Romanoff Vision

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LASIK

LASIK is the acronym for the laser refractive surgical procedure known as Laser Assisted In Situ Keratomilusis. It is an outpatient procedure that typically takes only a few minutes to do on each eye. LASIK can correct myopia (nearsightedness), hyperopia (farsightedness), and astigmatism.

LASIK is not a procedure that everyone qualifies for. There are many medical and ophthalmologic conditions that make it very risky to do the LASIK procedure. Dr. Bennett Romanoff is very conservative and cautious in his patient selection for this procedure. One has to have an excellent chance for success prior to surgery to be considered for LASIK. One has to be at least 20 years of age and go at least 2 years without a change of their glasses prescription to be considered for LASIK. Dr. Romanoff personally sees all candidates prior to surgery to determine if they qualify for LASIK, as well as performs the follow-up after surgery.

Since virtually all patients who choose to have this procedure have good vision with glasses to start with, anything less than excellent is not usually acceptable to the patient. LASIK will decrease ones dependence on glasses but some patients may still need them after the procedure if the final result is close to perfect, but not totally perfect. Also, those patients who are in the 40’s and have presbyopia will still need some type of reading glasses after LASIK. Generally speaking, the stronger ones glass prescription prior to LASIK, the less the chance of seeing down to the 20/20 line on the chart after the procedure. However approximately 65% of LASIK patients see better than 20/20 after the procedure.

Dr. Romanoff trained in Europe and in Israel back in the early 1990’s before the FDA approved this procedure here in the USA. As soon as laser refractive surgery was approved in the USA back in 1996, he was one of the first ophthalmologists in this area to perform this type of surgery. Back in the mid to late 1990’s PRK was the procedure of choice and finally in the late 1990’s, LASIK was approved. The rest is now history.

LASIK is done in an outpatient surgical suite. Many patients feel comfortable not having any sedation prior to LASIK, however Valium in a very low dose is offered for those who feel they might need it. Prior to starting the procedure, the eye is numbed with a few drops of topical anesthetic. A lid speculum, a small device use to keep the eye open during the procedure, is inserted between the eye lids.

After this is done, suction is applied to the eye which makes the eye very firm. This suction ring is only on for a few seconds. While it is on, the vision becomes very dim. As soon as it’s removed the vision returns. At this time a microkeratome is used to make a very thin flap on the cornea, the clear window of the eye. While this is being done, the patient hears a buzzing sound. After the corneal flap is made, the flap is folded over, thus exposing the area of the cornea that the laser sculpts to a new shape.

While the laser is sculpting the cornea to its new shape, the patients hears a rapid clicking sound. One’s vision is blurry during this part of the procedure. As soon as the laser does its job, the corneal flap is put back in its usual position and the vision becomes much clearer. The flap amazingly adheres on its own in 2 to 3 minutes.

After the procedure, a protective shield is placed over the eyes and the patient goes home to rest. The less one blinks in the first few hours after the surgery, the faster the cornea heals. Patients need to take a few eye drops 4 times per day for about one week post op. In the first 24 hours after surgery it is normal for the eye to water or feel like there is an eye lash in the eye. Virtually everyone feels totally recovered the next day and for most patients the vision is often excellent within 24 hours.

LASIK, like all surgeries, has inherent risks and possible complications. This needs to be an important consideration for anyone considering LASIK or any other type of surgery. Fortunately the chance of complication is not great with this procedure and most complications can be corrected. However, very rarely, serious complications including loss of vision can occur. Some patients who have a normal result may have under or over corrections of their vision. For this, the vision can be improved back to 20/20 with glasses, contacts, or additional LASIK surgery. When this is done it is referred to as an enhancement LASIK procedure.

Some temporary side effects than typically go away over time include:

Glare

Halos

Dry Eye Feeling

Hazy or Blurry Vision

Over or Under Correction

Scratchiness

Mild Discomfort or Pain

Rarely, some of these side effects can become permanent. Of all the above side effects, dry eye feeling is the most common side effect and usually lasts 1 to 3 months.

It is very important to become very knowledgeable of LASIK before deciding to have this procedure. It is also important to have realistic expectations since, like any surgery, it is not a perfect science and not everyone sees perfect afterwards. If one’s occupation depends on perfect vision, knowing that a 20/20 result is not guaranteed, then this is probably not the best procedure for that patient. Never the less, it is a wonderful procedure and millions of people around the world have had it successfully done and benefited from it.