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Vision Surgery

The important role your optometrist plays in achieving a successful outcome to refractive surgery

I recently had a patient who was attracted to a surgical center by a radio commercial that advertised low cost LASIK surgery. He was evaluated by a technician who told him that he was a good candidate for the procedure. The patient made an appointment for LASIK the following week.

The patient saw me a few days after the evaluation for a second opinion as he realized he was making a major medical decision. After my evaluation, I informed him that he was not a good candidate for LASIK. If he proceeded with surgery he would have terrible glare when driving at night. I referred him to the optometrist who manages the TLC Laser Center in Fairfield, which is the surgical group I use for my own patients. The optometrist confirmed my findings. He also found that his corneas were too thin to have LASIK surgery!

Naturally, my patient returned to my office and thanked me profusely. He almost became the victim of substandard medical care. Having your optometrist as your surgical case manager prevents these types of situations from occurring.

You would never think to walk into a surgeon's office for a quick evaluation before surgery without first having extensive testing and consultations with your internist or general practitioner. Refractive surgery must be managed the same way, in spite of the false advertising claims made by some surgical centers. As with any type of surgery, the role played by your primary care physician, or in the case of refractive surgery, your optometrist, is critical to the ultimate success of the actual surgery.

Your optometrist is the case manager of your refractive surgery experience. As a specialist in vision and as the eye professional that is most familiar with your unique visual history and requirements, your optometrist's management of your surgical care is invaluable in assuring a successful surgical outcome. Your optometrist guides, evaluates, discusses with you, and ultimately makes important decisions with respect to the surgeon and the type of laser instrument to be used, as well as to the various options regarding the degree and type of surgical correction most appropriate to your lifestyle needs.

A closer look at Dr. Lefland's responsibilities as your refractive surgery case manager.

On the initial consultation Dr. Lefland will: 
– Review your previous examination records to determine if you are a candidate for surgery 
– Discuss your options regarding the amount and type of correction the surgeon should be instructed to perform 
– Explain the limitations of the surgical outcome and how they may affect your lifestyle 
– Give you a frank, balanced presentation of the pros and cons of proceeding with surgery 
– Discuss your concerns and expectations and give you a realistic appraisal of what results you can expect if you proceed with LASIK 
– If you are a soft contact lens wearer, determine how long lenses must not be worn before evaluation, of if wearing rigid lenses, refit you with soft lenses for preoperative wear if do not wish to wear glasses before surgery 

On the Preoperative Examination Dr. Lefland will: 
– Perform an examination to evaluate your eye health 
– Perform specific tests to evaluate the size of your pupil (too large a pupil in dim light may be a contraindication for surgery or require the use of a different laser instrument) 
– Perform a careful refraction and decide the exact amount of correction that should be achieved by the surgeon 
– Determine which type of laser instrument and which surgeon would be most appropriate for your case 
– Contact the surgeon to arrange your appointment and transmit the examination findings, type of surgery and amount of correction to be performed on each eye 
– Request that pachymetry be performed before surgery to ensure that the corneas are thick enough to proceed with LASIK.

On the Postoperative Examinations Dr. Lefland will: 
– Evaluate the position of the corneal flap and the edge of the incision for various complications 
– Monitor and review the procedures you should follow during your recovery period

  • Start here for an overview of the different types of surgery to correct myopia, hyperopia and astigmatism; and the merits and drawbacks of each.
  • It’s the most popular vision correction surgery, by far. Learn what to expect before, during and after the procedure.
  • Complications from LASIK are few, but they do happen. It’s important to understand the risks, and how to minimize them.
  • Successful LASIK surgeons get that way from experience and the ability to screen out poor candidates for the procedure. Here’s the list of what makes you a good candidate.
  • An alternative to LASIK, PPK is a no-flpa eye surgery. Learn about the advantages and disadvantages, as well as what to expect.
  • A number of relatively new procedures are addressing the age-related decrease in ability to focus on near objects, that was once correctable only with bifocals.
  • These small lenses or optical devices are inserted into the cornea to alter its shape and correct vision problems.
  • Sometimes because of disease or injury, the cornea becomes so damaged that problems cannot be corrected with eyeglasses, contacts, or refractive surgery such as LASIK.