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LASIK Laser Eye Surgery Frequently Asked Questions
Provided by Dr. Mitchell Shultz


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What is ophthalmology?


Ophthalmology is the branch of medicine dealing with the prevention, diagnosis, and medical and surgical treatment of eye diseases, disorders, and injuries.


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What's the difference between an ophthalmologist and optometrist?


Both ophthalmologists and optometrists are commonly referred to as "eye doctors", however there are differences between the two. Doctors of Optometry complete four years of post-graduate optometry school. Optometrists examine eyes for vision and health problems, prescribe glasses, and fit contact lenses. They also prescribe many ophthalmic medications and often participate in pre- and post-operative care.

Ophthalmologists, on the other hand, attend medical school and have acquired a medical degree. Ophthalmologists are trained to provide a full spectrum of eye care, from prescribing glasses and contact lenses to complex and delicate eye surgery for specific conditions and diseases. In addition to medical school, every ophthalmologist completes a one-year internship and must spend a minimum of three years in residency.


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Why should I see an ophthalmologist?


If you have any of the following symptoms or conditions, you should see an ophthalmologist:
  • Eye pain
  • Decreased vision
  • Flashes of Light
  • Double vision
  • Eye discharge or tearing
  • Redness of the eye
  • Colored circles around lights
  • Specks or strings in your vision
  • Crossed eyes
  • Diabetes
  • Family history of eye disease

You should also seek the services of an ophthalmologist if you are referred by a family physician or a specialist.


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What kinds of eye treatment does Drs. Shultz offer?


Drs. Shultz provides the highest quality surgical eye care as well as comprehensive ophthalmic exams to evaluate and treat:
  • Cataracts
  • Glaucoma
  • Macular Degeneration
  • Diabetes
  • Diseases of the Cornea and Retina
  • Nearsightedness
  • Farsightedness
  • Astigmatism
  • Presbyopia
  • Laser treament for diabetes
  • Laser treatment for retinal tears
  • Laser treatment for Glaucoma

He also utilizes the latest advancements in:
  • Refractive Surgery
  • LASIK
  • PRK
  • Mulifocal Lens Implants
  • Accomodative Lenses
  • Phakic IOLs
  • Intracorneal Implants
  • Cosmetic Surgery



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How LASIK works


LASIK is a refractive surgical procedure to help correct vision problems. The term LASIK is an abbreviation or acronym for laser-assisted in-situ keratomileusis, which means "to reshape the cornea, from within, using a laser." In LASIK, the corneal surface is treated underneath a protective corneal flap. It is one of several corrective procedures for the treatment of familiar vision problems that you may already have heard of, including nearsightedness, farsightedness and/or astigmatism.

While glasses and contact lenses also help correct problems such as these, they are considered vision aids, not surgical procedures. LASIK and other procedures are, in fact, designed to help people eliminate or reduce the need for glasses or contact lenses. LASIK is not the appropriate procedure for everyone, and it is important to know if it is right for you.

You may experience nearsightedness, farsightedness and/or astigmatism because your cornea is inadequately shaped for the dimensions of your eye. In use since the late 1980s, LASIK utilizes a laser beam to remove small amounts of tissue from the cornea to reshape it and correct the refractive error. The reshaped cornea then focuses images directly on the retina. For many patients, a successful LASIK procedure can mean clearer vision with the potential to eliminate glasses or contact lenses.


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Customized Laser Vision Correction


There's a new LASIK procedure called CustomCornea that promises to deliver truly customized vision correction. This exciting new procedure can treat all of the conditions LASIK surgery is traditionally used to correct, as well as a range of vision problems that could not be detected before. Experts believe these problems, called higher order aberrations, are responsible for many low-light vision problems, including glare and halos. In October 2002, CustomCornea became the first FDA-approved laser vision correction procedure capable of measuring and treating higher order aberrations.


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Custom LASIK with the VISX CustomVue Laser


The Fingerprint of Your Vision™

Your vision is unique - as personal as your fingerprint or your DNA. WaveScan® technology provides your eye doctor with a map of your vision.

WaveScan Technology

Initially, you will meet with Dr. Shultz for a complete medical evaluation and eye history to determine whether you are a good candidate for the CustomVue procedure. Your doctor will discuss the benefits and risks of the procedure with you.

In addition to other diagnostic tests, a WaveScan measurement will be taken to map the unique characteristics of your vision. An individualized treatment plan can then be developed to address your unique vision needs. Once it is confirmed that you are a good candidate, Dr. Shultz will schedule you for a CustomVue procedure.

The CustomVue Procedure

On procedure day, you will be seated in a reclined position. Anesthetic drops will be placed in your eyes, and a flap will be created on your cornea. Your individualized treatment information is transferred from the WaveScan to the laser in order to drive the CustomVue procedure. The actual laser procedure typically takes several seconds. The majority of individuals feel no pain during the procedure.

After CustomVue, you will notice results immediately, and your vision will continue to improve over the next few days. You will be scheduled for a follow-up visit the next day and again several weeks after the initial procedure.


