LASIK Patient Guide
Transcript of LASIK Patient Guide
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Is LAsIK for Me?A Patit’s Guid to Rractiv Surgry
Octor 2008
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Is LAsIK for Me?A Patit’s Guid to Rractiv Surgry
TAble O COnTenTS
lASIK: A COMPReHenSIVe GUIDe . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2
Introduction . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2
What Is LASIK? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2
How LASIK Works . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4
Pre-LASIK Correction Prescription Form . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5
Risk Factors, Side Eects and Complications o LASIK . . . . . . . . . . . . . . . . 5
FDA: When Is LASIK Not or Me ? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 6
FDA: What Are the Risks? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 7
Alternatives to LASIK . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 8
Other Forms o Laser Reractive Surgery . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 8
ADVeRTISInG GUIDelIneS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 9
Inormed Consent . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 9
Testimonials . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 9
Advertising Claims . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 9
An InTRODUCTIOn TO InORMeD COnSenT . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 11
OMIC: Aid to Inormed Consent Document . . . . . . . . . . . . . . . . . . . . . . . . . 11
Introduction . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 11
Alternatives to LASIK . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 11
Some Potential Vision-Threatening Complications o LASIK . . . . . . . . . 11
Non-Vision-Threatening Side Eects . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 12
For Presbyopic Patients . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 13
Remember: LASIK Is Surgery! . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 13
ACKnOwleDGeMenTS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 14
AbOUT THe GUIDe’S COnTRIbUTORS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 15
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lASIK: A COMPReHenSIVe GUIDe
Itroductio
Is LASIK surgery the right choice or you? LASIK has delighted millions o patients
worldwide, but it is not suited or everyone. As a patient, it is important that you have
a clear understanding o the surgery, the procedure’s advantages and risks, and whether
or not you would make a good candidate.
Tat’s why the American Academy o Ophthalmology and the International Societyo Reractive Surgery have developed this comprehensive guide on LASIK. It provides
objective inormation rom the country’s leading LASIK experts, the U.S. Food and
Drug Administration (FDA) and the Ophthalmic Mutual Insurance Company.
LASIK was rst approved or use by the FDA in and has been gaining steadily
in popularity. Each year, approximately , Americans have the procedure and
the vast majority o patients are happy with their results. As with all surgery, however,
there are risks associated with the procedure. As a result, some patients have experi-
enced complications or side eects that have negatively aected their eyes and quality
o lie. Te inormation provided here is intended to help you:
Understand what LASIK is;•
Be aware o what would make you a good or poor candidate or LASIK;•
Be aware o and understand the possible risks and complications o LASIK;•
Select a surgeon;•
Evaluate LASIK advertising; and•
Become amiliar with the Inormed Consent process.•
what Is lASIK?
lASIK (asr i situ kratomiusis) is an outpatient surgical procedure used to
treat nearsightedness, arsightedness, and astigmatism. LASIK cannot reverse presby-opia, the age-related loss o close-up ocusing power, which mainly aects near vision.
With LASIK, the ophthalmologist (Eye M.D.) uses a laser to reshape the cornea,
which is located at the ront o the eye. Tis improves the way the eye ocuses light rays
onto the retina, at the back o the eye, allowing or better vision.
With normal vision, light rays ocus directly on the retina.
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It is importat or ayo cosidrig lASIK to hav raistic xpctatios.
LASIK allows many people to perorm most o their everyday tasks without wearing
corrective lenses. However, those hoping to achieve perect vision and become com-
pletely ree o the need to wear eyeglasses or contact lenses run the risk o being disap-
pointed. Everyone develops the need to wear reading glasses in their s or s due
to presbyopia. I your vision is ully corrected or distance with LASIK, you will need
reading glasses to correct or presbyopia once it has developed. I you are nearsighted
and do not yet need reading glasses, having LASIK may mean you will need reading
glasses at an earlier age than had you not had laser eye surgery.
