Spokane Eye Surgery Center

Technological advancements of the past few years have led to new ophthalmologic applications of optical lasers. Today, the laser can not only be used to repair ruptured blood vessels or punch tiny holes in a cloudy lens capsule, but can also be used to correct vision.

The new ActiveTrak laser’s precise computer controls allow this “cold” laser to remove only one cell from the cornea, while leaving the two adjoining cells completely unharmed. This amount of precision allows a doctor the ability to mold and form the cornea of a myopic or astigmatic eye (and sometimes the cornea of a hyperopic eye) to make the vision of the patient closer to normal. The two procedures by which these results are accomplished each have their own benefits and disadvantages.

VISX STAR S3 ActiveTrakT Excimer Laser System
Frequently Asked Questions:

What laser do you use?

We use the newest generation VISX STAR S3 ActiveTrak Excimer Laser System.
The VISX STAR TM systems have been used in over 2 million procedures worldwide. This newest laser system incorporates the VISX patented variable beam technology with an active eye-tracking system that works without pupil dilation, as well as other advancements to help the surgeon deliver the best possible treatment.

Why is the absence of dilation an advantage?

Dilation is accomplished by means of drops in the eye, which open the pupil as far as it will go. When the pupil is open to this degree, it is more difficult to appreciate the actual center of the treatment. Additionally, dilation causes glare and light sensitivity, which means patients have to wait for hours to appreciate their new vision.

What is the ActiveTrak eye tracker, and how does it help provide better laser vision correction?

The ActiveTrak eye tracker is a new 3-D eye-tracking technology. With ActiveTrak, the laser detects and compensates for eye movements by guiding the laser beam to keep it centered over the treatment area. The eye tracker adds a new level of precision and comfort not previously available.

What is variable beam technology?

Variable beam technology allows the doctor to treat patients with different laser beam sizes and shapes depending on the patient's visual needs. The STAR S3 ActiveTrak laser system combines VISX variable beam shaping with VISX scanning technology* when it places each shape on the patient's eye.

What if my eye moves during treatment?

ActiveTrak continuously positions the laser beam precisely on the eye throughout the procedure for accuracy. ActiveTrak realigns itself between each pulse insuring pinpoint accuracy.

Do all lasers have eye trackers?

No, not every laser on the market has an eye tracker. Drs. Jacobson and Ellingsen use the ActiveTrak system, which is the most advanced eye-tracking technology available. This new technology makes older eye-tracking technology - which require dilation - virtually obsolete.

*Scanning technology used in hyperopia treatments.

ANSWERS TO THE MOST COMMON QUESTIONS

A CLEARER LOOK AT LASER VISION CORRECTION...

Q. What is laser vision correction?

A. Laser vision correction, a type of refractive surgery, refers to the ActiveTrak laser surgical procedures available which can reduce or eliminate your dependency on glasses and contacts.

Q. What are the laser vision correction procedures available?

A. The two ActiveTrak laser surgical procedures available are Laser Assisted Intrastromal Keratomileusis (LASIK) and Photorefractive Keratectomy (PRK).

Q. How are LASIK and PRK similar?

A. Both LASIK and PRK use the precision of the excimer laser to reshape the surface of the eye (known as the cornea). Because the ActiveTrak laser is a “cool” laser, it will not burn or cut tissue. Additionally, the laser energy is applied to only a very small part of the surface of the cornea.

Q. How are LASIK and PRK different?

A. In the LASIK procedure, a microkeratome is used to create a thin cap of corneal tissue. This cap is gently folded back from the surface of the cornea so that the ActiveTrak laser can be used to reshape the cornea for vision correction. The corneal cap is then returned to its original position, adhering quickly without stitches. In the PRK procedure, the ActiveTrak laser is applied directly to the corneal surface for vision correction. To enhance healing following PRK, a soft contact lens is worn for two or three days and then removed.

Q. How is laser vision correction similar to radial keratotomy (RK)?

A. Laser vision correction and radial keratotomy are similar in that they are both refractive surgery procedures which reshape the surface of the eye for vision correction.

Q. How does laser vision correction differ from radial keratotomy (RK)?

A. In laser vision correction, your surgeon will use an advanced computer controlled ActiveTrak laser to reshape the surface of the eye. In radial keratotomy, your surgeon will use precise microscopic spoke-like incisions to reshape the surface of the eye. Radial keratotomy is currently rarely performed because of the advantages of laser surgery.

