Columbia University
Laser Vision Center
Why Choose Columbia?
The Columbia University Laser Vision Center is part of the Department of Ophthalmology at the world‐renowned Edward S. Harkness Eye Institute. We are part of a tradition of excellence in both clinical medicine and research dating back to the founding of the Institute in 1932. Our physicians pioneered the development of lasers for vision correction, having pioneered the use of excimer lasers for corneal refractive surgery. Today, Columbia continues to be recognized for its excellence in laser vision surgery and research.
Columbia University’s Laser Vision Center offers a full spectrum of vision correction options from LASIK to PRK. Our board certified ophthalmologists are some of the top eye surgeons in the field. During your initial screening evaluation, our physician not only determines if you are a candidate for vision corrective surgery, but also provides a comprehensive eye examination to screen for any other conditions that may affect the outcome of the procedure, as well as the overall health of your eyes and vision.
What to Expect Before the Procedure?
Initial Screening Visit – this is a free consultation provided by a certified ophthalmic support staff to determine the initial refractive state of the eye. For contact lenses users, please remove soft contact lenses for at least 1 week prior to your evaluation and hard contact lenses for 2 weeks prior to your evaluation.
Laser Vision Correction Dilated Examination – This examination is to determine your candidacy for refractive surgery. There is a $250, non‐refundable fee for this examination that is not covered by insurance. This evaluation constitutes a well care ophthalmologic examination. It includes, but is not limited to, the diagnostic imaging, refraction, and dilation of the eye. This exam is provided by certified ophthalmic support staff and by a board‐certified ophthalmologist. Based on your examination, your physician will the different type of surgical options for you and set a procedure date.
To schedule an appointment, please call (212) 342‐3746.
880 Third Avenue, 2nd Floor, New York, NY 10022 635 West 165th Street, 3rd Floor, New York, NY 10032
Tel: (212) 342‐3746 www.columbialasik.org
Columbia University
Laser Vision Center
Laser Vision Correction Surgery Waiver Form (Please bring this form to your initial screening visit)
Laser Vision Correction Screening* This is a free consultation provided by certified ophthalmic support staff to determine the initial refractive state of the eye. This exam in no way replaces a complete ophthalmic evaluation performed by an ophthalmologist and is not intended to diagnose or treat any other condition of the eye.
Patient Signature: ______Date: ______
Witness Signature: ______Date: ______
* Please remember to keep your contact lenses off for at least one (1) week prior to your screening visit.
Laser Vision Correction Dilated Examination This examination is to determine your candidacy for refractive surgery. There is a $250, non‐ refundable fee for this examination that is not covered by insurance. This evaluation constitutes a well care ophthalmologic examination. It includes, but is not limited to, the diagnostic imaging, refraction, and dilation of the eye. This exam is provided by certified ophthalmic support staff and by a board‐certified ophthalmologist.
Patient Signature: ______Date: ______
Witness Signature: ______Date: ______
880 Third Avenue, 2nd Floor, New York, NY 10022 635 West 165th Street, 3rd Floor, New York, NY 10032
Tel: (212) 342‐3746 www.columbialasik.org
Columbia University
Laser Vision Center
Vision Correction Surgery Pre‐ and Post‐Operative Instructions
Before Your Surgery On the day of surgery, please remember the following:
1. Do not wear any make‐up. Do not wear any mascara or eyeliner one (1) day prior to your surgery. 2. Do not wear any perfume or cologne, including any fragrant body lotion or cream. 3. Do not wear any contact lenses for at least 1 week prior to your surgery for regular soft lenses, and 2 weeks prior to your surgery for toric and hard lenses. 4. Arrive 15‐20 minutes prior to your procedure time. 5. Read, sign and date your consent forms. 6. Arrange for transportation or for someone to drive you home after surgery. 7. Fill any needed prescriptions.
