LASIK surgery is an extremely popular vision correction procedure that permanently changes the shape of the cornea. This advanced procedure can treat low to high levels of nearsightedness, farsightedness, and astigmatism to reduce or eliminate a patient’s dependency on contact lenses and glasses. Because Dr. Andrew Holzman focuses on providing the highest quality care, we have invested in the safest and most precise equipment. Dr. Holzman and the staff at our TLC Laser Eye Center offices in the greater Washington, D.C. area carefully perform pre-operative diagnostic testing to determine which LASIK technique, if any, is best suited for your vision correction needs. Our completely customized treatment plans can help you achieve the best possible outcome through refractive surgery.
Protecting a Valuable Asset: David’s Story
“After all my eyes have been through, I consider LASIK to truly be a miracle. First of all, I should mention that I am a commercial pilot and, previously, an Air Force pilot. Eyes have always been considered one of a pilot’s most valuable assets. Having good vision has been a concern of mine since the time I entered the Air Force Academy 30 years ago.
I decided that if I was going to have LASIK surgery, it should be performed by the best doctor I could find. My exhaustive research led me to Dr. Holzman, a veteran of more than 70,000 procedures. Using Dr. Holzman would require that I travel three hours for the surgery, but I had no doubts that the drive would be well worth it.”
—David Webb, Commercial Airline Pilot and Author
We invite you to read more testimonials from satisfied patients.
About Your LASIK Surgeon
Dr. Holzman has completed more than 70,000 vision correction procedures over the course of more than 25 years. He attended Emory University for his medical degree, where he graduated with honors. He completed an ophthalmology residency at George Washington University and a corneal surgery fellowship at the University of Pittsburgh Eye and Ear Institute. He is a fellow of the American College of Surgeons, American Academy of Ophthalmology, and American Society of Cataract and Refractive Surgery.
Conditions That Can Be Corrected with LASIK
LASIK can address many of the refractive errors patients struggle with on a daily basis. LASIK may be able to improve your vision, giving you 20/40 sight or better if you suffer from:
- Myopia: Better known as nearsightedness, this refractive error is the most common. Patients with myopia typically need corrective lenses to view objects in the distance, although they may have no problems reading and performing other up-close tasks.
- Hyperopia: Also known as farsightedness, patients with hyperopia have trouble reading and doing other up-close work, but may have excellent distance vision.
- Astigmatism: Abnormally shaped corneas create astigmatism. Patients with astigmatism typically experience moderately to severely blurry vision at any distance. Some patients may have astigmatism in conjunction with myopia or hyperopia.
- Presbyopia: This age-related form of farsightedness begins to take place in the mid- to late-40s for most patients. The natural lenses in our eyes begin to lose their flexibility over time. This makes it more difficult to view objects up close, and patients generally must rely on reading glasses. Unfortunately, there is no cure for presbyopia, but LASIK can improve vision when incorporated into a treatment called monovision. With this technique, Dr. Holzman will correct one eye to achieve distance focus and the other to see objects up close.
- Other Higher-Order Aberrations: Until fairly recently, LASIK and similar procedures were limited to treating nearsightedness, farsightedness, astigmatism, and presbyopia. With more advanced techniques and technology, Dr. Holzman can now address a variety of other vision issues, including blurred or double vision, halos and starbursts around lights, trouble seeing at night, and decreased contrast sensitivity. His advanced techniques also minimize the risk of developing higher-order aberrations following LASIK surgery.
Potential Risks and Benefits
LASIK has become incredibly popular not only because of the results it can provide, but also because patients recover more quickly and can experience fewer complications and side effects than with other methods of vision correction. Dr. Holzman has been consistently successful in helping our patients eliminate or reduce their dependence on glasses or contact lenses through LASIK surgery. Following LASIK performed at our practice, serious complications are extremely rare, and the chance of experiencing a vision-reducing complication is less than one percent.
To minimize risks, Dr. Holzman and the expert staff at the TLC Laser Eye Centers perform extensive pre-operative testing to determine which treatment is most appropriate. All LASIK patients receive thorough information concerning the risks involved in the procedure. Dr. Holzman will only recommend a treatment if he believes it is entirely safe and beneficial for you.