Q. Which refractive surgery procedure is best for me?

A. There are a variety of factors that your doctor takes into account when determining which refractive surgery procedure is best for you. Some of the factors include the prescription of your corrective lenses, your past eye history, and your current eye health. Your doctor will discuss these with you during the pre-surgical examination.

Q. What are the age requirements for refractive surgery?

A. If your eye is healthy and your prescription has been stable, the only age requirement for refractive surgery is that you need to be at least 18 years old.

Q. Will I need to do anything special in preparation for the procedure?

A. To find out more about vision correction options and which one may be right for you, you can schedule a no-cost personal consultation at Spokane Eye Clinic. If you are interested in proceeding with refractive surgery following your personal consultation, a comprehensive pre-surgical eye examination will be scheduled with your doctor.

Q. How long does the procedure take?

A. The actual procedure takes from 5 to 15 minutes. The total time for your surgical visit will range from one to two hours.

Q. Will there be any pain during or after the procedure?

A. PRK and LASIK are generally considered to be “painless procedures.” Your eye is anesthetized with eye drops prior to and during the procedure. Following the procedure and after the anesthetic wears off, most patients experience little or no discomfort. Some patients do, however, experience light sensitivity or watering of the eyes from one to three days following the procedure. You will have eye drops to take following the procedure to help relieve discomfort should you have any.

Q. Will I have to do anything special after the procedure?

A. After the procedure, you will need to have someone drive you home and you will need to plan on seeing your doctor during the first few days following the procedure. During this time, you will be taking eye drops which will comfort your eye and help reduce the risk of infection. If your eye is healing as expected, routine follow-up visits will be scheduled at one month, three months, six months, and one year post-operatively.

Q. What are the risks associated with refractive surgery procedures?

A. As with any surgical procedure, there exists the potential for side effects or complications. The degree and frequency of occurrence will vary from patient to patient. Early and temporary side effects include discomfort, light sensitivity, and vision fluctuation during the healing process. Infection risk is very low and, if present, is usually treated with antibiotic drops. Corneal haze may occur after surgery, but usually resolves with treatment and time. With laser correction, there is also a chance of over or under correction. Over and under corrections usually do not affect the overall vision results. High amounts of under correction or over correction are generally retreated with a no-cost enhancement procedure. Low amounts of under correction are corrected by wearing glasses as needed for activities such as night driving. Rarely (<2% of cases), best corrected visual acuity may be less than before surgery. As part of your pre-surgical examination, you will have the opportunity to learn more about and discuss the potential risks with your doctor.

Q. How will my eyes be affected long term after having had laser vision correction?

A. Between one month and one year after surgery, refractive stability is usually achieved. With about 10 years of follow-up worldwide, refractive errors following laser surgery seem to be quite stable.

Q. Will my vision change over time after the procedure?

A. Minor changes or fluctuations may occur over time and will vary from patient to patient. There will, however, be changes to vision unrelated to refractive surgery brought about by certain conditions of the eye related to aging, such as presbyopia. Presbyopia, the loss of flexibility and focusing power of the lens of the eye affecting near vision, usually develops between the ages of 40 and 50 and will occur whether or not you have had refractive surgery. Refractive surgery improves nearsightedness, but does not improve presbyopia. Many patients are candidates for monovision, however, which is a technique to counteract presbyopia. With monovision, one eye is corrected for distance vision and the other eye is corrected for near vision. Also, we know that some people become less nearsighted in their 50s and 60s. This may happen to some laser patients, although it has not yet been demonstrated. Your doctor can discuss the monovision option with you during your pre-surgical examination.

Q. Can refractive surgery be performed for nearsightedness, farsightedness, and astigmatism?

A. Yes. Nearsightedness (myopia), farsightedness (hyperopia), and most types of astigmatism can be treated with refractive surgery. Your doctor can discuss your particular situation during the pre-surgical examination.

Q. How much improvement in my vision can I expect with a vision correction procedure?

A. Results will vary depending upon your particular situation and healing tendencies. Outcome data does show that approximately 96% of patients achieve 20/40 vision or better - sharp enough to pass a driver’s license eye test without corrective lenses. Current Eye Clinic results show that 70 percent of eyes achieve the equivalent of 20/20 vision. Current retreatment rates are less than 4 percent.

