Refractive Surgery involves using an excimer laser to reshape the cornea (the front part of your eye) to correct a patient’s prescription and improve their vision. LASIK (laser-assisted in-situ keratomileusis) is the most widely performed refractive surgical procedure. During LASIK, a thin flap is created in the cornea. Next, an excimer laser reshapes the underlying corneal tissue to correct the patient’s nearsightedness, farsightedness, or astigmatism. The success rate of this frequently performed procedure is excellent, with approximately 99% of patients achieving 20/40 vision or better and over 90% of patients achieving 20/20 vision or better. Dr. Cassol can help you determine what these success rates mean for your personal vision goals. He has performed more than 10,000 refractive surgeries over the past decade.   

Because certain medications and medical conditions can be a contraindication to LASIK, you should discuss and disclose your complete medical history with Dr. Cassol during your consultation. FOR WOMEN ONLY: you should not have refractive surgery while you are pregnant or breastfeeding, because it can adversely affect your treatment results.

Because refractive surgeries are so commonly performed, we pride ourselves on staying up-to-date with the newest technology on the market. By partnering with Suburban Excimer Laser Center, we are able to make the newest lasers and surgical methods available to our patients. Dr. Cassol uses the VISX laser in combination with WaveFront Guided technology to accurately and efficiently perform refractive correction. He also uses an IntraLase® Femtosecond laser to create the corneal flap. This “bladeless” procedure offers more precision and safety, while minimizing healing time and post-operative symptoms. In addition, this advanced technology allows for a thinner flap. This means certain patients who were once unsuitable for LASIK due to thin corneas may now be candidates, due to the laser’s ability to precisely and consistently create a thin corneal flap. 

 

During the LASIK procedure, the surgeon first administers anesthetic eye drops to numb the patient’s eye. A speculum is then placed over the eye to prevent the patient from blinking. Next, an extremely thin flap is created in the outer layer of the cornea, either with a microkeratome (a small blade attached to a motor specifically designed for this purpose) or with a specialized infrared laser (read more about IntraLase above). The flap is reflected, and an excimer laser, programmed with an individual map of the patient’s eye, reshapes corneal tissue with quick pulses of concentrated light. This process usually only lasts a few seconds. Once the treatment is completed, the flap is repositioned and stays in place without any sutures. The entire procedure takes around 5 minutes per eye.

 

LASIK is an out-patient procedure with little down time. Following the procedure, patients are asked to go home and close their eyes for a minimum of 4 hours. They are also instructed to avoid strenuous activities, rubbing the eyes, swimming, and wearing eye make-up for a period of time, usually 1-2 weeks. Vision improves very quickly, and most patients are able to drive and return to work the following day. Antibiotic and steroid eye drops are taken postoperatively by the patient to prevent infection and reduce swelling.

Pricing for refractive surgery varies depending on the severity of your prescription. Unfortunately, the procedure is not covered by insurance, because it is considered elective. However, we do offer interest-free financing through Wells Fargo. You will need to schedule a consultation to determine your individual pricing and candidacy. The cost of an evaluation with Dr. Cassol is $50.00, which will be deducted from your total surgical cost. 

Anesthetic eye drops are used just prior to treatment to numb your eyes. Patients often feel the small device used to hold the eyelids open, however the laser treatment itself is not painful. An oral medication can also be administered prior to the procedure to help with relaxation. Don’t worry! No needles or intravenous medications are used. Post-operatively you may experience a scratchy or mild burning sensation for a few hours, however, most patients feel fine if they take a nap after the treatment.

As with any surgery, laser vision correction involves a degree of risk. During your consultation, Dr. Cassol will go over potential risks with you after reviewing your personal ocular and medical history, and he will answer any questions you may have. Potential short-term side effects of the surgery include minor discomfort, corneal swelling or haze, dry or watery eyes, light sensitivity, or a feeling of something in your eye; these are temporary and usually resolve within the first few weeks of the healing process.

The goal of laser vision correction surgery is to reduce your dependence on glasses and contacts, however, some patients still require correction for certain tasks, such as reading or driving at night. This is especially true for patients who are presbyopic.   Presbyopia is a normal age-related condition, which affects the ability to focus for reading and/or near work, typically in patients who are 40 or older. For patients younger than 40, it's important to understand that refractive surgery will not prevent presbyopia, and you will eventually need readers as you age. Patients who are already presbyopic and currently using bifocals or readers will still need readers following the procedure, unless you elect to have monovision. You can discuss this option (targeting your dominant eye to see in the distance and your other eye to see up close) with Dr. Cassol during your evaluation. Monovision should be trialed in contacts or glasses prior to having it surgically performed to assess vision, depth perception, and adaptability. Thoroughly discuss your individual vision needs with Dr. Cassol to determine how laser vision correction can best help you reach your vision goals.

During your evaluation, Dr. Cassol will determine and discuss which refractive surgical procedure is best for you. Below are two alternative procedures to restore vision if you are not a good candidate for LASIK:

 

Photorefractive Keratectomy (PRK) is an excellent alternative to other types of refractive surgery, especially for patients with thin, flat, or abnormal corneas. In addition, there is less dry eye and haze postoperatively compared to LASIK. During the PRK procedure, the top surface layer of the cornea (called the epithelium) is removed. No needles or incisions are required, and no flap is created. An excimer laser is used to reshape the inner corneal tissue. The epithelium usually grows back over 3-4 days, and a bandage contact lens is used to increase comfort during this period. Most patients regain their functional vision (able to drive and return to work) in 5-7 days. Click here for an in-depth comparison of LASIK vs. PRK.  

 

A Clear Lens Extraction (CLE), also referred to as a Refractive Lens Exchange (RLE), involves the removal of the clear lens of your eye, even though there is no cataract. Dr. Cassol surgically removes the natural lens of the eye and replaces it with an intraocular lens implant (IOL) of your choice in order to restore vision. Please reference the Cataract Section of our website for details regarding the surgical procedure and IOL options, as these procedures are nearly identical; the only difference is that a CLE is considered cosmetic, because the natural lens is clear and does not yet have a cataract. It’s important to note that during this procedure, you WILL lose the natural focusing ability of your eye (called accommodation). Therefore, if you do not elect to have a multifocal lens implanted, you will be unable to see up close and will need to wear readers after the procedure.