Fast Results and Other Benefits
Clear vision is a truly precious asset. Advancements in the field of ophthalmology have made laser vision correction procedures extremely safe and effective, and allowed millions of people to reduce, or even eliminate, their dependency upon glasses and contacts.
At the TLC Laser Eye Centers, we are committed to providing the highest standards of care in laser eye surgery. Dr. Holzman focuses on patient education, allowing those under our care to make informed decisions throughout every stage of their treatment. In addition to reviewing candidacy during an evaluation, we discuss the benefits and risks of the procedure.
If you know anyone who has undergone LASIK, you have most likely heard them rave about the benefits. LASIK can be used to correct nearsightedness, farsightedness, and astigmatism. LASIK enhances vision by reshaping the cornea, or the front surface of the eye, which focuses light upon the retina. The entire procedure can be completed in just a few minutes per eye, is nearly painless, and requires little healing time. Vision enhancement is nearly immediate, and patients can live a life that relies considerably less upon glasses and contacts. In fact, many of our patients who undergo LASIK no longer need corrective eyewear.
Minimizing Associated Risks
Like any surgery, LASIK carries some risk of complications. Some patients may experience dry eyes after surgery, but this condition is easily treated with eye drops and should resolve within six months. During the LASIK procedure, a flap is created in the cornea, allowing access to its inner layers. Complications related to healing of the flap, including infection and swelling, may occur. Other risks include glare, halo, difficulty seeing at night, or double vision.
The single most important step you can take in minimizing these risks is to choose a trusted, reputable surgeon. Dr. Holzman has performed more than 70,000 refractive eye surgeries with an extremely high rate of success. Our practice utilizes the latest technologies in the field, providing a high level of precision and accuracy during treatment, and taking every possible measure against over- or under-correction of your condition.
We also hold our patients to very strict candidacy standards. LASIK is not right for everyone, and roughly 20% of our patients do not meet the criteria we have outlined to be considered for the surgery. Dr. Holzman is skilled in additional refractive surgery options, like PRK, and if he decides you should not undergo LASIK, he will work to find a treatment option that works best for you.
To determine if you are a candidate for LASIK treatment, Dr. Holzman performs diagnostic pre-operative testing and evaluates your overall health. Important criteria include:
Patients who are not candidates for LASIK surgery may still benefit from other treatments such as PRK Surgery or corneal implants.
Pregnancy and Your Vision
Some patients are interested in enjoying clearer vision and a more convenient lifestyle as soon as possible, and wonder if they are candidates while they are pregnant or breastfeeding. Dr. Holzman can meet with you to discuss LASIK and pregnancy during a consultation at one of our offices.
First, a pregnant woman undergoes a number of physical and hormonal changes, which can cause adjustments in her vision. LASIK is advised only for patients with stable vision – pregnant or not. Stable vision helps to ensure that your LASIK results will not be compromised by future changes to your vision. This allows patients to enjoy long-term satisfaction with the results of their procedure.
Secondly, eye drops and other medications are administered as part of the LASIK procedure and recovery. Although these therapies are perfectly safe for adults, they should be avoided to protect a developing fetus that may be more sensitive.
LASIK and Breastfeeding
For similar reasons, LASIK is not recommended for women who are breastfeeding. In the months following childbirth (especially during breastfeeding), a woman will continue to experience hormonal changes that can affect her vision. The best way to enjoy optimal, long-lasting LASIK results is by seeking treatment after your hormonal changes and vision have stabilized. Additionally, the medications that are administered as part of the LASIK process will enter the woman’s body, including her breast milk. To prevent any potential health-related issues to your child, we recommend that women wait until nursing is complete to undergo LASIK.
In general, LASIK surgeons recommend that women wait at least two menstrual cycles after they give birth or stop breastfeeding before considering LASIK surgery. At this time, hormones will have largely returned to normal levels and a woman's eyesight should have returned to its pre-pregnancy prescription.
Other Reasons to Avoid LASIK
It is very important to know when to avoid LASIK. There are a number of eye conditions that can preclude a patient from LASIK. Patients suffering from persistent dry eyes may not be candidates for LASIK because the procedure could exacerbate the condition. Patients who have thin corneas are often better candidates for photorefractive keratectomy (PRK). If your vision is fluctuating - that is, if you have had to change your glasses prescription in the last year - LASIK surgery would not be recommended until your vision stabilizes. Because vision fluctuates during pregnancy and breast feeding, laser vision correction surgery would have much less predictable results for these patients, and probably would not be recommended until vision has stabilized.
