Refractive Surgery LASIK eye surgery is the best known and most commonly performed laser refractive surgery to correct vision problems, and can be a good alternative to glasses or contact lenses. Home LASIK 1st Entry At the UCI Health Gavin Herbert Eye Institute, our top priority is outstanding patient care. That is why our surgeons meet with each patient to determine his or her vision correction needs. Our refractive surgeons at the UCI Health Gavin Herbert Eye Institute are certified by the American Board of Ophthalmology. Additionally, all of our refractive surgeons have had advanced fellowship training and have been distinguished as top doctors in Orange County and the nation. Our relationship with you as a patient is focused on fulfilling the needs and priorities of your eye condition, applying state-of-the-art diagnosis and surgical procedures, and supplying experienced advice for achieving your best possible visual results. A typical evaluation begins with a vision counselor at the Refractive Surgery LASIK Center in the Gavin Herbert Eye Institute building on the main UCI campus. The counselor discusses different vision correction procedures and treatments that are available and gives a tour of our refractive suite. Next, the patient meets with one of our refractive surgeons. This ophthalmologist personally supervises all necessary measurements and tests, while answering all of the patient’s questions. Based on the examination and test results, the surgeon determines which vision correction procedure—LASIK, PRK, implantable contact lens or cataract surgery—is right for the patient. The surgeon and counselor remain available to the patient for further questions on the procedure and the healing process. After the procedure, the surgeon continues to meet with the patient for post-operative testing, measurements and follow-up care. By guiding the patient through each step of the process, we are able to individualize patient care, which results in greater patient satisfaction. Unlike most refractive surgery centers, at the Gavin Herbert Eye Institute, your surgeon takes the time to follow you through every step of your refractive surgery experience -- your preoperative evaluation, your surgery, and your post-operative care visits. Myopia Patients with myopia are nearsighted, meaning they can see near objects clearly but things at a distance are blurred. Myopia usually results when the eye is too large or elongated, which causes light entering the eye to focus before reaching the retina. LASIK (laser assisted in situ keratomileusis) is one of the most popular vision correction procedures for patients diagnosed with myopia. View Video Hyperopia Patients with hyperopia are farsighted, meaning they have good distance vision but close-up objects appear blurred. Hyperopia is due to the eye being smaller than normal, causing light entering the eye from close-in objects to come into focus too far behind the retina. LASIK (laser assisted in situ keratomileusis) is one of the most popular vision correction procedures for patients diagnosed with hyperopia. View Video Astigmatism Astigmatism is a condition that can impair vision both close up and at a distance. It occurs when the cornea and lens of the eye is oval in shape instead of round. This lets light enter the eye to focus at several points on the retina instead of one, causing blurring. Astigmatism often occurs with myopia or hyperopia. LASIK (laser assisted in situ keratomileusis) is one of the most popular vision correction procedures for patients diagnosed with astigmatism. View Video Presbyopia Most patients begin to experience presbyopia, meaning old-eyes, in their 40s. This occurs as the eye lens hardens naturally with age and loses the flexibility to focus on close-up objects. There now are laser vision correction options available for presbyopia, including monovision LASIK and PRK surgery, in which one eye is corrected for distance vision and the other is corrected for near vision. Surgeons at the Gavin Herbert Eye Institute’s Refractive Surgery LASIK Center conduct a thorough examination to see if the patient can adjust to this vision correction procedure. That involves a simulation in the office or having the patient test monovision glasses or contact lenses for a few days. Some people with presbyopia choose Refractive Lens Exchange (RLE), a procedure identical to cataract surgery with a lens implant that corrects for blurred objects at close range. View Video Cataracts A cataract is a clouding of the transparent dome-shaped surface of the eye that prevents light from reaching the retina. It results in blurred vision, glare and halos around objects. There are three types of cataracts: Nuclear cataracts, which form in the nucleus or center of the lens, usually as the patient ages. Cortical cataracts, which form in the cortex, outside of the eye lens. Over time, this cataract extends from the outside to the inside of the lens. They are common in diabetic patients. Subcapsular cataracts, which form at the back of the lens. This type of cataract is common in diabetics, people taking steroid medication and those who are farsighted or have retinitis pigmentosa. When a patient has small or slowly developing cataracts, they can compensate temporarily with prescription glasses or bifocal or avoiding activity such as driving at night. Eventually, surgery to replace the clouded lens may be needed. More information about Cataracts View Video Lasers At the Gavin Herbert Eye Instutute’s