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Frequently Asked Questions
Our Technology 'Frequently Asked Questions':
- What can a person expect from their uncorrected visual outcome on the
first day postoperatively with Thin-Flap or SBK LASIK and how does it
compare to other types of laser vision correction?
- What kind of pain or discomfort do patients experience with Thin-Flap or
SBK LASIK surgery and how does it compare to Femtosecond ALL-Laser LASIK?
- How does SBK LASIK represent an improvement over previous types of LASIK
surgery with a cap or flap?
- How do dry eyes affect the outcome of laser vision
correction?
- What are the possible goals of Epi-Laser or Thin-Flap,
either SBK or Femtosecond, LASIK?
- What is All Laser LASIK using the "DaVinci" Femtosecond laser?
- Who can be treated with Surface Epi-Laser?
- Why is hyperopic Epi-Laser the only chosen treatment at the Shealy Eye Laser Center?
- What has the Allegretto Wave Laser added to your practice at the Shealy Eye Laser Center?
- Why did the Shealy Eye Laser Center switch to Epi-Laser treatment for myopia?
- Why is Superficial Epi-Laser Vision Correction superior to LASIK with cap or flap formation?
- What occupations require Advanced Surface Laser Treatment?
- Why did Dr. Shealy abandoned LASIK with cap or flap formation, but will use the DaVinci Femto-second laser
and Thin-Flap SBK LASIK if a patient desires LASIK?
- Describe what Dr. Shealy's experience has been with different excimer laser platforms.
- How is farsightedness, hyperopia, and presbyopia best treated in our experience at the Shealy Eye Laser Center?
- How does the reduction of astigmatism affect the results of cataract surgery, either with a premium multi-focal lens or a standard mono-focal lens?
- What is the preferred treatment at the Shealy Eye Laser Center for re-treatment if LASIK surgery and Radial Keratotomy surgery has been performed in the past?
- What if my eye moves during laser vision correction?
- When do you perform surgery?
- How much time do I need off work?
- How long does the surgery take?
- How does the Allegretto Wavelight platform represent an improvement over lasers we have used at the Shealy Eye Laser Center in the past?
- What ranges of treatment are possible with the Allegretto Wave Front laser?
- What if I have questions about the technology at the Shealy Eye Laser Center?
- What if I was told I’m not a candidate by another doctor?
- If I have a very small prescription, can it still be corrected?
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What are the absolute contraindications to
laser vision correction?
Back to the top.
Laser Vision Correction 'Frequently Asked Questions':
- Can patients be treated with laser vision correction if they've had Herpes Simplex Keratitis?
- What traits are desired in candidates for laser vision correction?
- What is the most common complication of laser vision correction, seen in our office today?
- How long should I discontinue contact lenses before surgery?
- What is Superficial Epi-Laser or Advanced Surface Treatment (AST)?
- Why has advanced surface treatment (AST) or Superficial Epi-Laser nearly replaced LASIK in our practice at the Shealy Eye Laser Center?
- Why does laser vision correction worsen dry eyes in many situations?
- How has Dr. Shealy improved his results with Surface Epi-Laser?
- What is bladeless All-Laser LASIK?
- What are the complications of LASIK when a flap or cap is formed with either a blade or laser?
- What causes my eyes to be red or bloodshot after laser vision correction?
- When can I allow water to get in my eyes after laser vision correction?
- What type of sunglasses do we recommend?
- When will my vision improve after laser vision surgery?
- When can my son or daughter have laser vision correction?
- What does LASIK "board certified" mean?
- When does the cap or flap heal completely?
- Can I wear contact lenses after surgery?
- How soon can I wear make-up after surgery?
- What are the options for financing laser vision correction?
- What is epithelial ingrowth?
- What is the presbyopic phenomenon?
- If I am pregnant may I have surgery?
- What does the abbreviation LASIK stand for?
- What is a microkeratome?
- If I’m from out of town, can you recommend a hotel in the area?
- Does insurance cover the procedure?
- What is the average charge for laser vision correction in different parts of the world?
- How does Dr. Shealy feel about operating on one-eyed patients?
Back to the top.
Outcomes 'Frequently Asked Questions':
- What has been the experience at the Shealy Eye Laser Center with treating high myopia and average to thin corneas?
- What can a patient expect for an outcome in the first two to six weeks after laser vision correction at the Shealy Eye Laser Center?
- How long does it take to get crystal clear and stable vision after laser vision correction?
- How often are people retreated after laser vision correction?
- Describe the pain encountered before and during the recovery period of Surface Epi-Laser surgery.
- When will I be able to drive after advanced surface treatment laser vision correction and how does it compare with IntraLASIK and surface PRK?
- What are the chances of me seeing better than I currently do with glasses or contacts after surgery?
- What percentage of your patients see 20/20 after surgery?
- If I have glare with glasses or contact lenses, how will it be after surgery?
- How many vision correction procedures has Dr. Shealy performed?
- Can I drive the day after surgery?
- Can I play sports after surgery?
- If I need glasses after surgery, is that included in the surgery fee?
- When will I be able to start seeing my regular eye doctor?
- What is the upper limit of laser vision correction?
- How does Dr. Shealy treat high myopia?
- What is the treatment of choice for regressed NearVision CK at the Shealy Eye Laser Center?
Back to the top.
Physics of the Allegretto Wave Laser 'Frequently Asked Questions':
- Why did the Shealy Eye Laser Center switch completely to the Allegretto Wave Laser?
- How does higher order aberrations with Advanced Surface Treatment compare with LASIK?
- What are the characteristics of the Allegretto Wave Laser and how does it produce high performance vision?
- How does the Allegretto Wave Laser compare to other larger beam lasers?
- Why can't larger beam laser produce the same quality of vision as the Allegretto Wave Laser?
Back to the top.
Am I a candidate for laser vision correction surgery?
Back to the top.