There are a number of other eye conditions that can preclude you from LASIK:
- Cataracts: This gradual clouding of the crystalline lens obstructs vision, and should be addressed before undergoing LASIK.
- Glaucoma: Glaucoma involves high intraocular pressure (IOP) that can damage the retina and optic nerve. IOP increases during LASIK, so glaucoma sufferers may not be suitable candidates.
- Fuchs' Dystrophy - This condition involves the deterioration of the inner surface of the cornea, causing it to become unstable.
- Overly Large Pupils: Patients with overly large pupils may carry an increased risk of developing compromised night vision following LASIK.
- Severe Nearsightedness: Patients with severe nearsightedness are not usually considered good LASIK candidates.
- Keratoconus - Keratoconus involves the breakdown of collagen in the cornea, causing it to adopt a conical shape instead of a normal dome shape. Patients with keratoconus may not be candidates for LASIK because of corneal instability.
- Autoimmune Conditions: LASIK may not be advisable for those who suffer from diseases that affect their immune system because there is an increased risk of incomplete healing and other complications.
If you suffer from nearsightedness, farsightedness, or astigmatism, and wish to reduce or eliminate your need for glasses, you may be wondering: Is LASIK safe? The fact is that LASIK performed at our Washington, DC-area practice is very safe. Dr. Holzman has performed more than 70,000 vision correction surgeries. His experience and technologically sophisticated approach to refractive surgery minimizes risks and can ensure that you experience the best possible results of LASIK surgery. To determine if the procedure is right for you, Dr. Holzman will conduct a thorough review of your ocular health and overall health history.
The American Academy of Ophthalmology reports that between 0.2 and 2 percent of patients overall experience complications as a result of LASIK.
Studies Confirm the Safety of LASIK
The American Academy of Ophthalmology reports that between 0.2 and two percent of patients overall experience complications as a result of laser vision correction. Meanwhile, the U.S. Department of Defense has conducted 45 studies on the effectiveness and safety of LASIK. The complication rate among military personnel is 0.009 percent.
Dry eye is the most common side effect of LASIK, and it usually subsides after the recovery period. According to a large study, 35% of patients suffered from dry eye after LASIK, but 32% had a previous history of dry eye.
A 2009 study found that worldwide, 94 percent of patients surveyed reported satisfaction with their LASIK results. In the United States alone, the American Society of Cataract and Refractive Surgery reports that LASIK has a 96 percent satisfaction rate.
Recently, the Food and Drug Administration released the results of the LASIK Quality of Life Collaboration Project, which showed that patients surveyed in the U.S. had a 96.2% satisfaction rate after three months and a 98% satisfaction rate after six months.
Your Choice of Surgeon
Many patients do not realize that when it comes to any form of refractive surgery, they have the power to influence the safety of their procedure. In short, choosing an experienced surgeon using advanced technology can significantly improve the likelihood of a successful procedure involving minimal side-effects and long-term benefits.
Dr. Holzman is a leader in refractive surgery who lectures and teaches regularly, sharing his expertise with colleagues and medical students alike. Meanwhile, he performs bladeless LASIK involving the use of a laser instead of a blade to create the corneal flap, a technique that significantly reduces the risk of infection and flap complications. In fact, a study of more than 3,000 patients found that less than .05 percent of those who underwent bladeless LASIK between 2002 and 2009 experienced any kind of flap complication. Many patients have experienced life-changing LASIK benefits under his care.
“The LASIK procedure was short and easy, and I had better than perfect vision the very next day... Dr. Holzman is great and so are the other doctors and staff... Thank you very much for taking care of my eyes.”D.L. - June 24, 2018
How Much Does LASIK Cost?
During your comprehensive consultations, we invite you to ask any questions and gain a clearer understanding of the financial commitment LASIK requires.
