FAQs When Considering LASIK

There are a number of reasons having LASIK is extremely beneficial. Most obvious is the drastic improvement in vision it can produce. After having LASIK surgery, most patients enjoy clear natural vision. Among other things, this allows them to enjoy a much more active lifestyle and pursue activities that glasses and contacts may have once limited them. From a medical standpoint, it can also be argued that LASIK is actually better for the eyes than continuously wearing contacts, particularly those worn for extended periods of time. Recent scientific studies point out the serious risks of contact lens wear, and show that these risks may be higher than the potential surgical risks of LASIK. Additionally, having LASIK eliminates the expense of continually purchasing glasses, contacts, and contact lens solution to see clearly.

If you are a good candidate for LASIK and your surgeon is dedicated to the field, experienced, and knowledgeable, LASIK is very safe. Scientific military studies document that astronauts, Navy SEALS, and pilots have had the procedure. Dr. Updegraff has operated on thousands of patients with extremely high demands on their vision, from SWAT snipers to professional athletes. From the beginning of his practice, Dr. Updegraff has emphasized the need for stringent screening, attention to detail, and the highest level of surgical skill to minimize potential risks to patients having LASIK as has Dr. Brian Foster.

Having performed LASIK longer than most surgeons in the U.S., Dr. Updegraff has seen and treated every complication imaginable – in fact, he has developed a reputation for helping patients from all over the world who have had difficulties after receiving LASIK from another surgeon. Sadly, the majority of these could have been prevented by early diagnosis and intervention that was not provided. It is important to realize that doctors can take a weekend course and then begin doing LASIK – they hardly have the training to diagnose and manage complications.

Dr. Foster completed a fellowship in corneal surgeries, including LASIK giving him years of hands on experience prior to joining the Updegraff Laser Vision team. His experience with the cornea lends his expertise to qualifying and providing patients with the best results after LASIK Surgery.

With Dr. Updegraff & Dr. Foster, you know you’re in capable hands.

LASIK technology has also dramatically improved over the last decade, with advancements that have made the procedure safer and more accurate. With the advent of blade-free, all-laser LASIK, Wavefront-Guided Treatments, and Iris Recognition, many of the side effects and complications of the past are drastically reduced or eliminated.

That said, it is important to be informed of every eventuality and possible side effect of any surgery. Even though LASIK is performed with a machine, its results will only be as good as the surgeon operating it, and so it is crucial that you choose your LASIK surgeon carefully.

It is natural to have these concerns, and Drs. Updegraff and Foster completely understands where you’re coming from. More than 15 years ago, Dr. Updegraff had his best friend perform LASIK on his eyes, and even he – a world expert and researcher in LASIK, receiving the procedure from his best friend – remembers how nervous he felt.

To make your surgery as comfortable and safe as possible, Drs. Updegraff and Foster follow a system of patient care that Dr. Updegraff generated both from his own experience as a LASIK patient and from the tens of thousands of patients he has treated. Nothing is rushed, sedation is given, and there is even a staff member dedicated solely to holding your hand and attending to all of your concerns. The result is an unparalleled experience that many have tried to duplicate, but few have achieved. Drs. Updegraff and Foster are extremely comfortable performing LASIK and enjoys their work. In fact, many patients who were so “eye sensitive” that they couldn’t even wear contacts – much less ever believed they’d be able to receive LASIK – have said it was easier than having a dental cleaning!

This is very understandable.

Just remember – “don’t believe everything you read” and “consider the source” of your information. If sites do not identify themselves and do not provide scientific references, they are not to be trusted. Local attorneys, judges, and even individuals in the intelligence community have placed their trust in Dr. Updegraff, and they all have one thing in common: a trusted source of information about Dr. Updegraff.

The good news is that this promotes honest discussion about the topic, which Drs. Updegraff and Foster have been candid about with patients and peers since the beginning of practice and before while in school and fellowships. Interestingly, a recent peer-reviewed study demonstrated that extended-wear contacts have a higher risk than LASIK of causing sight-threatening outcomes – and this study looked at the older, “blade-flap” LASIK rather than all-laser LASIK. After several years of performing both forms of LASIK, Dr. Updegraff has witnessed safer outcomes with blade-free LASIK. Ultimately, he believes bladeless LASIK will deliver a better safety profile than extended-wear contacts.

