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Frequently Asked Questions
Are there any recent advances in laser refractive surgery?
When the FDA first approved LASIK, the ideal candidate had to fit into a very narrow qualification process. Only people with low and moderate levels of myopia were eligible. Gradually, the eligibility of a patient broadened, starting with high myopes, followed by patients with astigmatism, then people who were farsighted. Now a patient who is farsighted and has astigmatism is eligible. This means that the number of qualified candidates has probably increased fourfold.
Does that mean that people are getting better LASIK results now?
People are definitely getting better results now more than ever, although, the most profound reason is experience. Surgeons in the United States have caught up with our Canadian counterparts. A patient in the hands of an experienced surgeon shouldn't see a big difference, whether they had the surgery two years ago or if they have it now. Yes, improved technology has allowed more people (who were not previously good candidates) access to this procedure. However, the results will be dependent upon the surgeon's level of experience.
Tell me about flying spot lasers that we hear so much about.
Many doctors advertise this technology and it may sound impressive in theory. Let's look at reality. Imagine your cornea to be a hill -- it may have a few bumps or dips in its contour. Using a small spot size laser of varying energy to target each bump or dip, you could, in theory, smooth out those irregularities. In reality, all the technology needed to make this laser procedure work successfully is not available in the U.S. at this time.
Let's examine the whole process, starting with mapping a patient's cornea. Over 98% of patients have very smooth corneas; therefore, the size of the laser spot doesn't make a difference in these cases. More importantly, to fully utilize a flying spot laser, the surgeon also needs a complete feedback system -- a laser that can map out the cornea in real time, track it as the eye moves, and then feed the information to its laser arms as it is firing the laser beam. The feedback system is not yet available in the U.S.
Okay, then tell me what is the best laser?
The question you should be asking is -- who is the best surgeon? The best technology in the hands of an inexperienced doctor will get you mediocre or even worse, disastrous results... would it make a difference if you gave a small child a Hyundai or a Mercedes Benz? On the other hand, an experienced race car driver could definitely make a difference. In fact, the FDA came out with a warning as a result of rising complaints from patients who had gone to some of these low cost centers.
After all this discussion on LASERS, what do you use?
The VISX STAR platform's heritage of dependability and performance is well known. Because of this, Dr. Fong uses the STAR S4 from VISX. This is VISX's latest excimer laser system representing the most advanced laser technology platform available today. Integrating data collected by the WaveScan WaveFront System, the STAR S4 utilizes these exclusive VISX technologies to deliver precision custom ablations.
After refractive surgery, is seeing glare and halos still a big problem?
Yes and no. About 5% of patients report some glare and halo after surgery. Most of it is not serious. However, even this number would be reduced drastically if the patients were more carefully selected. For example, patients with large pupil size tend to have more problems. Proper counseling, and careful pre-operative exams would screen these patients out. Unfortunately, that is not always done, especially in some of these high volume centers. Sometimes, the problem can be solved, sometimes not. Many of these problems could have been avoided if the consumers used a little more common sense.
I am from out of town, How much time do I need to stay in town?
Allow yourself some flexibility to stay in New York City for at least 3 to 4 days. You will come to our offices 1 to 2 days before the scheduled date of surgery for your preoperative examinations. Although some doctors and centers allow preoperative exams to be done on the same day as surgery, Dr. Fong is adamantly against this. For obvious reasons, he is extremely careful and thorough. Proper preparation and informed consent is crucial prior to your operation.
The day after your surgery, you must return for a follow up visit. In about 98% of cases, this may be the only visit you will need. Don't miss your postoperative check up. In about 2% of cases, where there is slightly more inflammation, you may be required to stay a few extra days. This allows us to monitor your healing process a little closer. We encourage all our patients to call us at any time after your operation if there are any concerns at all.
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