You have questions about LASIK. Dr. Matthew Sharpe has the answers.
*Laser eye surgery, laser vision correction, and refractive surgery are terms that refer to LASIK and PRK.
There are two types of laser vision correction surgery: LASIK (Laser Assisted In Situ Keritomileusis, also called Custom Lasik, Wavelight, Topography-Guided, or Z-LASIK) and PRK (Photo-refractive Keratectomy, also called LASEK, Advanced Surface Ablation, or epi-LASIK) LASIK is the predominant type of laser vision correction, whereby a flap is made on the cornea, which is the clear dome of tissue overlying the iris (colored part of the eye). In this surgery, most people see well enough to drive and return to work the very next day. Your vision will continue to improve over several weeks to months, but your sight will be surprisingly good and you will be comfortable only 4-6 hours post-surgery. PRK surgery is quick and painless, just like LASIK. The recovery, however, takes longer and is more uncomfortable for the first two days. Your surgeon will place contact lenses over your eyes to protect the surface while they heal. Your vision will gradually improve over the coming weeks, but will take slightly longer than LASIK to be fully clear. The same laser is used and the end result is the same as LASIK, but PRK is better suited to some eyes for a variety of reasons. The most common reason why you would need PRK is if your cornea is too thin for LASIK. It would also be performed on someone who has had a corneal procedure in the past or for vocational reasons such as entering certain branches of the military.
We accept most insurance plans, and they vary by state. If you don’t see yours listed, we may still accept it, so be sure to ask when you come in.
Washington: Aetna, Cigna, Blue Cross Blue Shield (Regence, Premera, Lifewise), United, Humana, First Choice Health, Provider One, Medicare
Texas: Aetna, Humana, Blue Cross Blue Shield, Scott & White, Medicare
Illinois: Aetna, United, Blue Cross Blue Shield, Medicare
Most insurance/vision plans do not pay towards LASIK, but it it doesn’t hurt to check with your insurance carrier or health benefits administrator before coming in for your exam. A few forward-thinking companies are now paying for their employees’ LASIK including The Bill and Melinda Gates Foundation and Zillow in Seattle.
Yes, and we encourage it! You can use your Health Savings Account (HSA) or Flexible Spending Account (FSA) as payment for your surgery. This program allows you to put tax-free money from your earnings into an account that can be used to pay for medical expenses including LASIK, PRK, and ICL. It’s like getting a discount equal to your tax rate, for example: If your employment earnings are taxed at 20% and you LASIK cost is $3000, you will actually need to earn $3600 to pay for your surgery. Conversely, if you place a portion of your earnings into a HSA/FSA, that money will not be taxed like the rest of your paycheck, and you will only need to earn $3000 for your surgery. It’s like getting a 20% discount! I am such a fan of this program, and we try to educate all of our patients about this payment option during their consult.
Yes, you can. We accept all the major credit companies including, but not limited to Visa, Mastercard and American Express. Just make sure you check your daily credit limit as some cards have a cap.
The average cost per eye for LASIK and PRK in the US is $2300, with a range from $1500 to $3000. An advertised price lower than $1000 is typically only for the lowest prescriptions without astigmatism. Most LASIK providers will make you come in to receive a quote for surgery. At SharpeVision our pricing is clear and consistent and listed on our pricing page, so you’ll know what to expect to pay for LASIK before your consultation- just compare our pricing to the prescription of each of your eyes. For example, if your left eye is -1.25 and and your right eye is -1.0, your total cost of LASIK would be $495 + $2195= $2690 for both eyes. The price is the same whether you have LASIK or PRK. We also have a price-match guarantee: if you happen to get a lower price quote for LASIK or PRK somewhere else, we will match the price for service, just bring in your paperwork. It’s that simple!
Roughly 90% of our patients are candidates for laser vision correction. The most common reason for not being a candidate is that a lens-based procedure (ICL, clear lens exchange, cataract surgery) is better suited to the patient’s anatomy and lifestyle. This is why we offer a range of refractive surgery options, so that nearly anyone with glasses can see clearly without them after surgery.
One of the things that sets SharpVision apart is that we have every technology available to get you out of glasses, so we don’t have to shoehorn you into a procedure that might not be the best fit for you. The biggest two factors that affect the procedure recommendation and outcomes are: age and amount of prescription. Also important is your anatomy and eye health.
