. It is a big step toward having clear, uncorrected vision, and there is no obligation.
SharpeVisions’s physical space was architecturally designed and created specifically for the needs of our patients. Our humidity and temperature-controlled laser suite and state-of-the-art diagnostic and examination equipment allow for highly precise procedures.
SharpeVision has chosen the most advanced laser systems for all of our custom LASIK procedures. The Nidek Quest EC-5000 laser combines the best aspects of previous technologies all in one superbly precise instrument. The Nidek laser incorporates the wavefront, topographic, and refractive error measurements to create the ideal treatment for each individual eye. The laser’s high-speed infrared eye tracking, torsional error correction (TEC), and customized aspheric treatment zone (CATZ) ensures the best possible customization of any laser in the country.
The Ziemer® Femto Z4 laser has a pulse rate that is 20 times faster and with less energy than other femtosecond lasers, which allows for faster recovery of vision and shorter procedure time.
While we are proud to offer our patients the most technologically advanced equipment available, the single most important factor in the success of your treatment is the skill and experience of your eye surgeon. Dr. Nicholas Lancaster and his highly-trained team will walk you through each step to make your goal of clear, uncorrected vision a reality. This is where SharpeVision truly differs from other options in the Austin area.
While unlikely, if an enhancement procedure is needed within the first year, it will be provided at no additional cost.
Beyond one year, SharpeVision offers an optional LASIK4Life plan to all patients undergoing laser vision correction. Under this plan, if our doctors recommend additional laser, there is no fee. Ever! No restrictions. No additional requirements.
At SharpeVision, we provide the care you expect from a private practice without the corporate overhead. Because we own our lasers, we are able to charge less than corporate chains or private practitioners who share access or use mobile lasers. So you win in every way: results, experience, technology, and cost savings. We will help you determine the most practical and convenient way to cover your treatment fees. We ask for payment in full prior to your procedure. Here are payment options to consider:
Credit Cards: We accept Visa, MasterCard, Discover, and American Express. If you would like to pay with a debit card, please check your per-day dollar limit in advance.
Cashier’s Check: A cashier’s check from your bank is an easy way to have your funds in place and ready for payment. Please note: We do not accept personal checks as a form of payment.
Pre-Tax Accounts: FSA/HSA: If you have a Flexible Spending Account or Health Savings Account through your employer, you will still need to pay for your treatment on the day of your procedure. If your employer has provided you with an FSA or HSA card, please check your balance in advance and make sure your card is authorized to accept a transaction through SharpeVision. If you do not have an FSA or HSA card, you may use any of the forms of payment indicated above and submit your receipt to your employer for reimbursement.
Financing: SharpeVision offers guaranteed financing! Many options are available for financing your procedure – we can help you identify and apply for the financing that suits you.
A comprehensive, dilated examination is the only way to know which vision-correction procedure is best for you. We do this at no charge because we believe so strongly in giving patients all the information necessary to make the right treatment choice. While your exam involves comprehensive diagnostic testing, it is also our opportunity to learn more about you, your expectations, and your lifestyle. All of these factors play an important role in recommending the best procedure for you:
The complete exam can take up to 90 minutes. After all the data is collected, our doctor will examine you, discuss the treatment recommendation, and answer any questions you have. Your visit will include dilation of your pupils, which will affect your eyesight for about 4-6 hours, as you may have experienced with a routine eye exam.
Although LASIK is the most commonly performed procedure, PRK, ICL (Implantable Contact Lens), refractive cataract surgery, and RLE (Refractive Lens Exchange) are all commonly performed. Your age, amount of prescription, anatomy, and vocational needs, are all important factors in making a recommendation.
All along the way, we’ll communicate clearly and honestly about the procedural options and risks and answer any questions you have. Our goal is to help you be as prepared and comfortable as possible throughout your experience.
We’d like you to leave your contacts out prior to your treatment. Please leave them out at least three days for soft contacts and soft toric lenses (astigmatism correcting contact lenses), and three weeks for gas permeable lenses (RGP).
Please carefully read through the entirety of this literature and informed consent and note any questions. If you are 40 or older, pay special attention to the section on presbyopia/monovision. Monovision is often misunderstood, but we’re happy to explain and demonstrate it to you. We will have you sign a copy of the informed consent in our office prior to the procedure.
