LASIK Frequently Asked Questions

We do. The LDV Z4 Femtosecond laser from Ziemer AG (Port, Switzerland) creates the industry’s only customizable 3D LASIK flap. It uses a single, disposable, sterile patient interface capable of fashioning a 10 mm treatment zone. Using 1/10th the energy of competing systems the Z4 enhances safety and comfort. Ziemer is the international favorite for flap creation and provides the fastest visual rehabilitation.

The Nidek Quest, the world leader in Excimer technology, has been granted full FDA approval for the country’s first Custom Aspheric Topography-Guided laser system. This laser actually constructs a 3D model of your treatment and determines your final visual result before the surgery begins. Unlike using VisX and WaveLight, Dr. Lewis can test and validate your laser treatment in advance. You never have to worry about your answers to the “better one….better two” questions.

Both of these devices are more expensive than their competitors. We believe they are worth every penny.

No! Some of our patients describe mild pressure during the procedure and an occasional scratchy sensation for an hour or two. We provide Valium, preoperatively, and Tylenol, post-op, to ease the process.

Insurance does not cover LASIK. If your employer has a LASIK subsidy plan or a health benefit program, we will participate. Medical/Health Savings Accounts are an excellent way to help defray costs.

Usually, half a day. Most LASIK patients can drive to their follow up appointment and return to work the next day, but this varies. Everyone heals at a different rate and we can’t be sure when you can safely drive or perform your job. If you want to play it safe, take two days off.

If you wear soft lenses, we recommend one to two weeks.

If you wear gas permeable lenses, we recommend more than one month. Sometimes, we will ask you to stay out of lenses even longer.

If you can’t, have one eye done at a time and go without lenses in the preoperative eye only.

Almost all of our patients see 20/20 with both eyes and without glasses.

A small percentage may require an early enhancement (free), if they don’t achieve that vision.

I have performed over 10,000 LASIK procedures as well as over two thousand related procedures including Epi-LASIK, PRK, and EVO (Visian ICL: Intraocular Contact Lenses).

Some centers require that you see 20/40 or worse and have one diopter of refractive error before they will provide an enhancement.

We use a more individualized approach balancing patient expectations and safety.

Our present enhancement rate is approximately 6%.

Serious complications, like infection and/or irregular corneal astigmatism, are extremely rare. In our practice this occurs less than once every 4000 cases. We are committed to keeping this number as low as possible. Our recent acquisition of the Ziemer Z4 femtosecond laser adds an additional layer of safety to this already excellent procedure. Furthermore, all of our equipment receives preventative maintenance from the manufacturer in compliance with their recommendations.

You should stop wearing eye makeup a day before surgery and wait 48 hours before restarting.

We guarantee to do the best surgery possible and work with you until you are happy with your vision.

Guarantees are for toasters and other household appliances, not surgery. If you read the fine print in many of the guarantees offered elsewhere you’ll be surprised by the hidden costs and stunned by the multiple escape clauses. We have a reputation to protect and the Hippocratic oath to maintain. We are highly motivated to keep you happy and visually healthy.

Yes! In fact, if you are 40 or older and can take your glasses off to read, LASIK will abruptly precipitate your need for reading glasses. If you are in your 20’s or 30’s you’ll have some time before this happens. For some, monovision (one eye sees near, the other sees far) is an alternative. This will be addressed at your consultation.

Monovision works for some patients. In our office, a contact lens trial for monovision, is always required. Clear lensectomy with presbyopic lens implantation is an effective way to address both far and near vision concerns after age 40. Plan to discuss these options during your visit. You can also visit CataractPhiladelphia.com.

The ideal age for LASIK is between 18 and 101.

There are special considerations at both ends of this spectrum.

We expect to be adding later hours. Call the office directly for more information.

Most patients between –7.00 and +2.00 are acceptable candidates. Higher degrees of nearsightedness are better addressed with the new EVO (Implantable Contact Lens) from Staar Surgical. Visit VisianICL for more information.

This decision, however, requires a careful ocular evaluation.

Mild to moderate regular astigmatism usually isn’t a problem.

Sometimes. This needs to be discussed at length.

The larger diameter flaps created by the Z4 femtosecond laser and the enhanced peripheral ablation profiles provided by the Nidek Quest excimer have nearly eliminated pupil size as a disqualified for LASIK.

Most patients need supplemental lubrication (artificial tears, punctal occlusion, and warm compresses) for at least one month following LASIK. Contrary to prevailing wisdom, patients with dry eye and contact lens intolerance can still qualify for the procedure. Additional treatment modalities, including Mibo, and IPL are available in our office to address dry eye.

Remember, the EVO ICL is an excellent alternative. Dry eye is not associated with the EVO ICL.

Dry eye symptoms after LASIK typically resolve entirely in a few months.

No. Lately, however, patients are effectively utilizing ride services including Uber and Lyft.

Yes, no interest financing for 6 months is available through CareCredit.

We anticipate long-term excellent results following LASIK. We recommend regular, routine ocular health maintenance after surgery. We are committed to collaborating with you and your eye doctor in the decades ahead.

Aging of the eye will continue. This manifests in presbyopia (reading glasses for near vision) and the later, cataract development.

Yes. Almost all patients prefer this option. Rarely, surgery on different days is medically indicated or otherwise desirable. Naturally, there is no additional charge for this option.

No. In fact, you can’t stop seeing your eye doctor.

LASIK doesn’t eliminate the need to protect your ocular health.

We ask everyone to sleep soon after your procedure.

This helps the eye heal and allows the medication to wear off. Drops are required for two weeks.

You should avoid ocular trauma for the first few days.

Other restrictions:

The evaluation takes about an hour. The surgery only takes 15 minutes but you will be in the office for about two hours. We prefer to see you the day after surgery, a week or two after that, and then at one, three, six months, and twelve months.
These visits usually take less than half an hour.

There is no charge for routine visits during the first year.If you are being co-managed by your eye doctor, we will need to see you less frequently.

No.

That may be the case. Dr Lewis has access to technology and techniques your doctor may not. You are welcome to an evaluation to see if any new options exist.

James S. Lewis, MD,

• a board-certified,
• fellowship trained,
• corneal sub-specialist
• affiliated with the
• Wills Eye Surgical Network
• performs all surgery.

If you’d like to meet Dr. Lewis after your evaluation or on a day before your surgery simply let us know when you schedule.
He will always see you immediately prior to and just after your LASIK.

Yes. Nevertheless, we anticipate 2 million procedures in the US alone this year. Its time has come.

Yes. Absolutely!

Good Candidates

• are sick of their glasses and contact lenses
• want to see in the shower, ocean, and sporting field unaided
• don’t want their glasses to fog up or slip down their nose anymore
• want people to see what they really look like
• are tired of dragging contacts, glasses, and solutions around
• want to see their alarm clock
• are just tired of the hassle and dependence on lenses

Poor Candidates

• want a guarantee
• insist on 20/20 vision immediately after surgery
• are unwilling to tolerate mild initial fluctuation and other symptoms
• demand to be spectacle or contact lens free for life
• do not recognize that there is risk in having LASIK
• are obsessive, intolerant, uncompromising, or impatient
• don’t follow instructions or educate themselves about the surgery
• expect perfection

We have multiple checks and balances. This is our responsibility.
Also, the laser won’t be fired unless you are in the right position.
We will control your eye movements and blink reflex and keep you from jeopardizing the result. You will not be our “worst” patient!

You need excellence in both in order to get the desired outcome.

That is our plan.

Dial 1-215-886-9090 or send email to: jslewis@jamesslewismd.com