After Your Surgery 1. It is recommended that you keep your eyes closed for 5‐6 hours following the procedure. No television, reading, or computer use on the day of surgery. 2. Rest and use your drops during the first 24 hours after surgery, but do not interrupt sleep to take drops. 3. Do not drive for at least 12 hours after surgery. 4. Use clear protective shield(s) while sleeping. 5. Do not wear eye make‐up for at least one week after surgery. 6. When you shower, please keep your eyes closed and away from tap water, soap and shampoo. Alternatively, you can wear protective shields. 7. Do not participate in contact/impact sports for 2‐4 weeks. Golf and mild aerobic exercise is usually fine within a few days, or at your physician’s discretion. 8. Protective eyewear must be worn when participating in any sporting activity. 9. No swimming, hot tub, sauna or steam bath for 4 weeks after surgery. 10. No yard, garden, or wood work for 1 week after surgery. 11. When leaving after your surgery, avoid sitting in the front of the car that is equipped with airbags. 12. When you are outside, please wear protective sunglasses as you will be sensitive to light.
880 Third Avenue, 2nd Floor, New York, NY 10022 635 West 165th Street, 3rd Floor, New York, NY 10032
Tel: (212) 342‐3746 www.columbialasik.org
Facts You Need to Know About Laser Assisted In Situ Keratomileusis (LASIK) and Photorefractive Keratectomy (PRK) Surgery
Patient Information Booklet LASIK: Nearsighted Patients (0 to -14.0 diopters) with or without -0.5 to -5.0 Diopters of Astigmatism Farsighted Patients (+0.5 to +5.0 diopters) with up to +3.0 Diopters of Refractive Astigmatism Mixed Astigmatism Patients (≤ 6.0 diopters of astigmatism) PRK: Nearsighted Patients (-1.0 to -12.0 diopters) or Nearsighted Patients (0 to -12.0 diopters) with up to -4.0 Diopters of Astigmatism Farsighted Patients (+1.0 to +6.0 diopters) with no more than 1.0 Diopter of Refractive Astigmatism Farsighted Patients (+0.5 to +5.0 diopters) with +0.5 to +4.0 Diopters of Refractive Astigmatism
Please read this entire booklet. Discuss its contents with your doctor so that all your questions are answered to your satisfaction. Ask any questions you may have before you agree to the surgery.
VISX, Incorporated 3400 Central Expressway Santa Clara, CA 95051-0703 U.S.A. Tel: 408.733.2020
Copyright 2001 by VISX, Incorporated All Rights Reserved
VISX® is a registered trademark of VISX, Incorporated. VISX STAR Excimer Laser System™ is a trademark of VISX, Incorporated. Accutane® is a registered trademark of Hoffmann-La Roche Inc. Cordarone® is a registered trademark of Sanofi. Imitrex® is a registered trademark of Glaxo Group Ltd.
Table of Contents
Introduction ...... 1 How the Eye Functions ...... 2 What are PRK and LASIK? ...... 5 Benefits ...... 6 Risks ...... 6 The First Week Following Surgery ...... 7 The First Two To Six Months Following Surgery ...... 7 One or More Years After Surgery ...... 7 Contraindications ...... 7 Warnings ...... 8 Precautions ...... 8 Are You a Good Candidate for Laser Vision Correction? ...... 10 Before the Surgery ...... 12 The Day of Surgery ...... 12 After Surgery ...... 14 Results from Clinical Studies ...... 15 Long Term Post-Treatment Safety Problems ...... 17 Questions to Ask Your Doctor...... 19 Self-Test ...... 21 Summary of Important Information ...... 22 Answers to Self-Test Questions:...... 23 Glossary ...... 24
VISX STAR Patient Information Booklet 0030-2307D i
ii VISX STAR Patient Information Booklet 0030-2307D
Introduction The information in this booklet is provided to help you decide whether to have Photorefractive Keratectomy (PRK) or Laser Assisted In Situ Keratomileusis (LASIK) laser surgery. LASIK and PRK may be used to correct or partly correct nearsightedness (myopia), farsightedness (hyperopia), and astigmatism. Some other ways to correct these conditions are by wearing glasses or contact lenses, or by undergoing other kinds of refractive surgery such as radial keratotomy (RK) or automated lamellar keratectomy (ALK). PRK and LASIK (also called laser refractive surgery or laser vision correction) are completely different from RK and ALK.
Your doctor may recommend laser vision correction (PRK or LASIK) for both eyes. However, sometimes it is better to have laser vision correction done on only one eye. Talk with your doctor about whether it would be better to treat one or both of your eyes.