We will prescribe you an antibiotic drop and a steroid drop for use post-operatively. Generally, we ask that you get the prescribed eyedrops prior to the procedure to make it easier for you after. If you have allergies to any medications, we will prescribe an alternative medication. You can choose to fill the prescription at your local pharmacy or purchase our RecoveryKit in office for your convenience. A SharpeVision team member will explain and give you written instructions for your post-procedure care, which includes using these eye drops four times a day for seven days following your procedure.
Have a cool compress waiting for you in the refrigerator for when you get home. It will feel great on your eyelids after your procedure. You will experience watering, irritated eyes for about four hours after the LASIK procedure, and for one to two days following PRK. We supply you with “comfort drops” that numb the eye to help make you more comfortable after the procedure and will instruct you on how to use them.
We understand that this procedure may create nervousness and fear. We’ve worked very hard to make it easy for you. We offer an oral sedative to help you relax, and we encourage you to take it if medically appropriate. In lieu of a sedative, we offer a selection of wine and beer for you to enjoy before your procedure. We want your experience to be as comfortable as possible. All of your post-operative appointments will be scheduled before your procedure, so you can simply go home when the procedure is complete.
You may eat and drink normally before and after your procedure if you are having LASIK, PRK, MONO, or ICL surgery. We offer complimentary coffee, tea, hot chocolate, and still or sparkling water in our office. If you are feeling peckish, just let a staff member know and we will bring you an assortment of snacks to choose from. We also have juice on hand for those with hypoglycemia. If you are having RLE or Cataract Removal, we ask that you abstain from eating 12 hours prior to the procedure. Liquids are ok.
Please do not wear any makeup on your face or eyes, including mascara. We recommend using only an unscented moisturizer with sunscreen. If you forget, we have wipes available in the restrooms and at the front desk to help remove makeup. Please remove any false eyelashes (eyelash extensions are ok). Also, please forgo using colognes, perfumes, or fragrant lotions. Please wear deodorant as you normally would.
Be sure to arrange to have someone drive you home after the procedure. Do not attempt to drive yourself. Many of our patients call an Uber or Lyft after surgery to get home.
Warm, comfortable clothing. Our laser suite is kept at a constant 68 degrees and 40 percent humidity.
Sunglasses after the procedure. You will be more sensitive to light and air. If you forget, or don’t have access to sunglasses, just let your technician know and we will be happy to supply you with some.
Immediately following the procedure, you will notice a change in your vision. It’s always foggy at first, but most people can see well enough to read a clock from across the room. Your eyes will be numb for 15-25 minutes; then they will start to water and burn. After LASIK, this discomfort usually lasts 4-5 hours. After PRK, it can last 24-48 hours. After ICL, there is generally mild scratchiness the first day.
To help with the burning, we supply you with “comfort drops” that have numbing medicine and artificial tears in them. We will instruct you on how to use them depending on your procedure. Your eyes may water profusely, and you won’t feel like opening them. This is normal. Take ibuprofen or Tylenol® to help with the discomfort. For PRK, we will give a prescription for Gabapentin, a nerve blocking medicine that is helpful in reducing the discomfort.
After being driven home, place a cool compress on your eyelids to relieve any discomfort. Try to sleep or rest with your eyes closed. The oral sedative should also help you to sleep. You may eat and drink as you normally would. Please try and avoid looking at screens for a few hours.
You may resume normal activities the same or following day, but it’s ok to just rest, too! You can lift weight and exercise, but do not rub your eyes. Your vision may still be foggy; this is a normal part of your healing process and will clear in the days and weeks following the procedure. Most people see well enough to work the next day. You may resume looking at screens, but may find that your eyes tire sooner than normal. Use artificial tears frequently, as your eyes will dry out more quickly than usual.
You may see well enough to drive within 24 hours, but please have a driver available for your one-day, post-operative visit. It may take several weeks or more for your vision to stabilize, but you will soon enjoy much improved vision! Most people tell us, “That wasn’t too bad!” or “I should have done this years ago!”
Post-procedure visits will take as little or as much time as you need. Five to 15 minutes is average for a visit. These appointments are typically the day after and one month after the procedure. With Cataract Removal and RLE, we like to see you at one week post-operatively, too. We will check your vision and examine your eyes each time. It’s a great opportunity for you to ask follow-up questions. We don’t charge you for any procedure-related visits for the first year. However, if you have an unrelated eye problem, we can see you and submit the fee to your insurance company.