Factors That Determine the Cost
There are several factors that will determine exactly how much your LASIK surgery will cost. For example, some patients require treatment of only one eye, which costs less than treating both eyes. If you are considering LASIK surgery, it is important to keep in mind that your vision is an invaluable asset, and you should never compromise quality of care in the interest of saving money. You simply cannot put a price on the satisfaction you can achieve by choosing a renowned ophthalmologist who uses the safest, most advanced technology available.
Our Advanced Technology
One very important determining factor in the cost of LASIK performed by Dr. Holzman is the technology used in our offices. We use only the safest and most effective tools to provide our patients with the maximum benefits of LASIK surgery. For example, we proudly offer iLASIK, in which a special laser (iFS) is used to create the corneal flap rather than using a keratome blade to create the corneal flap. This allows Dr. Holzman to execute this step in the procedure with greater precision than ever before possible.
In addition to traditional LASIK surgery, we also offer custom LASIK, an ultra-precise variation that uses sophisticated wavefront three-dimensional diagnostics to map the most minute details of the patient's cornea. Wavefront LASIK, which carries a greater cost than traditional LASIK, enables Dr. Holzman to correct even higher-order aberrations, thereby reducing the risk of such side effects as glare, halos, blurring, difficulty seeing at night, and double vision.
Our practice uses the latest technology in our laser eye treatments to provide the maximum benefits and utmost safety to our patients. This includes the WaveLight® Excimer Laser. This advanced tool minimizes the risks of LASIK, while making the surgery faster and more precise than ever before.
Because LASIK is considered an elective surgery, it is not covered by insurance. To help put LASIK within the budgets of those who need it, we offer competitive pricing and payment plans. Contact us today to learn more about how to apply.
The Long-term Value of LASIK
If you are considering LASIK, it is very important to weigh the cost of the procedure against the cost of continuing to purchase glasses and contact lenses. Most patients who have undergone LASIK surgery will only need to wear reading glasses once they are over 40. Younger patients will no longer need corrective eyewear at all. Dr. Holzman can help you understand what your eyewear needs will be following surgery, and you can use that information to calculate whether LASIK may actually save you money over time.
The LASIK Pre-Operative Exam
Prior to performing any procedure, Dr. Holzman will perform a comprehensive eye exam. This is more intensive than a typical annual eye exam. During a LASIK pre-operative exam, he will perform a routine vision test as well as:
- A dilated eye exam
- Corneal topography tests to measure the curvature of the corneas and create a detailed map of their shape and size
- A tear film test for dry eyes (patients with chronic dry eye are generally not good candidates for LASIK)
These tests are quick and involve little to no discomfort. After Dr. Holzman has completed all the necessary tests, he can discuss whether LASIK is right for you and which technique is most appropriate for your vision needs.
Our completely customized treatment plans can ensure that you achieve the best possible outcome from your LASIK procedure.
The LASIK Procedure
Dr. Holzman has personally performed more than 70,000 procedures to improve patients vision with LASIK and other sophisticated treatments. The bladeless LASIK procedure performed at his practice uses the very latest technology and techniques to provide qualified patients with the outstanding results for which Dr. Holzman is known worldwide.
LASIK: Step by Step
On the day of your LASIK procedure, you should plan to arrive at the TLC Laser Eye Center at your scheduled time. Please do not be late. Avoid wearing any colognes, perfumes, or scented soaps that day. After being checked in, you will be offered a sedative to help you relax. You will be prepared for surgery, and the area around your eyes will be cleaned. Anesthetic eye drops will be administered to numb your eyes; no injections or needles will be used. When your eye is completely numb, a device will be placed between your eyelids to prevent you from blinking during the procedure.
The first step of the LASIK procedure is the creation of a corneal flap, which will be accomplished the safest and most precise way possible, using the IntraLase iFS laser system. No blades will be used. The LASIK procedure is not painful, but you may experience a sensation of pressure on your eye for a few seconds.
One of our two advanced excimer lasers will then be used to reshape your cornea according to the customized treatment plan developed from your pre-operative diagnostic testing. Depending on the amount of correction needed, the laser treatment will take approximately 10 to 40 seconds. The corneal flap is then repositioned. The corneal flap will heal on its own, and no sutures are necessary.
You can expect to experience a marked improvement in your vision within just a few hours of your surgery. Dr. Holzman will provide you with detailed instructions for having a successful recovery.
