Before After
Sunma Hayec
Before After
Kate Winslet
Jenifer Anistion
Before AfterCameron-diaz
Ashley Tisdaley
Before After2008/06/27
2008/06/25
Nose Surgery (Cont.)
The results will be long-lasting
It may take several months for swelling to fully dissipate and up to a year - and sometimes longer - for the outcome of the surgery to fully refine.
Although the results of nose surgery are usually permanent, cartilage may continue to reshape and move tissue that may change the outcome over time.
How much will nose surgery cost?
Cost is always a consideration in elective surgery. Prices for nose surgeries can vary widely. A surgeon’s cost may vary based on his or her experience as well as geographic office location.
Many plastic surgeons offer patient financing plans, so be sure to ask.
Cost may include:
- Surgeon’s fee
- Hospital or surgical facility costs
- Anesthesia fees
- Prescriptions for medication
- Medical tests
Your satisfaction involves more than a fee
When choosing a plastic surgeon for nose surgery, remember that the surgeon’s experience and your comfort with him or her are just as important as the final cost of the surgery.
It may take several months for swelling to fully dissipate and up to a year - and sometimes longer - for the outcome of the surgery to fully refine.
Although the results of nose surgery are usually permanent, cartilage may continue to reshape and move tissue that may change the outcome over time.
How much will nose surgery cost?
Cost is always a consideration in elective surgery. Prices for nose surgeries can vary widely. A surgeon’s cost may vary based on his or her experience as well as geographic office location.
Many plastic surgeons offer patient financing plans, so be sure to ask.
Cost may include:
- Surgeon’s fee
- Hospital or surgical facility costs
- Anesthesia fees
- Prescriptions for medication
- Medical tests
Your satisfaction involves more than a fee
When choosing a plastic surgeon for nose surgery, remember that the surgeon’s experience and your comfort with him or her are just as important as the final cost of the surgery.
Nose Surgery (Cont.)
When you go home
If you experience shortness of breath, chest pains, or unusual heart beats, seek medical attention immediately. Should any of these complications occur, you may require hospitalization and additional treatment.
The practice of medicine and surgery is not an exact science. Although good results are expected, there is no guarantee. In some situations, it may not be possible to achieve optimal results with a single surgical procedure. Another minor surgery may be necessary to reach the intended aesthetic goal.
Be care
Following your physician’s instructions is key to the success of your surgery. It is important that the surgical incisions are not subjected to excessive force, abrasion, or motion during the time of healing. Your doctor will give you specific instructions on how to care for yourself
My recovery
After your procedure is completed, a splint, internal tubes or packing will likely be placed inside your nose and a splint or bandages placed on the outside to support and protect the new structures during initial healing.
Be sure to ask your plastic surgeon specific questions about what you can expect during your individual recovery period.
- Where will I be taken after my surgery is complete?
- What medication will I be given or prescribed after surgery?
- Will I have dressings/bandages after surgery?When will they be removed
- Are stitches removed? When?
- When can I resume normal activity and exercise?
- When do I return for follow-up care?
The results will be long-lasting
It may take several months for swelling to fully dissipate and up to a year - and sometimes longer - for the outcome of the surgery to fully refine.
· Although the results of nose surgery are usually permanent, cartilage may continue to reshape and move tissue that may change the outcome over time.
If you experience shortness of breath, chest pains, or unusual heart beats, seek medical attention immediately. Should any of these complications occur, you may require hospitalization and additional treatment.
The practice of medicine and surgery is not an exact science. Although good results are expected, there is no guarantee. In some situations, it may not be possible to achieve optimal results with a single surgical procedure. Another minor surgery may be necessary to reach the intended aesthetic goal.
Be care
Following your physician’s instructions is key to the success of your surgery. It is important that the surgical incisions are not subjected to excessive force, abrasion, or motion during the time of healing. Your doctor will give you specific instructions on how to care for yourself
My recovery
After your procedure is completed, a splint, internal tubes or packing will likely be placed inside your nose and a splint or bandages placed on the outside to support and protect the new structures during initial healing.
Be sure to ask your plastic surgeon specific questions about what you can expect during your individual recovery period.
- Where will I be taken after my surgery is complete?
- What medication will I be given or prescribed after surgery?