On the day of your procedure, we will check you in, review and sign the consent form. All of your post-operative appointments will be scheduled before your procedure, so you can simply go home when the procedure is complete.
We want you to be as comfortable as possible, so we will offer you a sedative (Valium/diazepam or beer or wine).
Your technician will give you protective booties and a bonnet to put on and walk you into the Laser Suite where you will lie down on the laser bed, which moves under the microscope. Dr. Lancaster will hold your head to keep you steady. Your non-treated eye will always be shielded. He will gently hold your eyelids open to keep you from blinking. You won’t feel the need to blink because your eyes will be numb.
Dr. Lancaster will gently talk you through each step of the process so you know what you will feel, see, and hear. He monitors your eye through the microscope at all times. The entire procedure takes about three minutes per eye; the first laser takes 20 seconds. The second laser takes 10-50 seconds depending on the amount of your prescription.
During the flap creation, you will feel pressure and your vision will go dark for about 20 seconds. Dr. Lancaster will tell you when this is about to happen, so it doesn’t surprise you. Try not to be alarmed; This is perfectly normal and expected.
During the second laser, you will focus on a flashing light for 10-50 seconds. Don’t worry if your eye moves, as an amazingly fast infrared tracker follows your eye. If your eye moves, the laser moves with it. If the movement is too fast or far, the laser pauses until you’re back in position.
Immediately following the procedure, you will notice a change in your vision. It’s always foggy at first, but most people can see well enough to read a clock from across the room. Your eyes will be numb for 15-25 minutes; then they will start to water and burn. After LASIK, this discomfort usually lasts 4-5 hours. To help with the burning, we supply you with “comfort drops” that have numbing medicine and artificial tears in them.
After being driven home, place a cool compress on your eyelids to relieve any discomfort. Try to sleep or rest with your eyes closed. You may resume normal activities the same or following day. You can lift and exercise, but do not rub your eyes. Your vision may still be foggy; this is a normal part of your healing process and will clear in the days and weeks following the procedure. Most people see well enough to work the next day.
PRK ONLY: Dr. Lancaster will place a bandage contact lens on your eye(s) for five days for comfort and healing while your corneal membrane grows back.
In preparation for the EVO ICL, a separate appointment is scheduled to accomplish two main objectives:
We will instill many medicated drops in your eyes to prepare you for the implant. The implant itself takes less than 10 minutes per eye, with about 20 minutes between eyes to prep the operating room.
The procedure is painless, although most people are initially uncomfortable with the bright light of the microscope. There is also numbing medicine that will sting for about ten seconds until it takes effect. Dr. Lancaster will let you know what you’ll see and feel.
Your vision will be very blurry and foggy immediately after the procedure due to the many drops, surgery, and bright lights.
We need to check the pressure in your eyes about two hours after completion. You are welcome to stay in the office, or leave and return after two hours. We will review the medications and plan on seeing you the following day. You may experience some mild grittiness, but not pain. If you feel nauseated, vomit, have intense pain, or sudden decrease in vision, let us know immediately. The following day, your vision will be much better, but still somewhat foggy, and maybe mildly scratchy.
During your comprehensive eye exam, we will take a careful history of your past eye history, medical history, medications. We will ask your symptoms such as glare at night time, difficulty reading near objects or seeing street signs, difficulty with night vision. We will take careful measurements of your eyes for potential future surgery. After the examination one of our doctors will discuss your options which generally include: glasses, contact lenses, refractive surgery such as cataract with intraocular lens implant or refractive lens exchange. The difference between the two is only that with a cataract your natural lens is cloudy and with a refractive lens exchange your lens is fairly clear, or at least without significant symptoms of a cloudy lens. We will discuss the procedure, its risks and benefits as well as the above alternatives. We will then schedule the procedure.