I you are having LASIK over the age o and are interested in correcting your pres-
byopia (i.e., decreasing your dependence upon reading glasses), you may want to con-
sider a strategy called monovision. Tis technique corrects your vision to allow or near
or intermediate vision in one eye and distance vision in the other eye. Tis means that
each eye is working independently instead o together. For monovision, your dominant
eye — the one you would use to look into the viewnder o a camera — would become
the distance eye and the other would be used or near vision. With this technique,
the brain learns to adapt to eyes set to ocus at dierent distances. Not everyone is
comortable with this dierence in ocus, especially those who spend a lot their timeplaying sports or do a lot o night driving. However, many people nd they adapt well
to monovision when they try it out rst, using contact lenses, beore having LASIK.
In act, many preop LASIK patients over are already using monovision with their
contact lenses to decrease their dependence upon reading glasses, and are comortable
with it. Contact lenses are actually the best way to demonstrate monovision beore
surgery, as they most accurately replicate what the patient will see ater surgery.
Nevertheless, some patients respond so positively to a “monovision demonstration”
with trial rames (spectacles) during the preoperative evaluation that a contact lens
trial is not necessary.
I 20/20 visio is sstia or your jo or isur activitis, cosidr hthr 20/40
visio oud satisy you. More than percent o people who have LASIK achieve
somewhere between / and / vision without eyeglasses or contact lenses.
Also, you would need to be comortable with the possibility that you might need
a second surgery (“retreatment”) in order to attain your desired results, or that you
might need to wear glasses or certain activities, such as reading or driving at night.
Te greater your reractive error (that is, the greater your nearsightedness, arsighted-
ness or astigmatism, or combination o these conditions), the more likely you would
require retreatment or glasses.
It is important to discuss your liestyle, including your work and recreational and lei-
sure activities, with your prospective surgeon beore deciding to go ahead with LASIK.
Some work, sports and other activities are not compatible with LASIK.
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Ho lASIK works
LASIK is perormed in an outpatient surgical setting, with the patient reclining under
a surgical device called an excimer laser. First, your eye is made numb with a ew drops
o topical anesthetic. An eyelid holder, called a speculum, is placed between the eyelids
to keep them open and prevent you rom blinking.
A suction ring placed on your eye lits and attens the cornea and prevents your eye
rom moving. You may eel pressure rom the eyelid holder and suction ring, similar to
a nger pressed rmly on your eyelid. From the time the suction ring is placed on youreye until it is removed, vision appears dim or goes black.
LASIK with laser making corneal ap
Te surgeon then creates a hinged ap o paper-thin corneal tissue using an automated
microsurgical device, either a laser or an instrument called a microkeratome blade.
Te corneal ap is lited and olded back. Te excimer laser, which has been prepro-
grammed with measurements specically or your eye, is then centered above your eye.
You will look at a special pinpoint o light (called a xation light or target light) while
the laser sculpts the exposed corneal tissue. Ater the laser has reshaped your cornea,
the surgeon replaces the ap in position and smoothes the edges without placing any
stitches. Your corneal ap will never adhere to the surace o the eye with quite thesame strength it did prior to the surgery, so there is a rare but possible risk o the ap
becoming displaced with sufcient orce.
Ater surgery, you should avoid rubbing the eye, which may cause the ap to shit out
o place. o help protect the cornea as it heals, the surgeon may place a transparent
protective shield over your eye. Te shield may only be needed at night to prevent you
rom rubbing the eye during sleep.
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An eye shield worn ater LASIK
You should arrange to have someone take you home ater the surgery. aking a nap
or simply relaxing or the rest o the day is recommended. Usually your vision will be
clear enough to drive to the ollow-up visit the next day. Te doctor may advise waiting
several days beore you resume a normal work schedule. Te doctor should advise you
on how long you should wait beore resuming sports, exercise, or strenuous activity.
Ater LASIK surgery, you will receive eyedrops to help prevent inection and inam-mation during the healing process and to alleviate dryness. You must be sure to ollow
any instructions rom your doctor and return or ollow-up appointments as directed.
Bear in mind that it may take three to six months or vision to stabilize completely.
All LASIK patients should ask their doctors or a record o their pre-LASIK correc-
tion prescription. Tis inormation is important or you to give to the doctor who may
perorm a uture cataract surgery or other eye disease diagnosis and treatment.