When is LASIK not for me?
Back to the top.
Our Technology 'Frequently Asked Questions':
- Question: What can a person expect for their uncorrected visual
outcome on the first day postoperatively with Thin-Flap or SBK LASIK and how
does it compared to LASIK with Femtosecond flap making technology?
Answer: See our chart:

Back to the question.
Back to the top.
- Question: How does the discomfort with Thin-Flap or SBK LASIK surgery compare to Femtosecond ALL-Laser LASIK?
Answer: See our chart:

Back to the question. Back to the top.
- Question: How does SBK LASIK represent an improvement over previous types of LASIK surgery with a cap or flap?
Answer: Better mechanical microkeratomes make flaps more superficial on the cornea. These flaps have a more silk-like smoothness in the top of the cornea as compared with the burlap-like, coarse areas of the deeper cornea. Thus thin flap LASIK is less disruptive to the cornea cutting fewer corneal nerves and giving a higher quality of vision with quicker visual recovery time.
Back to the question. Back to the top.
- Question: How do dry eyes affect the outcome of laser vision correction?
Answer: Surgical procedures can disrupt the production of tears. The
lack of continuous tears and reflex tears results in dry eyes. Patients with dry
eyes are less likely to achieve optimal vision. In most cases dry eyes are
worse especially when making a cap or flap as compared to no cap or flap
with surface Epi-Laser. Patents who seek laser vision correction may have
underlying dry eye symptoms such as scratchiness, mucous discharge,
irritation from wind or smoke, eyes sticking together when awakening in the
morning, light sensitivity, contact lens discomfort and contact lens
solution sensitivity. Dryness of the eyes occurs as we naturally age along
with medications and autoimmune disease such as rheumatoid arthritis. We
recommend the use of artificial tears and tear duct plugs in most patients
above the age of 47. This will greatly diminish dry eyes symptoms
which are mostly temporary after laser vision correction.
Back to the question.
Back to the top.
- Question: What are the possible goals of Epi-Laser or Thin-Flap,
either SBK or Femtosecond, LASIK?
Answer: With any type of laser vision correction, you can eliminate
the distortions, minification or magnification effect of glasses. Although
contact lenses will provide this relief, we find that the risks and ongoing
complications with contact lenses have a higher risk to benefit ratio. This
is well documented across America.
Back to the question.
Back to the top.
- Question: What is All Laser LASIK using the "DaVinci"
Femtosecond laser?
Answer: The "DaVinci" Femtosecond laser is the newest
high-repetition laser that cuts into the cornea making a flap or cap
under
the surface layers. This cap is then lifted and the Allegretto Wave
Laser treatment is placed underneath, in the stroma. It has all the same
features as LASIK in which a cap is made with a mechanical microkeratome.
Dry eyes and structural weakening of the cornea with flap complications
occur. Back to the question.
Back to the top.
- Question: Who can be treated with Surface Epi-Laser?
Answer: We general treat patients that are up to -10 D of myopia,
and up to +6 diopters of myopic cylinder, and up to +4 diopters of
hyperopia, and up to +4 diopters of hyperopic cylinder. Our highest
mixed astigmatism are about -6 diopters. These numbers may vary
depending upon our goal with our patient. Some patients are happy to be
have their astigmatism reduced and to correct spherical residual
presciptions with glasses or spherical contact lens.
Back to the question.
Back to the top.
- Question: Why is hyperopic Epi-Laser the only chosen
treatment at the Shealy Eye Laser Center?
Answer: The graphs below show a comparison between the global
subsets of data for the treatment of hyperopia whether performed on the
surface or performed with flap or cap formation. Please note that a
slight early overcorrection occurs producing initial slight
near-sightedness and markedly exaggerated improvement in near vision
which over time, two weeks or so, results in marked high performance
distance vision.
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Global Data; Hyperopic Ablation |
Dr. Shealy's Results;
Hyperopic Surface Ablation |
We have found that nearly 100% of our selected patients will see
20/20 or better when patients desire distance only correction. Please
note that hyperopic Epi-Laser takes time to result in 20/20 or better
vision, which is thought to be due to remodeling of the corneal
epithelium and heaping up of the surface epithelium as it smoothes over
the gap produced in the cornea by the Epi separator.
Back to the question.
Back to the top.
- Question: What has the Allegretto Wave Laser added to your
practice at the Shealy Eye Laser Center?
Answer: the Allegretto Wave Laser has provided faster treatment
times, superior clinical results, elimination of glare and halos,
maintenance of the natural shape of the eye.
Back to the question.
Back to the top.
- Question: Why did the Shealy Eye Laser Center switch to Epi-Laser
treatment for myopia?
Answer: The graphs below show the global data results for the
flap or cap LASIK treatment.
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Global Data; Myopic Surface
Ablation |
Dr. Shealy's Results;
Myopic Surface Ablation |
Nearly all of our myopic patient will achieve levels of 20/20 or
better (100%) with surface Epi-Laser and the use of Mytomycin C when
indicated. Back to the question.
Back to the top.
- Question:
Why is Superficial Epi-Laser
Vision Correction superior to LASIK with cap or flap formation?
Answer:
Dr. Shealy agrees with several leading ophthalmologists like Ming Wang,
MD, PhD, that "newer technologies and better medical management of
post-op discomfort have allowed us to offer superior results with
patient safety in mind." 90% of LASIK complications are related to the
flap or cap formation. Back to the
question.
Back to the top.
- Question: What
occupations require Advanced
Surface Laser Treatment?
Answer: The United States Department of Defense recommends no-cut
Superficial Epi-Laser for Navy pilots, Navy Seals and Air Force fighter pilots.
This is also recommended for patients involved in police enforcement and
fire fighting. Recently we've recommended this procedure for Brahma bull riders,
ultimate fighters, and patients playing all major contact sports.
Back to the question.
Back to the top.