On the day of the procedure, we will administer oral sedatives to help you relax, lots of eyedrops to dilate your pupils and have you change into a surgical gown. The procedure itself is painless; you are awake but relaxed due to the sedatives. The laser portion of the procedure (if you choose to have laser-assisted cataract surgery/RLE) takes about three minutes and is also painless. There is a gentle suction placed on your eye to hold it still during the 30 to 45 seconds of laser. You are then taken to the operating room where your eye will be prepped (cleaned) and draped. The procedure to remove your natural lens and replace it with an intraocular lens takes between seven and 12 minute
Immediately afterward your vision will be blurry, and you may be light sensitive due to the dilating drops. You go home immediately after the procedure where you should rest quietly for the rest of the day. There will be eyedrops for you to put in as directed. Generally there is no pain after the procedure, and we will plan on seeing you the next day. Your surgeon will give you their cell number, so that you can contact them if you have anything unusual or have questions.
Day one after the procedure you will see your surgeon to ensure that everything looks OK. Your vision will most likely still be foggy/blurry but sometimes is quite clear. In fact most of the time the vision is 20/20 or close to that, although there is always a minimum of some fog/blur. Don’t worry if it’s not perfect on day one. It virtually never is.
Week 1 to week 6 postoperatively: at this time period you will be monitored by your surgeon to make sure everything is going OK. The goal generally is to get you seeing perfectly at distance without glasses. Approximately one out of 20 patients may need a slight touchup with the laser to get slightly better vision. If you have opted for a multifocal lens, your near vision also may be fairly good. Ask your surgeon more about the specifics when the time comes.
Unparalleled Expertise. Meet our Austin Refractive Surgeon and Optometrist.
Dr. Lancaster is a Refractive Surgeon at SharpeVision Modern LASIK & LENS. He has lived all over the world and is fluent in Spanish.
Meet Dr. Nicholas Lancaster
Dr. Blechman is the lead Optometrist at SharpeVision Austin. With many of her family members also in the Austin area, she couldn’t imagine a better place to practice medicine.
Meet Dr. Jenna Blechman
This information is to help you make an informed decision about having LASIK or PRK to treat your nearsightedness, farsightedness, and/or astigmatism. Take as much time as you need to make a decision about signing the form. You are encouraged to ask any questions and have them answered to your satisfaction before you give permission for surgery.
Prior to moving forward with the decision to have surgery, it is important that you fully understand the risks of these treatments and have the information you need to fully assess these risks and any alternative treatments you may want to consider. Through the information we make available to you- our brochures and videos, website, and discussion with the SharpeVision team- it is our hope and expectation that you feel educated and informed about the safety and efficacy of the procedure. We realize this is an important decision for you, and we want you to feel comfortable and informed in making it.
You will be given this informed consent form again in-office to review and sign. In signing this form, you are stating that you have read this informed consent thoroughly, and although it contains medical terms that you may not completely understand, you have had the opportunity to ask questions and have them answered to your satisfaction. In addition, you are stating you have watched the informational video, have received a notice of privacy practices, and have had ample opportunity to discuss these terms and have all your questions answered.
Every surgery has risks, as well as benefits, and you should evaluate this risk/benefit ratio for yourself after consideration of the information presented by our staff, the information in the video, and written information that follows. You will be asked to sign an Informed Consent document on the day of your procedure.
Laser Assisted in Situ Keratomileusis (LASIK) uses a femtosecond laser, or a microkeratome, to create a corneal flap on the surface of the eye. After opening the flap to expose the tissue below the cornea’s surface, the excimer laser is used to remove thin layers from the cornea to reshape it. The flap is then returned to its original position.
Photorefractive Keratectomy (PRK) uses the same excimer laser, which produces a beam of light to remove thin layers from the cornea to reshape it after the surface layer (corneal epithelium) has been removed. The surface layer typically grows back over 4-5 days. Healing time is significantly longer than LASIK.
Laser vision correction permanently removes tissue from your cornea. And while LASIK and PRK are permanent operations to the cornea, additional laser treatments are usually possible to correct residual prescriptions that occur in a small percentage of patients.
There are a number of contraindications or relative contraindications for laser vision correction. These include patients with unstable refractions, certain abnormalities of the cornea, abnormal corneal topography, insufficient corneal thickness, irregular astigmatism, unrealistic expectations, a visually significant cataract, uncontrolled glaucoma, uncontrolled external disease, uncontrolled connective tissue or autoimmune disease, certain ocular anatomical issues, functional monocularity, overly steep or flat corneas, dry eye syndrome, pregnancy or lactation, poorly controlled diabetes, prior incisional or lamellar keratorefractive surgery, and significant occupational or recreational risk, among other factors. If you have one or any of these conditions, LASIK or PRK will probably not be recommended.
