A: There are several considerations with this question. First, you must ask yourself, “Why do I want LASIK?” LASIK decreases or eliminates your dependence on glasses and/or contact lenses. An ideal candidate is someone who requires good uncorrected vision for their job (law enforcement or firefighting) or their other daily activities or hobbies. If your glasses or contact lenses interfere with your sports and recreation, for example, swimming, scuba diving, snow skiing or rock climbing, you may also be a good candidate. Patients also have LASIK because of decreased tolerance for wearing contact lenses. Many patients decide to have LASIK because they are tired of the hassle or the ongoing expense of contact lenses. This is a very common and legitimate reason for having LASIK, but be sure of your motivations and discuss this with your surgeon prior to surgery.

The question “Am I a candidate…?” involves your refractive correction (the strength of your glasses or contact lenses) and the thickness, shape and health of your cornea. LASIK corrects nearsightedness up to 14.00 diopters, farsightedness up to 6 diopters and astigmatism up to 6 diopters. For those with higher degrees of refractive error, there may be newer surgical treatments available which may be a better option for a given individual which Dr. Mills will be happy to explain at the time of your consultation. The best way to tell if you are a candidate is to schedule a consultation with Eye Care Professionals at (775) 322-1000 and bring your old glasses or contact lens prescription for our inspection.

A: Our refractive surgery coordinator will be glad to discuss pricing and payment options with you. Charges include your initial consultation, your surgery, the laser facility fee and one year follow-up with your surgeon. Individual insurance plans and their coverage change quickly, so please contact us for insurance authorization.

A: Eye Care Professionals’ surgical fee includes the laser facility charges, the surgeon fee, a complete eye examination and pre-op exam and all postoperative examinations for one year. In a small percentage of cases, enhancement surgeries may be required. If an enhancement is necessary, a small additional out of pocket expense will be required.

A: The answer is a qualified “Yes.” For more information, read about monovision below.

A: No. Dr. Mills has done LASIK on several patients in their 60s and even some in their 70s. However, healing and recovery of your best vision may be a little slower than in a 20-year-old patient.

A: You must be 18 and have a stable glasses prescription.

A: Yes, LASIK should not be done on patients with keratoconus. In some patients, the cornea is too thin to perform LASIK. LASIK cannot be performed on a patient who has an active eye disease. LASIK can be performed on a patient with diaetes, but not a patient with active diabetic retinopathy. Active autoimmune disease such as lupus or rheumatoid arthritis, because it affects healing, is a contraindication to LASIK surgery. LASIK cannot be done while on Cordarone or Accutane.

A: No. During pregnancy, the increased hormones soften the collagen of the cornea, resulting in variable vision and unpredictable surgical results. Also, performing LASIK on a patient who is nursing is not recommended.

A: Monovision is a correction in presbyopic patients (over 40 years of age) of the dominant eye for distance and the non-dominant eye for near. This is a common method of correcting vision in patients requiring bifocals after reaching their 40s. This method of vision correction can be done with refractive surgery or with contact lenses. In fact, President Reagan and Vice President Al Gore used a contact lens for monovision. If both eyes in a presbyopic patient are corrected fully for distance, reading glasses are then required. This may be the desired result. Not everyone can adjust to monovision. If not, then the non-dominant undercorrected eye can be enhanced for distance correction. For patients over 40, a detailed discussion with the doctor to determine the patient’s visual needs and goals is required. A trial of monovision with contact lenses can help predict which patients will do well with this type of laser correction.

A: There is a charge by Eye Care Professionals for the use of the laser for enhancement surgery. The vast majority of patients do extremely well following their initial surgery and will not need any enhancements.

A: Usually not, but some plans are beginning to pay a portion of LASIK surgery. Our insurance department keeps current on these coverage changes. Please contact us to arrange authorization.

A: You will have one or two examinations prior to your surgery. You will be examined by your surgeon one day post-op. Also, you will have exams one week, one month and three months after your surgery day. Of course, if you have or the surgeon has any concerns, you will have examinations as needed.

A: Most patients have LASIK done on both eyes at the same surgical setting. There is convenience for the patient in having both eyes done simultaneously. LASIK has a very low complication rate; however, it is a surgical procedure. For example, there have been cases reported of vision loss from infection or retinal hemorrhage. Dr. Mills may, on occasion, encourage you to consider having LASIK done on one eye at a time.

A: We usually perform our LASIK surgeries on Tuesdays. Most patients return to work by Thursday or Friday of the same week although depending on healing, treatment parameters, as well as your job, this may vary from patient to patient.

A: Dr. Mills has done cataract surgery on patients who have had RK, PRK and LASIK surgeries in the past without complications. It is more difficult to determine the power of the intraocular lens (IOL) used during cataract surgery after refractive surgery.

