Rochester New York Lasik Surgery

Laser Vision Correction FAQ's

1. What is an Excimer Laser? An excimer laser is an ultraviolet "cold" laser beam that is capable of reshaping the cornea. It is extremely precise and can remove minute quantities of tissue with accuracy up to .25 microns or .00004 of an inch. For comparison, a human hair is approximately 100 microns thick.

2. What is the difference between a broad beam and a flying spot laser? The older lasers treated a 6-mm area with a 6-mm beam. The newest generation of lasers utilize a computer-controlled smaller spot or "flying spot". The spot size is 2 mm with the Technolas and .8 mm with the LADARVision system. Flying spot lasers allow for a greater degree of customization.

3. Are all flying spots the same? No. Lasers vary widely in spot size, presence or type of tracking, pulse rates, tissue removal, blend zones, optical and transition zones and range of FDA approvals. All of these factors have an influence on eventual outcome.

4. What is PRK? PRK stands for Photo-Refractive Keratectomy and refers to the procedure where the cornea is reshaped by applying the laser energy to the surface of the eye. The outer layer of the cornea is removed either mechanically or with the laser, and the upper tissue of the cornea is ablated. PRK received FDA approval in the United States in 1995. The outer skin must regenerate as part of the healing process.

5. What is LASIK? LASIK is a newer laser eye surgery procedure that preserves the outer skin of the eye. With LASIK a flap is created of the outer skin and some of the underlying tissue. Since the outer skin does not need to regenerate, the visual recovery is usually much quicker and comfort levels are higher.

6. What is LASEK? LASEK is an even more recent development. It is a surface ablation similar to PRK with preservation of most of the components of the outer skin like LASIK. Another popular term for LASEK is "Advanced Surface Ablation". Visual recovery and comfort levels with LASEK are somewhere in between PRK and LASIK.

7. Do You Recommend LASIK, LASEK or PRK? We always recommend the treatment that represents the best combination of safety and efficacy for your eye. Many different factors that include degree and type of optical error, pupil size, corneal thickness, lid and orbital anatomy, visual needs and analysis of risk factors are all part of this decision process. Robbins Laser Site currently performs LASIK on approximately 80% of our patients.

8. What is LADARVision and why is it so important? Many other lasers rely on the patient fixating on a blinking light for centration and treatment. Even in the most cooperative patient, rapid eye movements (saccades) or involuntary loss of fixation can degrade the quality of the ablation. Only LADARVision actively measures and compensates for rapid eye movements at in incredible 4000 times per second with laser radar. Only LADARVision has been clinically proven to improve both safety and outcomes. 

9. Can You Treat Nearsightedness? The LADARVision 4000 is approved by the FDA to treat nearsightedness with and without astigmatism.

10. What is Astigmatism? If the eye is not optically round, the image will be distorted or blurred. This optical aberration is called astigmatism. It is not a disease and is not a contraindication to laser vision correction.

11. Can Astigmatism be Corrected with the Laser? Yes. Different lasers vary in their ability to correct astigmatism. The Technolas 217 is approved to correct up to 3 D or units of astigmatism with myopia. The LADARVision is approved to correct up to 4 D with myopia and 6 D with farsightedness.

12. Can You Treat Farsightedness? Yes. The LADARVision is approved by the FDA to treat up to 6 D of farsightedness, with or without astigmatism.

13. What is Presbyopia? Presbyopia is the term used for the progressive loss of near acuity that occurs with age. Most individuals with previously "perfect" vision will eventually require glasses for close-up tasks. If you need reading glasses over your contacts, you most likely suffer from presbyopia and will still need glasses up close even after successful laser vision correction. Some individuals can maintain both distance and near vision with something called "Monovision".

14. What is an "off-label" use of the Laser? The FDA has provided guidelines for applications of the Laser energy that are 'proven safe and effective'. Any use of the laser outside these limits is considered "off-label".

15. What is Wavefront and Higher Order Aberrations? Glasses and contact lenses correct approximately 90% of the focusing errors present in the average eye. Adaptive optics developed by astronomy physicists have taught us that higher order optical defects can be measured and do impact the quality of vision. The LADARVISION system with the LADARWAVE upgrade is the first laser system in the United States approved by the FDA for the treatment of these optical defects. 