- Question: Why did Dr. Shealy abandoned
LASIK with cap or flap formation, but will use the DaVinci Femto-second
laser and Thin-Flap SBK LASIK if a patient desires LASIK?
Answer: Epithelial ingrowth has been decreased with the use of
the DaVinci Femtosecond laser and Thin Flap SBK in LASIK cases involving cutting or cap or flap as
compared to using a microkeratome. This epithelial ingrowth occurred in
53% of the patients above 50 years of age. The epithelial ingrowth was statistically greater in
retreated patients and was necessary 20% of the time. Our no-cut technique has eliminated epithelial ingrowth and
scarring, which can occur when lifting the cap or flap in about 6% of
patients, see April, 2007 Ophthalmology Times, Thomas E. Clinch, MD, or
see our consent form. Dr. Shealy prefers the no-cut technique since it has eliminated ALL
epithelial ingrowth. Recent FDA panels have scrutinized LASIK safety data
which in many older lasers led to nighttime glare and haloes,
predisposition to ectasia, and dryness of the eyes secondary to certain
collagen vascular diseases such as rheumatoid arthritis. These safety
issues have been addressed by making more superficial flaps with less
invasion into the cornea, stroma and nerves. The satisfaction patients
have with laser vision correction far overshadows its risks especially
when compared to the wearing of thick glasses and contact lenses which
have their safety concerns also. Back to the question.
Back to the top.
- Question: Describe what Dr. Shealy's
experience has been with different excimer laser platforms.
Answer:
Dr. Shealy has personally owned
four excimer lasers since 1996.
These lasers were mostly broad beam laser and removed
large amounts of tissue in a short amount of time. Many patients
complained of nighttime glare and halos and his retreatment rate was
nearly 25%. Visual quality was not possible for large ranges of astigmatism,
farsightedness, and nearsightedness. A high
rate of flap abnormalities including epithelial ingrowth and scarring
occurred. Replacing cutting surgery
to surface surgery with Allegretto Wave laser,
improved outcomes with better staff, doctor and patient
satisfaction. Most of our patients realized that they saw better than
ever before compared to their vision with glasses or contact lenses.
Back to the question.
Back to the top.
- Question: How is
farsightedness, hyperopia, and
presbyopia best treated
in our experience at the Shealy Eye Laser Center?
Answer: Dr. Shealy has found that surface ablation is absolutely
necessary in the treatment of farsightedness when a patient desires the
least invasiveness. Intraocular implants may not be centered in the
pupil so that when you make a cap, with either a laser or bladed
keratome, decentration off the visual axis may occur. The decentration of the cap or flap can
be avoided with the use of surface ablation and the area of treatment
can be centered nicely along the visual axis which is tracked by the
Allegretto Wave eye tracker. Our results have been spectacular and
patients can practice monovision by having the non-dominant eye
predictably overcorrected, making the patients independent of reading
glasses or bifocals 90 to 95% of the time. The Allegretto Wave Laser corrects
up to 6 diopters of farsightedness with 6 diopters of astigmatism. We've
noticed almost no haze formation and a very low retreatment rate as
compared to hyperopic LASIK techniques. Since the cornea is more prolate
or parabolic after surgery, patients have better near vision than would
be expected from myopic LASIK or Epi-LASIK surgery. We
have found at our center that large amounts of farsighted
astigmatism is better corrected with Advanced Surface Treatment.
Back to the question.
Back to the top.
- Question: How does the
reduction of astigmatism
affect the results of cataract surgery, either with a premium multi-focal
lens or a standard mono-focal lens?
Answer: The use of limbal relaxing incisions (LRIs) and laser surface astigmatic correction are necessary to
achieve excellent post operative uncorrected visual acuity in cataract
patients. In over 1,800 cataract patients, nearly 40% required additional
corneal surgery due to greater than .05 diopters of corneal astigmatism.
Back to the question.
Back to the top.
- Question:
What is the preferred treatment at the Shealy Eye Laser Center for re-treatment if LASIK surgery
and Radial Keratotomy surgery has been performed in the past?
Answer: Flap lifting after LASIK surgery is considered
obsolete after six months and is not a minor consideration because of
scarring complications. Surface ablation is the only present form of treatment used
with either LASEK using alcohol, or the amoils epithelial brush. This is
also true for cutting procedures like previous radial keratotomy patients.
Buttonhole flaps and partial flaps are one of the most devastating
complications of LASIK and require off label use of Mitomyocin-C and
photorefractive keratotomy to correct patients prescriptions on the
cornea surface. Back to the question.
Back to the top.
- Question: What if my
eye moves
during laser vision correction?
Answer: Our laser performs fast active tracking in which it tracks each
of the 200 laser pulses per second 4 times each second, the tracker changes its
tracking patterns 6,000 times per second and thus responds to any eye movement. Watch our
video of the Allegretto Wave in action.
Back to the question.
Back to the top.
- Question:
When do you perform surgery?
Answer: We now perform consultations at convenient times for the
patient especially due to their busy lifestyles. Patients who have inability to take off work for surgery
during the week can be scheduled early Saturday AM with advanced notice.
Back
to the question. Back to the
top. Patient Scheduling Considerations:
- Question:
How much time do I need off work?
Answer: Femtosecond and Thin-Flap SBK LASIK patients can go back to work the next
day and can see almost 20/20 immediately. Most patients require one day off work, however, most
patients can go back to work the next day, depending on their job
requirements. Almost all patients have excellent vision within two days.
Some patients with HUGE prescriptions who can not have LASIK, up to 13 diopters of myopia, require an additional day from work and we recommend
that they have surgery Thursday or Friday before the weekend. 98% of the visual recovery occurs within the first 6 to
24 hours after surgery. Patients as a rule recover from their surgery in
two days. Back to the question.
Back to the top.
- Question: How
long does the surgery take?
