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Back to Procedures and Treatments Depend on Experience in Laser Eye Procedures The two surgeons are nationally recognized by VISX, the company that makes the equipment used for laser refractive surgery. VIXS ranks Dr. Jenkins and Dr. Omphroy among the top five percent of laser refractive surgeons in the nation. Because of their experience with thousands of laser eye procedures, they are the only surgeons in Hawai’i certified to train other surgeons to use the VISX excimer laser for the procedure. This web site can help you make an informed decision about laser refractive surgery. If you have further questions, email Dr. Jenkins and Dr. Omphroy and they will respond within a few business days. When you choose Dr. Jenkins or Dr. Omphroy, you will meet directly with them, not a technician, both before and after your procedure. They are opthalmologists trained in complete eye care. To your left are a number of categories with information ranging from what to expect during and after the procedure and the risks involved. About Laser Procedures
LASIK & PRK The cornea and lens combine to focus visual images on the back of the eye. When the overall shape of the eye or the curvature of the cornea is incorrect, visual images become blurry. The cornea accounts for approximately two-thirds of the focusing power of the eye. By surgically changing the corneal curvature, the rays of light are focused clearly on the retina, and most or all of the blur can be eliminated. Laser vision correction is not a new procedure. Around the world, millions of procedures have been performed since the 1980s. In the United States, where Food and Drug Administration (FDA) approval came in the mid-1990s, more than two million surgeries have been performed using the VISX laser–the procedure preferred by Drs. Jenkins and Omphroy. LASIK LASIK surgery is a common surgical procedure to correct nearsightedness, farsightedness and astigmatism. Using the excimer, or cold laser, the doctor removes the damaged tissue beneath the corneal flap with very little or no scarring. The entire procedure from start to finish takes a matter of minutes. Patients have reported clearer vision within a few hours following the surgical procedure. Advantages of LASIK include:
PRK Photo-Refractive Keratectomy (PRK) is another method of surgically reshaping the cornea using the excimer laser. The difference between LASIK and PRK is that for PRK, the corneal flap is not created. That is, the outer layer of the cornea remains in place and the laser removes tissue directly from this outer layer. As in LASIK, the laser treatment is very brief. Unlike LASIK, the healing period is longer. The corneal curvature is changed so that visual images are properly focused on the back of the eye. The correction for nearsightedness, farsightedness and astigmatism are the same as LASIK. In either procedure, once your vision is stable, your treatment is permanent, resulting in less dependence, maybe complete freedom, from glasses and contact lenses! First Step The first step is to set up a consultation:
As part of your consultation, we perform a thorough eye exam. To help you make an informed decision, we review all aspects of laser vision correction and what you can reasonably expect from the procedure. We will carefully evaluate your eyes and answer any questions. If you choose to have laser surgery, we'll tell you what you need to do to be ready. Mainly, you'll need to stop wearing contact lenses before the procedure—one week for soft lenses and four weeks for hard or gas-permeable lenses. Day of the Procedure Arrive at the Laser Eye Center of Hawaii as rested and relaxed as possible. Allow for two hours at the center. Wear comfortable clothing. Do not wear makeup, earrings, hair spray, perfume or cologne on the day of your laser procedure. Arrange for someone to drive you home. You will be asked to sign an informed form of consent and arrange for payment. (We can help you arrange financing; please ask our staff for the information in advance.) Pre-ops Meet with your surgeon to discuss any last-minute questions. We'll use anesthetic drops to numb your eye. If you are having LASIK, your surgeon may prescribe a mild oral sedative. In both procedures, sterile surgical conditions are well maintained.