16. What is CK? CK is conductive keratoplasty. It is a non-laser treatment that heats the cornea with a hot needle. CK is FDA approved for the temporary treatment of low degrees of farsightedness.

17. When can I return to work after surgery? After LASIK laser eye surgery, the majority of our patients see well enough to drive the next day. We recommend that most individuals plan on missing 2-3 days of work. However, in many instances work and normal activities can be resumed the day following surgery. There are no restrictions in terms of heavy lifting or bending. It is important to avoid contamination of the eye or exposure to harsh irritants. If you have an unusual occupation or hobby, make sure you discuss this with the staff prior to surgery.

18. Do you treat both eyes at once? Bilateral laser eye surgery is an option. The majority of our patients do electively have both eyes treated on the same day. In all cases, we perform laser eye surgery on one eye first and proceed with the second eye only there are no observed problems with the first laser eye surgery.

19. Will I experience glare at night or halos? Glare and/or halos are a known complication of refractive surgery. The older RK incisions frequently extended into the central visual axis, and almost all patients experienced some glare. The larger treatment zones and more gradual transition areas possible with flying spot lasers has reduced the incidence and severity of these problems. FDA clinical trials have shown that wavefront-guided CustomCornea treatments with the LADARWAVE system have further decreased the incidence and severity of this problem.

20. Another doctor told me I was not a good candidate for LASIK. Does it make any sense to get second opinion? Absolutely! You may not be a suitable candidate for older technology, but perfect for a more recent development. Also, lasers vary in their capabilities and how much tissue they remove. The LADARVision 4000 is particularly tissue-sparing when compared to other flying spot lasers. Also, for eyes with thinner than average corneas, LASEK may be a safer alternative.

21. Can anything go wrong? Again, the answer is a definite yes. Any surgeon who guarantees his results or claims to have never seen a complication is either dishonest, inexperienced or both. Years of experience and the latest technology does not guarantee a perfect result, but certainly improves your odds. The timely treatment of such things as infection or excessive inflammation can make a vast difference in the visual outcome.

22. I was told my cornea is too thin for LASIK? What does this mean? For LASIK laser eye surgery, we need to have sufficient corneal thickness to make the outer flap, remove tissue to change the prescription, and leave at least 250 microns untouched in the corneal bed. Some microkeratomes and lasers are more tissue sparing than others, so it may be a good idea to obtain a second opinion. LASEK is often an excellent alternative for individuals with thinner than average corneas.

23. Can I pay by credit card? Robbins Laser Site accepts most major credit cards including MasterCard, Visa and Discover.

24. Is Financing Available? We have a variety of payment plans available either through independent private lending institutions. We also accept most major credit cards.

25. When Is Your Next Informational Seminar? The internet and our free personal consultations have made monthly seminars superfluous. However, we do occasionally hold seminars to introduce new technology and will be offering web-based seminars  (webinars) in the near future. Contact our office either via phone at 585-787-2020 or via email  lasikinfo@aol.com for more information.

26. What is involved in the preoperative testing? You will receive a complete eye examination including refraction, slit lamp and retinal evaluation. In addition, we will perform some specialized tests such as corneal topography, pachymetry, pupillometry and wavefront measurements of the optical aberrations. For LADARVision, a special digital photograph of the eye is taken to aid the computer in tracking and alignment. This step is unique to the LADARVision system. You will receive drops to dilate the pupils and relax the focusing muscles within the eye. You should expect to be blurry for many hours following the exam.

27. Do I need to remove my contact lenses prior to the evaluation? We can perform many of the pre-surgical tests without removal of your contacts for an extended period of time. However, it is necessary to remove your contact lenses for the prescribed period of time prior to the actual surgery.

28. Will my surgery be performed by Dr. Robbins? Yes. Dr. Robbins performs all of the refractive laser eye surgery at Robbins Laser Site. Other doctors may assist with the pre-operative testing, counseling and post-operative care, but every surgical procedure at Robbins Laser Site is performed by Dr. Robbins.