Answer: The laser application time is less than 15 seconds, which
is less time than is required to pour a cup of juice. The actual operation time
is about 15 minutes. Please allow 1 to 3 hours
for the pre and post operative surgery process.
Back to the question.
Back to the top.
Advantages of the Allegretto Wavelight Laser:
- Question:
How does the Allegretto Wavelight platform represent an improvement
over lasers we have used at the Shealy Eye Laser Center in the past?
Answer: Lasers were
originally large beams without fast active tracking. Beam quality and fineness
of
calibration required that newer laser platforms be manufactured with fast
active tracking and flying spot technology. These lasers took into
account wave front principles to reduce aberrations so that larger
optical zones reduces nighttime glare and halos. Recently we have
acquired new aberrometry driven capabilities to our laser to reduce
preexisting or existing aberrations. Thus the overall quality of vision
after laser vision correction with advanced surface ablation and
speed of application of the
beam determine how accurate the eye prescription is eliminated and how the
quality of vision is obtained. We compare our Allegretto Wave Laser results with
all the doctors using this laser throughout the world. This allows us to make
the best nomograms. Back to the question.
Back to the top.
- Question: What
ranges of treatment are
possible with the Allegretto Wave Front laser?
Answer: There are two basic types of lasers that include traditional or
large beam lasers and wave front based lasers. Wave front based lasers
produce a higher quality of vision with more accuracy and re-treatment rates of
less than 1%. The Allegretto Wave Front Laser has the largest range of approval
of up to 6 diopters of hyperopia with 6 diopters of astigmatism and 13 diopters of myopia with 6 diopters of astigmatism.
Back to the question.
Back to the top.
- Question: What if I have
questions about the
technology at the Shealy Eye Laser Center?
Answer: Dr. Shealy tries to be available at all times for patients
and he tries to be one on one with each patient candidate. He is one of a
few ophthalmologists that completely dedicates his practice to laser vision
correction and does not perform routine eye care or fit glasses and contact
lenses. Back to the question.
Back to the top.
- Question: What if I was told I’m not a candidate by another doctor?
Answer: We found with newer technology including the Allegretto Wave laser, Epi-separators, and new pharmaceutical agents, almost all patients may have their glasses or contacts eliminated.
Back to the question.
Back to the top.
- Question: If I have a very small prescription, can it still be corrected?
Answer: Superficial Epi-Laser can be upgraded at anytime in the future since
it involves the surface of your cornea. Small corrections of -0.50
sphere to -0.50 cylinder can be corrected. LASIK with cap or flap formation can only be performed once
safely. Back to the question.
Back to the top.
- Question: What are the absolute
contraindications to laser vision correction?
Answer: Patients with active keratoconus are better with surface
Surface Epi-Laser and are not candidates for LASIK with a cap or flap.
Topographical abnormalities such as inferior corneal steeping of 1.4
diopters or more, patients that have hepatitis B or C and perfectionist
patients with unreasonable expectations. This is Dr. Shealy's 'middle of
the road' approach to laser vision correction.
Back to the question.
Back to the top.
Laser Vision Correction 'Frequently Asked Questions' to all
ophthalmologists and other eye care professionals:
- Question: Can patients be treated with laser vision
correction if they've had Herpes Simplex Keratitis?
Answer: Dr. Herbert Kaufman has performed the Herpetic Eye
Disease Study associated with testing, cultures and treatments. He found
1. oral medications have nothing to offer us for treating stromal
disease and iritis, 2. oral medicines did not effect the incidents of
stromal disease in patients with herpes epithelial disease, 3. oral
medicines did prevent recurrence of herpes in only 1/2 of the patients
with recurrent stromal disease. Secondly, he found that steroids
benefitted acute disease of the stromal cornea and that there was no
damage caused by them. The study also determined that true bilateral
herpes keratitis is very rare but can occur. He uses Viroptic for
epithelial disease and has a new hope, Ganciclovir, which inhibits viral
DNA synthesis for use in the future as it comes in from Europe. Dr.
Kaufman feels that patients that have had Herpes are good candidates for
refractive surgery in which he performs LASIK. If a patient has active
disease, he starts Viroptics a couple days before LASIK and keeps it up
for two weeks after LASIK. He will perform laser vision correction
surgery in patients that are asymptomatic for a few weeks by giving them
oral Valtrex 500mg twice daily for a few days and two weeks after
surgery. He's noted no reoccurrences of herpes in these patients with
LASIK. Dr. Shealy follows his recommendations at his center.
Back to the question.
Back to the top.
- Question:
What traits are desired in candidates for laser vision correction?
Answer: Candidates for laser vision correction have the following
characteristics;
- Very unhappy with their dependence on corrective lenses.
- Think they are poor candidates for contact lenses.
- Believe wearing corrective lenses restricts them in sports and
similar activities.
- Think they look better without glasses.
- Worry about what would happen to them if they lost/broke their
glasses or contact lenses.
- Would prefer merely functional vision without correction to
excellent vision with corrective lenses.
- Would be happy if their uncorrected vision could be much
improved, even if corrective lenses were still necessary.
- Adjust well to change.
- Are easy-going; can tolerate disappointment.
- Are not perfectionists.
Back to the question.
Back to the top.
- Question: What is the most common complication of laser
vision correction, seen in our office today?
Answer: The primary stimuli to dry eyes in our practice is aging,
gender, medications, previous ocular surgery, low dietary omega-3 fatty
acids, and artificially dry environments (heating, and air
conditioning). Patients feel grittiness, foreign body sensations, blurry
vision, and tired eyes when reading. Inflammatory blepharitis and tear
deficiency both play roles; however, the number one reason for patients
seeking laser vision correction is contact lens intolerance. This
intolerance may usually mean underlying dry eyes. Topical restasis
starting one month before surgery and combined with a low dose topical
steroid post operatively help. At our center we are now placing punctal
plugs in our patients nearly all of the time in females with a history
of hysterectomy or hormonal changes related to physiological biochemical
aging.