Your age is important, because our eyes go through different stages:
Your prescription amount (degree of nearsightedness) is important for several reasons. The higher the degree of nearsightedness, the more tissue LASIK and PRK removes from your cornea, and each person has a slightly different amount, and limit. At SharpeVision we measure the thickness of your cornea with both sound and light to get a highly accurate measure. LASIK removes tissue from beneath the laser created flap. PRK removes tissue from the surface of your cornea.
Your ocular anatomy is important, in that some people are not LASIK candidates due to the shape and thickness of their cornea. If your cornea has signs of instability, or is too thin, we don’t operate on it. Some people can safely due PRK but not LASIK due to these same factors. Anatomy is also important when considering an Implantable Contact Lens (ICL) because you need adequate room between your natural lens and the back of your cornea to allow an ICL to be implanted.
Your eye health must be excellent to safely perform vision correction surgery. This is a big part of why we perform a free comprehensive exam at SharpeVision.
At SharpeVision, we offer LASIK, PRK, ICL, and IOL. The recommendation depends on your age, prescription amount, anatomy, and other factors. We spend a lot of time making sure you know the what, the why, and the pros and cons of our recommendation.
Of course there are risks associated with every kind of surgery, and laser vision correction is not exception. To put it in perspective, however, the risk of laser vision correction is significantly less than the risks of wearing contact lenses. Yes, you read that correctly. The conclusion of a 2016 article from the academic journal Ophthalmology stated: “Compared with contact lens wear, current LASIK technology improved ease of night driving, did not significantly increase dry eye symptoms, and resulted in higher levels of satisfaction at 1, 2, and 3 years follow-up.” Price MO et al. Ophthalmology. 2016;123(8):1659-1666.
There are very few things that can go wrong during the surgery, and the chances of any of those things occurring are slight. More important to the outcome of your surgery, we advise everyone to check out the surgeon’s credentials, experience, online presence and reviews, and to then visit the center and get an overall feel for the practice. Did you have a good feeling about the team, the physical appearance and processes internally? I believe that a higher volume of patients is good for practice consistency and to hone results. However, if you feel like they’re rushing you through, you may not receive the same attention and responsiveness of a smaller practice. This can be an issue at a multi-surgeon clinic. I feel like we have found the perfect combination at SharpeVision: we do a lot of procedures, which keeps us polished, and our surgeon-run boutique centers keep our patients at the front of everything we do.
At SharpeVision, we always follow our data to ensure that we’re getting what we think we are getting. Our patients achieve 20/20 or better uncorrected vision 96% of the time. In younger patients and those with lower (-3 or less) prescriptions, it’s as high as 99% of the time, and in our older patients with higher degrees of prescription (over -6), 89% achieve 20/20 or better uncorrected vision. Some people have never had 20/20 with glasses, and those people will likely get only as clear as they had with a good pair of glasses. Those that can see the 20/15 or 20/10 (better than 20/20) lines with glasses will likely get that same vision without glasses after LASIK or PRK.
If your vision is worse after LASIK than it was before with glasses or contacts, it’s almost always due to dry eyes or residual prescription. Both of these are fixable with time (for dry eyes which is almost always the cause of foggy vision for a month or more after LASIK) or with additional laser to touch it up (which is necessary approximately 1% of the time and free for the first year after surgery).
The most common risk with laser eye surgery is developing blur due to dry eyes or needing more laser, due to residual prescription. Experiencing blur in the first weeks to several months post-operatively is almost always one of two things: dry eyes- which almost everyone has temporarily to some degree and blurs vision intermittently, but is temporary; and residual prescription that will require a little more laser to improve clarity. Less than 2% of all patients in our practice end up needing more laser. The risk of needing more laser increases in our older patients (over 45 years old) and with higher degrees of astigmatism and nearsightedness (over -6 diopters of nearsightedness and over -1.5 diopters of astigmatism). In terms of infection, the risks of laser vision correction are lower than wearing contact lenses. And after the surgery, your chances of infection over you lifetime go down even lower since you are no longer putting contacts in your eyes.