Refractive Surgery LASIK Center, we are dedicated to finding our patients’ best personal vision. We do this by offering the most state-of-the-art vision correction laser available – the Visx Star S4 laser. View Video Our ophthalmologists use the Intralase Method™ for all our LASIK treatments. The blade-less Intralase® femtosecond laser is the safest way of creating the corneal flap for vision correction treatment. The Intralase® femtosecond laser has a special association with UCI and the Gavin Herbert Eye Institute. Dr. Ronald Kurtz and Tibor Juhasz, professors at the Gavin Herbert Eye Institute, co-invented the blade-less laser. Former institute director Dr. Roger Steinert pioneered its use in corneal transplants. The Intralase Method™ uses a computer-guided, ultra-fast laser used to create a corneal flap without affecting the cornea. Using pulses of laser light, the Intralase Method™ creates microscopic bubbles at a predetermined depth just below the cornea surface that are gently separated to create the corneal flap and expose a smooth treatment area for LASIK treatment. The precision afforded by the Intralase Method™ makes it an option for patients who haven’t been candidates for traditional LASIK because of their thin corneas. Results from clinical studies have shown that more patients have 20/20 vision and reported less trouble seeing in dimly lit conditions after having LASIK done in combination with the Intralase Method™. LASIK Laser assisted in-situ keratomileusis, or LASIK, is a refractive procedure involving a laser that cuts through a flap on the cornea and reshapes it to correct such eye conditions as myopia and astigmatism. LASIK Surgery was first approved for use in the United States in 1995 and remains one of the most popular vision correction procedures, improving vision to 20/40 or better in 95 percent of patients. The procedure takes only a few minutes and vision is improved often on the day after surgery. LASIK (laser-assisted in situ keratomileusis) surgery was first approved for use in the United States in 1995. It remains one of the most popular vision correction procedures to correct nearsightedness (myopia), farsightedness (hyperopia) and astigmatism. Millions of patients worldwide have enjoyed clear, crisp vision after undergoing LASIK surgery. Using the latest in LASIK technology, Gavin Herbert Eye Institute’s Refractive Surgery LASIK Center surgeons customize each procedure to deliver even more precise vision correction. Many patients find that they have better vision than when they wore glasses or contact lenses. During the LASIK procedure, the surgeon carefully creates a thin flap that is gently folded back to expose the corneal surface for reshaping with the excimer laser. The flap is then carefully re-folded over the treatment area, acting as a bandage as the eye heals. Most patients see their vision improve within hours after treatment. Many are ready to return to work or their normal activities the following day. View Video PRK or Advanced Surface Ablation Not all patients are good candidates for LASIK surgery. For patients whose corneas are too thin or who have other considerations, other options include PRK (photorefractive keratectomy), LASEK (laser epithelial keratomileusis) or Epi-LASIK surgery. During these procedures, the laser treatment is done directly on the surface of the cornea after removing a small amount of the outer layer of cells. The PRK procedure can be done to correct nearsightedness (myopia), farsightedness (hyperopia), or astigmatism. View Video Phototherapeutic Keratectomy (PTK) PTK or Phototherapeutic Keratectomy uses the ablative properties of the laser to treat various medical conditions of the cornea such as opacities or irregularities. Conductive Keratoplasty Conductive Keratoplasty or CK uses low energy radio waves to change the focus of the eye to allow for near vision (to treat presbyopia). This is an alternative to laser based procedures such as LASIK or PRK, and may be an option for you. Unlike LASIK or PRK, no tissue is removed from the eye during a CK procedure, and takes only a few minutes. CK is also being investigated as a way to correct certain types of astigmatism that create an irregular eye surface due to trauma or surgical incisions. Phakic IOL (Implantable contact lens) Patients for whom LASIK or PRK is not indicated because of extreme nearsightedness, thin corneas or other conditions have another treatment option, often called an “implantable contact lens.” The implant, technically known as a phakic intraocular lens, is surgically inserted without removing the natural lens. Implantable lenses are currently available to correct nearsightedness and are in development for patients with farsightedness and astigmatism. At the Gavin Herbert Eye Institute’s Refractive Surgery LASIK Center, we offer two types of implantable lens. The first is a soft, foldable lens made of a polymeric material that resembles the natural collagen of the cornea and is biocompatible with the eye. During the procedure, the surgeon makes a small incision at the edge of the cornea. The lens is folded and carefully inserted into the anterior chamber of the eye and placed behind the iris, or colored part of the eye. Healing is relatively quick and patients often see immediate improvement in their vision. Most patients don’t feel or notice the lens once it is implanted. The lens is intended to be placed permanently but it can be removed if necessary. The second type is a phakic intraocular