Back to the question.
Back to the top.
- Question: How long should I discontinue contact lenses before surgery?
Answer: Contact lenses should be discontinued to achieve a natural
corneal shape before surgery. Soft contact lenses should be out 1 to 3 days
prior to surgery. Toric soft contacts should be discontinued 1 week before
surgery. Patients with gas permeable hard contact lenses should discontinue contacts
until the best corrected visual acuity is obtained.
Back to the question.
Back to the top.
- Question: What is Superficial Epi-Laser or
Advanced Surface Treatment (AST)?
Answer:
Advanced Surface Treatment separates the epithelium from the Bowman's membrane,
creating a thin epithelial sheet, which is discarded. This makes possible
laser vision correction for more patients, especially those with thin
corneas or dry eyes. Uncorrected visual acuity was significantly better with
cell removal on post operative days three to seven as compared to
keeping the epithelial cells intact. This is much safer as compared to cutting
procedures like IntraLase, RK, or even mechanical cutting LASIK. All of our patients prefer this to other procedures. Using
the Allegretto Wavelight Laser has given us the highest quality of
vision compared to other lasers that we have used.
Back to the question.
Back to the top.
- Question: Why has advanced surface
treatment (AST) or Superficial Epi-Laser nearly replaced LASIK in our practice at the
Shealy Eye Laser Center?
Answer: Improved equipment, better pharmaceutical treatment, and
increased concern over LASIK complications have greatly improved staff
and patient satisfaction. Our center has found that the risk for kerectasia has decreased dramatically, especially in patents with no
preoperative warning signs. Lifting the LASIK flap for enhancement has,
in the past, increased epithelial ingrowth and scarring of the cornea.
The rate of epithelial ingrowth has decreased from about 10% to none.
Visually significant epithelial ingrowth, when removed, was found to
reoccur 50% of the time, causing great problems to our patients
Back to the question.
Back to the top.
- Question: Why does laser vision
correction worsen dry eyes in many situations?
Answer: About 14% of the US population already has dry eyes. The
causes of dry eyes may be related to lack of tears or improper tears. As
we age, tear production decreases especially after menopause and during
pregnancy in women. Contact lenses also result in increases in tear
evaporation and general irritation causing contact lens discomfort. A
wide variety of medications can reduce tears especially anti-histamines,
sleeping pills, decongestants and et all. Autoimmune disease like
rheumatoid arthritis can produce Sjogren's Sydrome and is accompanied b
y dry eyes and dry mouth. Environmental factors like dust, smoke, high
altitudes, work settings, heaters, and air may reduce eye lubrication. Below is a check list of dry eye symptoms:
q Dry Sensation
q Scratchy, Gritty Feeling
q Burning
q Stinging
q Itching
q Excess Tearing (Watery Eyes)
q Mucous Discharge
q Irritation from Wind or Smoke
q Redness
q Tired Eyes
q Light Sensitivity
q Contact Lens Discomfort
q Contact Lens Solution Sensitivity
q Soreness
q Lid Infections/Sites
q Sensitivity to Artificial Tears
q Eyelids Stuck Together at Awakening
Back to the question.
Back to the top.
- Question: How has Dr. Shealy improved his results with
Surface Epi-Laser?
Answer: Patients are screened for dry eye situations commonly
seen in some collagen vascular diseases, aging, and biochemical age
related changes, especially in females. We now routinely perform
occlusion of the tear duct, known as punctal occlusion in patients who
are at risk especially those undergoing LASIK with a cap or flap in ages
50 or above.
Back to the question.
Back to the top.
- Question: What is bladeless
All-Laser LASIK?
Answer: Bladeless, All-Laser LASIK involves cutting into the
stromal tissue with a laser. It has the same complications as blade
microkeratome LASIK. Those complications are quite extensive to include
epithelial ingrowth, dry eyes, structural weakening of the cornea,
interface inflammation, and a higher incidence of retreatment.
Back to the question.
Back to the top.
- Question: What are the
complications of
LASIK when a flap or cap is formed with either a blade or laser?
Answer: There are four basic complicated outcomes to include:
• Epithelial defect
• Diffuse Intralamellar Keratitis
• Flap slippage
• Incomplete flap The results, in percentages, are as follows are for two well known microkeratome systems:

Back to the question.
Back to the top.
Question: What causes my eyes to be
red or bloodshot after laser vision correction?
Answer: Sometimes the blood vessels in the conjunctiva will break and
bleed. Many patients will notice this especially if they have worn contact lenses
over a period of years. It usually takes at least 3 weeks for redness or
bloodshot to disappear, but please remember this will not affect your
vision. Back to the question.
Back to the top.
Question: When can I allow water to get
in my eyes after laser vision correction? Answer: Please allow 10 days to 2 weeks before entering a natural body of
water such as a pond, river, lake, or ocean. You may get into a spa or
chlorinated pool one week after surgery. You may shower or bathe at any time
after surgery; however please avoid getting water or soap in your eyes by keeping
them closed while performing such activity. Back
to the question. Back to the
top.
Question:
What type of sunglasses do we recommend? Answer: We have found that
avoiding high intensity ultraviolet light during the first 6 to 12
months, cuts down on the incidences of corneal haze. This hazing is a
mild sun burning of the superficial cornea. We recommend polarized UV sunglasses such as Maui Jim that are available at the Sunglass Hut.
Patients that have Surface Ablation should wear these sunglasses for at
least one year especially in the mountains or at the ocean for protection
from the sun's UV rays. They are especially advantageous for
patients who work and drive during dimly lit conditions since they do not
reduce light intensity like regular sunglasses during the non-daylight hours.
Back to the question.
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Question: When will my vision improve after laser vision surgery?
