Q: Am I a candidate for laser correction?

A: Candidacy us best determined based on the results from your preoperative evaluation with your optometrist, the pre-testing at Horizon and the recommendations of the Horizon optometrist and surgeon. It is important to understand that not everyone is a suitable candidate. Some basic requirements include a stable eyeglass prescription, best corrected vision of at least 20/40, healthy cornea, with no active eye disease and a minimum age of 18 years old.


Q: What is laser vision correction?

A: It is a surgical procedure that uses a laser beam of light to gently reshape the front surface of the eye. The laser removes very small bits of tissue to flatten the cornea (to correct nearsightedness), steepen the cornea (to correct farsightedness) and/or smooth out corneal irregularities (to correct astigmatism). The reshaped cornea can focus images onto the retina for sharper vision. LASIK and PRK are two types of laser vision correction.


Q: What is the difference between LASIK and PRK?

A: LASIK involves creating a thin flap of corneal tissue, which is reflected and then a laser is used to shape the eye. In PRK surgery, there is no flap creation.


Q: How long has laser eye surgery been performed?

A: The first refractive surgery, radial keratotomy, was performed in 1963. PRK first was performed in 1987. LASIK was developed in 1991. Horizon has been performing refractive surgery procedures since 1996.


Q: Am I too old for refractive surgery?

A: Although there’s no real “maximum age” for laser vision correction, we would first need to determine that the overall health of your eyes is good, and that your vision problems are not being caused by eye disease.


Q: Will I need reading glasses after refractive surgery?

A: Depending on your age, you may need reading glasses after treatment. Nearly everyone will require reading glasses by their mid-40’s. This is known as presbyopia. Presbyopia is a natural change of the lens inside the eye. If you are wearing bifocals or readings glasses now, you will still need reading glasses after treatment. One treatment option with refractive surgery is known as monovision. In a monovision treatment, the patient’s dominant eye is corrected for distance with their non-dominant eye being left slightly nearsighted for close vision. You may still need reading glasses following monovision. KAMRA VisionTM is another alternative for presbyopia. This treatment would involve the placement of a small inlay into the cornea of the non-dominant eye. The inlay focuses the light and provides that eye improved near vision.


Q: How safe is refractive surgery?

A: The FDA has approved LASIK as a safe and effective procedure. iLASIK - powered by iDesign is approved by NASA for their astronauts and military pilots. It is important, however, to remember that refractive surgery is not the right choice for everybody.


Q: Does refractive surgery hurt?

A: You will be given anesthetic drops to completely numb the front surface of your eye. You may feel a pressure sensation around your eye during the creation of the flap during iLASIK. After the procedure is finished, you will feel a gritty sensation for a few hours (iLASIK) to a couple of days (PRK) but most people experience very little pain. You will be supplied with a pain medication to take following the procedure.


Q: How does refractive surgery correct astigmatism?

A: Astigmatism is corrected by using a laser to reshape the cornea in such a way that the light entering the eye and reflected on the retina is focused.


Q: Can I have both eyes done at the same time?

A: Most surgeons perform the refractive surgery procedure on both eyes during the same appointment.


Q: How long does it take?

A: The actual procedure takes about 10 minutes per eye. Depending on your prescription, and the amount of correction needed, the laser itself only takes 20-50 seconds to correct your vision.


Q: What if I blink or move during the procedure?

A: Your eye will be held open with an instrument so you can’t blink. It is placed immediately before the treatment and removed immediately afterward. During the treatment itself, the surgeon turns on a focusing mechanism to assure that treatment is precisely centered. Your job is to watch a blinking target light. The laser’s computer will also be using its tracking system to monitor the position of your eye. The eye tracker adjusts the laser treatment to follow the tiny movements your eyes make.


Q: What if I’m very nervous during the treatment?

A: You will be offered an anti-anxiety medication that is taken orally and this will help reduce apprehension. The surgeon will talk you through the surgery, so there will be no surprises.


Q: How will I see after the surgery?

A: When you stand up after the procedure, things will be blurry – like you are looking through a fog. This blurriness should settle overnight. The vast majority of our LASIK patients achieve legal driving vision or better, the very next day. Visual recovery varies. You can resume normal activities one to two days following surgery but it may take 1 to 2 months for your vision to fully stabilize. Initially, your vision might not be crisp and may fluctuate slightly. This is perfectly normal.


Q: When will I be able to drive?

A: On the day of your surgery it is important to have a driver take you home. You will also need a driver to bring you to your first post-operative appointment. We recommend that you avoid driving or using hazardous equipment until you feel comfortable enough to drive safely.


Q: Can I go back to work right away?

A: Most people who have LASIK return to work in four days. PRK patients are advised to take one week off of work.


Q: When may I go back to wearing makeup?

A: You may resume wearing makeup about 10 days after your surgery. Throw out your old mascara and buy new to decrease your risk of infection.


Q: Are there any side effects?