Drs. Updegraff and Foster have never minimized the risk of surgery, but it is only fair to put risks in perspective and to base them on scientific evidence. To shed light on Dr. Updegraff as a person, early in his career, he was asked to be the medical director of a corporate LASIK center. When he was asked to stop calling LASIK a “surgery” and instead tell patients it was a “procedure,” he refused, promptly left, and went on to build one of the most respected LASIK practices in the world – which he based on frank discussion, honesty, and trust. Drs. Updegraff and Foster are patient advocates and readily help patients throughout the world who may have had a complication from LASIK. Updegraff Vision has been dedicated to developing a unique safety system so that the more common complications can be avoided.

But even though Dr. Updegraff has performed LASIK on snipers, Navy SEALs, federal agents, and pilots, LASIK is not for everyone. Because of this, 20 percent of patients examined in our complimentary screening are counseled not to have LASIK. Instead, half of them are better suited to different procedures, such as PRK, implantable contact lenses, or clear lens replacement and the other half are told to stay with their contacts and glasses. Some of our nicest word-of-mouth referrals come from patients we have “turned away.”

Dr. Updegraff himself is proof that LASIK is a lasting procedure that will not need to be redone every few years: He had LASIK in 1994 and is still 20/20 today!

We believe the perception that LASIK doesn’t last stems from three specific types of patients:

Patients who have chronic dry eyes or who use ceiling fans: Chronic dryness causes the skin cells on the surface of the cornea to thicken, like a callous, to protect the eye. This thickening reverses the flattening from LASIK, which was what improved vision after surgery. In order to prevent this, LASIK patients should be educated about how to maintain their post-LASIK vision, as well as encouraged to attend their routine eye exams to diagnose an issue before it becomes a problem.

Hyperopic (farsighted) LASIK patients: We rarely recommend hyperopic LASIK because it steepens the cornea rather than flattening it. Instead of having a large, flat optical zone, like with nearsightedness, farsighted LASIK creates a circular groove on the outside of the cornea. Although initial results were good, over time patients “healed” in the trough with the surface epithelium (skin cells), and their vision regressed. Most of these patients require multiple retreatments, and Dr. Updegraff believes this is one of the key reasons for the perception that “LASIK doesn’t last.” Comparing farsighted LASIK to nearsighted LASIK is like comparing apples to oranges.

Patients with cataracts: If the lens inside your eye changes shape as you age, it will change your prescription. These patients are best suited for lens implant surgery.

There is no question that some patients who had LASIK several years ago experience these symptoms. However, since the introduction of the femtosecond laser, wavefront-guided treatments, and iris recognition, Dr. Updegraff has noticed fewer patients referred with these symptoms.

Think about it this way: If Dr. Updegraff performed LASIK on a piece of plastic identical to an eye, the results would be aberration-free – better than with glasses or contacts – every time. The only variable is how your eye responds to and heals after the reshaping. LASIK has drastically changed since its inception, so comparing the contemporary LASIK procedure to what was done 10 years ago is like comparing dial-up modems to today’s wireless internet.

There are other reasons for patients to experience glare, starbursts, and haloes, such as an imperfect tear film (dry eye) or the development of imperfections in the natural lens inside your eye (cataract). Also, hyperopic LASIK, which steepens rather than flattens the cornea, is much more likely to result in these low-light aberrations. Because of this, Drs. Updegraff and Foster primarily perform LASIK to correct myopia and astigmatism; they often recommends alternative procedures, such as intraocular lenses, for hyperopic patients.

In our experience, about half of the patients who inquire about LASIK are doing so because their contacts are causing discomfort, inflammation, or infections – potential signs and symptoms of dry eye syndrome.

Updegraff Laser Vision believes the perception that LASIK causes dry eye was generated from a lack of detailed care for this group of patients, who may have actually had dry eye prior to receiving LASIK. Because they were never told or educated about their condition beforehand, they’ve forever made a direct association of their dry eye symptoms with their LASIK surgery.