Download a pre-LASIK correction prescription orm at
www.aao.org/upload/KCardfnal.pd.
Have your doctor ll out this orm, and save it or uture reerence.
Risk actors, Sid ects ad Compicatios o lASIK
LASIK, like any surgery, has potential risks, complications, and side eects that should
all be careully considered beore you decide to have surgery. Be sure to discuss these,
along with any other concerns, with your Eye M.D.
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Risk actors
Te main risk actors that might aect whether LASIK would be appropriate
or you are:
dry eye syndrome.• I dry eye is let untreated prior to surgery, patients may
be disappointed with their LASIK results. I dry eye is diagnosed and adequately
treated beore surgery, you will have the same chance o a successul outcome as a
patient without pre-existing dry eye. I you have very severe dry eye, however, it
might disqualiy you as a candidate or the surgery. You are more likely to have dry
eye i you are older, especially i you are a woman ater menopause. You are also
more likely to have dry eye i you have an immune system disorder, or i you are
taking hormone replacement therapy or other medications with dry eye as a side
eect, such as anti-depressants or certain blood pressure-lowering medications.
You shoud scrd or dry y or you hav lASIK or othr rrac-
tiv surgry.
large pupil size• , as evaluated in the pre-LASIK exam, has been thought to
be a actor in undesirable side eects such as “glare” and “halos,” but there are
conicting reports about the relationship between pupil size in low light and
these disturbing visual symptoms. Tere is a risk o night vision problems aterLASIK, irrespective o pupil size.
keratoconus• , a degenerative corneal condition, or a amily history o this
disorder. Your Eye M.D. should check you or this condition beore surgery.
thin corneas• . Patients with thin corneas may not be good candidates or
LASIK but may be considered or other orms o reractive surgery. Your Eye
M.D. should check the thickness o your cornea beore surgery.
degree of refractive error• . Very high levels o reractive error (nearsighted-
ness, arsightedness, astigmatism, or certain combinations o these errors) may not
be compatible with LASIK. In addition, i your correction prescription has notremained the same or about a year, your vision may not be stable enough to make
you a good LASIK candidate.
age• . Te ideal LASIK patient is over years o age, since the reractive error
is more likely to be changing below this age. Some patients over the age o
are still experiencing change in reractive error making them unsuitable or
LASIK. Your Eye M.D. should conrm stability o your reractive error beore
considering LASIK.
pregnancy• . I you are pregnant or nursing, you are not a good candidate or
LASIK, because your reractive error may uctuate.
other conditions• . A number o other general health conditions and less-
common eye conditions or injuries may aect whether a person is a good candidate
or LASIK. Be certain you and your surgeon review your medical and eye health
history, current health status and medications during the pre-LASIK exam.
For inormation rom the FDA about risk actors or LASIK, see
the “When is LASIK not or me?” section o FDA’s LASIK Web
site at www.da.gov/cdrh/lasik/when.htm.
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Compicatios ad Sid ects
LASIK has been perormed on millions o patients in the United States in the past
years, and the overall rate o severe complications is low. Most LASIK complica-
tions can be treated without any loss o vision, but vision loss may rarely occur.
inflammation and infection• are possibilities with any surgical procedure.
Tese can usually be cleared up with medications, but rarely may lead to the need
or another surgical procedure or to the loss o vision.
problems with the corneal flap• sometimes require urther treatment,
which might include additional surgery.
ectasia, or bulging of the cornea• , may require urther treatment.
Tere is a chance, though small, that a LASIK patient’s vision will not be as good•
ater the surgery as it was beore, even with glasses or contact lenses. Te patient
may have sigifcaty rducd visio (usually correctable by treatment and/or
wearing corrective lenses) or prmat oss o visio (extremely rare).
over-or under-correction• o the patient’s reractive error, or a rductio
i th rractiv corrctio ovr tim, could mean that the person might stillneed to wear corrective lenses or some or all activities, or need a retreatment
with LASIK or another, similar reractive surgery to achieve the patient’s desired
results.
Below is a list o the more common side eects and possible complications o LASIK.
In most cases, these side eects disappear within three to six months ater the surgery.