Answer: All laser vision
patients have an immediate improvement in their vision in the range of 20/20 to
20/30 immediately after surgery. The visual improvement seems to be
faster with all laser vision correction as compared to AST or
superficial epi-laser. Recently we've noticed that the visual recovery
time of AST is almost the same as All laser LASIK. This has been due to
the improvements in contact lens and pharmaceutical management. At six
weeks 100% of our AST patients will see 20/20 and 67% 20/15 or better if
normal 20/20 vision was achieved with contacts or glasses before
surgery. Back to the question.
Back to the top.
Question:
When can my son or daughter have laser vision correction? Answer: When
they are appreciative of the financial cost of having laser surgery and
have stable nearsightedness, they are a good candidate. The prescription
needs to be stable for at least 6 month before correction can be
performed. Back to the question.
Back to the top.
Question:
What does LASIK "board certified" mean? Answer: LASIK board certified means that the doctor has had 50 of
his surgical patients evaluated. These patients have been studied and
followed up on after surgery for their clinical results for a six-month
period and their outcomes have been determined. Three random surgical
cases by the doctor have been video taped and have been reviewed by a
board of independent ophthalmologists from the American Board of Eye Surgery.
Back to the question.
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Question: When does the cap or flap heal
completely? Answer: Caps require patients not to rub their eyes
indefinitely or to receive blunt force trauma to the eye. We recommend
that a shield be worn for the first 72 hours for the cap to become
adherent. We very seldom perform cap or flap surgery any more.
Caps or flaps never heal completely, so this must be
taken into consideration by patients who might be exposed to trauma or
striking of their eye. This is especially important for patients in the
military, police or fire fighting professions.
Back to the question.
Back to the top.
Question: Can I wear contact lenses after surgery?
Answer: The goal of laser vision correction is to eliminate glasses and
contact lenses. Very rarely, less than 1 in every 1,000 patients, a contact lens
may be necessary for ectasia or astigmatism which may occur after correction.
Contact lenses are successful 99% of the time to correct residual
prescriptions. Back to the question.
Back to the top.
Question: How soon can I wear
make-up
after surgery? Answer: You may wear make-up 72 hours after
surgery. Back to the question.
Back to the top.
Question:
What are the options for financing laser vision correction? Answer: We
provide no interest financing or low monthly-extended payment plans, through
CareCredit.
Back to the question.
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Question: What is epithelial ingrowth?
Answer: In 1% to 15% of surgeries, cells may
be embedded or proliferate under the flap or cap after surgery. Chronic ingrowth may recur after surgery associated with Intrastromal enhancements
about 35% of the time. Some may need anterior lamellar grafts.
Back to the question.
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Question: What is the
presbyopic phenomenon?
Answer: Presbyopia or loss of focus is age related due to the
lens growth, like the layers of an onion that occurs in an incremental
fashion as you grow older. This makes the ciliary muscle less able to
flex our lens for focusing as we get older. Back to the question.
Back to the top.
Question: If I am
pregnant may I have surgery?
Answer: We prefer not to operate on pregnant patients because of
perceived liability. Back to the
question. Back to the top.
Question: What does the
abbreviation LASIK stand for?
Answer:
This means laser assisted intrastromal keratomileusis, which a flap or
cap is created with an epithelial separator or microkeratome. This
creates a two piece cornea which Dr. Shealy feels alters the
biomechanics and corneal integrity. Dr Shealy does not perform corneal
transplants or other types of corneal surgery. He refers all of these
patients to a corneal specialist if they need further surgery or request
such. All corneal transplant procedures eventually require laser vision
correction. Back to the question.
Back to the top.
Question: What is a microkeratome?
Answer: A microkeratome is a cutting devise much like a
carpenter’s plane. It is used to make a flap from the top layer of the
cornea under which the laser is applied in laser vision correction.
Back to the question.
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Question: If I’m from out of town, can you recommend a hotel in the area?
Answer: Yes, our office manager can assist you with this
information. We offer an overnight at
Don Hall’s Guest House with limousine transportation service.
Back to the question.
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Question: Does insurance cover the procedure?
Answer: Please contact your local insurance carrier. Your agent
is more familiar with your account and coverage policies, so get in
touch with them for advice. We are not licensed or qualified to give you
guidance in this area. Back to the
question. Back to the top.
Question: What is the
average charge for laser vision correction
in different parts of the world? Answer:
The cost of traditional flap LASIK surgery per eye is:
| Norway |
$700 to $1,200 |
| United Kingdom |
$1,500 to $3,600 |
| Spain |
$3,000 |
| USA |
$2,400 |

The cost of glasses in the United Kingdom, to include spectacle
changes every two years, annual examinations every two years, cost
$9,800 over a lifetime. Rigid contact lenses, changed every two years,
including solutions, tests and exams, cost $17,800 in the United Kingdom over
a lifetime while daily disposable contact lenses cost $31,000 over a
lifetime. Patients that only need glasses to read will spend $8,100 over
their lifetime for reading glasses. The mentality has changed in Europe,
once laser vision correction was considered Rolls Royce treatment,
but now is considered a better long term investment than glasses or
contact lenses. Back to the question.
Back to the top.
Question: How does Dr. Shealy feel about operating on
one-eyed patients? Answer: Dr. Shealy is very
conservative and probably would not
operate on a one-eyed patient which is the policy of 62% of the
ophthalmologists in the United States.
Back to the question.
Back to the top.
Outcomes 'Frequently Asked Questions':
- Question: What has been the experience at the Shealy Eye
Laser Center with treating high myopia and average to thin corneas?
Answer: In Ocular Surgery News 2007, our experience with Surface
Epi-Laser was confirmed by showing better visual outcomes.
Back to the question.
Back to the top.
- Question: What can a patient expect for an
outcome in the first two to six weeks after laser vision correction at
the Shealy Eye Laser Center?
