LASIK Surgery


Please note: Dr. Quiring does not perform refractive or LASIK surgery. He provides pre-operative and post-operative care for refractive surgery patients. 

LASIK is the most common procedure in refractive surgery. Refractive surgery is a term used for a group of procedures that alter the optics of the eye in order to produce clear vision without the aid of eyeglasses or contact lenses. 

Below is a list of refractive surgery procedures that are currently available:

Laser Assisted In-Situ Keratomileusis (LASIK)
This procedure combines the power of the LK with the precision of the excimer laser. LASIK is a procedure that reshapes the internal part of the cornea. This procedure uses an instrument called a microkeratome to lift up a thin layer of the cornea, called a "flap," followed by the sculpting of the internal cornea underneath the flap using the Excimer Laser. After the tissue has been reshaped, the flap is replaced in the original position. LASIK is a very short outpatient procedure and can be used to treat low, moderate, and high levels of nearsightedness and astigmatism, as well as low to moderate levels of farsightedness. LASIK provides less postoperative pain, faster recovery and stability, and less scarring as compared with PRK.

Photo-Refractive Keratectomy (PRK)
First, the cornea has the surface layer of cells scraped off. Then the abraded surface is flattened with an excimer laser. This surface layer of cells must regrow before visual rehabilitation. While these cells are growing back, the cornea is at high risk of infection, scarring, and is painful.

Radial Keratotomy (RK)
Incisions are made in the cornea in a pattern like spokes on a wheel and the center of the cornea is left untouched. The incisions cause the center of the cornea to flatten thus reducing nearsightedness. This procedure is accurate only for low amounts of myopia, moderately painful, tendency towards persistent fluctuations in vision, and can progress into farsightedness even years after surgery.

Astigmatic Keratotomy (AK)
A modification of RK in that the incisions are made in an arcuate pattern and only in the orientation of the astigmatism.

Lamellar Keratoplasty (LK)
A device called a keratome is used to cut a horizontal layer of tissue from the cornea called a cap. In nearsightedness, another layer of tissue is removed with the keratome and the cap is placed back into place. The removal of this second layer flattens the central cornea, reducing nearsightedness. In farsightedness, The cap is made a little thicker than with nearsightedness but no central layer is removed. This causes the central cornea to steepen, reducing farsightedness. This procedure can correct a large amount of refractive error and works best with high nearsightedness or farsightedness.

Questions & Answers
Below are answers to frequently asked questions about LASIK. If you are interested or would like to ask more specific questions, you can call our office with questions for Dr. Quiring.

Can I have my LASIK Post-Operative care performed by Dr. Quiring?
Yes, Dr. Quiring has been performing follow-up care for LASIK for over seven years now (100's of patients). Dr. Quiring is qualified to perform follow-up care for the entire year following surgery, no matter where you have your surgery.

Our Post-Operative global fee covers any and all visits after your surgery for one full year (including a comprehensive examination one year after surgery). This fee also includes Pre-Operative testing. This fee is subject to change without notice.

Can I have my Pre-Operative evaluation for LASIK refractive surgery at Quiring EyeCare Associates?
Yes, we can perform all the necessary pre-operative testing, except corneal thickness measurements (pachometry). Pachometry is performed by the surgeon. The fee for pre-operative testing is included with our global Post-Operative follow-up care fee.

Are you a candidate for LASIK refractive surgery?
LASIK is the procedure of choice for correcting nearsightedness, farsightedness, and astigmatism. A brief screening should help you determine if you're a good candidate for LASIK surgery. It is recommended that your prescription be stable for 2-3 years before having the procedure performed. Certain systemic diseases that can interfere with healing, such as diabetes, autoimmune diseases, AIDS, and collagen-vascular diseases will prevent you from having the surgery. Also, certain eye diseases, such as keratoconus, and other corneal diseases, extreme dry eye, glaucoma, and previous intraocular surgery is may also prevent you from having the surgery. Your doctor will go through the complete list at your screening or comprehensive eye exam.

What Laser is used for LASIK?
With the latest advances in Excimer Lasers and surgical procedures there are several other options available to correct vision problems. The VISX Excimer Laser is a computer-controlled laser used by the surgeon to delicately sculpt the cornea for better focusing. The VISX Excimer Laser is ideal for eye surgery because it uses a "cold" or non-thermal light beam, thereby virtually eliminating the possibility of thermal damage to the surrounding tissue. The two most common procedures that are performed with the VISX Excimer Laser are PRK and LASIK.