In a minority o patients, these problems may be permanent:
Discomort or pain•
Sensations o scratchiness or dryness, which are symptoms o “dry eye”•
Hazy or blurry vision•
Poor night vision and/or difculty driving at night•
Glare, halos or starbursts around lights•
Sensitivity to light•
Reduced sharpness o vision called “contrast sensitivity”•
Small pink or red patches on the white o the eye•
For inormation rom the FDA about complications o LASIK,see the “What are the risks?” section o FDA’s LASIK Web site at
www.da.gov/cdrh/lasik/risks.htm.
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Atrativs to lASIK
Tere are several alternatives to LASIK or correcting your vision. Eyeglasses and con-
tact lenses are the most common methods o correcting reractive errors. Tey work
by reocusing light rays on the retina, compensating or the shape o the eye and
cornea. You should discuss your vision status, goals and liestyle with your Eye M.D.,
who will help you weigh the risks and benets and decide which o these options
would be the best choice or you.
Othr orms o lasr Rractiv Surgry
Some orms o laser reractive surgery do not require the creation o a corneal ap.
Tese include photoreractive keratectomy (PRK), Epi-LASIK and laser-assisted
epithelial keratomileusis (LASEK), in which the surgeon uses the laser to sculpt
the cornea without creating a corneal ap. Tere are advantages and disadvantages
to each o these, which you should discuss with the reractive surgeon.
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ADVeRTISInG GUIDelIneS
You’ve likely seen and heard LASIK advertisements. Te American Academy o
Ophthalmology encourages its members to ollow its ethical guidelines or reractive
surgery advertising, which are summarized below. Tese were developed with the
help o the Federal rade Commission and the American Society o Cataract and
Reractive Surgery. For the complete guidelines, see:
www.aao.org/about/policy/upload/Guidelines-or-Reractive-Surgery-
Advertising-3-26-04.pd.
Iormd Cost
Because o space and time limitations, advertising cannot include all o the elements
o appropriate inormed consent disclosures. Do not depend on advertising as a way
to understand all the risks and benets o any surgical procedure.
Tstimoias
Because o the difculty in supporting claims made by patients who have had thesurgery, some states prohibit the use o patient testimonials by physicians. Tere is
no certainty that your results will be comparable to those o any other patient.
Advrtisig Caims
Patients have diering needs and expectations and may experience dierent surgical
outcomes. Accordingly, advertising claims are not a substitute or discussions between
you and the surgeon regarding your particular needs and expectations and the range
o possible outcomes.
Be wary of the following types of claims:
“Throw away your glasses!” LASIK may correct your arsightedness, nearsightedness
or astigmatism, and it may allow you to unction without eyeglasses or contact lenses
or many activities; however, there is no certainty that you will be permanently ree
rom wearing any eyeglasses or contact lenses ollowing LASIK. LASIK cannot correct
presbyopia, the age-related loss o close-up ocusing power, and by age or , many
people, even those who have had LASIK, will need to wear reading glasses.
“This laser is ranked highest by the FDA.” Te Food and Drug Administration does
not rate devices comparatively.
“We use a scanning laser so that you get the best results.” Although there maybe potential advantages to using a scanning laser, that does not guarantee you a
better result.
“Our (LASIK) surgeons are more experienced than any of their colleagues in
(state, city, region).” Claims o this kind would require reliable, current evidence
o the number o LASIK procedures perormed by each reractive surgeon in the
claimed region, which would be quite difcult to obtain.
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“Find out more about LASIK — the safe and easy alternative to glasses!”
Generally, it is not appropriate or an advertisement to state that surgery is sae or
easy. All surgery has risks. You should discuss the possible risks and side eects o
LASIK with your surgeon during your consultation.
“Unlike other procedures, PRK (LTK, LASEK, “bladeless” LASIK) laser vision correc-
tion doesn’t involve knives or cuts to the eye.” Tis type o claim downplays the
act that all these procedures are surgeries with risks. Don’t let the use o such words
as “treatment,” “therapy,” “vision correction,” or “enhancement” ool you into thinkingthat laser reractive surgery is anything other than a surgical procedure. Laser proce-
dures are, in act, surgeries.