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LASIK with the Alcon LADARVision 4000 CustomCornea Laser


The CustomCornea difference

Traditional LASIK surgery can provide excellent results in correcting a wide range of common vision problems like nearsightedness, farsightedness and astigmatism. These vision problems are known as lower order aberrations.

CustomCornea is a new kind of LASIK procedure that takes a similar approach and can help with many of the same visual problems. There are two reasons CustomCornea is different. CustomCornea is the first laser vision correction procedure to go beyond reshaping your cornea based on your prescription for eyeglasses or contacts. The procedure is completely customized to your eyes and your eyes alone. Secondly, CustomCornea can help with other vision problems that could not be detected previously, known as higher order aberrations. Experts believe these aberrations can be responsible for vision problems like glare and halos in low-light conditions and at night.

Higher order aberrations cannot be treated by traditional laser vision correction procedures or even by wearing glasses or contacts. In October 2002, CustomCornea® became the first laser vision correction procedure FDA approved to address higher order aberrations.


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How CustomCornea Works


There are three steps to every CustomCornea procedure; Capture, Match and Treat.

Capture

In this first step, the LADARWave® wavefront device is used to capture your eyes' unique combination of higher and lower aberrations. These devices create a wavefront map of each eye by shining an eye-safe beam of laser light into the eye and measuring the reflected light waves as they pass through your visual system and exit the eye.

Match

In this second stage, a wavefront map for each eye is input to the laser system and converted to a guide for the laser. When both patient and doctor are ready for surgery to begin, the map is computer-matched with the eye's exact position so the treatment is extremely precise. Since each eye has its own unique wavefront map, treatment with CustomCornea is truly customized.

Treat

If Dr. Shultz determines that CustomCornea treatment is right for you, then your cornea will be reshaped using the state of the art LADARVision 4000, guided by the data from the wavefront map. The treatment is designed to correct your unique profile of both lower and higher order aberrations at the same time.


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What is PRK?


Photorefractive Keratectomy, or PRK, was the first FDA approved surgical procedure developed to reshape the cornea using a laser. The major difference between LASIK and PRK is the way the middle layer of the cornea is treated. With LASIK, a flap is created in the top layer, folded back for the reshaping of the underlying corneal tissue beneath the protective corneal flap and immediately put back into position at the end of the procedure. With PRK, the laser makes direct contact with the cornea after pulling back or removing the top layer, called the epithelium. Thus, no protective flap is created. After reshaping the resulting exposed corneal tissue, the top layer, or epithelium, is left to heal with time during a natural healing process and without the aid of a protective flap. Generally, there is more discomfort with PRK than with LASIK. However, under certain conditions, Dr. Shultz may recommend PRK instead of LASIK.


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Vision Problems LASIK Cannot Correct


One common vision problem, presbyopia, cannot currently be treated by any laser vision correction surgery. This condition is the result of an inelastic lens, not a misshaped cornea, and is part of the natural aging process for many people. If you have presbyopia and require reading glasses, laser vision correction surgery will not correct the problem. Although results vary from patient to patient, if you currently wear contact lenses to correct nearsightedness or farsightedness along with reading glasses for presbyopia, laser vision correction may eliminate or reduce the need for the contact lenses, but not for the reading glasses. If you are interested in the treatment of Presbyopia, please refer to the Crystalens section of this website for a new exciting alternative to LASIK in which cataracts, refractive error and Presbyopia are addressed.


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What is Glaucoma?


Glaucoma is a disease usually characterized by an increase in pressure within the eye. This may in time result in damage to the optic nerve, loss of peripheral or side vision and ultimately blindness. The higher the pressure within the eye, the greater the chance of damage to the optic nerve. Unfortunately, these symptoms are not always detectable in a patient, and glaucoma is a leading cause of blindness in the U.S., especially for older people. It is therefore important to have regular eye examinations.


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What causes glaucoma?


There are likely many factors working together which result in the disease called glaucoma. Increased pressure within the eye results from abnormal circulation of the clear fluid called aqueous humor. Aqueous humor is continually produced within the eye and constantly drains from the eye. If there is either an overproduction of aqueous humor or insufficient drainage of the fluid, pressure builds up within the eye and the optic nerve may be damaged. Recently, the circulation of blood to the optic nerve has been implicated as a possible important factor in the causality of glaucoma.


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Is glaucoma preventable?


Glaucoma cannot be prevented. Although early detection and treatment by your eye care specialist are the keys to minimizing optic nerve damage and preventing blindness from glaucoma, the disease itself is not preventable.

Dr. Shultz can detect it by examination:
  • Measure intraocular pressure (tonometry)
  • Inspect the drainage angle of your eye (gonioscopy)
  • Evaluate any optic nerve damage (ophthalmoscopy) and optical coherent tomography (OCT Scanning)
  • Test the peripheral or side vision of each eye (perimetry or visual field testing)



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How is it treated?