Recovery After LASIK
Patients who receive laser vision correction with Dr. Holzman often enjoy an improvement in their vision within just 24 hours of their surgery. Additionally, our patients' recovery in the following days and weeks is generally straightforward and painless, with very minor side effects that quickly diminish.
The Day of Your Procedure
After LASIK, your eyes will be examined with a slit lamp microscope. This special tool focuses a thin sheet of high-intensity light into the eye, providing a stereoscopic view of the cornea. This allows Dr. Holzman to examine the epithelium, or the outer layer of the cornea, to make certain that the flap is in proper position to heal.
The quick, dramatic improvement in the way patients see the world is one of the reasons so many people turn to LASIK. Patients with higher prescriptions may notice that their vision is significantly better almost immediately after their surgery, and patients with lower prescriptions often say that their sight improves within six to eight hours. However, since all of our patients will experience some blurriness following LASIK, arrangements should be made for a friend or family member to drive you home.
You may experience some discomfort while recovering at home, which is why we recommend that you rest your eyes to reduce irritation. After taking a nap, you may notice that your eyes feel better and your sight is even clearer. Other patients may sleep through the night and wake up the next morning excited that they can see well without their glasses.
The Week of Your Procedure
The day following your procedure, you will return to our office (or see your referring doctor) for a follow-up examination to ensure you are healing properly. Within the first few days of LASIK, patients may also experience some mild side effects, which quickly subside. The most common side-effects include:
- Sensitivity to light
- Hazy or blurry vision
- An itching or burning sensation in the eyes
- Dry eyes
- Bloodshot eyes
- Gritty sensation in the eyes
Many patients return to their everyday activities, including work, errands, or even a trip to the gym within a couple of days of their procedure. Although non-contact sports can be resumed, patients should abstain from any activities that put the eye in danger of trauma, such as volleyball or martial arts, until their doctor provides their approval. Since LASIK works by reshaping your cornea, it is very important that patients avoid putting any creams or make-up around their eye for at least a week.
The Month of Your Procedure
Contaminated water can cause infection, so activities like swimming, saunas, or steam baths should be avoided for at least a month. Patients should also refrain from rubbing their eyes during this time to allow the corneal flap to properly heal. Your vision will stabilize in the weeks after the procedure, and it is not uncommon to experience subtle shifts in your sight during this time. While some patients prefer to wear glasses during certain tasks like driving or reading, many enjoy seeing without any dependence on corrective eyewear.
“Just had my one year LASIK follow up yesterday, 20/20 vision... everything & everyone was professional and thorough. Like everyone else, the actual procedure - while a bit strange - had no pain, was super quick, and I could see when I stood up. Thanks Dr Holzman! ”Christina T. - March 25, 2018
Life After LASIK
You're probably familiar with LASIK's ability to transform important aspects of your life, but you may still be wondering how long these results will last. The lasting impact your procedure will ultimately have is largely dependent on your choice of surgeon. Dr. Holzman is a skilled, experienced specialist who uses advanced techniques to maximize the benefits you receive.
How Long Do LASIK Results Last?
LASIK is a type of refractive surgery that uses a specialized laser to reshape the cornea, correcting irregularities in its curvature that can lead to nearsightedness, farsightedness, and astigmatism. After surgery, LASIK patients can often enjoy reduced dependency upon glasses and contacts or even eliminate their dependency altogether. Because the cornea itself is altered during LASIK, many people believe they will have 20/20 vision, or even better, for the rest of their life. In an ideal world, the eyes would defy the inevitable effects of aging. But the natural aging process takes a toll on the eyes, whether they have undergone LASIK or not.
In short, a number of factors will determine how long the effects of LASIK will last. Many of our patients enjoy the maximized benefits of their procedure for years and even decades. As presbyopia, or trouble seeing close up, develops, some patients will need to supplement their vision with reading glasses or bifocals. This condition usually becomes apparent after age 40. Additional age-related eye conditions and diseases, like cataracts and glaucoma, can also compromise the effects of LASIK.
About 5 percent of LASIK patient will require a touch-up procedure at some point, restoring their 20/20 vision. If you choose to undergo LASIK again, Dr. Holzman can use the same corneal flap created during your initial surgery.