- Will I have dressings/bandages after surgery?When will they be removed
- Are stitches removed? When?
- When can I resume normal activity and exercise?
- When do I return for follow-up care?
The results will be long-lasting
It may take several months for swelling to fully dissipate and up to a year - and sometimes longer - for the outcome of the surgery to fully refine.
· Although the results of nose surgery are usually permanent, cartilage may continue to reshape and move tissue that may change the outcome over time.
Nose Surgery (Cont.)
Important facts about the safety and risks of nose surgery
The decision to have nose surgery is extremely personal and you’ll have to decide if the benefits will fulfill your goals and if the risks and potential complications are acceptable.
Your plastic surgeon and/or staff will explain in detail the risks associated with surgery. You will be asked to sign consent forms to ensure that you fully understand the procedure you will undergo and any risks or potential complications.
The risks include:
- Rupture of small surface vessels of the nose
- Infection
- Poor wound healing
- Anesthesia risks
- Bleeding (hematoma)
- Nose asymmetry
- Cardiac and pulmonary complications can occur in longer surgical procedures and may be associated with the formation of, or increase in, blood clots in the venous system
- Change in skin sensation (numbness)
- Nasal airway alterations may occur after a rhinoplasty or septoplasty that may interfere with normal passage of air through the nose
- Nasal septal perforation (a hole in the nasal septum) may develop but is rare; additional surgical treatment may be necessary to repair the nasal septum but in some cases, it may be impossible to correct this complication
- Pain, which may persist
- Unfavorable scarring
- Skin contour irregularities
- Skin discoloration and swelling
- Sutures may spontaneously surface through the skin, become visible or produce irritation that require removal
- Possibility of revisional surgery
The decision to have nose surgery is extremely personal and you’ll have to decide if the benefits will fulfill your goals and if the risks and potential complications are acceptable.
Your plastic surgeon and/or staff will explain in detail the risks associated with surgery. You will be asked to sign consent forms to ensure that you fully understand the procedure you will undergo and any risks or potential complications.
The risks include:
- Rupture of small surface vessels of the nose
- Infection
- Poor wound healing
- Anesthesia risks
- Bleeding (hematoma)
- Nose asymmetry
- Cardiac and pulmonary complications can occur in longer surgical procedures and may be associated with the formation of, or increase in, blood clots in the venous system
- Change in skin sensation (numbness)
- Nasal airway alterations may occur after a rhinoplasty or septoplasty that may interfere with normal passage of air through the nose
- Nasal septal perforation (a hole in the nasal septum) may develop but is rare; additional surgical treatment may be necessary to repair the nasal septum but in some cases, it may be impossible to correct this complication
- Pain, which may persist
- Unfavorable scarring
- Skin contour irregularities
- Skin discoloration and swelling
- Sutures may spontaneously surface through the skin, become visible or produce irritation that require removal
- Possibility of revisional surgery
Nose Surgery (Cont.)
Procedural Steps:
What happens during nose surgery?
Step 1 – Anesthesia
Medications are administered for your comfort during the surgical procedure. The choices include intravenous sedation or general anesthesia. Your doctor will recommend the best choice for you.
Step 2 – The incision
Surgery of the nose is performed either using a closed procedure, where incisions are hidden inside the nose, or an open procedure, where an incision is made across the columella, the narrow strip of tissue that separates the nostrils.
Through these incisions, the soft tissues that cover the nose are gently raised, allowing access to reshape the structure of the nose.
Step 3 – Reshaping the nose structure
Surgery of the nose can reduce or augment nasal structures with the use of cartilage grafted from other areas of your body.
Most commonly, pieces of cartilage from the septum, the partition in the middle of the nose, is used for this purpose.
Occasionally a piece of cartilage from the ear and rarely a section of rib cartilage can be used.
Step 4 – Correcting a deviated septum
If the septum is deviated, it is now straightened and the projections inside the nose are reduced to improve breathing.
Step 5 – Closing the incision
Once the underlying structure of the nose is sculpted to the desired shape, nasal skin and tissue is redraped and incisions are closed. Additional incisions may be placed in the natural creases of the nostrils to alter their size.
Step 6 – See the results
Splints and internal tubes will likely support the nose as it begins to heal for approximately one week.