The increased pressure can usually be controlled with eye drops, sometimes in combination with pills. These medications decrease eye pressure, either by slowing the production of aqueous humor within the eye or by increasing the drainage of it from the eye. Laser treatment or even surgery may be needed when medical treatment alone is unable to prevent progression of optic nerve damage.


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What is a Cataract?


Simply put, a cataract is a "clouding" of the lens in your eye. The lens, located just behind the iris, or the colored part of your eye, works like the lens of a camera. It picks up images, then focuses the lights, colors, and shapes on the retina - the transmitter located at the back of your eye that sends the images to your brain.

The human lens, made mostly of protein and water, can become clouded--so clouded it keeps light and images from reaching the retina. Eye injury, certain diseases, or even some medications can cause the clouding. But, in over 90% of cases, clouding is caused by the aging process.

A cataract can be the reason sharp images become blurred, or seeing things at night is more difficult. It may also be why the eyeglasses or contact lenses that used to help you read, or do other simple tasks, no longer seem to help.


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What a Cataract Is Not


A cataract is not a "film" over the eye, and neither diet nor lasers will make it go away. The best way to treat a cataract is to remove the old, clouded lens and provide a replacement.


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One of the Safest & Most Successful Procedures Performed Today


Great advances have been made in cataract surgery. Millions of people undergo this vision-improving procedure every year. And, they experience excellent results.

For patients, it's a simple operation. A tiny incision is made in the eye. Through this incision, the surgeon inserts an instrument, about the size of a pen tip. The surgeon uses an ultrasonic instrument that breaks up and gently removes your cloudy lens.

Once the clouded lens has been removed, the next step is to replace it. That is, to implant an artificial lens that will do the work of your own lens. This artificial lens is referred to as an intraocular lens or IOL.


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How will it feel?


Cataract surgery is an outpatient procedure. You'll spend just a few hours at the Surgery Center. Because your eyes will be treated with anesthetic, you should feel little to no discomfort.

After the surgery, you'll be given a short time to rest. Then, the very same day, you can go home. Within the next 24 hours, Dr. Shultz will want to see you for an evaluation. Drops will be prescribed to guard against infection and help your eyes heal. For a few days, you may need to wear a clear shield.


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The Miracle of Cataract Surgery


When your cataract has been removed it may seem like a miracle. All the things you couldn't see clearly are bright, clear, and vivid again. In fact, many people will tell you they haven't seen life so clearly in years.

Once you see how good the world looks, you'll be so glad -- like millions of others just like you -- that a cataract is one thing you can live without.

As with any surgical procedure, there are risks. You and Dr. Shultz should consider the potential risks and benefits, and determine if cataract surgery is right for you.


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What is Crystalens™?


Crystalens, a single-focus lens, is the result of Dr. Cumming's discovery and effort. Made from a proprietary and specially formulated solid silicone Biosil™, Crystalens is a cataract replacement lens that works naturally with your eyes' muscles to give you the quality of vision you enjoyed when you were younger.

The revolutionary design element that makes Crystalens the state-of-the-art replacement lens are "hinges" which are designed to allow the lens to move, or accommodate to focus on objects near, far and all distances in-between seamlessly.

Unlike old-style fixed focal lenses, which didn't move, Crystalens has the ability to move, thus focusing as your eye's natural lens did when you were younger. Dr. Shultz will take precise measurements to ensure the correct lens power selection for your eye.


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The Crystalens Procedure


The medical procedure to implant the Crystalens is the same safe, proven cataract surgery performed annually on over 7 million eyes globally. Over 65 million procedures have been done in the US in the last 25 years.

Typically performed in an outpatient surgical facility, the actual surgery takes less than twenty minutes. In a pain free procedure, Dr. Shultz will place a few drops in your eye, then use an ultrasonic probe to remove the cloudy lens from your eye. The Crystalens is then gently placed where your original lens used to be. Once surgery is complete, Dr. Shultz will place additional drops in your eye to prevent infection and decrease inflammation. Because the opening into the eye is so small, it heals quickly on its own, without any need for stitches.


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What makes you a good candidate for the Crystalens™?


The best way to find out is to have Dr. Shultz perform a thorough examination and advise you of a customized treatment plan for effectively correcting your vision.

Virtually everyone who has cataracts and is in good general health is a candidate for implant surgery, but people with chronic infections, uncontrolled diabetes, or other health problems may have to wait until these conditions are under control prior to surgery.

People who have had prior corneal refractive surgery are acceptable candidates for Crystalens implantation as long as their eye is in good health. Dr. Shultz can tell you more.

If you've already had cataract surgery, you're not a candidate for the Crystalens procedure.


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The Crystalens™ Experience


The Crystalens experience brings the details of your life into focus with the clarity of youth. Crystalens allows you to not lose sight of the things that are most important in your life, by giving you back the precision you had when you were younger. Start living life in the details. See the world the way you want to be seen.


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Mitchell Shultz, M.D.
Shultz Vision LASIK & Vision Restoration Center

Office Address:

18350 Roscoe Blvd.
Suite 101
Northridge, CA 91325
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