LASIK Procedure In LASIK, a small flap is made on the surface of the cornea. A suction ring will hold the eye in place. You will not see anything or feel any pain, but you may feel some pressure at this time. When the flap is turned over, your vision will become a little blurry. You will be asked to fixate on a red target light. The laser part of the procedure is performed in 20-60 seconds. The flap is then placed back into position and the surgeon will wait 3 to 5 minutes for the eye to create a natural vacuum to hold the flap down. The typical LASIK procedure takes about 10 minutes per eye. Once the surgery is complete, you will be able to go home almost immediately. First, we place some additional drops into your eyes and instruct you on using your medications. PRK Procedure You will rest in a comfortable reclining chair with hour head under the laser equipment. An eyelid holder will be placed in your eye to keep you from blinking. The surgeon will prepare your eye for the laser by removing the top surface of the cornea. You will feel pressure but no pain. When the eye is prepared, you will be asked to look at the red target light. The laser makes a clicking sound as it works. The actual laser part of the procedure takes seconds. At the end of the PRK procedure, a clear bandage contact lens is placed onto your eye. This will help keep you comfortable while the outer surface heals. The typical PRK procedure takes about five minutes per eye. After the Procedure The 1st Day Following the surgery, go home and rest. You may experience slight feelings of discomfort. With the LASIK procedure, this may last a few hours; with PRK, a few days. Asophthalmic (steroid) drops will help promote healing. You can expect your vision to be fairly blurry. In the case of PRK, your vision may worsen over the first three days. With LASIK there is usually a dramatic improvement in vision in the first 24 hours. Do not plan on driving until you feel vision has improved. This may be a week with PRK and a few days with LASIK. Sensitivity to light is normal and will improve.
The 1st Week Before leaving The Laser Eye Center, we’ll give you complete instructions including a post-operative appointment schedule. This includes examinations the day after, a week after and one, three, six and twelve months after the procedure, with annual checkups after that. The earlier stages of PRK recovery are also longer. Your vision may get worse for the first three days. This is normal. You will notice an improvement about Day 5 and it will continue for several weeks. We recommend using eye drops for at least three months. The frequency will be modified after the one-month visit. With LASIK your vision improves more rapidly and you may feel comfortable enough to drive in two days. You will be using eye drops for about ten days. The 1st Year It may take as long as three months for your vision to stabilize following PRK or LASIK surgery. Recovery is generally faster with LASIK and stability may be achieved as soon as two weeks. With LASIK, although the flap is relatively secure in one week, we advise you not to rub your eyes hard for a month. With PRK the post-operative steroid drops must be continued as your doctor recommends. Deviations from this regimen may lead to haze or regression. FDA Approval The U.S. Food and Drug Administration (FDA) is mandated to protect consumers through rigorous proofs of safety in food, drugs and medical devices. The products must not only be safe, they must be effective and labeled honestly. Technology has brought us more and more complicated medical procedures, and the FDA has responded by requiring detailed manufacturing information and extensive performance testing. Need to link pdf file talking about PRK, LASIK and Customvue The VISX Laser The VISX laser system, which Drs. Jenkins and Omphroy use, was the first device for corneal, refractive surgery to seek FDA approval. This device has been approved for nearsightedness, farsightedness and astigmatism. The VISX laser system has met the FDA's stringent standards involving manufacturing, performance and quality, failure mode analysis, animal tests (begun in 1986), toxicology tests, and human clinical studies. Around the world, millions of procedures have been performed since the 1980s. In the United States, where FDA approval came in the mid-1990s, about two million procedures have been performed using the VISX laser; the laser of choice for the Ke Ala 'Ike surgeons. VISX holds more than 25 U.S. patents on hardware and surgical methods. To decide whether laser vision correction is a good alternative for you, it is important to understand the potential risks. In general the risks are low, but there are still important factors to consider. There are very low (2% or less) rates of complications relating to undercorrection, overcorrection, night glare and halos, or loss of best-corrected vision. Infection occurs in less than one/tenth of one percent of procedures. The chances of risks with PRK versus LASIK are about the same but of a different nature. Most risks with PRK are related to healing, while in LASIK they relate to creating the corneal flap. Estimated rates of complications for both procedures include:
