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Call to make an appointment for a full exam.
(toll free 1-877-542-3937) The
examination costs you nothing and will determine whether or not you are a
candidate for IntraLASIK. To see a list
of general guidelines, click candidate.
The pre-surgical examination for IntraLASIK takes about 1 1/2 hours and you
will have plenty of time to have your questions answered.
Both before your full exam and surgery, you need to be out of your
contacts as directed by the contact lens guidelines.
At the full exam we will ask about your health and visual history, make
topographical maps of your corneas, measure your corneal curvature and perform
an autorefraction. We measure
corneal thickness and diameter, measure your maximum pupil size under dim
illumination, measure your glasses, and check your vision with and without your
glasses. The optometric physician
will give you a personalized analysis of your data, estimate your odds of
needing an enhancement, and discuss your visual expectations during the healing
period. The doctor will also analyze
your ocular health and perform a careful refraction.
While your eyes are dilating, you will watch a video that details the
steps of surgery, what to expect, and discusses risks and complications and how
they are handled if they were to occur. After
the dilation, your prescription will be confirmed with yet another refraction,
and the doctor will evaluate the internal health of your eyes.
Despite dilation, most people see well enough to drive themselves home
afterwards.
At your full exam you will be given a list of "day of surgery" instructions,
a sample of or coupon for artificial tears, and a prescription for antibiotic drops.
You will need to pick up a box or two of the artificial tears individual use
tubes and begin using them every 2-3 hours while awake for 4 days before
surgery. You will also need to stop
by your pharmacy and fill the prescription for the antibiotic drops, which you
will use after surgery.
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On the day of your surgery, make sure to eat before you come in so the sedative
will not upset your stomach. Drink
plenty of water, and avoid alcohol and caffeine.
We ask you not to wear any eye makeup.
Since perfume or cologne can interfere with the laser, we ask you not to
wear them.
You will need a driver to bring you to the clinic as well as to take you home
after surgery. You can expect to be with us from
1 1/2 to 2 hours. When you check into
our office on the day of surgery, you will read and sign a consent form stating
the risks and alternatives to IntraLASIK surgery.
You will then meet with the patient
 education counselor, who is part of
your surgical team. You
will be given Valium and Vicodin with a drink of water to help relax you and
reduce the likelihood that you will be tense during the procedure, and to help
you take the recommended 2-3 hour nap after surgery.
Your counselor will provide you with your post-operative steroid drops
and instruct you on how to use them with the antibiotic drops and artificial
tears you
have already purchased. After this
you meet with Dr. Will, he will examine your eyes, and you will have the opportunity to ask him questions.
Next, a technician will cleanse the area around your eyes
and bring you into the Intralase laser suite. When you lie down under the laser, you will be instructed to look up at a
light. Anesthetic
drops will be placed in your eye. A
retainer will be positioned to prevent you from blinking.
Your
vision will start to fade, and you may feel some pressure.
When optimal pressure with the suction ring is achieved, the Intralase will create the flap,
which takes about a minute. The suction
ring is then removed. Your vision
will be hazy, but you will still be able to see the
light. When
you are moved into the next laser suite and lie down on the bed, the tracking device
will be locked on to your line of sight so any eye movement will be compensated
for. After the laser reshapes the
cornea, your eye will be hydrated and Dr. Will will lay the flap back into
position and smooth the edges. He
will then check the flap for adhesion, and the eyelid retainer will be removed.
When both eyes are done, he will examine the flaps with the microscope,
and the technician will instill your first set of antibiotic and steroid drops.
You will be provided protective goggles, which will be put on to prevent you
from rubbing your eyes when you go straight home to nap.
You will wear these goggles for your post-operative nap, and for your
first three nights after surgery. If
you cannot fall asleep after the surgery, that is when you may experience
discomfort, watering, and light sensitivity.
Lie down for a few hours with your eyes closed.
You may take the extra Vicodin in your surgical pack if needed.
Many people say their eyes feel great when they wake up.
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Your
first follow up appointment after surgery is the next day.
Most people see well enough to drive themselves to this appointment,
however use good judgment. You will
also have  appointments at approximately 1-2 weeks, 1-2 months, and again at 3
months or later if necessary. You
may choose to have your appointments in any combination at any of our three
offices in
Vancouver,
Lake
Oswego
,
and
Salem
.
Your doctor will monitor you at each visit to ensure proper healing and
visual recovery.
When
Dr. Will creates the flaps on your corneas, the nerves that supply the flap
tissue are separated from the flap when it is laid back.
As a result, for a while after surgery, your corneas will be less
sensitive and more prone to dryness until the nerves regenerate.
The only problem with the dryness is that your eyes will not be able to
sense that and therefore will not know to produce regular tears like they
constantly do now. After surgery it
will be your responsibility to keep your eyes hydrated so they can heal
properly. You will be putting the
artificial tears drops (the same kind you used before surgery) in your eyes every hour
while awake for the first few weeks until the nerves regenerate back into the
flaps and your normal tearing response takes over again.
The prescribed antibiotic and steroid drops are typically used 5-7 days
after surgery.
During
the first few weeks, while you are healing, you can expect your vision to
fluctuate quite a bit. You will have
times when you see well, and times when you feel out of focus.
Often, one eye will see more clearly than the other, and sometimes they
will switch. Your vision tends to
improve as you heal. You will also
experience glare and haloes around lights, especially at night.
These will be most noticeable for the first few weeks, and gradually
subside over weeks to
 months. Your
eyes may tire more easily for a while.
Part of the visual results a person achieves from IntraLASIK depends on
the
healing process after the surgery itself. Your present prescription lies
somewhere on a mathematical number line.
-10 -9 -8 -7 -6 -5
-4 -3 -2 -1 0
+1 +2 +3 +4 +5 +6 +7 +8 +9 +10
(nearsightedness)
desired (farsightedness)
You will be
intentionally overcorrected from your prescription past the zero point and
shifted into the opposite prescription a slight amount. The reason for
this is because as you heal, your vision will slide backwards slightly towards
the prescription you began with. The goal is to heal back to the zero
point on the number line, which means no residual prescription. The amount
you will be overcorrected from nearsightedness into farsightedness (or vice
versa) is relative to the average amount a person with your prescription will
slide backwards while healing. However, if you happen to heal faster or
slower than that average, you may end up on either side of the desired zero
point and have a bit of residual prescription. The higher or more
complicated the prescription, the greater the odds of not drifting precisely to
the zero point.
If this occurs and the resulting visual acuity is not
satisfactory, an enhancement can be performed at three to six months from the
original surgery. An enhancement involves re-lifting the original flap and
treating the residual prescription with the laser if there is adequate corneal
tissue.
The first two weeks after your surgery
are when the most dramatic healing occurs. With the healing comes
variability of vision. Expect the vision to fluctuate initially. One
eye may be more clear than the other. Your vision may vary from day to day
or hour to hour. You will probably notice glare and haloes around lights,
especially at night. Rarely does any of this interfere with driving and
everyday activities. After the critical two-week time period of healing,
the vision begins to stabilize, and any glare and haloes you may have noticed
begin to slowly disappear over several months.
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