Answer: We have found that 90% of our patients see as good or
better than they did with their glasses during this time period. About
50% of our patients gained vision over their contacts or glasses
compared with the global average of about 20%.
- Question:
How long does it take to get crystal clear and stable vision after laser vision
correction?
Answer: Thin flap LASIK requires almost 2 weeks to get crystal
clear and stable vision. IntraLASIK requires 3 to 4 weeks and is delayed
as compared to thin flap LASIK. Epi-LASIK on the other hand requires
approximately 60 days to achieve stable and crystal clear vision, but in
our hands, the incidents of 20/20 or better increases dramatically over
LASIK cutting techniques so that our retreatment rate is 0.25% as
compared to 10% with LASIK cutting or flap surgery.



Back to the question.
Back to the top.
- Question:
How often are people retreated after laser vision correction?
Answer:
Our re-treatment rate is less than 0.25%. This compares much more
favorably than a
5% to 10% rate noted with other lasers. Back to the question.
Back to the top.
- Question: Describe the pain encountered
before and during the recovery period of Surface Epi-Laser surgery.
Answer: Dr. Markomanolakis, from Athens, Greece, described the
mean pain score in 163 patients on the first post operative day. See the
following graph:

The mean pain scores remained below the threshold for burning sensation
during the first two to ten hours after the operation. At 24 hours after
laser treatment, the mean pain score was 0.18 which indicated only mild
discomfort, far below the threshold of needing oral medications (4),
pain without medication (3), burning (2), and discomfort (1.46). The
judicious use of Imitrex, Ambien, and topical steroids make the patient
as comfortable as if they had LASIK either with a mechanical keratome or
Interlase.
Back to the question.
Back to the top.
- Question:
When will I be able to drive after advanced surface treatment laser
vision correction and how does it compare with IntraLASIK and surface
PRK?
Answer: Approximately 90% of our patients can drive comfortably 4 days
after epi-LASIK laser vision correction. All patients can drive
at one week after epi-LASIK laser vision correction with 20/40 vision being the
legal driving limit. The uncorrected vision at one month
post-operatively is 88% at 20/20 or better. About
42% see 20/16 or better at one month. This study is based upon 1,000 eyes
that underwent epi-LASIK surgery, presented at the American Academy of
Ophthalmology in Las Vegas in 2006.

Back to the question.
Back to the top.
- Question:
What are the chances of me seeing better than I currently do with glasses or contacts after surgery?
Answer: 98% of our patients report seeing better than they ever have with
a pair of glasses or contact lenses. They also report seeing better than their
friends who have had laser vision correction. This vision is called high
performance vision and is achieved with the Allegretto Wave Laser.
Back to the question.
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- Question:
What percentage of your patients see 20/20 after surgery?
Answer: The FDA statistics are listed under the
Allegretto Wave outcome
sheet. Back to the question.
Back to the top.
- Question:
If I have glare with glasses or contact lenses, how will it be after surgery?
Answer: Most patient notice a reduction in glare
after wave front
optimized ablation with the Allegretto Laser! It may take 1 to 3 months for
healing to take place. Back to the question.
Back to the top.
- Question:
How many vision correction procedures has Dr. Shealy performed?
Answer:
We have performed over 20,000 laser vision correction procedures
and 5,000 to 6,000 refractive procedures related to keratomileusis or
incisional keratotomy. Back to the
question. Back to the top.
- Question: Can I drive the day after surgery?
Answer: Most of our patients drive the day after surgery to our office.
Some patients may feel uncomfortable with driving to the first visit
post-operatively. Patients usually can drive pretty well during the day
following surgery, the last thing to improve is vision for night
driving. Back to the question.
Back to the top.
- Question: Can I play sports after surgery?
Answer: We encourage people who play contact sports to have AST,
since there is no flap or cap to dislodge. This is also true for police
officers and those in the armed services. You will be able to play sports after surgery, but should wear
protective goggles for racquetball and certain projectile sports activities.
Back to the question.
Back to the top.
- Question: If I need glasses after surgery, is that included in the surgery fee?
Answer: No. Back to the
question. Back to the top.
- Question: When will I be able to start seeing my regular eye doctor?
Answer: You may elect to see your regular eye doctor after Dr. Shealy
releases you. Back to the question.
Back to the top.
- Question: What is the upper limit of laser vision correction?
Answer: The combination of frozen BSS to chill the cornea after surgery,
a tight bandage contact lens, and aggressive pharmaceutical management
has reduced the incidence of pain to the point where 85% of surface
ablation patients have roughly the same comfort level as LASIK patients.
Use of mitomycin-C has removed significant haze as a complication of
surface ablation which is entirely disappeared three months after
surgery. Dr. Shealy
has performed advanced surface treatment on patients in the -12 to -15 diopter range with great success and in his
limited experience, has found these patients achieved 20/20 or better
vision. Back to the question.
Back to the top.
- Question: How does Dr. Shealy treat high myopia?
Answer: Dr. Shealy prefers to threat high myopia with
advanced surface treatment using mitomycin-C. He has treated up to 15
diopters of myopia successfully, but would prefer higher levels of
myopia to be treated by Dr. Rozakis or Dr. Hastus who have been
performing this type of this surgery for last few years.
Back to the question.
Back to the top.
- Question: What is the treatment of choice
for regressed NearVision CK at the Shealy Eye Laser Center?
Answer: A renowned ophthalmologist who has performed many
NearVision CK's has convinced me to allow the patient to fully regress.
The regressed patient needs to be treated on the surface by attempting
an overcorrection of one half to three-quarters of a diopter. This can
cause irregular astigmatism in some patients making their best corrected
vision slightly reduced, but it is my best treatment option at this
time.
Back to the question.
Back to the top.
Physics of the Allegretto Wave Laser 'Frequently Asked Questions':
- Question: Why did the Shealy Eye Laser Center switch
completely to the Allegretto Wave Laser?