While initial swelling subsides within a few weeks, it may take up to a year for your new nasal contour to fully refine.
During this time you may notice gradual changes in the appearance of your nose as it refines to a more permanent outcome. Swelling may come and go and worsen in the morning during the first year following your nose surgery.
What happens during nose surgery?
Step 1 – Anesthesia
Medications are administered for your comfort during the surgical procedure. The choices include intravenous sedation or general anesthesia. Your doctor will recommend the best choice for you.
Step 2 – The incision
Surgery of the nose is performed either using a closed procedure, where incisions are hidden inside the nose, or an open procedure, where an incision is made across the columella, the narrow strip of tissue that separates the nostrils.
Through these incisions, the soft tissues that cover the nose are gently raised, allowing access to reshape the structure of the nose.
Step 3 – Reshaping the nose structure
Surgery of the nose can reduce or augment nasal structures with the use of cartilage grafted from other areas of your body.
Most commonly, pieces of cartilage from the septum, the partition in the middle of the nose, is used for this purpose.
Occasionally a piece of cartilage from the ear and rarely a section of rib cartilage can be used.
Step 4 – Correcting a deviated septum
If the septum is deviated, it is now straightened and the projections inside the nose are reduced to improve breathing.
Step 5 – Closing the incision
Once the underlying structure of the nose is sculpted to the desired shape, nasal skin and tissue is redraped and incisions are closed. Additional incisions may be placed in the natural creases of the nostrils to alter their size.
Step 6 – See the results
Splints and internal tubes will likely support the nose as it begins to heal for approximately one week.
While initial swelling subsides within a few weeks, it may take up to a year for your new nasal contour to fully refine.
During this time you may notice gradual changes in the appearance of your nose as it refines to a more permanent outcome. Swelling may come and go and worsen in the morning during the first year following your nose surgery.
Nose Surgery (Cont.)
What to expect during your consultation
The success and safety of your nose surgery depends very much on your complete candidness during your consultation. You’ll be asked a number of questions about your health, desires and lifestyle.
Be prepared to discuss:
- Why you want the surgery, your expectations and desired outcome
- Medical conditions, drug allergies and previous medical treatments
- Use of current medications, vitamins, herbal supplements, alcohol, tobacco and drugs
- Previous surgeries
Your surgeon may also:
- Evaluate your general health status and any pre-existing health conditions or risk factors
- Examine and measure your face
- Take photographs for your medical record
- Discuss your options and recommend a course of reshaping your nose
- Discuss likely outcomes of a nose surgery and any risks or potential complications
- Discuss the type of anesthesia that will be used
Preparing for surgery
Prior to surgery, you may be asked to:
- Get lab testing or a medical evaluation
- Take certain medications or adjust your current medications
- Stop smoking well in advance of surgery
- Avoid taking aspirin, anti-inflammatory drugs and herbal supplements as they can increase bleeding
Special instructions you receive will cover:
- What to do on the night before and the morning of surgery
- The use of anesthesia during your nose surgery
- Post-operative care and follow-up
Your plastic surgeon will also discuss where your procedure will be performed. Surgery of the nose may be performed in an accredited office-based surgical center, outpatient or ambulatory surgical center, or a hospital.
The success and safety of your nose surgery depends very much on your complete candidness during your consultation. You’ll be asked a number of questions about your health, desires and lifestyle.
Be prepared to discuss:
- Why you want the surgery, your expectations and desired outcome
- Medical conditions, drug allergies and previous medical treatments
- Use of current medications, vitamins, herbal supplements, alcohol, tobacco and drugs
- Previous surgeries
Your surgeon may also:
- Evaluate your general health status and any pre-existing health conditions or risk factors
- Examine and measure your face
- Take photographs for your medical record
- Discuss your options and recommend a course of reshaping your nose
- Discuss likely outcomes of a nose surgery and any risks or potential complications
- Discuss the type of anesthesia that will be used
Preparing for surgery
Prior to surgery, you may be asked to:
- Get lab testing or a medical evaluation
- Take certain medications or adjust your current medications
- Stop smoking well in advance of surgery
- Avoid taking aspirin, anti-inflammatory drugs and herbal supplements as they can increase bleeding
Special instructions you receive will cover:
- What to do on the night before and the morning of surgery
- The use of anesthesia during your nose surgery
- Post-operative care and follow-up
Your plastic surgeon will also discuss where your procedure will be performed. Surgery of the nose may be performed in an accredited office-based surgical center, outpatient or ambulatory surgical center, or a hospital.