Sometimes, patients with dry eyes are not good LASIK candidates. However, with appropriate dry eye management before and after surgery, many can have a successful LASIK procedure. This will be addressed at the consultation.

False. As we age, the natural lens loses its flexibility (which is called presbyopia). LASIK doesn’t speed this process up or slow it down. In our 20s and 30s to 40s, our natural lens changes its shape – it thickens like a magnifying glass – to help us see up close. So, when you are young and using contacts for distance, your natural lens is helping you see up close. This is no different for LASIK. As we age and the lens loses its ability to flex, we will all eventually need reading glasses to see up close. The premature need for reading glasses after LASIK is caused by too much flattening or overcorrection. Updegraff Laser Vision avoids this by performing a thorough cycloplegic dilated exam at every LASIK screening.

The ideal LASIK candidate is someone who is myopic (nearsighted) with or without astigmatism; is 18 or older, whose vision is stable and is tired of being held back by their dependency on glasses and contacts. Many of Updegraff Laser Vision’s happiest patients are those with active lifestyles – these patients, in particular, appreciate being able to go swimming, play sports, or keep on the go without having to worry anymore about whether or not they’ll be able to see.

In addition, an ideal patient is one who is well-informed, who has expectations that have been thoroughly discussed, and who follows all pre-operative and post-operative instructions.

The only way to definitively find out whether or not you are a candidate for LASIK is to attend a complimentary consultation at Updegraff Laser Vision.

Several factors will be evaluated to determine if LASIK is the best option for you. The first primary factor is whether or not you have a level of vision correction that’s within the broad range where LASIK is safe and effective. Second, the shape of your eyes and your vision should be stable; that is, you should not have had frequent changes in your prescription. Third, you must not have any underlying medical condition that would rule out performing LASIK.

Other important considerations are the thickness of your corneas and whether or not you have ever experienced dry eye. All of these factors will be taken into consideration to determine whether LASIK could offer you the highest probability of the best possible outcome. He will only recommend that you have LASIK if he believes it is the best option for you.

We have been correcting astigmatism with the excimer laser for more than 15 years, and with the invention of iris recognition technology, the accuracy of astigmatism correction has greatly improved. Patients often tell us that correcting their astigmatism with LASIK gave them better vision than they’d had with glasses and contacts. This is because contacts can spin on the surface of the eye, which creates blur when the toric correction is not properly aligned; the same is true for bent glasses. Many of these patients will have better vision after having LASIK than they had with glasses and contacts.

A very small group of patients with astigmatism may also have underlying corneal diseases, but during their consultations we determine that they are not LASIK candidates. Our screening guidelines are stringent and include tests that are not routinely performed in other eye care centers, because he wants to ensure that each of his LASIK candidates will benefit from the procedure as well as have a stable, long-lasting result.

Dr. Updegraff limited performing hyperopic LASIK more than 15 years ago because of its lack of stability and quality of vision, even though it is an “approved” procedure. It is currently used for very low hyperopic correction with astigmatism. Most corporate facilities do hyperopic treatments for high degrees of hyperopia, which can actually account for over half of their volume. But in Dr. Updegraff’s experience, although these patients may initially be happy, in the long-term they uniformly need re-treatments or secondary procedures. Instead, these patients are typically best suited to having lens implants, which most corporate centers do not have the skill or capability to offer. To learn more about lens implants, visit Updegraff Laser Vision.

No. Because LASIK shapes the front surface of the eye, it doesn’t matter whether you are 25 or 85 years old – the same amount of tissue will need to be removed to obtain the same effect.

Updegraff Laser Vision recommends that pregnant women do not have LASIK, and that new mothers be at least three months postpartum and/or breastfeeding before undergoing LASIK. He also suggests to avoid planning pregnancies for four to five months after having LASIK to allow time for any potential enhancements.

Over 20% of patients having their complimentary consultation at Updegraff Laser Vision are recommended not to have LASIK for a wide range of reasons. This is why we encourage people considering LASIK to undergo our screening. There is no need to waste energy worrying about the cost, the procedure, etc., if you aren’t sure you’re even a good LASIK candidate. About 80% of patients who hope to have LASIK with Drs. Updegraff and Foster are determined to be good candidates for the procedure.