Answer: After owning three excimer lasers, we noted that the
Allegretto Wave Laser improved our visual outcomes with nearly 90% of
our patients seeing 20/20 or better. Patients noticed elimination of
glare and haloes due to the maintenance of the natural shape of the eye.
Treatment times became faster and they were more comfortable for the
patients. After switching to surface technology, we noted an increase in
the quality of vision with the elimination of major complications unique
to laser or mechanical-assisted flap LASIK procedures. Visual recovery
times were improved beyond PRK with or without alcohol debridement.
Patients preferred not to participate in any studies comparing PRK to
Surface Epi-Laser according to Canadian ophthalmology experts who had
more experience with laser and surface laser technology.
Back to the question.
Back to the top.
- Question: How does higher order aberrations
with Advanced Surface Treatment compare with LASIK?
Answer: Higher order aberrations are less at 3 months with LASIK
than with Epi-LASIK.
Back to the question.
Back to the top.
- Question: What are the characteristics of the Allegretto Wave
Laser and how does it produce high performance vision?
Answer: The Allegretto Wave Laser represents flying spot, the
latest advance in small beam laser technology. The energy level can be
measured at three points within the laser beam path due to it's small
spot size. Each spot is half overlapped nine treatment pulses later.
This is necessary to provide a clean path for each overlapped ablation
spot without interference of the plume emanating from the first pulse.
The pattern of pulse placement has a repetition rate of 200 to 400 Hz so
that tracking pattern is changed 6,000 times each second, thus providing
a very smooth ablation profile resulting in a crisper, less scattered
focal point.
Back to the question.
Back to the top.
- Question: How does the Allegretto Wave Laser compare to other
larger beam lasers?
Answer: The Allegretto Wave Laser ablation is applied in a manner
to maintain the original curvature of the cornea. The resulting shape
factor value, known as the Q factor, results in a -0.41 to -0.61 value.
This provides the purest prolate ellipsoid focus for reducing abberated
vision.
Back to the question.
Back to the top.
- Question: Why can't larger beam laser produce the same
quality of vision as the Allegretto Wave Laser?
Answer: Larger beam lasers remove larger amounts of tissue within
a fixed time period. The ablations must be delivered at lower repetition
rates. The effect of lower repetition rates and larger beams results in
more corneal dehydration and swelling between pulse placement which is
more delayed resulting a less smoother ablation with more crater and
ridge formation. The beams tend to be less homogeneous with hot and cold
areas adding to the focus scatter. The peripheral ablations result in
more spherical aberration and coma causing night glare and haloes and
reduced quality of vision as the pupil changes in size.
Back to the question.
Back to the top.
Am I a candidate
for laser vision correction surgery?
With today's fast-paced active lifestyles, the need for unimpaired vision
becomes more and more obvious and the hope for freedom from glasses and
contact lenses is what makes many people consider laser vision correction.
Most people have friends or family members that underwent a laser vision
correction procedure.
Patients who request refractive surgery want
to be less dependent on their glasses or contact lenses. Many patients enjoy
sports such as swimming, boating, hiking, and water-skiing. Some elect to have
surgery to enable them to become pilots or policemen. Many patients feel
visually and socially limited in their every day life activities. Occasionally a
patient may have one myopic or hyperopic eye making his or her vision
unbalanced. Patients may develop myopia or astigmatism after an unrelated
eye surgery, such as cataract surgery; which can be corrected with vision
correction surgery at the time of the surgery or afterwards.
Patients should have a
prescription that has been stable for approximately 12 months. Therefore,
patients as a rule should be
18 years of age or older. There is no upper age limit. Patients with lower or
moderate degrees of myopia will have the most immediate and best results most of
the time. Most will have near normal uncorrected vision. Patients with very high
degrees of myopia can have the procedure done, but may require enhancement
surgery following the initial procedure to further refine distant or
monovision
reading goals. Patients with less that eight diopters of myopia usually select
bilateral surgery; while those with higher levels may elect surgery at three to
seven days apart. During that time period they may be fitted with glasses or
soft extended contact lens. Patients must have healthy corneas. Keratoconous or
central thinning of the cornea is a contraindication. Hyperopic corrections may
be reduced or eliminated by using laser ablations that steepen the internal
layers of the cornea.
However, there are certain
people who are less than ideal candidates for laser vision correction. In
general, you are not a good LASIK candidate if one or more of the following
conditions apply to you:
-
Your age is under 21; in
this case your growth phase has not been fully completed which means that
your eyes can still change.
-
You are pregnant or
nursing; pregnancy causes changes to your hormone system which can cause
your vision to change.
-
Glaucoma or high blood
pressure
-
Keratoconus, a corneal
irregularity
-
Inflammation of the eye;
uveitis, blepharitis or iritis
-
Herpes simplex that has
infected your eye
-
Previous severe injuries
on the eye
-
Corneal scars or
infections
-
Certain
medications
-
Unstable refraction
-
Other diseases of the eye
such as AMD, diabetic retinopathy, cataract or others
If any of the indications
listed above apply to you, make sure you consult with Dr. Shealy prior to
considering LASIK. During the consultation with Dr. Shealy, please be sure
to mention all medications you are taking and any medical conditions you
have that might affect the success of the laser correction.
LASIK is also not
recommended for patients with:
If any of these apply, the
right technology or surgery technique may be able to still provide you with
a satisfying treatment. These patients are encouraged to speak with Dr.
Shealy to find the best vision correction option.
Additionally, an in-depth examination of
your eyes, your individual case, your expectations, and your lifestyle will
help us better determine if you are a candidate.
Back to the question.
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I still have a question.
If you can't find the answers you're looking for on our FAQ page or you
have specific concerns about laser vision correction, fill in the following
form and Dr. Shealy or a staff member will get back to you as soon as
possible.
Call for a
FREE consultation! 260-486-0065 or toll free 1-800-644-6393!
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