Common Questions about Laser Treatments
Below are some of the questions we are generally asked. The answers provided should address most of the queries that you might have about the various treatment procedures. If you don't find the answer to your question, please do not hesitate to call. We will try to answer all your questions to the best of our knowledge.
About whether you are a suitable candidate for a refractive laser treatment
Q: How do I know if I am a good candidate for a refractive laser treatment?
A: The first step is a screening evaluation. There's a minimal charge involved and it doesn't take long. After running a number of tests on the various machines, we will be able to give you a good idea of whether or not you are a candidate. If you feel that you need additional information, go home and research your options. A lot of information is provided on our website.
Who is typically a good candidate? If you are nearsighted or farsighted, with or without Astigmatism, you can generally be treated successfully.
It is very important that your doctor has the scope to offer alternative treatment options, so that you are not given a 'one-size-fits-all' solution to your problem.
Q: Does that imply that some people are not candidates for laser treatment?
A: For several reasons, some people are not good candidates:
- Someone with an unrealistic expectation of what the treatment can do. Corrective eye laser treatment is wonderful, but it is not perfect – it will not make every single person see 20/20 and better. With any procedure it is impossible to guarantee a particular outcome. Someone who says, 'I expect absolutely perfect eyesight afterwards and expect to never have to wear glasses again' might not be a good candidate.
- Someone who is over the age of 40 might still need reading glasses. However, we have certain technology to address this problem at least partially in selected cases.
- Someone with severe nearsightedness or who needs a very large correction may fall outside the scope of laser correction. Other options, e.g. a phakic lens implant, are potentially available in these cases.
- Someone with a non-refractive problem in their visual system, such as a retinal weakness, may require medical or other surgical management of their situation.
- Someone with an inherited eye or corneal disease in the front part of the eye, such as keratoconus.
Rest assured that the vast majority of eye problems have alternative treatment options available such as tiny implantable contact lenses that can be used to restore normal vision.
Q: How do I know whether my specific problem(s) can be treated with laser?
A: To find out whether your eye problem(s) can be treated, make an appointment at Optimed Eye and Laser Clinic for an individual consultation with Dr Potgieter and his staff. After the initial testing, you will be informed of whether or not your specific problem can be corrected by laser, which will enable you to make an informed decision.
Q: If I am a borderline case, would you still advise a laser treatment?
A: We have always erred on the conservative side and this approach has served us and our patients well. So if you have any adverse health condition or if there are any indications that the procedure will not give the desired results, we will advise alternative treatments, highlighting the one that will likely give you the optimal result.
Q: Can I be too old or too young for a laser treatment?
A: The lower age limit for a laser treatment is 20 years. There is no upper age limit (the oldest patient whom we have treated at Optimed was 76 years old).
Q: If I want to know if I qualify for a laser treatment, what is the first step?
A: Call us for an appointment to book an evaluation. We have two levels of screening:
- The first is a low-cost screening evaluation, where we determine whether or not you are a candidate for laser treatment and for what type of procedure you qualify.
- The second is the full evaluation, during which we do the actual measurements required for the calculation of your unique treatment.
About the different types of laser treatments
Q: Since there are several different types of laser treatments, how do you decide which one is the correct procedure for me?
A: As you correctly observed, there are several types of corrective laser treatment techniques. The reason is that, similar to most other medical procedures, corrective laser treatments are not a one-size-fits-all solution. That is why it is absolutely necessary to have your eyes examined and diagnosed by an appropriately qualified ophthalmologist with experience in laser treatments to establish your specific circumstances and to then suggest the best procedure that will provide you with the desired outcome.
We have the experience and flexibility to recommend and perform the correct type of laser treatment. Visit our website for more details about the different types of treatments we offer.
About the risks associated with laser treatments
Q: If I decide to have it done, is a corrective laser treatment safe? Can my eyes be damaged? I have heard some horror stories, but I do not know how valid they are.
A: When a refractive laser treatment is administered by a qualified, experienced ophthalmologist under sterile conditions, it is very safe and yields excellent results. The procedure has been extensively tested scientifically and clinically. Since its introduction almost 25 years ago, more than 20 million eyes worldwide have been corrected by laser. The recipients are generally very happy with the results.
Unfortunately there have been occasional problems with laser procedures and they get a lot of media exposure, as though such cases are the norm. But as you will appreciate, there are usually valid reasons why any medical treatment can go wrong.
All medical procedures have associated risks, which, in the case of laser procedures, are very small providing that the following are adhered to:
- Your eyes are thoroughly examined beforehand to identify any contra-indications.
- The deviations on each eye are accurately measured.
- The correct laser procedure is chosen and performed by a skilled and experienced ophthalmologist under sterile conditions.
- You co-operate during the procedure.
- You faithfully use the prescribed medication afterwards.
- You take good care of your eyes, especially during the first two weeks after the procedure.
Dr Potgieter has performed more than 10 000 procedures, with a very high success rate and an extremely low incidence of complications. This is why, over the years, colleagues regularly refer patients to him.
Q: Can a corrective laser treatment weaken the cornea?
A: If done correctly, the integrity of the cornea is preserved. On the first day after the procedure, it is often impossible to see any evidence of the treatment with a slit lamp microscope. However, there may sometimes be a slight redness of the eye for the first few days, which is temporary.
Q: What are the long-term outcomes of laser corrections?
A: After extensive clinical trials, no adverse long-term effect could be demonstrated if the procedure was performed correctly.
Q: Can a laser treatment cause a cataract, glaucoma or other eye problems?