A: Some people experience dry eye, which is typically relieved with eye drops and disappears over time. Others may experience starbursts or halos around lights, especially at night. Usually this effect will lessen or disappear over time. In a small number of people (less than 1 percent), their vision worsens rather than improves.


Q: Will I have dry eyes after surgery?

A: You may experience dry eyes after surgery, which generally disappears over time. However, if dry eyes are persistent you may require long term use of tear drops or other forms of treatment.


Q: What are the possible complications?

A: There has never been a reported patient experience of severe vision loss as a result of refractive surgery. The procedure itself is safe. The excimer laser is computer controlled, pre-programmed with your treatment data and activated by the surgeon. There is a remote possibility of the vision loss due to infection or inflammation – we use sterile techniques in the surgery suite and will instruct you in the use of antibiotic and anti-inflammatory drops required after the procedure. Refractive surgery does have its risks and are further explained in the Informed consent you will sign prior to surgery. These include: Under or over correction, corneal flap healing problems, pain or discomfort, dry eye, hazy vision, sensitivity to light, glare at night, loss of best corrected visual acuity, or infection.

The majority of patients have a trouble-free experience. The doctors will be happy to discuss any concerns that you may have.


Q: Will my night time driving be affected?

A: Some patients may experience problems with driving at night, such as starbursts or haloes around lights in the initial months after surgery. However, with the advanced technology used today, these issues are minimal and will subside over time as the eyes heal. Rarely, night vision disturbances are permanent.


Q: How long will it last?

A: In most cases, laser vision correction is permanent, especially if your eyeglass prescription was stable before treatment. Normal age-related vision changes will still occur after treatments. There may be the possibility of retreatment, should that occur.


Q: How often will I see the doctor following my surgery?

A: Your post-operative appointments will be scheduled: at One-Day with your surgeon or the HLVC optometrist. You will see your own optometrist for post-op visits at one week, as well as at one, three, six and twelve months – or more if you should require closer follow-up.


Q: What about contact lens wear?

A: Because contact lenses can alter the shape of your cornea, you will need to remove your contacts prior to your pre-operative assessment at Horizon. If you wear soft lenses, they should be removed a minimum of two weeks. If you wear rigid/gas permeable lenses, at least 4-6 weeks of discontinuation is needed prior to your assessment. The cornea needs to return to it’s natural shape before measurements are taken. Following your pre-operative assessment, you may be able to return to occasional contact lens wear before your surgery.


Q: How much does refractive surgery cost?

A: For details on pricing, please call Horizon to speak with our patient consultants.


Q: Do you offer financing?

A: We offer options from several companies to help you finance this investment. Medicard or the Royal Bank of Canada can be contacted for more information.


Q: What is the percent of patients that need enhancements?

A: About 5% of our patients will benefit from an enhancement treatment, which is performed at no charge up to 24 months following your original treatment. The likelihood of needing an enhancement is dependent on the degree of refractive error. High myopes, hyperopes or those with high astigmatism are more likely to need a second treatment.


Q: When can I take a flight after surgery?

A: It is recommended you avoid flying for one week after surgery.


Q: Do I have to avoid all activities post-operatively?

A: You will need to rest on the day of surgery. You will be light-sensitive and may require pain medication. You can return to your normal activities as soon as you feel comfortable.


Q. What is XTRA or cross-linking?

A. Cross-linking is a medical procedure that combines the use of ultra-violet light and riboflavin eye drops to add biomechanical strength to the cornea; Xtra is cross-linking performed in conjunction with LASIK or PRK.


Q. Are there any safety concerns regarding the use of ultra-violet light or riboflavin in the eye?

A. The ultraviolet-A light exposure during the Xtra procedure is comparable to the exposure of the eye to sunlight for one full day outdoors. Riboflavin, also known as Vitamin B2, is naturally occurring in the body. It is a photosensitizer that has been safely used in corneal cross-linking procedures for over a decade. Riboflavin is non-toxic and it is used as an additive in food and pharmaceuticals.


Q. How does Xtra work?

A. After completion of a standard refractive procedure, a few drops of riboflavin are applied to the cornea, allowed to soak in and then the eye is exposed to ultraviolet-A light. The light activates the riboflavin, which leads to the formation of chemical bonds between collagen molecules, strengthening the cornea.


Q. Are there any age limits for Xtra?

A. Patients that are good candidates for refractive surgery are generally eligible for Xtra. The doctors at Horizon will determine if Xtra is needed.


Q. Will the addition of Xtra to my procedure affect my recovery or visual outcome in any way?

A. You should expect no change in your recovery or visual outcome as a result of Xtra.


Q. Is Xtra the same as the corneal cross-linking used for conditions like keratoconus?

A. Generally yes, although longer soak times, and longer exposure to the UVA light are used to treat keratoconus.


Q. Are there any restrictions as to what I can do after Xtra?

A. The only limitations are those your doctor recommends following refractive surgery.


Q. Can anyone tell by my appearance that I have had Xtra?

A. No. An eye treated with Xtra cannot be differentiated from the normal appearance of an eye treated with Lasik or PRK only.