lens for patients with moderate to extreme myopia who aren’t good candidates for LASIK surgery. This type of lens is placed behind the cornea and attached to the iris to give the eye additional focusing ability. Microscopic stitches used to close the incision dissolve over time. After patients recover from surgery, they usually have good distance and near vision. After a phakic lens implant, most patients no longer need glasses. However, as the patient ages, it is normal for natural lens function to decrease, which may make reading glasses necessary. Cataracts also may develop over time. If cataract surgery is required later, the phakic implant is removed and the surgery proceeds in a standard manner. View Video Frequently Asked Questions For more information, please call: 949-824-9970 Your pre-operative visit All eyes are unique. Not all people are candidates for the refractive surgery procedure. No two cornea maps are the same just like with a SNA sample or fingerprint. Before refractive surgery is considered, you will be required to undergo a series of diagnostic tests to determine the stability of your vision. After a thorough evaluation of your eye, your refractive surgeon will be able to determine if you are a candidate. This thorough diagnostic evaluation is the first step in creating a positive outcome for your best possible visual outcome. The refractive surgeons at the Gavin Herbert Eye Institute will perform this initial eye exam which includes: Complete review of overall eye health Glasses or contact lens history review The measurement of corneal thickness, including corneal topography The measurement of your prescription or refractive errors WaveScam measurements for higher order aberrations. Dry eye test Complete dilation to view the back of the eye or the retina As part of your initial evaluation, your Gavin Herbert Eye Institute refractive surgeon will educate you about refractive surgery. This will involve the history of refractive surgery, any risks, the procedure process itself, and the successes of this amazing eye surgery. If you have been told in the past that you are not a candidate for refractive surgery you might want to call us about the latest advancements or other options. Depending on your unique visual situation you may now be a candidate for the surgery. Expectations Your decision to have laser vision correction is a serious decision. Ultimately, you will be the one to make the final decision. When selecting a refractive surgeon it is important to select a surgeon that can honestly explain your visual needs. The ultimate goal of LASIK is to reduce your dependence on glasses and contact lenses. LASIK does not always create perfect 20/20 vision, though most cases are successful in improving vision. After Surgery These instructions may be changed by your doctor. Please follow your doctor’s instructions. General Cleanliness Do not get anything in your eye(s) such as makeup, soap and water, or any particular matter. If you do, this will greatly increase your risk of infection. Avoid swimming pools and hot tubs for one week. Do not rub your eye(s) or allow any trauma to your eyes for one month. Immediately After Surgery Go home and go to sleep. When you are asleep your body goes into a healing mode. Sleeping is the best thing you can do for yourself. If you are uncomfortable, take two Extra Strength Tylenol tablets. Repeat once every 2-4 hours as needed. You should not drive a car, operate machinery, or attempt stairs immediately following surgery. You will be given an eye shield for your operative eye(s). Please wear the shields for the first day/night after surgery and the following two nights at bedtime to prevent you from rubbing your eye(s) while sleeping. First Day After Surgery You will return to the clinic the first day after surgery. You can expect your vision to be hazy. Medicated Eye-Drop Instructions You may begin putting drops in your operative eye(s) after surgery, unless instructed otherwise by the doctor. You can expect your eye(s) to sting when you put them in. Your drops will include: anti-inflammatory drops, antibiotic drops, and lubricating drops. Your surgeon will give you instruction on how to use these drops depending on the type of surgery you have. The Following Days Your vision may fluctuate for the first 1-2 months. You may notice some light sensitivity and/or glare particularly at night. Any immediate post-operative discomfort you will feel will begin to subside. You may notice some temporary over correction for the first few weeks. All of this is normal. Get plenty of rest. Monovision Monovision is an option for patients aged 40 and older who have difficulty reading due to the unique natural aging process (presbyopia). This is a technique in which one eye is corrected for distance vision while the other eye is corrected for near or intermediate vision. Monovision provides a viable option for active people who require both distance vision and near vision in their daily activities. Because monovision is a compromise, reading or distance glasses may still be needed for certain activities- such as reading fine print or driving at night. Special testing is performed to see if monovision is right for you. Dry Eyes If you have dry eye problems, please inform your surgeon so that you may be started on treatment prior to your surgery. Laser refractive surgery may increase your dry eye symptoms for 3-6 months after surgery, and you may need additional drop therapy to manage your symptoms.