“Achieve permanent vision correction with refractive surgery!” Not everyone
achieves a stable reraction ater surgery, and everyone experiences gradual changes
in their vision over time due to the normal aging process.
“Visit the Smith Laser Center and leave with 20/20 vision!” Results cannot be
guaranteed.
“LASIK surgery is a safe and painless procedure.” Patients undergoing reractive
surgery typically experience some pain and discomort or a short time ollowing
surgery, and, or a rare ew patients, these may persist.
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An InTRODUCTIOn TO InORMeD COnSenT
Te ollowing brie summary o an Inormed Consent document developed by the
Ophthalmic Mutual Insurance Company (OMIC) indicates many o the possible
complications and risks o LASIK and is presented to you here as an example o what
you might see on the Inormed Consent document you may be asked to sign beore
having LASIK surgery. Your surgeon will ask you to read and sign a consent orm
beore surgery. Tis step is required by law to make sure you understand all possible
risks and complications o the surgery. It should be read careully beore surgery andi questions arise, talk with your surgeon. For the complete document, see:
www.omic.com/resources/risk_man/orms/consent/
LASIKconsent071906.rt.
Samp Iormd Cost
introduction
Tis inormation is being provided to you so that you can make an inormed decision
about the use o a device known as a microkeratome, combined with the use o a device
known as an excimer laser, to perorm LASIK reractive surgery. LASIK is one o a
number o options or correcting nearsightedness, arsightedness and astigmatism.For LASIK, the surgeon uses the microkeratome to shave a thin layer o the cornea to
create a tiny ap. Te ap is opened like the page o a book, exposing tissue just below
the cornea’s surace. Next, the surgeon uses the excimer laser to remove ultra-thin lay-
ers rom the cornea to reshape it in order to reduce nearsightedness. Finally, the ap is
returned to its original position, without the need or any sutures.
LASIK is an elective procedure. Tere is no emergency condition or other reason that
requires or demands that you have it perormed. You could continue wearing contact
lenses or eyeglasses and have adequate visual acuity. Tis procedure, like all surgery,
presents some risks, many o which are listed below. You should also understand that
there may be other risks not known to your doctor, which may become known later.
Despite the best o care, complications and side eects may occur. Should complica-
tions arise in your case, they might aect the outcome o your surgery even to the
extent o making your vision worse ater LASIK than beore.
alternatives to lasik
I you decide not to have LASIK, there are other methods o correcting your near-
sightedness, arsightedness or astigmatism. Tese alternatives include, among others,
eyeglasses, contact lenses and other reractive surgical procedures.
some potential vision-threatening complications of lasik
I understand that:
Te microkeratome or the excimer laser could malunction, requiring the pro-.
cedure to be stopped or could result in a distorted cornea, and glasses or contact
lenses may not correct my vision to the level possible beore LASIK; a perora-
tion o the cornea could occur, causing loss o some or all o my vision;
An eye inection that could not be controlled with antibiotics or other means.
could lead to permanent scarring and loss o vision or require corrective addi-
tional surgery or, i very severe, corneal transplantation or even loss o the eye;
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Keratoconus, a degenerative corneal disease aecting vision that occurs in.
approximately / in the general population could develop;
Other very rare complications threatening vision could occur. Tese include,.
but are not limited to, corneal swelling, corneal thinning (ectasia), appearance
o “oaters” and retinal detachment, hemorrhage, venous and arterial blockage,
cataract ormation, total blindness, and even loss o my eye.
non-vision-threatening side effects I understand that these conditions usually occur during the normal stabilization
period o rom one to three months, but they may also be permanent requiring chronic
care or additional surgery:
Increased sensitivity to light, glare, and uctuations in the sharpness o vision;.
eye irritation related to drying o the corneal surace; overcorrection or under
correction causing nearsightedness or increase in astigmatism and that this
could be either permanent or treatable;
Glare, a “starbursting” or halo eect around lights, or other low-light vision.
problems that may interere with the ability to drive at night or see well in dim
light. For most patients, this is a temporary condition that diminishes with
time or is correctable by wearing glasses at night or taking eye drops. For some
patients, however, these visual problems are permanent.