Maximizing Your Benefits
Choosing a reputable, technologically advanced practice is the best way to maximize your LASIK results. Our practice combines unparalleled experience - Dr. Holzman has successfully performed more than 70,000 surgeries - with the most innovative techniques and equipment to provide patients with their best possible results. We use advanced tools like Wavefront diagnostic technology for highly customized corneal reshaping, and the ALLEGRETTO WAVE™ laser system to provide unparalleled control and accuracy during surgery.
Potential Side Effects after LASIK
As with any surgical procedure, LASIK can cause side effects, some short-term and some that may last for an extended period of time. We believe it is important to educate patients on these potential side effects so that they can make well-informed decisions about their eye care. During your consultation, Dr. Holzman will explain the procedure itself, and address any concerns you may have about LASIK side effects, which include:
- Vision disturbances - After undergoing LASIK surgery, you may experience disturbances to your normal vision. During the first few weeks or months, you may experience halos, hazy vision, and glare or starbursts in dimmer settings. These side effects should wear off gradually, and usually disappear within three to six months. In rare cases, patients continue to experience long-term vision disturbances.
- Red spot on eye - Some patients develop a red spot on the white of their eye following LASIK surgery. This red spot, called a subconjunctival hemorrhage, results when a blood vessel in the outermost protective coating of the eyeball breaks. These red spots rarely occur, but if they do, they are harmless. Any spots will disappear within a few days to a couple of weeks after surgery. Prior to transporting you to the surgical suite, we prep your eyes with a series of eye drops meant to minimize this risk.
- Flap complications - During LASIK surgery, Dr. Holzman uses a femtosecond laser to create a flap in the cornea of your eye. After reshaping your corneal tissue, Dr. Holzman closes the flap to heal on its own. Sometimes complications effect the healing of the flap, though this is rare. If the flap does not adhere properly, this can create tiny wrinkles in the surface of the cornea, which may affect your vision.
- Dry eyes - Some patients develop dry eyes following surgery, but this side effect usually goes away within six months. The LASIK procedure can cause a decrease in your tear production, resulting in dry eyes. Patients who have severe dry eyes may not be candidates for the procedure.
- Infection - Infection rarely occurs following LASIK surgery. Dr. Holzman will give you detailed post-operative instructions, including directions on using medicated eye drops, to help minimize the risk of infection.
By choosing a highly-trained surgeon like Dr. Holzman, you are taking the first step to minimize the chance of side effects. By conducting a comprehensive exam and obtaining precise data prior to surgery, Dr. Holzman can create a custom surgical plan intended to minimize risk and enhance your vision.
A Closer Look at Subconjunctival Hemorrhage
The red spot that some patients develop after their LASIK procedure is called a subconjunctival hemorrhage (bleeding under the conjunctiva). This condition does not pose any health risk, and will have no effect on the results of your LASIK procedure. In fact, a subconjunctival hemorrhage is a superficial issue, and it does not last for long.
We are proud to say that the incidence of subconjunctival hemorrhage among our patients is very low.
The conjunctiva is the thin, moist, clear membrane that covers the white part of the eye and the inside of the eyelids. This protective layer of the eye has a network of nerves and very small blood vessels. These blood vessels are delicate and prone to breaking, which can result in a subconjunctival hemorrhage. In addition to LASIK, the conjunctival blood vessels may rupture due to:
- Heavy sneezing
- Heavy coughing
- Heavy lifting
- Rubbing the eye
- Trauma to the eye
- Severe eye infection
How Do I Know I Have It?
Most patients realize they have this condition when they look in the mirror. They may find that the white part of their eye carries a bright red spot.
How Long Does It Last?
A subconjunctival hemorrhage is like a bruise on the skin: it will resolve on its own when the body absorbs the blood. Compared to the skin and other parts of the body, it takes the conjunctiva a little longer to absorb the blood. Generally, the blood will remain trapped under the transparent conjunctiva for a week or two before the red spot goes away.
How Do I Treat It?
Since the body will absorb the blood, no treatment is necessary. It is simply a matter of waiting. If you are having other side effects from your LASIK procedure, such as dry or itchy eyes, you may want to use eyedrops and other therapies approved by your doctor to improve your comfort level.