Is the surgery painful?
The surgery itself is painless. A sedative with local anesthesia is given. There is some mild scratchiness the day of surgery, but the next day your eyes will feel nearly normal. The more you rest your eyes on the day of surgery, the greater your vision improvement and comfort will be on the first morning after surgery.

How much does LASIK cost?
The cost does vary depending on where the procedure is performed and whether you decide to have Custom Wavefront LASIK.  Also, the pre-operative examination that we perform prior to surgery is considered part of our global post-surgical follow-up fee.

Will I have to take time off work?
You will need to take the day of surgery off from work. Just before surgery, some patients are given the option of having a sedative that will make it impossible for you drive home from surgery that day. You should bring a friend or family member to drive. Most people can go work the day after surgery. If there is the possibility of something spraying in your eyes at your work, you'll want to wear safety glasses for about a week or take a few days off. People that have high refractive errors may find it difficult to read fine print for a week or two after surgery, so over-the-counter reading glasses can be used until the vision stabilizes.

Are there any restrictions after surgery?
Patients use antibiotic drops for one week or so following surgery and moisturizing drops for a few weeks (and sometimes a lubricating ointment at night). It is recommended that you keep any water or debris out of the eyes for the first week following surgery. Water sports, skiing, or anything that might spray water or debris into your eyes should be avoided for one month following surgery. It is also recommended that you do not rub your eyes for the first three to six months following surgery.

Can both eyes be operated on at the same time?
Most surgeons today prefer to operate both eyes at the same time. Occasionally, for very high or unusual refractive errors, surgeons will operate on the eyes separately, a week or two apart.

What are my chances of seeing as well as with my glasses or contacts on?
The primary purpose of the surgery is to allow you to be able to function normally during your daily activities without contacts or glasses. The statistics say that about 50-65 percent of people will reach 20/20 depending on their original prescription. Approximately 98-99 percent will see 20/40 or better without glasses, which is considered functional vision. Some people may require part-time glasses for night vision. Those people over the age of 40 will most likely need reading glasses. The natural aging process that effects our ability to focus is not corrected by this surgery.

Is there an age limit for LASIK?
The minimum age is 18 years old. People up to about 80 have been operated on, but there really is no upper limit. As long as there are no contraindications, anyone should get a good result no matter your age. Cataracts are quite common over the age of 65, and by manipulating the power of the intraocular lens that is placed in the eye at the time of cataracts surgery, we can get the same results as with LASIK surgery.

Can contact lens wear affect the outcome of surgery?
Contact lens wear can change the shape of the cornea. It is necessary to stop soft contact lens wear one week before surgery, RGP contact lens wear four weeks before surgery, and PMMA contact lens wear six weeks before surgery. However, it is best to stop your contact lens wear as soon as possible before surgery to decrease the probability of contact lens wear affecting the surgical outcome. Depending on the amount of time you have been wearing contact lenses, it may take longer than these guidelines for the cornea to return to its original shape. This process will be monitored very carefully with sophisticated testing.

How do I know it's safe?
U.S. clinical trials have shown no sight threatening complications for nearly four years. The lamellar keratoplasty (LK) portion of LASIK has been performed safely for over 40 years. The FDA has proven the excimer laser safe and effective for the treatment of nearsightedness, farsightedness and also astigmatism.

Are there any side effects?
The most common side effects are haloes around lights and decreased night vision. These side effects usually diminish within six to nine months following surgery. Irregular astigmatism can delay good vision for six to 12 weeks. Sometimes, the re-fitting of contact lenses can return good vision until the irregular astigmatism goes away. Over-correction may make it difficult to read for those even under 40 years of age. If this happens, it is usually temporary. In very rare cases, the corneal flap can become wrinkled which requires that it be lifted and replaced.

Is LASIK permanent?
Reports from LASIK being performed for nearly twelve year's worldwide show that the surgery appears to be permanent. A small percentage of people, particularly those with high refractive errors, may require a refinement procedure approximately six months after the surgery. Your doctor will discuss your options with you.