A: Dr. Mills has been performing refractive surgery since 1995 and LASIK surgery since 1999. Our surgeons have performed over 5,000 refractive surgeries, including LASIK, PRK (photorefractive keratectomy), AK (astigmatic keratotomy) surgeries for astigmatism and RK (radial keratotomy) and more recently ICL (implantable collamer lens) surgery and Refractive Lens Exchanges (RLEs). In addition Dr. Mills has performed KAMRA Corneal Implant surgery for reading vision restoration.

A: Although the eye is made numb with eyedrops, there is some pressure on the eye and the eyelids while the laser keratome is used. To decrease a patient’s stress and discomfort during that part of the procedure, patients are given Valium preoperatively. There is no discomfort during the laser’s use. You will be given one pain pill after completion of the surgery. The eye will usually feel scratchy for about three hours after LASIK. Usually, no other pain medicines will be required.

A: Most often, we wait to ensure that the vision has stabilized at three months. Occasionally, earlier intervention is required.

A: Most often, the original flap is lifted, the laser correction performed and the flap allowed to re-adhere. Rarely, other surgical procedures such as AK, RK or PRK will be recommended for further treatment. On occasion, the flap will have to be recut and the laser repeated.

A: Yes. Twenty staff and family members have had refractive surgery by Dr. Mills . The office staff has seen the excellent results and the happy, satisfied patients and decided also to have the procedure.

A: Yes. LASIK can be performed one year after RK surgery. The results are generally very good, but there may be a slight increase in surgical risk. Also, not all blurred vision after RK surgery can be corrected by more refractive surgery.

A: Virtually all patients have much better uncorrected vision the morning after surgery. However, very nearsighted or very farsighted patients may take a week or longer before achieving their best vision.

A: Minor complications, which can result in less than optimal outcomes and blurry vision, occur in about 1% of patients. Severe complications such as infection or retinal hemorrhage have occurred in about 1 in 15,000 cases.

A: Our enhancement rate is less than 5%, which is less than half of the national average. Some of these enhancements are patients who were unsuccessful trying monovision.

A: Potential undesirable side effects include dry eyes, problems with night vision and halos or ghosting of vision. Most of these symptoms will clear in weeks or months and some patients say that the night vision or halos are no worse than they experienced with their contact lenses. For reasons that are not completely understood, the eyes are drier than normal for up to six months after LASIK. This is, of course, more of a problem in our high and dry climate, requiring frequent use of lubricating drops and sometimes temporary plugs to keep the eyes better lubricated. Other less common side effects are explained during our preoperative patient education.

A: There have been rapid improvements in both the laser and microkeratome to make the flap. Improvements are expected for patients with unusual problems such as thin cornea, extreme farsightedness and extreme nearsightedness. LASIK does not work as well for patients with these problems. If you have these difficulties, the doctors at Eye Care Professionals will discuss with you your best options. Some currently available alternatives include PRK, ICL and refractive lens exchange.

A: Yes, LASIK can be done for patients with diabetes, as long as the diabetes is under good control. LASIK should not be performed if the patient has complications related to diabetes such as diabetic retinopathy and hemorrhages or macular edema.

A: Yes. Dr. Mills is board-certified by the American Board of Ophthalmology.

A: Yes, all surgical equipment is sterilized before use on each patient. All disposables, including the microkeratome blades, are replaced after single use on a patient, and new sterile blades and disposables are obtained for the next patient.

A: The Intralase procedure represents a tremendous step forward in LASIK technology. Femtosecond Laser LASIK, also known as blade-free LASIK, utilizes an advanced femtosecond laser to create the flap during the LASIK procedure rather than the traditional mechanical microkeratome device. The vision-correcting laser ablation is then carried out beneath this flap using the VISX S4 CustomVue excimer laser platform, which we currently use and which continues to be the industry standard. This advanced technology allows for a more precise, more accurate and more controlled flap creation. This in turn makes for an even safer and more successful experience for the patient. Some patients have had reservations when considering a procedure involving a blade, which is eliminated, as the name implies, with this newer version of the technology.

A: SMILE stands for Small Incision Lenticule Extraction. This is a flap-free procedure in which vision correction is achieved by removal of a lenticule of corneal tissue through an adjacent tunnel incision. While this does show some promise it has more limitations in terms of range of corrections treatable with this technology and also does not have as much success with astigmatism correction in general. This is only indicated for near-sightedness with lower levels of astigmatism as compared to LASIK which can correct near-sightedness, far-sightedness and higher levels of astigmatism. In addition LASIK has the ability to correct some of the more complex aberrations in the eye called “Higher Order Aberrations” which SMILE in unable to address.