Reducing the Risk
Before you enter the surgical suite, Dr. Holzman has his team will prepare your eye for surgery. During this preparation, you will be given a series of three drops of Naphcon A. This medication helps to reduce the risk of developing subconjunctival hemorrhage. With this precautionary step and our years of experience in performing LASIK, we are proud to say that the incidence of subconjunctival hemorrhage among our patients is very low.
Preventing and Treating Dry Eyes after LASIK
Dry eyes after LASIK are fairly common. Most patients will experience some degree of dryness immediately following their LASIK procedure, but symptoms typically dissipate as time passes. Since dry eye is also commonly seen in patients prior to LASIK surgery, often because of contact lens use, Dr. Holzman will review your medical history to determine if you are at-risk for this condition.
At TLC Laser Center, all LASIK candidates are given a comprehensive pre-operative examination. If we find that you have any pre-existing dry eye symptoms, we can provide you with treatment before undergoing LASIK surgery. After LASIK, Dr. Holzman will provide medicated eye drops to help relieve initial dry eye symptoms and promote proper healing. Although rare, dry eyes symptoms can sometimes persist. In these cases, we can provide additional treatments, including tear supplementation, punctal occlusion, and anti-inflammatory therapies.
“LASIK is a scary, risky procedure, so you want to go to the best possible provider. I'm not sure you could find a better place than TLC. They are extremely professional, knowledgable, and accommodating, and best of all they will be honest with you...”Benjamin M. - April 26, 2017
Astigmatism and LASIK
Astigmatism is a condition in which an irregular corneal shape compromises the ability to focus. A LASIK procedure can refine the shape of the cornea to correct astigmatism and reduce or eliminate the need for glasses or contact lenses.
A properly functioning cornea has a symmetrical shape. Its continuous curvature refracts light entering the eye, allowing us to perceive clear images. When astigmatism is present, the cornea has an oblong shape that hinders proper focus. The result is unclear vision at any distance. A patient may experience moderate to severe astigmatism depending on the extent of the corneal irregularities.
Causes of Astigmatism
It is a common misconception that squinting, reading in poor lighting, or sitting too near the television are causes of astigmatism. In fact, sufferers are usually born with astigmatism, and it can stay the same or worsen over time. Other causes of astigmatism include eye injury, disease, and surgery.
The most common symptom of astigmatism is blurred vision at any distance. Those with astigmatism often experience fatigue, headaches, squinting, eye discomfort, and irritation. These symptoms can vary depending on the severity of theastigmatism. Patients experiencing any of these symptoms should contact a qualified ophthalmologist for a comprehensive eye examination.
LASIK Can Treat Astigmatism
LASIK (Laser-Assisted In Situ Keratomileusis) is a surgical procedure that uses a laser to reshape the cornea. The LASIK procedure involves creating a small flap in the epithelial layer of the cornea (the outermost layer) and reshaping the stroma, or the middle layer. The goal of LASIK is to refine the shape of the cornea to properly focus light. Many astigmatism patients wear glasses or contact lenses to compensate for their corneal irregularities, but LASIK can dramatically reduce or eliminate the need for corrective eyewear.
Presbyopia and LASIK: See Clearly with Monovision
Patients in their 40s often begin experiencing presbyopia, a weakening of the crystalline lens, which can make it more difficult to focus and refocus at various distances. LASIK surgery can still benefit patients over 40, but it must be performed in a special way to account for presbyopia. LASIK monovision is a variation on this popular procedure that helps mature patients retain the ability to focus at a range of distances. If you are considering LASIK after 40, Dr. Holzman can help you reduce or eliminate your need for prescription eye wear.
Patients in their 20s and 30s can enjoy complete vision correction with traditional LASIK surgery. After age 40, this treatment can address distance vision, but will not eliminate the need for reading glasses. For patients 40 and older who would like to avoid wearing glasses, Dr. Holzman offers laser vision correction with a monovision adjustment.
To administer LASIK monovision, the dominant eye is treated for a full distance vision correction, while the other eye receives a slight under correction that is optimal for reading. Every patient has a dominant eye that is favored for distance vision, usually on the same side as the dominant hand. Because the dominant eye is the one the brain relies on for visual information, your brain easily makes the adjustment when the non-dominant eye takes the role of ‘reader.’