Inadequate correction rom LASIK procedure that may require uture enhance-.
ment procedures, such as more laser treatment or the use o glasses or contact
lenses even years ater the surgery.
Tere may be a “balance” problem between my two eyes ater LASIK has been.
perormed on one eye but not the other, which could cause eyestrain and make
judging distance or depth perception more difcult.
Te corneal incision will not be as strong as the cornea originally was at that site.
and the treated eye may be more vulnerable to all varieties o injuries, at least
or the rst year ollowing LASIK. I understand it would be advisable or me to
wear protective eyewear when engaging in sports or other activities in which the
possibility o a ball, projectile, elbow, st, or other traumatizing object contact-
ing the eye may be high.
I understand that there is a natural tendency o the eyelids to droop with age.
and that eye surgery may hasten this process.
I understand that there may be pain or a oreign body sensation, particularly.
during the rst hours ater surgery.
Te long-term eects o LASIK are unknown and that unoreseen complica-.
tions or side eects could possibly occur.
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Even percent clarity o vision is still slightly blurry. Enhancement surgeries.
can be perormed when vision is stable UNLESS it is unwise or unsae. I the
enhancement is perormed within the rst six months ollowing surgery, there
generally is no need to make another cut with the microkeratome. Te original
ap can usually be lited with specialized techniques. Ater six months o heal-
ing, a new LASIK incision may be required, incurring greater risk. In order
to perorm an enhancement surgery, there must be adequate tissue remaining.
I there is inadequate tissue, it may not be possible to perorm an enhancement.
An assessment and consultation will be held with the surgeon at which time the
benets and risks o an enhancement surgery will be discussed.
As with all types o surgery, there is a possibility o complications due to anes-.
thesia, drug reactions, or other actors that may involve other parts o my body.
I understand that, since it is impossible to state every complication that may
occur as a result o any surgery, the list o complications in this orm may not
be complete.
for presbyopic patients
For those patients requiring a separate prescription or reading: Te option o mono-
vision has been discussed with my ophthalmologist.
remember: lasik is surgery!
Tere are millions o satised and delighted patients who have undergone LASIK
successully and who are enjoying its many benets. However, there are some who have
experienced side eects or complications that have had a serious, negative impact on
their lives. Use the inormation provided here to help you evaluate your expectations o
LASIK, select the right surgeon, and discuss your candidacy along with the risks and
benets with your doctor beore making a decision about LASIK. An inormed patient
is a better, more satised patient.
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ACKnOwleDGeMenTS
he American Academy o Ophthalmology thanks the ollowing individuals
and organizations or their help in developing this guide:
richard abbott, md, Secretary o Quality o Care and
Knowledge Base Development, American Academy o Ophthalmology
daniel s. durrie, md
flora lum, md, Policy Director o Quality o Care and
Knowledge Base Development, American Academy o Ophthalmology
marguerite mcdonald, md, President o the International Society o
Reractive Surgery o the American Academy o Ophthalmology
james j. salz, md
paul weber, Vice President, Ophthalmic Mutual Insurance Company
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AbOUT THe GUIDe’S COnTRIbUTORS
american academy of ophthalmology
Te American Academy o Ophthalmology is the world’s largest association o eye
physicians and surgeons—Eye M.D.s—with more than , members worldwide.
Eye health care is provided by the three “O’s” – opticians, optometrists and ophthal-
mologists. It is the ophthalmologist, or Eye M.D., who can treat it all: eye diseases and
injuries, and perorm eye surgery. o nd an Eye M.D. in your area, visit the Academy’sWeb site at .aao.org.
international society of refractive surgery (isrs)
Te International Society o Reractive Surgery o the American Academy o
Ophthalmology is the world’s largest and strongest eye care organization solely
dedicated to reractive surgery. It has a strong international presence, with over
, members rom more than dierent countries.
ophthalmic mutual insurance company (omic)
Te Ophthalmic Mutual Insurance Company is the largest provider o proessionalliability insurance or ophthalmologists in the United States. It is the only insurance
carrier endorsed by ophthalmic specialty organizations—including the American
Academy o Ophthalmology—or their members.