Nose Surgery
Nose Surgery Also known as rhinoplasty, nose surgery improves the appearance and proportion of your nose, enhancing facial harmony and self confidence. Surgery of the nose may also correct impaired breathing caused by structural abnormalities in the nose.
The first step:
Choose a surgeon you can trust
Plastic surgery involves many choices. The first and most important is selecting a surgeon you can trust.
Beauty for life: 
Enhancing your appearance with nose surgery
While the shape of your nose is usually the result of heredity, the appearance may have been altered in an injury or during prior surgery.
Also known as rhinoplasty, surgery of the nose improves the appearance and proportion of your nose, enhancing facial harmony and self confidence.
Surgery of the nose may also correct impaired breathing caused by structural abnormalities in the nose.
What can surgery of the nose accomplish?
Rhinoplasty can change:
- Nose size, in relation to the other facial structures
- Nose width, at the bridge
- Nose profile, with visible humps or depressions on the bridge
- Nasal tip, that is large or bulbous, drooping, or too upturned
- Nostrils that are large, wide or upturned
- Nasal asymmetry and deviation
Is it right for me?
Nose surgery is a highly individualized procedure and you should do it for yourself, not to fulfill someone else’s desires or to try to fit any sort of ideal image. Surgery of the nose is a good option for you if:
- Your facial growth is complete and you are 13 years of age or older
- You are physically healthy
- You stop smoking
- You have specific, but realistic goals in mind for the improvement of your appearance
2008/06/21
LASIK Eye Surgery (cont.)
What are the advantages of LASIK surgery?
In summary, despite the risks outlined above, LASIK has been proven to be safe and effective for most people. With careful patient screening and selection, reasonable expectations, and in the care of an experienced surgeon, most patients will be very pleased with their results. These are some of the other advantages of LASIK:
1. is able to accurately correct most levels of myopia (nearsightedness), hyperopia (farsightedness), and astigmatism.
2. The procedure is fast, usually lasting only five to 10 minutes, and is generally painless.
3. Because the laser is guided by a computer, it is very precise and results are very accurate.
4. most cases, a single treatment will achieve the desired outcome; however, enhancements are possible if needed, even many years after the initial surgery.
In summary, despite the risks outlined above, LASIK has been proven to be safe and effective for most people. With careful patient screening and selection, reasonable expectations, and in the care of an experienced surgeon, most patients will be very pleased with their results. These are some of the other advantages of LASIK:
1. is able to accurately correct most levels of myopia (nearsightedness), hyperopia (farsightedness), and astigmatism.
2. The procedure is fast, usually lasting only five to 10 minutes, and is generally painless.
3. Because the laser is guided by a computer, it is very precise and results are very accurate.
4. most cases, a single treatment will achieve the desired outcome; however, enhancements are possible if needed, even many years after the initial surgery.
What are the disadvantages of LASIK surgery?
Because each patient will heal slightly differently, results may vary from patient to patient.
LASIK could make some aspects of your vision worse, including night vision with glare and halos.
LASIK may make dry-eye symptoms worse in certain individuals.
In rare circumstances, LASIK can make your vision worse and not correctable with regular glasses or contact lenses.
LASIK Eye Surgery (cont.)
What are the risks of LASIK? 
LASIK has been shown to be a very effective procedure, and most patients are very happy with their vision following the procedure. However, like any surgical procedure, LASIK does come with some risks. In order for you to decide whether LASIK surgery is right for you, you need to be aware of potential risks and complications and weigh these carefully before proceeding with surgery.
1. You may be over-corrected or under-corrected. Most patients are satisfied with their vision after a single treatment, but in some cases, you may not achieve quality vision initially and need a second surgery, called an enhancement, to sharpen your vision. Patients with more extreme prescriptions are at higher risk for needing an enhancement. This enhancement cannot be performed for many months after your initial surgery to allow for your eyes to heal appropriately from the first surgery and for your eyeglass prescription to stabilize. In some rare cases, you may not be able to have an enhancement if your corneas are too thin or abnormally shaped after surgery.