Yes, LASIK is safe long-term! Having had LASIK over 20 years ago myself, I know from experience. But there are two things that will change your vision, whether or not you have had LASIK, that are in everyone’s future if they live long enough: presbyopia– which is the loss of flexibility in the eye in our mid 40s that requires bifocals or taking off your glasses to see up close if you’re nearsighted, and a cataract-which is the clouding of the lens in your eye that occurs gradually throughout our 60s onward until it affects our vision enough to decide to have it taken out. LASIK does not affect either of these conditions.
During the surgery, your surgeon will thoroughly numb the surface of your eyes with specialized drops. This makes it so you won’t feel the need to blink. He or she will then insert an instrument that will hold your eyelids out of the way. If you try to blink, your eyelids will not move. Your surgeon will talk to you while he is numbing your eyes in preparation for surgery, so you know what is coming next and won’t be startled.
The only way to know for sure is by coming in for a complete eye exam at SharpeVision or another LASIK provider. We perform the entire exam completely free of charge. During your 90 minute exam, we will dilate and scan your eyes with specialized machines to obtain a variety of data, including your corneal shape and thickness, your precise prescription, and the health of your eyes. There are many factors that help us determine not only if you’re a candidate, but to set expectations and educate you as much as possible to help you make the best decision.
No, not just by looking at your prescription. Your general optometrist measures your prescription and level of astigmatism for glasses and contacts and can refer you to a LASIK provider, but they cannot confirm if you will be a candidate for laser eye surgery. To know if you are a candidate, you need to have a complete eye exam at a LASIK provider. At SharpeVision, we use highly specific equipment to topographically map the surface of your eyes and get multiple prescription measurements, among other things. Our refractive surgeon-trained optometrists will then discuss all the results with you and determine if you are a candidate for LASIK.
If it has been more than one year since your exam, then yes, you should schedule another free exam either by phone or online. If your consult was within the last year, and you aren’t having any new problems with your eyes, you can still schedule another free exam, or you can call us and we will go over your chart with you and schedule your surgery, with our surgeon’s approval. The prescription of your eyes will not have changed enough during this time to require another exam. And our surgeon will always re-check your eyes pre- and post-surgery, no matter how long ago you had your initial exam.
We currently don’t have an option to book your surgery online. If you have already been approved as a candidate for laser eye surgery, please call us to schedule your surgery. If you have not yet had your free eye exam and consultation, you can book that online by clicking the “Book an Appointment” button at the bottom of this page.
You might be too old for LASIK, but you are never too old to get out of glasses and contacts. One of the most important factors in determining whether or not you’re a candidate for laser eye surgery is your age. As we age, the lens inside our eye gets gradually more cloudy (typically in our 60s and 70s) which is called a cataract. By removing the clouded lens and inserting a new one with you custom prescription, we can potentially make it so you not only don’t need glasses, you see better than you have seen in years.
The US FDA has approved the lasers for those 18 years old and older. So while we can’t do LASIK on anyone under 18, we advise them to take care of their eyes, not to sleep in contacts, and monitor any progression of their nearsightedness.
No one ever has. However, LASIK is a surgical procedure and does have risks that vary by your age, prescription, and numerous other factors. Please see “risks of laser surgery” above.
It really isn’t! Unlike most surgeries that require painful injections or nerve blocks to numb an area, all it takes to numb your eyes for LASIK are specialized numbing drops. You won’t feel any pain during the procedure, but what you will feel is some pressure, even with loads of numbing eye drops. Once in a while, someone will say that they felt a lot of pressure. Most everyone is apprehensive about the procedure, and I can certainly understand since I have also been under the laser. To help with this, we’ll offer you a mild sedative to calm your nerves, or you can choose to have beer or wine in Austin and Chicago in lieu of a sedative. And remember, our surgeon will talk you through the procedure from start to finish to make sure you’re not startled and know what’s coming next. It’s about 3 minutes per eye, 6 minutes total. We do our best to make it as easy and comfortable as humanly possible.
The number and types of tests performed at your preoperative LASIK exam vary somewhat by practice, but should contain at least all the elements of a complete eye exam, with the addition of topographic measures of the front of your eye.
