Laser Vision Correction

The decision to have laser vision correction is very personal. Motivations may include:

• Increased comfort

• Lifestyle needs

• Career considerations

• Cosmetic concerns

Surgery should only be considered if you:

• are over 18 years of age

• have had stable refraction for one year

• are within the limits of the following refractive corrections:

• myopia (nearsightedness): -1.0 to -9.0 diopters

• hyperopia (farsightedness): +1.0 to +4.0 diopters

• astigmatism: up to 4.0 diopters

• are not currently pregnant or breast-feeding

• are not being treated for severe medical conditions, especially ones affecting healing or vision

• are free from any eye maladies or abnormalities (keratoconus, severe dry eye)

• are not currently using Accutane

No refractive surgeon can guarantee a perfect outcome. While the laser is remarkably precise — removing 0.25 microns per pulse — each eye is different. Success depends on a number of factors, which Dr. Sorenson can discuss with you.

The FDA reports 94% of myopic patients correct to 20/40 vision or better, the DMV standard for driving without corrective lenses. Nearly two thirds of patients achieve 20/20 vision or better. Laser surgery will certainly reduce, and in most cases eliminate, your need for glasses, however there is a 0.2% chance that your vision will not be as sharp as before surgery. You may be unsatisfied with the outcome, and there is also a risk of infection. All risks can be further discussed in consultation with Dr. Sorenson.

The initial exam will take around 90 minutes and is performed in our office. We will evaluate your eyes for corneal irregularities such as glaucoma or cataracts, use the Orbscan Corneal Topographer to create a digital map of the surface of your eye, and take ultrasonographic measurements of your cornea. We will also cross-check your existing glasses or contact prescription.

Dr. Sorenson will discuss your examination findings with you and advise whether laser vision correction is a good choice for you. Eyes that are not good candidates for this procedure may be better suited for alternative surgical treatments or continued use of contact lenses or glasses. Sometimes, an additional examination prior to the surgery may be required.

Before your visit, do not use soft contact lenses for one week or hard lenses for three weeks. Bring your glasses and any prescriptions you have to the initial visit, and bring dark glasses to wear after the exam. You may want someone to drive you home.

Arrange for transportation to and from the surgical center before surgery. Do not wear makeup on day of surgery, and do not use contact lenses for one week (soft lenses) or three weeks (hard lenses) prior to surgery.

Upon arrival at the Laser Facility, register with receptionist and relax until called. A technician will escort you to an exam room, where you will receive instructions and Dr. Sorenson will examine your eyes.

You will then be escorted to the Laser Suite where the procedure will be performed. The treatment takes about 10 minutes per eye. You will feel some pressure as Dr. Sorenson uses a laser to create the flap. You will hear continual guidance, so you will always be aware of what is happening. Once the flap is created, the VISX Star S4 Smoothscan or the Alcon Allegretto 400 laser system is used to reshape the cornea. The procedure is painless and lasts only a few minutes.

After the surgeon replaces the flap to its proper position, your eyes will be allowed to rest for a few minutes under microscopic observation. When everything is in proper order, antibiotic and anti-inflammatory drops are placed on your eye.

• You will wear dark goggles which will protect your eyes on the day of your treatment.

• You will be instructed about application of drops, and appropriate activities for the following day.

• You will be given an appointment for a post-operative examination on the following day.

Recovery from laser eye surgery is rapid. Many people experience better vision shortly after their surgery. Eye discomfort is uncommon, but an optional eye drop is available if needed for relief.

• Apply the antibiotic and anti-inflammatory drops for five days as instructed. Use the artificial lubricant drop often for one month.

• Avoid submerging head in water for 10 days.

• Wear protective goggles (given to you by Dr. Sorenson) during sleep for five days.

• Do not rub your eyes for one month.

• Report any decreased vision, pain, or redness immediately to Dr. Sorenson.

Visual fluctuation can occur for several weeks. It is more common in eyes requiring larger treatments and in eyes with underlying dryness. If you have dry eyes before laser vision correction, the symptoms may heighten for a period after surgery. Using artificial tears for a few weeks is often helpful.

Some people note night time glare with lights, or a halo around bright objects, similar to that seen with contact lenses. These symptoms rarely affect the ability to function normally and usually dissipate over the course of the first few months.

Individuals over age 40 may need reading glasses, unless monovision was intended.

Dr. Sorenson will examine you at the Berkeley office the first day after surgery. You may prefer to ask someone to drive you to this visit, though many people feel visually competent to drive themselves. Many people return to work the day after surgery. After the first day, you will have follow-up evaluations at day four, three weeks, three months, six months and yearly thereafter. It is important to continue yearly eye examinations; despite the absence of glasses, your eyes should still be evaluated for glaucoma and other eye diseases.

After several months, the vision level achieved with laser vision correction is typically stable. The use of glasses after surgery is uncommon. Some patients who have elected monovision for assistance with reading will wear driving glasses or night-only glasses.

While some regression can occur, only 7% of-laser treated eyes require a second treatment. If your eye requires an additional laser treatment, Dr. Sorenson will arrange the necessary treatment for you.

The data submitted by VISX and ALCON to the FDA reports that 94% of all myopic eyes recover to better than or equal to 20/40, and 60% of eyes achieve 20/20 or better vision. Some eyes lost best corrected vision (the vision attained with glasses after surgery), but the incidence was 1/300. When asked whether they were satisfied about having the corrective eye surgery, 299 out of 300 answered affirmatively. By and large, laser vision correction is a successful, reproducible and predictable surgery utilized to modify the shape of the cornea.

Data from our practice over the past several years suggests a 99% rate of 20/40 uncorrected visual acuity, with 80-85% achieving 20/20 vision or better, The rate of second procedures for residual nearsightedness or other corrections is approximately 7%.