Please read this booklet completely. Discuss any questions with your doctor before you decide if laser vision correction is right for you. Only an eye care professional trained in laser vision correction can determine whether you are a suitable candidate. Some people, such as military pilots, have job-related vision requirements that cannot be met by having RK, ALK, PRK, or LASIK.
VISX STAR™ Patient Information Booklet 0030-2307D 1
How the Eye Normal Eye Functions Light entering Retina eye The cornea and lens of the eye focus light like a camera lens to form an image on the retina at the back of the eye. The Cornea cornea, where light first Lens enters the front of the eye, provides about two thirds of the eye’s focusing power, and the lens inside the eye provides the other third.
Nearsightedness Nearsighted Eye Some eyes focus, or Light refract, the light too much, entering Retina eye so that the images of distant objects are formed in front of the retina, and the image on the retina is Cornea blurred. This condition is called nearsightedness, or Lens myopia. Myopia usually starts in childhood and gets progressively worse through adolescence. It usually stops changing by the late teens, but it can sometimes continue to get worse into the mid-twenties.
2 VISX STAR™ Patient Information Booklet 0030-2307D
Nearsightedness can be corrected by any method that reduces the total refractive power of the eye. Eyeglasses and contact lenses do this by putting in front of the eye “negative” lenses that are thicker at the edge than in the center. PRK and LASIK treatments correct nearsightedness by flattening the central part of the cornea to reduce the total refractive power of the eye.
Farsightedness Farsighted Eye In farsightedness the image focuses beyond the retina. Light entering Retina In our youth, the natural eye accommodating (focusing) power of the eyes often compensates for farsightedness. But as we Cornea age, our eyes become less Lens able to accommodate. For this reason, farsightedness most commonly becomes a problem later in life. Many farsighted eyes do not need correction until the individuals reach their forties or fifties. Farsightedness can be corrected by any method that increases the total refractive power of the eye. Eyeglasses and contact lenses do this by putting in front of the eye “positive” lenses that are thicker in the center than at the edge. PRK and LASIK treatments correct it by making the central part of the cornea more steeply curved.
VISX STAR™ Patient Information Booklet 0030-2307D 3
Astigmatism
Astigmatism corrections bring all rays of light from different focal points to one focal point. Astigmatism may be all myopic (nearsighted), hyperopic (farsighted), or a combination of both (mixed). PRK and LASIK treatments correct astigmatism by altering the central cornea by different amounts at different radial orientations to correct for the uneven focus of light rays.
Nearsighted and Astigmatic Eye Farsighted and Astigmatic Eye
Light Light entering Retina entering Retina eye eye
Cornea Cornea
Lens Lens
Mixed Astigmatic Eye
Light Retina entering eye
Cornea
Lens
4 VISX STAR™ Patient Information Booklet 0030-2307D
What are PRK and LASIK? PRK is laser surgery to correct refractive errors Eye After Treatment including nearsightedness Light (myopia), farsightedness entering Retina (hyperopia), and eye astigmatism. To correct nearsightedness, the excimer laser beam is applied to flatten the front Cornea of the cornea by removing Lens small amounts of tissue from the front of the cornea. To correct farsightedness, the excimer laser beam is applied to steepen the front of the cornea by removing small amounts of tissue from a ring-shaped area around the center of the cornea. To correct astigmatism, the excimer laser beam removes small amounts of tissue from the corneal surface that correspond to the cornea’s astigmatic shape.
An excimer laser produces a powerfully focused beam of ultraviolet light. The laser is controlled by the surgeon. It produces a series of rapid pulses that remove small and precise amounts of corneal tissue. Excimer laser light does not penetrate into the eye and leaves other eye structures (iris, lens, retina) undisturbed. PRK and LASIK differ from RK. RK uses a knife to make deep cuts around the center of the cornea.
VISX STAR™ Patient Information Booklet 0030-2307D 5
LASIK is similar to PRK, but View of Microkeratome on Eye does not treat the front surface of the cornea. The
Eye doctor uses an instrument called a microkeratome to Lifted Suction Ring create a circular flap of Circular Corneal corneal tissue. The flap is Flap then lifted from the outer