There are other tests that are sometimes done, such as corneal hysteresis (measures the rigidity of your cornea) that has emerged as a helpful predictor for glaucoma, OCT (ocular coherence tomography) that is a helpful imaging device that gives exquisitely detailed imaging of the structures of the retina and front of the eye. These and others are generally done only when necessary to further diagnose and treat a specific condition that is found on the comprehensive exam.
At SharpeVision, we perform all of the routine exam components, and a couple that are specific to our sub-specialty, the aberrometry and topography. We specialize in vision correction, so if we suspect someone of having a retinal, neurological, motility, orbital, glaucoma, or other eye problem outside of our sub-specialty, we refer them to colleagues in that sub-specialty.
One of the elements that I believe is critical to getting the best possible results at SharpeVision is that we ALWAYS recheck the prescription on the day of the procedure. We have 6 different data points for your prescription amount:
Immediately after LASIK, you will see better, but your vision will be foggy. Most people will still have some foggy vision the next day, but most of the initial fog is gone, and you will be able to see well enough to drive, look at a screen and function well. Vision will improve for several weeks to several months, and may be good one day, and foggier the next. The reasons for the fluctuation is that the surface of your eyes is recovering for those weeks or months. We’ve typically seen more dryness in women than men, and in older patients as compared to younger. It does get better though, and ultimately returns to baseline. That is, if you have dryness before LASIK, you will likely have the same dryness afterwards. The big exception to this is if your contacts are causing the dryness, or if the issue isn’t dryness, but an allergic reaction to your contacts called “Giant Papillary Conjunctivitis.” In either of those circumstances your eyes may feel much better after LASIK or PRK once they’re healed.
After PRK, your immediate vision will be similar to LASIK, but tends to get noticeably worse on day two or three postoperatively, and then start to get better. Vision after PRK catches up to the vision after LASIK, and indeed the results are statistically the same after the one month postoperative mark.
This question is answered very differently between practices. The answers I’ve heard have been as long as six weeks out of contacts before they’ll even see you to as short as three days before the procedure. The reason, in my opinion, is dogma, or historical dictates that have not kept up with actual practice. I’ve been performing LASIK and PRK full time since 1999 and have observed these practices evolve in some places and not in those who don’t directly practice, or who have never questioned the practice of these onerous dictates.
Our policy is:
The reasons to be out of contacts are to reduce or eliminate any effects of the contact lenses on your eyes. These effects may be very short term: reducing the bacterial CFUs (colony forming units) on your lids, and ocular surface. This reduction of bacteria occurs in about two days. Medium term: the dogma/conventional wisdom is that soft contacts can mold or change the shape of your eyes and therefore your prescription. I believe this is absolutely true if you wear Rigid Gas Permeable (RGP) lenses (more below), but not true of soft or soft toric (astigmatism correcting) contact lenses. At SharpeVision, we ALWAYS recheck your prescription very carefully on the day of your procedure. The reason for this is to confirm all our measurements from the day of your exam. Now here’s what I think is the cool part: we find slight variations in prescription on most people. That is, (almost) anything you measure in the body will fluctuate a small amount (height, weight, temperature, etc.) but the fluctuations are present whether you’ve worn contacts or not. So our results are the same excellent results in everyone.
*Caveat! RGP (hard/inflexible contacts) are an exception! RGP lenses absolutely do mold the shape of your eye. This is where the SharpeVision method makes the process as easy as possible, while ensuring excellent outcomes. We have our patients come in for a free comprehensive exam even if they’re wearing their RGP lenses. We can tell them they’re a candidate based on their prescription, corneal thickness, and all the other elements of the exam. If they’re not LASIK candidates, they don’t have to undergo the burden of not wearing their contacts for a long time. We also discuss the effect of RGP lenses on their eyes. We require these patients to wear glasses only (occasionally switch to soft contacts) for a minimum of three weeks, then have them come for a recheck of their prescription. This is where the majority of any change in prescription will be determined. Then we schedule their procedure at least two weeks after that, and check the prescription again a third time very carefully. If we measure more astigmatism, or a significant change in prescription, we postpone their procedure, and recheck again in at least two more weeks. I can only recall doing this one time. This protocol has worked perfectly in my opinion. It allows us to monitor stability of the prescription over time.
PS: If you don’t have any glasses to wear before the procedure, we frequently write a prescription for temporary glasses that you can get online for under $20.