You should understand that LASIK or PRK will not prevent you from developing naturally occurring, age-related eye-health problems such as glaucoma, cataracts, retinal degeneration or detachment.
These procedures are elective and involve complex surgery to the eye. Not everyone is a good candidate for laser vision correction. The ideal candidate is over 18 years old, has had stable vision for at least six months, has a healthy cornea, has refractive errors within the treatable range, does not have a disease or condition that could impair the procedure or healing process, understands that the goal of the procedure is to improve vision and reduce dependency on glasses and contact lenses, and has been fully educated about the procedure and its risks and benefits. Please let your doctor or a SharpeVision team member know if you still have questions that have not been answered.
Having surgery on both eyes at the same time is called Bilateral Simultaneous LASIK/PRK.
The possible ADVANTAGES of having LASIK or PRK performed on each eye at separate times are:
SAFETY: You will not experience the risk of developing an infection in both eyes at the same time, which although extremely rare, could lead to significant loss of vision in both eyes. Since the pressure in the eye is increased significantly for a short period of time during the LASIK procedure, there is a very remote possibility of internal bleeding or damage to the retina that could lead to significant loss of vision or even blindness. Having the procedure done one eye at a time would avoid the possibility of this occurring to both eyes. It is also possible to develop a delayed cloudiness in the cornea or even scarring which is not visible immediately after the procedure. Although this is uncommon and generally clears with time, it can result in significant loss of vision for a prolonged period. Should this occur in both eyes at the same time, carrying out normal activities could be difficult;
ACCURACY: The doctor can monitor the healing process and visual recovery in the first eye and be able to make appropriate modifications to the treatment plan for the second eye, which could increase the likelihood of a better outcome in the second eye;
VISUAL RECOVERY: Although most LASIK patients experience very fast recovery in their vision, the recovery can, at times, be delayed. With PRK patients, healing time is much longer. Therefore, if the eyes are treated separately, you can function with the other while the first eye fully recovers. This is especially true if you are able to wear a contact lens in the eye that has not been treated; and
SATISFACTION: You will be given the opportunity to determine whether LASIK or PRK has produced satisfactory visual results without loss of vision or other uncommon and undesirable side effects such as glare, ghost images, or increased light sensitivity. If you are over the age of 40, you will have the opportunity to experience the change in your vision, which results from the correction of your nearsightedness. This could influence your decision on whether or not you would like to have monovision.
Having surgery on both eyes at the same time is called Bilateral Simultaneous LASIK/PRK.
The possible DISADVANTAGES of having LASIK or PRK performed on each eye at separate times are:
INCONVENIENCE: It may be inconvenient for you to have each eye treated at separate visits. This will necessitate two periods of recovery from the laser surgery and may require additional time away from work and additional appointments at our office for follow-up care;
VISUAL RECOVERY: There will be a potential period of imbalance in vision between your two eyes. This is especially important if you are unable to wear a contact lens in the non-treated eye. It is generally not possible to wear glasses with a non-prescription lens over the treated eye and a prescription lens over the non-treated eye, because it tends to produce a strong sense of imbalance, dizziness, and a form of double vision. Treating both eyes at the same time will usually restore balance between the two eyes more rapidly; and
COST: Professional and facility fees may be greater if the eyes are operated on different days, and the additional time off work can be costly.
As with all surgery, there is a possibility you may experience other complications, including, but not limited to, those due to drug reactions, among others. Failure to provide the staff of health care professionals with your complete medical history may increase your risk of developing complications. Therefore, you should tell your doctor about any drug allergies, pre-existing medical and eye conditions, and medications that you are taking. While disclosing all medications is important, of particular importance are: hormone replacement therapy, diabetes medicine, steroids (such as Prednisone), Plaquenil, Accutane, or antihistamines, as they may influence healing.
LASIK and PRK surgery can possibly cause loss of vision or loss of best-corrected vision. This can be due to infection, irregular scarring, or other causes and unless successfully controlled by antibiotics, steroids, or other necessary treatment could even result in loss of the eye involved. Vision loss can also be due to the cornea healing irregularly, which could add astigmatism and make wearing contacts lenses necessary. Useful vision or night vision could be lost. It is also possible that you may not be able to successfully wear contacts after LASIK or PRK.