Undercorrection and regression problems are more common in high myopia cases. Undercorrection This is more common than overcorrection. Slight undercorrection will not seriously affect your vision. It may be desirable in patients over 40 to help with reading vision. If there's significant undercorrection, we will perform an enhancement at no additional cost. The higher the myopia, the more frequently undercorrection occurs. Overcorrection An initial overcorrection may occur and usually corrects itself within the first month. Overcorrection will make your vision at close range more difficult. After laser vision correction, your distance vision clears first, followed by your near vision. Overcorrections are rare, about 2% or two of every 100 procedures. Night Glare and Halos A common condition following the surgery, and usually clears within the first three months after the procedure. These symptoms usually resolve after the second eye is corrected. Sometimes a weak prescription for night driving may be needed. The incidence of night glare and halos (beyond the early months) is 2%. Loss of Best-Corrected Vision A small number of patients experience a slight loss of visual sharpness following laser vision correction. This means that even with your best correction, you may loose ability to read the bottom one to three lines of the eye chart. This can be due to irregular healing or an irregular flap and may improve over the first year. This occurs in less than 2% of the procedures. Infection While most feared, it is extremely rare. If it does occur, it happens in the first 48 to 72 hours. You will receive antibiotic drops after the procedure to help prevent infection. Infection occurs in less than one-tenth of one percent of the procedures. Haze Occurs when protein develops on the surface of the eye after laser refractive procedures. A trace haze is very common. Even moderate amounts of haze will not affect your vision. Ultraviolet light appears to aggravate haze, so it is important, particularly in Hawaii, to wear good ultraviolet protection. Serious haze may occur in less than 1% of PRK procedures, and is very rarely seen with LASIK. Regression This is a tendency for the eye to drift back toward your original prescription. This occurs more commonly in patients with higher amounts of myopia. Enhancement procedures can be performed to "tune up" your treatment. In some cases, glasses for night driving may be all that you need. Corneal Flap Risks These are very rare. These occur in less than 1% of the procedures. This may result in loss of best-corrected vision. Dry Eyes Unrealistic Expectations Laser vision correction is exciting, but it is essential that you understand the procedure and the associated risks. A patient who has unrealistic expectations and falls short of them will be the unhappiest patient of all. Although our procedures have a high degree of success, we cannot, and do not, promise you 20/20 vision without eyewear correction. With laser vision correction we can significantly reduce your dependence on glasses and contact lenses, but most patients still eventually require glasses for reading and some may even need a thin pair of glasses for critical distance activities. It is best for you to think of this procedure not as eliminating your need for glasses, but reducing your dependence upon them and improving your vision. Will It Work For Me? Most likely. That's the short answer. It depends on a number of factors, including age and health. Since each patient is unique, we recommend that you call or email our office to see if you are a candidate for either procedure. In general you must be over 18 for treatment of simple myopia (up to ®¢6.00 with minimal astigmatism) and over 21 for treatment of myopia up to ®¢12.00 and astigmatism up to 4.00. Your vision has to have been stable for at least a year. You must be free from certain diseases of the cornea and retina such as cataracts or glaucoma. You should not be planning to become pregnant in the next 6 months and should be in good general health. Various visual problems are explained below. It is helpful to know the type or level of your eye disorder so you can better judge whether laser vision correction is for you. If you don't know the level of your problem, don't worry. We can help you with that through a screening. How the eye works Your eye focuses light and works like a camera. Light enters through the cornea, the "window of the eye." The rays of light travel through the pupil to the lens; the lens fine tunes the focus of light onto the retina. The retina turns light into electrical impulses that travel to the brain, which interprets the image it receives. When the light rays coming into the eye aren't focused properly, the eyes need correction, traditionally through glasses or contact lenses. Now laser vision correction offers a more permanent solution. To see if you are a prime candidate for laser vision correction, complete the self-evaluation provided below and/or call our office for further consultation. |
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