2. You may still need glasses or contact lenses after surgery to achieve your best vision. This is extremely rare for the average person; however, it is something you should discuss with your surgeon. In addition, if both of your eyes are corrected for good distance vision, you will still need glasses for close work when presbyopia develops as a part of normal aging process.
3. Your results may not be permanent. Although uncommon, some patients do experience a regression of their desired treatment effect many years after the surgery. This is more common in patients with hyperopia, or farsightedness. Those who need reading glasses are especially prone to having changes in their vision after LASIK surgery. If regression does occur, it may be possible for you to have an additional surgery many years after your initial LASIK.
4. You may experience visual aberrations, especially in low light. Visual effects that can occur with LASIK and decrease visual quality include: anisometropia (difference in refractive power between the two eyes), aniseikonia (difference in image size between the two eyes), double vision, hazy vision, fluctuating vision during the day and from day to day, increased sensitivity to light, glare, shadows, and seeing halos around lights. These visual aberrations are extremely unusual; however, they may be incapacitating for some time and may not ever go away completely.
5. Dry eye symptoms may persist or get worse. Most people experience some dry-eye symptoms immediately after surgery. In some cases, people may develop worsening of dry-eye symptoms, such as burning and redness, or even decreased vision, after surgery. This condition is occasionally permanent and may require medication to improve tear production or punctal plugs, which temporarily close off the drainage system for tears.
6. You may lose vision. Rarely, LASIK may result in worse vision that cannot be corrected with glasses or contact lenses. This could result from flap-related complications, equipment malfunction, infection, scarring, or extreme changes in corneal shape postoperatively.
LASIK has been shown to be a very effective procedure, and most patients are very happy with their vision following the procedure. However, like any surgical procedure, LASIK does come with some risks. In order for you to decide whether LASIK surgery is right for you, you need to be aware of potential risks and complications and weigh these carefully before proceeding with surgery.
1. You may be over-corrected or under-corrected. Most patients are satisfied with their vision after a single treatment, but in some cases, you may not achieve quality vision initially and need a second surgery, called an enhancement, to sharpen your vision. Patients with more extreme prescriptions are at higher risk for needing an enhancement. This enhancement cannot be performed for many months after your initial surgery to allow for your eyes to heal appropriately from the first surgery and for your eyeglass prescription to stabilize. In some rare cases, you may not be able to have an enhancement if your corneas are too thin or abnormally shaped after surgery.
2. You may still need glasses or contact lenses after surgery to achieve your best vision. This is extremely rare for the average person; however, it is something you should discuss with your surgeon. In addition, if both of your eyes are corrected for good distance vision, you will still need glasses for close work when presbyopia develops as a part of normal aging process.
3. Your results may not be permanent. Although uncommon, some patients do experience a regression of their desired treatment effect many years after the surgery. This is more common in patients with hyperopia, or farsightedness. Those who need reading glasses are especially prone to having changes in their vision after LASIK surgery. If regression does occur, it may be possible for you to have an additional surgery many years after your initial LASIK.
4. You may experience visual aberrations, especially in low light. Visual effects that can occur with LASIK and decrease visual quality include: anisometropia (difference in refractive power between the two eyes), aniseikonia (difference in image size between the two eyes), double vision, hazy vision, fluctuating vision during the day and from day to day, increased sensitivity to light, glare, shadows, and seeing halos around lights. These visual aberrations are extremely unusual; however, they may be incapacitating for some time and may not ever go away completely.
5. Dry eye symptoms may persist or get worse. Most people experience some dry-eye symptoms immediately after surgery. In some cases, people may develop worsening of dry-eye symptoms, such as burning and redness, or even decreased vision, after surgery. This condition is occasionally permanent and may require medication to improve tear production or punctal plugs, which temporarily close off the drainage system for tears.
6. You may lose vision. Rarely, LASIK may result in worse vision that cannot be corrected with glasses or contact lenses. This could result from flap-related complications, equipment malfunction, infection, scarring, or extreme changes in corneal shape postoperatively.
LASIK Eye Surgery (cont.)
What is my doctor looking for during my evaluation?
Your eye doctor should look for risk factors prior to surgery that may make you a less than ideal candidate for surgery and discuss any abnormal findings with you at length. The following are considered to be risk factors for refractive surgery.