Q. How long after refractive surgery will it take for my eye to feel normal?

A. Healing times vary from patient to patient with the average patient’s eye feeling normal within 48-72 hours after PRK and 24-48 hours after LASIK.

Q. Should I have both eyes operated upon at the same surgery?

A. PRK is usually done one eye at a time. Most patients currently have LASIK surgery and most elect to have both eyes done at the same surgery. While there may be some additional risk to bilateral surgery, the risk is statistically unidentifiable and there is a considerable convenience benefit to bilateral surgery. Occasionally, patients may elect to have one eye done at a time and sometimes your doctor will recommend having only one eye done.

Q. How do I function during the time between the first and second eye treatments?

A. If you wear contacts, you can continue wearing the contact in the uncorrected eye until your doctor instructs you to discontinue its wear in preparation for surgery on the second eye. If you wear glasses, you can have one lens without any correction put into your glasses over the eye that has been treated until the second eye is treated.

Q. How soon after refractive surgery will I be able to return to work?

A. The amount of time required for recovery will vary from patient to patient. Factors affecting how soon you will be able to return to work include your healing time, your occupational demands, and the particular procedure which you have done. On average, most patients return to work one to three days after the procedure.

Q. Are there any limitations to activities, such as swimming, following refractive surgery?

A. Once your eye is healed as determined by your doctor during your follow-up visits, there are generally no limitations to the activities which you may perform. Your doctor will be able to discuss your particular situation with you. As always, it is recommended that you wear proper eye protection when engaging in any activity which can cause injury to the eye.

Q. If I am pregnant, should I wait to have refractive surgery?

A. Yes. Since your vision will have a tendency to fluctuate during pregnancy and while nursing, it is recommended that female patients who are pregnant or are nursing delay having refractive surgery until their vision stabilizes afterwards.

Q. Will my family eye doctor/optometrist be able to perform the before and after eye care associated with refractive surgery?

A. If you regularly see one of our doctors who does not perform refractive surgery or an eye doctor who does not practice at Spokane Eye Clinic, he or she can perform the necessary pre- and post-operative eye care as long as he or she is certified in refractive surgery co-management.

Q. Where are the procedures performed?

A. Laser Assisted Intrastromal Keratomileusis (LASIK) and Photorefractive Keratectomy (PRK) are performed at the Spokane Eye Surgery Center located at 208 W. 5th Avenue, in Spokane, Washington. 99204

Q. How much does refractive surgery cost?

A. The overall fee is dependent upon which procedure is needed. For all procedures, the fee includes the cost of the procedure, enhancements when necessary, and follow-up care for one year. Currently, LASIK is $1,200 per eye (includes pre and post-op) and PRK is $1,200 per eye. If an enhancement is necessary, the facility fee (currently $150 per eye) will be the responsibility of the patient. Since refractive surgery is generally considered to be an elective procedure, it is usually not covered under most insurance programs. There are a few progressive companies that may provide coverage. Additionally, many companies have flex plans and payroll deduction policies which may be of benefit to you. We also accept the following major credit cards: Visa, Mastercard, and Discover. We also have financing programs available to you for your convenience.

Q. Is financing available?

A. Yes, financing is available through the Spokane Eye Clinic. Eligible patients at the eye clinic my finance the procedure over 2 to 4 years with the current interest rate of 8 to 9 percent.

Q. What about intrastromal corneal ring surgery (ICR)?

A. ICR surgery has recently been approved for myopia under 3 diopters with minimal astigmatism. Currently, Eye Clinic physicians are considering and investigating its use. The procedure currently seems to have no cost advantage, applies to a limited number of refractive candidates, and has much less follow-up experience than LASIK or PRK. Its main advantage seems to be its potential reversibility. We will continue to keep you posted about our current opinion regarding ICR surgery.

Q. How do I find out more about vision correction?

A. To find out more about vision correction options and which one may be right for you, we welcome you to schedule a no-cost personal consultation at Spokane Eye Clinic. Our appointment lines are (509) 456-8121 locally, 800-824-0664 inside Washington, and 800-523-1384 outside Washington.

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