Refractive surgery is not right for you if you want a guarantee of a perfect outcome. Although our goal is to reduce or even eliminate myopia or hyperopia, with or without astigmatism, your outcome cannot be guaranteed. If you were nearsighted, overcorrection could result in farsightedness. If you are farsighted, over-correction could result in Nearsightedness. Overcorrections often diminish over time but could be permanent. It is possible that your initial favorable results could regress over time. Due to the normal healing process, small overcorrections and undercorrections may occur. If after the procedure you are overcorrected or undercorrected, it may be possible or necessary to have an additional surgery to fine-tune or enhance the initial result. However, small overcorrections or undercorrections are usually tolerated well by patients and do not require additional treatment.
You may experience a “starburst” or “halo effect” around lights at nighttime. If you have high myopia, high astigmatism, or dry eyes, you may be more likely to have night-glare issues. Your overall vision at night may not be as sharp as during the day, and you may experience increased sensitivity to light or glare.
This condition would become evident in the weeks or months following surgery. PRK has a small risk of haze, which is difficult to treat and may result in loss of best-corrected visual acuity and permanent loss of visual sharpness or clarity. Measures will be taken and medications employed to minimize this risk.
The duration and intensity can vary widely from person to person. You may experience dry eyes following the procedure, causing mild to severe irritation, discomfort, and blurring of vision. If this occurs, you may need to use certain over-the-counter or prescription medication for an indefinite period of time. This condition may be permanent. Post-menopausal women or patients taking certain medications may be at a higher risk of developing dry eyes.
LASIK and PRK do not correct presbyopia, which occurs in most people around the age of 40 and may require them to wear reading glasses for close-up work. People over 40 that have their nearsightedness corrected will find that they need reading glasses for clear, up-close vision. The exception to this may be if monovision is attempted; however, monovision is not a guarantee that near vision will be clear without glasses or contact lenses. If you are over 40 years of age and decide to have laser vision correction to correct both eyes for distance vision, you may need reading glasses to see objects at approximately three feet or closer. If you are over 40 years, be sure you understand monovision, which corrects one eye for near vision and one eye for distance.
As part of the normal aging process, the lens of our eye becomes less flexible, which is the reason why reading glasses, bifocals, or removing distance glasses become necessary to see up close in our mid-40s and beyond. Monovision is one treatment for presbyopia. While laser vision correction cannot currently cure presbyopia, it can make it possible for these patients to see close without reading glasses. Monovision is a process of providing both distance and near vision by focusing one eye on distant objects and one eye on near objects. It can be more difficult to see at night with monovision. You understand that adapting to monovision can take 12 weeks or more and that it may never occur to your total satisfaction. Monovision can sometimes be reversed, if you decide that it doesn’t work for you.
Nearly everyone develops cataracts with age. This is still true after laser vision correction. Some patients may have mild cataracts at the time of laser vision correction that are not yet visually significant. If this is true for you, laser vision correction will not prevent this condition from worsening as your cataracts advance. If the cataracts advance to the point laser vision correction cannot help correct your vision, you will need standard cataract management practices.
You may develop a rare corneal condition called corneal ectasia in which the cornea progressively thins and blurs vision. This condition can be difficult to diagnose in its early stages, and laser vision correction may accelerate this degeneration. LASIK patients are at higher risk for developing ectasia than patients who have PRK.
You understand that you could develop keratoconus. Keratoconus is a degenerative corneal disease affecting vision that occurs in approximately 1/2000 people in the general population. While there are several tests that suggest which patients might be at risk, this condition can develop in patients who have normal preoperative topography (a map of the cornea obtained before surgery) and pachymetry (a corneal thickness measurement). Since keratoconus may occur on its own, there is no absolute test that will ensure a patient will not develop keratoconus following LASIK or PRK. Severe keratoconus may need to be treated with a corneal transplant while mild keratoconus can be corrected by contact lenses or glasses.
You may develop a corneal flap complication that could require your procedure be postponed either temporarily or indefinitely. If you develop certain complications with your corneal flap following surgery- including, but not limited to, striae (wrinkles), epithelial ingrowth, or inflammation- your flap may need to be re-lifted, which can cause additional complications. The equipment used in the procedure may also malfunction. Depending on the circumstances, these complications could cause loss of vision.
