Refractive surgery is a way of improving your vision without glasses or contact lenses.
Dr. John Davidson is one of the best "Refractive Surgeons" in California and he performs refractive surgery at the NVision Laser Eye Center in Camarillo. The NVision Laser Centers has an agreement with their patients called "Vision for Life". If you see Dr. Steensma every year for your annual eye examinations, and your eyes change requiring another LASIK procedure, it will be free.
Dr. Steensma will provide much of the pre-surgical and post-surgical care. Optometric participation is beneficial for the patient, the optometrist and the surgeon. For the patient, continuity of care is maintained and eye care becomes more convenient and accessible. Co-management affords Dr. Steensma the opportunity to maintain his role as primary eye care provider during and after the procedure. He will do the pre-op exam and then provide follow you care for a year after the surgery. The surgeon is allowed to work at his highest skill level doing surgery, not follow up visits.
Currently there are 3 types of refractive surgery:
- PRK (Photo-Refractive-Keratectomy)
- LASIK (Laser-In-Situ-Keratomileusis)
- ICL (Implantable-Contact-Lens)
PRK is an outpatient laser vision correction procedure used to improve vision and reduce or eliminate the need for eyeglasses or contact lenses. With PRK the surgeon utilizes the excimer laser to reshape the curvature of the eye for patients with nearsightedness, farsightedness and astigmatism. PRK may be suitable for people with larger pupils, thin corneas, dry eyes or other corneal issues.
PRK vision correction surgery was introduced in the 1980s and has successfully transformed the vision of millions of people. Since the early 1990s, it has evolved into what is now known as advanced PRK, or Advanced Surface Ablation (ASA).
In this procedures, instead of creating a flap (like LASIK), the surgeon removes the cornea’s outer epithelium and uses a laser to reshape the exposed cornea. The epithelium then grows back during the next few days.
THE PRK PROCEDURE
PRK laser vision correction procedure does not use scalpels and no incisions are made. Prior to the procedure, an extremely detailed map of your eyes’ surfaces are created by a computer and then used by your NVISION laser vision correction surgeon to calibrate the excimer laser to your exact prescription. Once the laser has been properly calibrated, the technician will place an eyelid holder in your eye to keep it open throughout the procedure. The NVISION technician will insert a few anesthetic drops to numb the eye and prevent pain. To accomplish the reshaping, the surgeon first removes the protective surface layer (epithelium) from the cornea. (The epithelium is regenerated within three to five days.) Your NVISION surgeon will then smooth the area and proceed with applying computer-controlled pulses of cool laser light to reshape the curvature of the eye. Deeper cell layers remain virtually untouched.
The PRK laser vision correction process is completed in approximately 30 to 60 seconds, and immediately afterwards, a clear bandage contact lens is placed on the cornea to protect it. Additional eye drops are applied. Since a layer about as slender as a human hair is typically removed, the cornea should maintain its original strength. Often, only one eye is treated per surgery day, although your surgeon may decide to do both of your eyes on the same day.
LASIK
LASIK is by far the most commonly done refractive procedure. It was originally developed for those patients with extreme amounts of nearsightedness, but has now become the preferred procedure for most people. It produces much better results than previous refractive surgery methods did.
Most patients after LASIK see well enough to function without glasses or contact lenses much of the time. About 90% see 20/40 or better and 50% see 20/20. Some people still need glasses when critical vision like night time driving is required.
The LASIK procedure:
You will be awake and alert during the entire procedure. Drops are used in your eyes so you don't feel any pain or discomfort. A very thin flap of cornea is created, and when the flap is folded back a laser is used to remove a microscopic amount of tissue. Then the flap is returned to its original position. The procedure only takes a few minutes. The laser reshapes the central part of the cornea with an ultraviolet laser. The laser used is called an Excimer laser. What happens is closely bound molecules in a high energy state are subjected to an electrical discharge in a laser cavity producing a beam of ultraviolet light. The UV beam destroys the molecular bonds of the corneal tissue destroying tissue. The tissue destroyed is less than a hair thickness. There is very little heat created in adjacent tissue so the device is very precise. When the cornea changes shape the light entering the eye is properly focused on the retina resulting in clearer vision.
Bladeless Custom LASIK
In the past, the corneal flap was created with a blade. Now it's done with a Femtosecond laser.
NVISION is the first and only laser eye centers in Southern California to offer the latest and most advanced Femto surgical laser. Dr. John Davidson uses this laser to create the corneal flap, which is the first step of the Bladeless Custom LASIK procedure. The Swiss developed Ziemer Femto LDV has been the laser of choice in Europe and Japan since 2009. When compared to other lasers, the Z-LASIK Femto LDV Crystal Line Laser provides the following benefits:
Faster Visual Recovery – small bubble technology with overlapping bubbles creates a very smooth surface resulting in quicker recovery of vision and better quality of vision in a shorter period of time.