1. High prescriptions: Patients with extreme eyeglass prescriptions (high myopia or high hyperopia) may not be good candidates for LASIK because too much corneal tissue would need to be removed to safely perform the procedure.
2. Thin corneas: Because all excimer laser surgery (LASIK and surface ablation) requires the removal of small amounts of corneal tissue to correct your refractive error, the thickness of your corneas must be measured before surgery. Patients who have very thin corneas are at risk for excessive corneal weakening after surgery and may not be good candidates for LASIK. In these cases, surface ablation or other procedures may be more appropriate.
3. Abnormal corneal curvature: There are many devices used today to measure the overall shape and curvature of your cornea. These devices are called topographers and are an essential part of your initial evaluation. Abnormalities in the shape and curvature of your cornea may indicate that your cornea is weaker than that of the average person, and this will exclude you from having LASIK safely.
4. Dry eyes: Patients with dry eye symptoms, such as burning, redness, and tearing may have worse symptoms after LASIK surgery. This occurs because corneal nerves are cut during this procedure, and these nerves are partly responsible for stimulating tear secretion. Most patients have a full return back to their baseline state after surgery; however, patients with significant dry eye before surgery may not be appropriate surgical candidates
5. Large pupils: Although less common today, some patients still notice glare, halos, or other night vision issues after LASIK. Patients with larger pupils may be more prone to noticing these things, so your screening evaluation should include measurement of your pupil size in a dark room.
6. Previous refractive surgery: Prior corneal surgery or other types of refractive surgery, especially radial keratotomy (RK), may complicate additional procedures. You should talk to your eye doctor about this situation in order to make the best decision possible about your ability to be corrected with further surgery.
Your eye doctor should look for risk factors prior to surgery that may make you a less than ideal candidate for surgery and discuss any abnormal findings with you at length. The following are considered to be risk factors for refractive surgery.
1. High prescriptions: Patients with extreme eyeglass prescriptions (high myopia or high hyperopia) may not be good candidates for LASIK because too much corneal tissue would need to be removed to safely perform the procedure.
2. Thin corneas: Because all excimer laser surgery (LASIK and surface ablation) requires the removal of small amounts of corneal tissue to correct your refractive error, the thickness of your corneas must be measured before surgery. Patients who have very thin corneas are at risk for excessive corneal weakening after surgery and may not be good candidates for LASIK. In these cases, surface ablation or other procedures may be more appropriate.
3. Abnormal corneal curvature: There are many devices used today to measure the overall shape and curvature of your cornea. These devices are called topographers and are an essential part of your initial evaluation. Abnormalities in the shape and curvature of your cornea may indicate that your cornea is weaker than that of the average person, and this will exclude you from having LASIK safely.
4. Dry eyes: Patients with dry eye symptoms, such as burning, redness, and tearing may have worse symptoms after LASIK surgery. This occurs because corneal nerves are cut during this procedure, and these nerves are partly responsible for stimulating tear secretion. Most patients have a full return back to their baseline state after surgery; however, patients with significant dry eye before surgery may not be appropriate surgical candidates
5. Large pupils: Although less common today, some patients still notice glare, halos, or other night vision issues after LASIK. Patients with larger pupils may be more prone to noticing these things, so your screening evaluation should include measurement of your pupil size in a dark room.
6. Previous refractive surgery: Prior corneal surgery or other types of refractive surgery, especially radial keratotomy (RK), may complicate additional procedures. You should talk to your eye doctor about this situation in order to make the best decision possible about your ability to be corrected with further surgery.
LASIK Eye Surgery (cont.)
Am I a good candidate for LASIK?
Refractive surgery is not for everyone. In addition to having a complete eye exam to find out if you are a candidate for surgery, there are certain questions you should ask yourself before considering LASIK or other refractive procedures
1. Am I willing to accept a low but real risk of surgical complications? Even though modern LASIK is extremely safe with rare complications, there are still times when unavoidable complications occur that can negatively affect your vision.
2. Does my career allow me to have LASIK? Although there are now very few organizations that prohibit their employees or members to have refractive surgery, if there is any doubt, then it is important to ask your employer, professional society, or military service whether or not it is allowed for you to undergo refractive surgery.