You may be disappointed if you are not a LASIK candidate, but the good news is that you may qualify as a candidate for other procedures that also reduce or eliminate the need for glasses, such as lens implants, PRK, or LRI.

Updegraff Laser Vision has prided itself in vetting and investing back in his practice by acquiring the most advanced laser technologies. Dr. Updegraff became the first LASIK surgeon in the Tampa Bay area to own and use the IntraLase laser, which enabled his procedures to be blade-free. In doing so, he has performed more blade-free, all-laser LASIK surgeries than most surgeons in the U.S.

First, remember that this is your vision.

Second, the good news is, in most cases, all LASIK fees are similar. Corporate providers often create a perception that they are less expensive and offer the same service as Updegraff Laser Vision. However, an investigative report by Channel 10 from several years ago revealed that by the time the corporate-center patient “upgraded” to options that we provide as standard, the overall cost was comparable – not to mention, they were getting a surgeon who flew into town once a month just for LASIK and was not available for any post-LASIK care.

Drs. Updegraff and Foster are committed to providing the highest-quality care at every step of your LASIK experience. We own only the best and most advanced equipment available, including wavefront technology, iris recognition, and a pentacam. Our surgical suite is climate-controlled with HEPA filters, and all procedures are performed with “sterile” techniques that are often abandoned due to cost at other facilities.

Additionally, our price covers the LASIK procedure itself and your complete post-operative care, as well as an enhancement, if necessary, within a year of your surgery. In other words, we spare no expense in making sure that you have the highest-quality surgeon, staff, and equipment available to you at all times. You only have one set of eyes, and we would never cut corners and provide sub-standard LASIK in order to offer it for a lower price.

To make LASIK even more affordable, we offer financing options. Also, patients often use their Flex Spending Account (FSA) dollars for LASIK. To learn more, read about Financing Precision LASIK™.

No. Updegraff Laser Vision believes that all-laser LASIK is safer, more accurate, and less likely to cause complications than the older, bladed LASIK procedure, so he made it the standard of care he provides to each patient. This is not the case at many other centers who will charge more for each “upgrade” to modern technology.

Yes, your doctor can play a role in determining your candidacy and monitoring post-operative progress. Prior arrangements must be made for you so that this “co-management” will result in the best possible care.

Are you tired of glasses and contacts?

FAQs About the LASIK Consultation

Patients often comment that their complimentary consultation at Updegraff Laser Vision was the most thorough eye exam they have ever had. This is for good reason – we are determining whether or not you are an excellent candidate for LASIK.

At your consultation, a certified ophthalmic technician who has been trained with Dr. Updegraff will obtain a Wavefront image of your optical system, as well as perform corneal mapping. The thickness of your corneas will be measured and analyzed in three different ways. Your corneas are then compared to thousands of matched normal and abnormal corneas to screen for subtle corneal disease that would prevent you from having LASIK. After the testing, all of the findings will be reviewed and your eyes will be evaluated at the microscope. All questions will be answered. If all is well, we will perform a cycloplegic dilation (see question below) as one last safety check and to look and make sure the back of the eye is healthy. Plan on taking two hours for the entire consultation.

For those who don’t have two hours and want to know if they are preliminarily a “LASIK candidate,” a quick 30-minute screening is available. While this doesn’t replace a complete consultation, it can help some people formulate a plan to have LASIK in the future, now they know they are likely a candidate.

The cycloplegic dilated exam allows the doctor to get a complete look at the eye, front and back. It is also necessary to obtain your true prescription. A cycloplegic exam is different from most dilations you’ve had by your eye doctor. The true purpose of this exam is to immobilize the muscle inside your eye that naturally changes the shape of your lens. This test provides us with your “true” prescription, and prevents creating an overcorrection with the laser. Again, a lot of facilities bypass this crucial test to save time and money. For most young patients, overcorrection will not be noticed until years later.

