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FAQs regarding Laser Vision Correction (LVC)

Q: What is the difference between Custom and Traditional Laser Vision Correction (LVC)?
A: Wavefront-guided Custom LVC attempts to treat tiny aberrations in a patient’s visual system, along with nearsightedness, farsightedness, and astigmatism. The treatment parameters are generated using an aberrometer that gives the laser a very detailed map of all these tiny imperfections, similar to a “fingerprint” which is specific to your eye. This gives you the best chance possible to obtain 20/20 or better vision and decreases the chance of glare and haloes at night. One special note: It is felt that the flap created during LASIK (whether by Intralase laser or by microkeratome) actually ADDS minor aberrations to a custom treatment and, therefore, LASEK may be a better choice when custom LVC is performed with some patients achieving 20/10 vision!

Q: What is Intralase?
A: This is a laser used to perform “all-laser” LASIK. A flap is still made, even though it is created with a laser. This flap still has similar potential to create flap problems and slippage as the microkeratome flap does. For this reason, some ophthalmologists believe that LASEK is a safer procedure because no flap is created in LASEK.

Q: What can I expect from the LVC procedure?
A: Prior to treatment, Dr Tschoepe administers anesthetic eye drops to the patient to numb the eye. After the eye drops have had a chance to take effect, the patient is led to a treatment room and positioned in a comfortable chair underneath the laser system. Once the patient is centered, he or she is asked to focus on a small, bright light visible from the bottom of the microscope. This allows the eye to be suitably aligned, and the actual treatment can then begin. The results of the patient’s pre-operative eye exam will determine the treatment parameters that are entered into the laser’s computer.

Q: Are both eyes treated the same day?
A: Most LVC patients have the procedure on both eyes the same day; however, the procedure can also be performed unilaterally.

Q: How long does the procedure take?
A: The actual time the laser is treating the eye is typically less than 2 minutes per eye. Total procedure time is 10 to 15 minutes.

Q: Will I achieve 20/20 vision?
A: Most patients reach 20/20 vision, and with Custom LVC, some have achieved 20/10; however, a small percentage achieve only 20/40 or better vision after one or more treatments. This means they can drive legally, play sports and participate in normal daily activities without having to rely on glasses or contacts.

Q: What if my vision is not 20/20?
A: If you are functioning well, this is not a problem. If the decreased vision is causing some trouble, however, this can usually be resolved with an “enhancement” of the original LVC procedure after the vision has stabilized. Enhancements are required in a low percentage of patients who have LVC.

Q: Am I a good candidate for LVC?
A: The large majority of nearsighted, farsighted, or astigmatic people are potential candidates for the laser treatment. The best candidates tend to be people who are dissatisfied with their contact lenses or glasses and are motivated to make a change, whether it’s due to occupational or lifestyle reasons. There are certain medical conditions such as glaucoma, pregnancy, keratoconus, etc. that may exclude a potential patient from LASIK, but that patient may still be a candidate for some other refractive procedure to decrease his dependence on glasses or contacts.
To ensure you are a candidate, you will want to make an appointment for a free consultation where Dr Tschoepe can examine your eyes thoroughly.

Q: What happens if I move my eye during the procedure?
A: Dr Tschoepe uses 3 different lasers, each of which has it’s own characteristics. Two of them have an eye tracker which moves the laser if and when the eye moves. This has really been shown to be of greatest benefit when the patient has nystagmus, an uncontrolled back and forth motion of the eyes, but most lasers now employ this technology to make Custom treatment possible.

Q: When can I return to work and normal activities, like driving?
A: With LASIK, most patients are able to return to work and normal activities the day following the procedure. Although vision may fluctuate a little, it is functional within 24 hours after surgery. With LASEK, some patients are able to return to work and drive in 1-2 days while 80% can drive by day 4 (eg, Monday after a Thursday surgery).

Q: Will I eventually need reading glasses after LVC?
A: After the age of 40, the lens behind the cornea will lose its elasticity resulting in the need for reading glasses. Laser vision correction cannot eliminate this problem by itself. For this reason, many patients over 40 are considering another refractive procedure called Refractive Lens Exchange. This uses a lens implant approved by the FDA for use in cataract patients which is a multifocal lens (eg ReStor) to replace the hardening natural lens in order to satisfy both distance and near requirements in the same eye. This is considered by the FDA as “off-label” use of an approved device. The other option to be considered is monovision LVC. Monovision correction is when one eye is corrected to see for distance and the other eye to see close up. This results in the ability to see in all circumstances, without the need for glasses. This type of vision may take a little time to adjust to, however, many people are happy with the outcome.

Q: Why are the prices so different from place to place?
A: Several factors are involved, and only a few are addressed here, but one must first understand that our fees include many things:
• Screening and evaluation
• Complete eye exam
• Facility Fee Laser
• Manufacturer Royalty Fees
• Post-operative Med bag with Medications
• All Follow-up Visits for 3 months

Many expensive resources and technology are required in the LVC procedure. Another caveat is that one should be sure to read the fine print. Most of the time, very few people are actually candidates for the low priced procedures. Lastly, the discounters may use a “one-size-fits-all” philosophy whereby only LASIK is offered, or the patient is told he is not a candidate without telling him he may actually be a good candidate for a different procedure other than LASIK.

Q: How do the discounters do it?
A: They are hoping to survive on the high volume they need to generate in order to make a profit, but quality and attention to detail may be lacking. They rely on a less discerning group of patients who assume that LVC is simply a commodity, like buying a stereo, where the only difference is price.

Q: Why should I choose Dr Tschoepe as my surgeon?
A: Dr Tschoepe does more refractive procedures than any other surgeon in New Braunfels. He has done thousands of LVC procedures, as well as thousands of cataract and other refractive surgeries. He is the trusted surgeon of choice for many eye care professionals and other physicians, and above all, Dr Tschoepe truly cares for his patients and their welfare…he wants to be your eye doctor for life.