Shorter procedure time – the Ziemer laser delivers 5 million pulses per second compared to 60,000 to 200,000 pulses with all the other Femtosecond lasers – the procedure is at least 3 times faster making it much more comfortable.
Safer – the energy per pulse delivered is less than 10% of that of other Femtosecond lasers. This results in reduced discomfort and essentially no associated inflammation and light sensitivity. Also no chance of bubbles inside the eye and no problems with scars in the cornea.
More Precise – allowing surgeon to create thin flaps with confidence which is helpful in patients with high corrections and thin corneas.
Less chance of Dry Eyes – since the Femto LDV Ziemer is a gentler laser with less energy, the chances of dry eyes are reduced.
Click the image to see ZLASIK:
After the procedure:
Almost everyone experiences a dramatic improvement in vision, often as soon as the next day. Prescription eye drops are used for 4-5 days after surgery. Vision is normally blurry for the first 6 hours. There will be mild foreign body sensation for 1 to 2 days. There will be mild tearing, light sensitivity for 1 to 2 days. There will be dry eye sensations for about a month. There will be minimal visual fluctuation and halos around lights at night for the first month. In some cases an enhancement procedure needs to be done for better vision. This decision is usually made at the 3 month follow-up.
The contraindications for LASIK are:
- Any significant auto-immune disease
- Uncontrolled vascular disease such as diabetes
- Pregnant women or nursing women
- Corneal disease
- Patients with a history of keloid formation
- Patients with a history of herpes eye infections
- Patients with only one eye
LASIK costs:
LASIK surgery costs will vary based on your prescription, medical conditionsand the type of laser technology that the surgeon will recommend for you. NVision LASIK procedures usually range from $1,999 per eye to $2,995 per eye. Your surgery will normally include a complimentary LASIK consultation, Nationwide Lifetime Commitment, six pre & post-op visits. You can get a much accurate estimate for your LASIK procedure on the day of your consultation.
Payment plans:
NVISION Laser Eye Centers offers several payment plans to help make laser vision correction affordable. Credit lines with flexible terms may be available to cover the cost of the procedure. This easy finance plan allows you to customize your account by selecting the amount you need and your repayment terms.
CareCredit offers $0 Down, 0% Financing for 24 months for those who qualify
NVISION’s Financing Program with payments as low as $99/month, for 48 months.
NVISION Laser Eye Centers offers reduced rates for all Major Insurance Plans, that could substantially reduce your cost for laser vision correction.
Many employers or insurance providers offer Flexible Spending Accounts, Health Spending Accounts, or Health Reimbursement Arrangements to help offset medical expenses. These accounts may allow you to set aside pre-tax dollars for procedures like LASIK. Ask your employer or insurance provider about deducting pre-tax dollars from your paycheck for potential savings on your laser vision correction procedure.
Many patients pay for their procedure using a personal credit card and pay it off over time.
For some patients, laser vision correction surgery is not the best course of treatment, such as for patients who have extreme nearsightedness or farsightedness, have cataracts, or have extremely dry eyes. For these patients, we may recommend the Phakic intraocular lens (IOL). In this form of treatment, an intraocular lens is surgically implanted into the cornea. The lens is permanent (although it can be surgically removed) and needs no maintenance. The Phakic IOL reduces the need for glasses or contact lenses by correcting your vision inside the eye, without removing the eye’s natural lens.
THE PHAKIC IOL PROCEDURE
Phakic IOLs are inserted in the eye and correct refractive errors by focusing light properly on the retina, the sensory tissue on the back of the eye. Because people who are nearsighted have difficulty focusing light and images properly, distant objects come to focus in front of the retina instead of on it, making them appear blurred or out of focus. When a Phakic IOL is implanted, nearsightedness is corrected by bending and focusing light directly on the retina, reducing the need for contacts and glasses. The procedure is also fully reversible.
As with any vision correction surgery, a comprehensive examination with your eye care professional is necessary to determine if you are a candidate. Patients may be asked to discontinue wearing contacts several weeks before the examination so an accurate prescription reading can be taken. Others may need to schedule a procedure prior to surgery, which will help manage the pressure within the eye after the IOL has been implanted.
Phakic IOL surgery is an outpatient procedure. During the surgery, your doctor may use eye drops or injections to numb or prevent movement of the eye. A precise incision will allow the doctor to insert the Phakic IOL in front of or just behind the colored part of the eye (iris). A bandage contact lens and a clear eye patch will be used to cover and protect the eye until your doctor feels it is all right to remove.
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