Cycloplegic dilation can last up to 48 hours. Most nearsighted patients are able to drive home or go to work after the dilated exam. If you are concerned about driving after the dilation, it’s best to bring someone with you who can drive you home. We will also provide you with a pair of disposable sunglasses to cut down on glare.

You should plan on being at Updegraff Laser Vision for approximately 2 hours for your Precision LASIK™ consultation. This length of time is necessary to definitively determine whether or not LASIK is the best choice for you.

No. Dr. Updegraff will not perform LASIK on a patient who has gone through a consultation earlier that day because it isn’t safe. An integral part of the consultation process is the cycloplegic dilation of the eyes, which allows us to determine your true prescription. A cycloplegic dilation can last longer than 24 hours, and because the eye tracker relies on the pupil and the details of the iris for Iris Recognition, Dr. Updegraff will not perform LASIK on dilated eyes. If a doctor performs LASIK on a patient immediately after their consultation, it means that a weaker, less effective dilation drop was used, and so the patient’s prescription may be incorrect, resulting in a much higher probability of complications.

If you wear soft contact lenses, plan on keeping them out for at least 5-7 days prior to surgery. If you wear rigid gas permeable or hard contact lenses, plan on keeping them out for at least 10-14 days prior to surgery. In some cases, it is necessary that they not be worn for a period of time longer than two weeks.

It is necessary to keep out your contact lenses for at least three days prior to your LASIK consultation.

FAQs About the Day Of Surgery

After your procedure is scheduled, you will be given instructions for discontinuing wear of your contact lenses. This allows the cornea to return to its natural shape, and the duration of time in which you can’t wear contacts varies from one to several weeks prior to your surgery and will be determined by the doctor at your screening. Otherwise, there is no other preparation besides arranging for your transportation on the day of and the day after your procedure, as well as wearing warm clothes, since the laser suite is cold.

Plan on being here for about two to three hours on the day of your surgery. This allows time for you to talk with your professional consultant prior to surgery, to make sure all of your questions are completely answered, and also for you to relax before going in. You will then be in the LASIK suite for approximately 20 minutes, and the surgery takes about five minutes per eye. After your procedure, a doctor will examine you before sending you home to ensure that you are doing well and that everything went smoothly.

Yes. Dr. Updegraff is the owner and medical director of Updegraff Laser Vision. He is the only surgeon, and he performs each surgery.

Dr. Updegraff performs each Precision LASIK™ by Updegraff surgery in the state-of-the-art LASIK suites at our main office in St. Petersburg, Florida. These LASIK suites are maintained at surgery center standards, are “lint-free,” and feature HEPA filters.

Yes, Dr. Updegraff usually does LASIK on both eyes on the same day. However, if you are more comfortable doing one eye at a time, Dr. Updegraff will give you that option, as long as you are aware of the advantages and disadvantages.

LASIK is virtually painless. You will be awake during the procedure, but we will provide a light sedative to keep you relaxed. A staff member will numb your eyes using anesthetic eye drops, and you will feel cool fluid and pressure, but you will not feel pain. Dr. Updegraff will talk you through each step, and one of our team members will hold your hand during your procedure as an extra level of comfort.

Yes, you will be awake during LASIK. However, you will be given the option to take a light sedative such as Valium prior to surgery, to help you relax. You don’t have to take it if you don’t want to – about one out of every ten patients elects not to – but many patients feel it helped them remain calm and relaxed. Dr. Updegraff does not want anyone to feel rushed, and if you are anxious, he will wait until you are comfortable. Precision LASIK™ by Updegraff should be a pleasant, comfortable experience.

FAQS About What to Expect After LASIK

Even though LASIK is quick (each eye takes just a few minutes to reshape) and doesn’t involve knives, it’s still surgery, and so the necessary precautions should be taken.After your surgery is complete and you have been examined to ensure your LASIK is perfect, you will be sent home wearing clear shields over your eyes. We will provide you with a sleeping pill, and you will be asked to rest for the next 5-6 hours while your eyes begin to heal. It is important to refrain from sleeping where there is circulating air (ceiling fans), as this can dry your eyes. By the time you return for your one-day post-operative appointment the following morning, you should be able to resume nearly all of your regular activities.