Some patients fear that it may be difficult to adjust to monovision, but most find that this is not the case. Dr. Holzman always suggests patients use contact lenses to try monovision before having LASIK surgery. Wearing these contacts day and night for a period of a few days allows you to determine whether the monovision adjustment is for you.
Patients who choose monovision enjoy a full range of vision without depending on glasses, and for many, this is an optimal solution. However, not everyone is a candidate for this treatment. Dr. Holzman always explains that monovision patients must be willing to compromise a small amount of visual acuity for distance, since they will be using one eye instead of two.
Cataracts and LASIK: Is It an Option?
In the past, patients who had undergone cataract surgery were not candidates for laser eye surgery. As a result, compensating for pre-existing corneal abnormalities like nearsightedness, farsightedness, and astigmatism required corrective eyewear. Today, we can address these issues and help you avoid glasses and contacts with LASIK surgery for post-cataract patients.
During cataract surgery, Dr. Holzman removes a clouded crystalline lens and replaces it with an artificial intraocular lens (IOL). Today, different styles of IOLs, such as multifocal and toric lenses, can address some vision impairment issues in addition to replacing a cloudy lens.
How Long Should I Wait for LASIK?
Cataract patients considering LASIK should wait a few months following surgery before undergoing the treatment in order to ensure their eyes have healed without complication. Once a patient's eyes have fully stabilized, Dr. Holzman conducts comprehensive exams with each patient to determine candidacy for the treatment. Patients undergoing LASIK after cataract surgery should be in good overall health, with no ocular health issues beyond aberrations.
Information About Retreatment
At TLC Laser Centers, the vast majority of our patients enjoy clear, sharp vision after LASIK surgery, reducing or eliminating their dependency on prescription lenses. When a patient is seeking further vision enhancement or an additional correction, a second LASIK surgery can refine your results. At our Washington, DC, Virginia, and Maryland laser vision treatment centers, patients receive a lifelong commitment to refractive vision care. We can also perform LASIK touch-up procedures for patients who underwent their primary surgery with another practice.
About LASIK at TLC
For decades, people have been enjoying the benefits of LASIK surgery to correct nearsightedness, farsightedness, and astigmatism. The highly precise laser used during the procedure reshapes corneal tissue, correcting the way that light strikes the retina. Using the most advanced technologies available, Dr. Holzman has consistently realized high success rates for LASIK patients. We also offer blade-free LASIK, which is now safer and more effective than ever before.
We are so confident in a great outcome, we provide a Lifetime Commitment for qualified patients. Ninety-nine percent of our patients have no need for a second surgery, but if you do require a touch-up within the first year, you will receive a second enhancement procedure with the same technology at no additional charge.
Candidates for a Second Procedure
The best way to avoid the need for a second surgery is to first ensure that you are a good candidate for the procedure. For example, women who are pregnant or nursing are advised to delay LASIK because of hormonal changes that can effect vision. At TLC Laser Centers, we apply strict candidacy standards to achieve the best possible outcome for our patients. Second LASIK surgery candidates are most often farsighted with a high degree of refractive error, or are over the age of 50.
If your vision is blurred within a few months of LASIK surgery, you may need a corrective enhancement. Additional testing must be done to determine candidacy for a second LASIK surgery. During the enhancement procedure, the flap created during the first surgery is lifted, and the laser is used to further reshape and refine the cornea. For this reason, the cornea must be healthy and have a sufficient amount of tissue remaining.
Patients with Presbyopia
LASIK surgery is considered to be a permanent correction of your vision. However, aging changes our eyesight over the years. Patients over 40 may begin to develop presbyopia and require reading glasses to see objects up close. A small percentage of people may experience a slight decline in distance vision, and in these cases, a second LASIK surgery can be performed.
Learn More about LASIK
LASIK eye surgery performed by an experienced and reputable surgeon can greatly improve your quality of life. If you want to learn more about the LASIK procedure, the cost of LASIK, or your candidacy for the procedure, please contact our practice to schedule a consultation at one of our five offices.
“Dr. Holzman is the best - very honest, very professional yet very friendly and personable.” Ben E.