laser eye surgery

eye care
?What is refractive surgery??
Refractive surgery changes the way light focuses on the retina of your eye. Two common types of refractive surgery are LASIK and PRK. In both procedures, an excimer laser is used to reshape the corneal curvature. Both procedures can be used to correct nearsightedness, farsightedness and astigmatism.
Why should I have this type of surgery??

Since the purpose of the surgery is to decrease your dependence on glasses or contact lenses, the most common reasons people have this surgery are:

  • They have an occupation where glasses or contact lenses are difficult to wear. (Police, fire, paramedic, pilots, flight attendants etc.)
  • They find glasses and contact lenses inconvenient in sport activities such as water and snow sports.
  • They cannot or do not like to wear contact lenses.
  • They find glasses give them a limited field of vision.
  • They would prefer to eliminate as much as possible their dependence on glasses or contact lenses.
What is LASIK surgery??

With LASIK (Laser-Assisted In-Situ Keratomileusis), the middle portion of the cornea is treated by first lifting up the surface of the cornea. The laser is then used to reshape the exposed corneal surface. The procedure takes only a few minutes and is done as follows:

  • Your eye is anesthetized with eye drops
  • An instrument called a microkeratome is used to create a "flap" to expose the middle layer of the cornea.
  • The laser is then used to vaporize very thin layers on this exposed corneal tissue until the eye is reshaped.
  • The flap is then "floated" back in place to restore the corneal surface.
  • Once the surgery is over, you will wear a protective eye shield for the first day.
  • You can usually return to work the next day after surgery.
What is PRK surgery??

With PRK (photorefractive keratectomy), the outermost layer of the cornea is removed. The laser is then used to reshape the exposed corneal surface. The procedure takes only a few minutes and is done as follows:

  • Your eye is anesthetized with eye drops
  • The outermost layer of the cornea is removed with the laser or the layer is mechanically removed with a special brush
  • The laser is then used to vaporize very thin layers on this exposed corneal tissue until the eye is reshaped.
  • Following the procedure a special contact lens is applied and is usually worn for 2-3 days.
  • It may take several days for your vision to become clear enough to drive and return to work.
What do I have to do to prepare for this surgery??
There are very little restrictions for patients in order to prepare for this type of surgery. If you wear contact lenses, you should remove them three to four days before the surgery. There are no food or eating restrictions; you can eat the day of the surgery. In fact the entire procedure usually takes about fifteen minutes from the time you walk into and out-of the surgical suite. The surgery itself takes just a few minutes. After surgery, you should not drive and so should make arrangements for transportation home.
Is there any pain??
The surgery itself is generally painless. After the surgery, there may be some mild to moderate pain
for one to three days (mostly with PRK; not with LASIK), which may be relieved by oral medications and topical eyedrops.
How successful is this surgery??
A substantial number of people experience immediate return of good vision after surgery. About two thirds of Dr. Fichman's patients are seeing approximatly 20/20 soon after surgery. The remaining one-third have 20/40 the first day with a gradual improvement during the next few months.
Which is better for me: PRK or LASIK??
Each patient is different and this question is best answered on an individual basis. Generally speaking, for low corrections, both procedures can provide excellent results. For moderate to high levels of correction, LASIK is preferred.
Can I do both eyes at the same time??
We can do both eyes at the same time or one eye at a time. This question is best answered on an individual basis taking into consideration your specific profile.
What range of nearsigntedness can be treated with laser??
In Canada, the excimer laser procedure is approved for the treatment of nearsightedness within the range of -1.00 to -12.00 diopters, and astigmatism from 0.75 to 4.00 diopters. We generally only offer PRK as an option for very low levels of correction. LASIK is a good surgical option to treat low, moderate and high levels of nearsightedness. Dr. Fichman has successfully treated up to 22 diopters with the laser. Because each patient needs to be considered on the basis of their individual medical profiles, use the above ranges as a guideline. Dr. Fichman would be pleased to discuss your specific surgical requirements during a consultation with you.
What if I have astigmatism??
Both LASIK and PRK are able to treat astigmatism at the same time as we treat nearsightedness. No additional procedures are necessary-it is all done during the same laser procedure.
What if I am farsighted??
Dr. Fichman can treat farsightedness up to 6 diopters with the LASIK procedure. For the latest information on this exciting capability, call our office to obtain the most current information.
Do I need to take time off work??
With the LASIK procedure, in most cases, you can return to work the day after surgery. With PRK, it may take several days for the vision to become clear enough to drive.
Will my vision return to its original level after surgery??
You will be assessed after the operation to see what, if any, fine-tuning or enhancement surgery
needs to be done to further improve your vision. Dr. Fichman will provide all the follow-ups necessary to help you obtain the best possible results.
What ages are suitable for PRK or LASIK surgery??
Dr. Fichman prefers patients to be at least 18 years old, with a stable prescription. There is no
upper age limit.
What happens if I wear contact lenses??

Before your eye exam to determine your options for surgery you must do the following:

  • If you are wearing hard or gas permeable contacts, they must be out of your eyes at least three weeks prior to your exam.
  • Soft lenses must be out at least 48 hours.
  • Bring in your glasses to the exam if available..
How can I find out if refractive surgery will work for me??
Dr. Fichman will perform a full consultative eye exam after which you will be told if you are a surgical candidate and what type of procedure (LASIK or PRK) would be best for you.
How can I book an appointment with Dr. Fichman??
Just call us for an appointment! We will book you in as soon as we can for a consultative eye exam. This eye exam with Dr. Fichman should take about one and a half hours, and will specifically determine your chances for success with surgery. The exam consists of a thorough evaluation and analysis of your eyes. and your visual system. During your exam, Dr. Fichman will spend as much time as you need to fully answer all of your questions.
Will my insurance company cover laser surgery??
Some insurance companies do cover PRK and LASIK and if covered, it is under major medical and not a vision plan. Let us know which insurance company you deal with and we will be able to tell you if you are covered. Dr. Fichman deals with several medical finance companies who can help you obtain financing should you need it. We will assist you with your application and their payment options are very reasonable and flexible. We can ensure that your monthly payments will be kept to minimum should you so desire. It usually takes an hour to determine if you qualify. You may also pay by cash, personal checks and Visa.


lasik eye surgery