This depends on your working conditions and the requirements of your position. Many people take only the day of surgery off work, and then return after their post-operative appointment the following morning. When planning how much time you will miss, keep in mind that plenty of rest after the surgery will aid in the natural healing process of your eyes. You should also ask the doctor about your specific circumstances.

Most activities, such as running and lifting weights, can be resumed the day after your procedure. Contact sports will require the use of protective eyewear, and you must wait two weeks before swimming.

One of the most common culprits of a loss of effectiveness years after LASIK is the use of ceiling fans. This is because you don’t produce tears while you sleep, but your eyelids open slightly and the existing tears evaporate away. The surface of the eye has a “skin” layer, or epithelium, that protects the cornea. When the surface dries, and a fan circulates additional air over your eyes, the epithelial cells grow like a callous in an attempt to protect the eye from dryness.

This causes patients to think their “LASIK isn’t working,” even years after the surgery. But if they turn the fans off and use an over-the-counter gel at night, the majority of these patients are able to return to their previous post-LASIK vision.

This can even affect those who haven’t had LASIK – these patients are largely overlooked, and instead are given a “new” glasses prescription at an optical outlet, never realizing what is actually going on.

LASIK should eliminate the need for using glasses for distance vision. However, as we age, the natural lens loses its flexibility (which is called presbyopia). High-quality LASIK doesn’t speed this process up or slow it down.

In our 20s and 30s to 40s, our natural lens changes its shape – it thickens like a magnifying glass – to help us see up close. So, when you are young and using contacts for distance, your natural lens is helping you see up close. This is no different for LASIK. As we age and the lens loses its ability to flex, we may all eventually need reading glasses to see up close.

LASIK does not remove the lens from your eye, so you can still develop cataracts. If you do need cataract surgery later in life, your earlier LASIK surgery will have no impact on it, and you can still have them removed as normal. Dr. Updegraff provides all LASIK patients with a card that has all the “pre-LASIK” values a surgeon needs to help calculate the lens power needed for cataract surgery. Put this in a safe place in the event that your records are no longer available.

Retreatments and the expert ability to do them is crucial to having high-quality LASIK. The ability to lift a flap to “fine-tune” is one of the most important aspects of the LASIK procedure. It’s like a “two putt” on the green for a pro golfer – if they are 80 feet from the hole and the first putt puts them within one foot of the hole, there is an extremely high probability they will sink the putt with the second swing. With LASIK, most cases of “fine-tuning” are because the surface skin cells steepen the cornea as a reaction to the flattening from the first laser reshaping. When a retreatment is performed by lifting a flap, such a small amount of tissue is removed that the skin cells don’t react like they did with the first major shaping. This is why nearsighted and astigmatism retreatments are uniformly stable.

With Precision LASIK™ by Updegraff, we encourage patients to address any leftover prescription within three to six months of the initial surgery, rather than to ignore it and have it become a problem years later.

Again, retreatments should not be looked at negatively, because they are an important part of making LASIK patients satisfied with their vision. Retreatments can be expensive and time-consuming for a facility. Precision LASIK™ by Updegraff takes the approach of addressing this head-on rather than avoiding it and having to address it years later. In the long run, it is not only the “right” thing to do, it has proven to increase our patient satisfaction and word-of-mouth for our practice. The cost and time associated with performing retreatments are actually an investment in patient satisfaction.

Reducing or eliminating the need for retreatments has always been a goal with Precision LASIK™. Dr. Updegraff has a strong belief in developing safety systems and repetition. Anyone who has played a sport competitively knows that, whether it’s a golf swing or a tennis stroke, practice is the key to becoming proficient. This philosophy transfers to LASIK in that the laser technology is incredibly accurate, but there are other variables that can be controlled by the surgeon. From the environment in which the lasers are kept and how they are maintained, to how the surgeon manipulates the tissue, the details can matter.

Precision LASIK™ by Updegraff has focused on these variables for over a decade, minimizing their impact on your outcome. This is evident in the facility and technologies Dr. Updegraff continues to invest back into, as well as in the professional staff – most of whom have been with him for over a decade – who are continuously refining and improving their delivery of your LASIK surgery and care.

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