During pregnancy, your vision measurements can fluctuate and could influence your results. If you know you are pregnant, or are attempting to become pregnant within the next three months, it is important you advise your doctor right away.
With the recommendation of your doctor, the laser can be used to perform laser vision correction outside of the FDA guidelines, including when treatment may otherwise be contraindicated. If you are choosing to have laser vision correction and have a prescription outside of the approved ranges or have contraindications, you understand and accept the risks of doing so. In addition, following PRK laser vision correction, an anti-cancer medication known as Mitomycin-C (MMC) is applied to the cornea as an off-label use to reduce the potential for corneal haze.
You understand that there are situations in which treatment may be contraindicated, including, but not limited to: unstable refraction, abnormalities of the cornea, uncontrolled disease, history of severe or active eye infection, glaucoma, certain systemic medications, poorly controlled diabetes, pregnancy or lactation, and prior incisional or lamellar keratorefractive surgery. Therefore, it is important that you provide your complete medical history.
You should also be aware that there are other complications that could occur that have not yet been reported before the creation of this consent form, as LASIK and PRK surgeries have been performed only since the 1990’s and longer-term results may reveal additional risks and complications.
You are aware of the alternatives to laser vision correction, which include eyeglasses, contact lenses, and other types of refractive surgery or refractive lens implants. When tolerated well, glasses and contacts are a good alternative to LASIK or PRK. In addition, refractive surgery is continually evolving, and other refractive procedures may be available as an alternative to LASIK or PRK. You should also be aware that having any refractive procedure could potentially disqualify you from some professions, including the military, certain law enforcement agencies, and aviation occupations, among others. We strongly encourage you to check with any profession of interest for specific regulations.
After the procedure you should avoid rubbing your eyes. Your eyes may be more susceptible to traumatic injury after LASIK or PRK. Protective eyewear for all contact and racquet sports, or in any other situation where a direct blow to the eye could occur, should be worn. Additionally, you will be given medications and instructions to help prevent infection and regulate healing. It is imperative that you follow ALL instructions exactly as they are given to you. It is also imperative that all follow-up visits be kept as directed.
The cornea and the lens of the eye focus light like a camera lens to form an image on the retina. Light first enters the cornea, which provides a majority of the eye’s focusing power. The lens inside the eye provides the remainder. Natural degrees of variation in the shape of the eye affect how well we see. Laser vision correction can be used to treat three of the most common focusing problems: myopia (nearsightedness), hyperopia (farsightedness), and astigmatism.
In performing laser vision correction procedures, the surgeon controls a computer-guided excimer laser that emits cool pulses of ultraviolet light to remove a small amount of tissue at the front of the eye. The procedures are designed to reshape the corneal curvature, which allows light to focus on the retina and improve your vision. Excimer laser energy is absorbed superficially, so the other eye structures such as the iris, lens, and retina remain undisturbed.
Myopia, or nearsightedness, results when the eyeball is too long or the cornea is too steep. Light will focus in front of the retina, causing blurred vision in the distance.
Hyperopia, or farsightedness, occurs when the eyeball is too short or the corneal curvature is too flat, causing light to focus behind the retina. Hyperopia, which causes blurred near and far vision, can be confused with presbyopia, an age-related change in vision causing the need for reading glasses.
Astigmatism occurs when the eyeball is oblong-shaped, like a football. As a result, light cannot be focused properly, blurring vision at all distances. Astigmatism is often present along with myopia and hyperopia.
Presbyopia occurs in our mid-40s as the natural lens loses its flexibility to change the eye’s focus from distance to near. Laser vision correction does not change this process. Whether it is glasses with bifocals, contacts with reading glasses, or laser vision correction with reading glasses, the loss of flexibility is the problem, and you will need some help with this even after LASIK or PRK.
Monovision is enjoyed by millions of people and is an option that will be thoroughly discussed and demonstrated at your exam. With monovision, the focus of one eye, usually your dominant eye, is treated for perfect distance vision, while your other eye is treated for near vision. It is not an option for everyone and can sometimes be reversed after a period of adaptation, should you decide that it is not working for you.
Refractive surgery describes various procedures that modify the refractive error, or prescription, of the eye. Most of these procedures involve altering the corneal shape.