A: Laser treatments will not cause any of these eye problems, nor will it treat them.
Q: Will a laser treatment affect future eye surgery, e.g. cataract, retinal detachment or other eye problems that may develop later in life?
A: Since the structure of the eye is not weakened, any other eye operation is possible afterwards. It is important, however, to inform the surgeon if you had a laser treatment as, in some cases, the preparations for the new surgery may be influenced (this is especially true for cataract surgery, since the calculation of the lens power to be implanted into the eye during cataract surgery is affected by the laser procedure).
Q: Laser equipment seems to be largely computer-driven. Can my eye be damaged if the computer goes faulty of something else goes wrong, like if the power fails?
A: Our equipment has many fail-safe characteristics that cater for almost any eventuality. During the actual treatment, which literally takes a few seconds per eye, Dr Potgieter can manually override or stop the process if he has any suspicion that something is wrong. After years of experience, it is possible for the surgeon to anticipate and recognise potential problems instantly and avoid them. Doing a laser correction is very similar to an experienced pilot flying an aircraft. When a problem appears, he/she can override the computer.
Moreover, the clinic is equipped with an uninterruptible power supply as well as an emergency generator to cater for power outages. We therefore have a double back-up system – so rest assured, you are in safe hands.
About Laser Treatments in itself
Q: How established are corrective laser treatments? Or is it still experimental?
A: The first type of laser surgery, known as Photo Refractive Keratectomywas first performed in 1988. Lasik in its current form has been performed since 1994. The latest types of treatments, Femtosecond Lenticule Extraction and Small Incision Lenticule Extraction, have been performed since 2007.
So to answer your question, corrective laser treatments is an established and proven technology to correct refractive errors and the technology has continually improved. Moreover, it has been tested and authorised by the US Food and Drug Administration, the controlling body for such matters in the US.
Laser corrections yield excellent visual results. More than 20 million eyes worldwide have to date been corrected using laser.
Q: Will my refractive error regress faster after the laser treatment?
A: No. A laser treatment has no influence on the normal refractive variations of the eye.
Q: Will I ever need glasses again?
A: From the age of 40, as a natural process, the lens in your eye gradually becomes inelastic, making it increasingly difficult to adjust its shape and, therefore, its focus. So although your eyes should still have good distance vision as you become older, you may require reading glasses to see close-up objects clearly.
About what you can expect after the procedure
Q: How long after the procedure can I go home?
A: Since you receive a local anaesthetic in the form of eye drops, you can go home very soon after the procedure. Do, however, arrange for someone to drive you home and to bring you to the clinic the next day for your first follow-up visit.
Q: How often should I go for follow-up examinations after the treatment?
A: The standard follow-up visits are at day one, week one and months 3, six and 12. However, since we are committed to provide ongoing care, we recommend that you visit us annually to test for other phenomena such as glaucoma, as these risks remain unchanged after the treatment.
Q: When can I continue with my normal lifestyle?
A: Work: As soon as you feel ready and capable, you can return to work.
Sport: You may proceed with jogging, tennis, golf and aerobic exercises immediately. However, contact sport should be avoided for approximately six months after the procedure. Sport like squash needs to be practiced with safety goggles to protect the eyes, should a squash ball or racquet accidentally hit you in the face. Swimming can be resumed six weeks after the procedure.
Driving: As soon as the visual standard for driving is achieved (20/40 or 85% vision), you can get behind the wheel. Most patients obtain this visual standard within one day after the procedure. Night driving may, however, be a problem for the first few weeks, as some patients experience glare and halos, which decreases over time.
Make-up: Eye shadow can be used again one week after the procedure, but mascara and eyeliner should be avoided for 2 to 3 weeks.
Q: If my eyes regress after the procedure, can I wear spectacles or contact lenses to enhance my vision? Is it possible to repeat the procedure?
A: Glasses or contact lenses can be worn after a laser treatment without any risk to the eye.
In most cases it will not be necessary to repeat the procedure, but an enhancement procedure can be done any time after the initial procedure, provided the cornea is thick enough to safely accommodate the enhancement. This is usually only necessary when the initial refractive error was high or complex.
Laser treatment provides a permanent solution to refractive errors and will not cause further refractive changes in the short- and long-term.
Q: What precautions, if any, should I take after the laser treatment?
A: Whether you had a laser treatment or not, you should refrain from rubbing your eyes! It is a bad habit that weakens the structure of the cornea.
For the first month, avoid unnecessary water into the eyes.
Other than that, no special precautions are necessary and you may continue, within reason, as if no procedure was performed.
Q: Will it harm my eyes if I work on a computer, watch TV, read a lot, etc afterwards?
A: No. You may continue with your normal activities. However, if you have difficulty performing certain activities, tailor them to your ability to cope with them.
About the cost of a laser treatment
Q: I understand that a laser treatment is very expensive. Do medical schemes pay for it, and if not, how much will it cost?
A: Medical schemes, as a rule, exclude refractive treatments from their basket of benefits. Most plans, however, will cover the pre-operative evaluation and associated tests in full.
Some of the more comprehensive plans may cover the treatment, depending on the rules of the insurer. Once we've done a full workup, we routinely provide patients with a motivation letter, which includes a quote for the specific type of treatment for which they qualify. The cost will depend on the type of procedure and whether one or both eyes have to be corrected.
In most cases the on-going cost of replacement glasses or contact lenses with cleaning solutions over a couple of years can pay for the procedure. Moreover, you will be able to lead a normal life and play sport without the restriction of optical aids. How does one attach a monetary value to that?