3. Has my vision been stable long enough to have LASIK? While minor changes in your prescription are not uncommon from year to year, if your prescription continues to get progressively stronger (for example, more myopic, more hyperopic, or more astigmatism) each year, then you may not yet be a good candidate for refractive surgery.
4. Do I have any health conditions that make me a poor surgical candidate? Certain advanced autoimmune diseases, such as lupus and rheumatoid arthritis, may influence postoperative healing.
5. Do my recreational activities make me a bad surgical candidate? There is a lifelong risk of LASIK flap dislocation if there is significant trauma to the eye, so people who participate in contact sports such as boxing, martial arts, or wrestling are not likely not be a good candidate for LASIK. In these instances, other refractive procedures, especially surface ablation, may be more appropriate choices.
6. Am I too young or too old to have LASIK? There are no hard and fast rules about the appropriate age to have LASIK. However, patients under age 18 are rarely stable enough for LASIK, and older patients may begin to develop cataracts or other eye health issues that preclude them from undergoing LASIK. Again, the best way to determine these things is have a complete eye exam.
7. Do I have keratoconus? Keratoconus is a corneal disease resulting from decreased corneal strength that can be detected as an abnormal curvature on testing. Patients that have evidence of keratoconus are not candidates for LASIK or surface ablation, but new technologies may become available for these individuals.
Refractive surgery is not for everyone. In addition to having a complete eye exam to find out if you are a candidate for surgery, there are certain questions you should ask yourself before considering LASIK or other refractive procedures
1. Am I willing to accept a low but real risk of surgical complications? Even though modern LASIK is extremely safe with rare complications, there are still times when unavoidable complications occur that can negatively affect your vision.
2. Does my career allow me to have LASIK? Although there are now very few organizations that prohibit their employees or members to have refractive surgery, if there is any doubt, then it is important to ask your employer, professional society, or military service whether or not it is allowed for you to undergo refractive surgery.
3. Has my vision been stable long enough to have LASIK? While minor changes in your prescription are not uncommon from year to year, if your prescription continues to get progressively stronger (for example, more myopic, more hyperopic, or more astigmatism) each year, then you may not yet be a good candidate for refractive surgery.
4. Do I have any health conditions that make me a poor surgical candidate? Certain advanced autoimmune diseases, such as lupus and rheumatoid arthritis, may influence postoperative healing.
5. Do my recreational activities make me a bad surgical candidate? There is a lifelong risk of LASIK flap dislocation if there is significant trauma to the eye, so people who participate in contact sports such as boxing, martial arts, or wrestling are not likely not be a good candidate for LASIK. In these instances, other refractive procedures, especially surface ablation, may be more appropriate choices.
6. Am I too young or too old to have LASIK? There are no hard and fast rules about the appropriate age to have LASIK. However, patients under age 18 are rarely stable enough for LASIK, and older patients may begin to develop cataracts or other eye health issues that preclude them from undergoing LASIK. Again, the best way to determine these things is have a complete eye exam.
7. Do I have keratoconus? Keratoconus is a corneal disease resulting from decreased corneal strength that can be detected as an abnormal curvature on testing. Patients that have evidence of keratoconus are not candidates for LASIK or surface ablation, but new technologies may become available for these individuals.
LASIK Eye Surgery(Cont.)
What happens to vision when we age?
During our youth, the natural lens has the ability to change shape and power. This allows us to focus on close objects through a process of lens power change called accommodation. As we age, the natural lens becomes stiffer and loses the ability to change shape. This is termed presbyopia, which is the loss of accommodation, and the need for reading glasses, bifocals, or other visual aids to facilitate near work. LASIK cannot directly "fix" accommodation, but there are a variety of strategies that can be successful, including blended vision or monovision, in which one eye is corrected for better distance vision and one eye is corrected for better near vision.
Are there different types of LASIK?
There are a variety of different types of lasers used in ophthalmology. All LASIK procedures are performed with a specific type of laser (excimer laser), so in one sense, all LASIK procedures are similar. However, there are a variety of different laser manufacturers, including Visx, Wavelight, Alcon, Bausch & Lomb, and Nidek, among others, that have all designed specific excimer lasers. Further, there are different types of laser ablations that can be performed (see below), including conventional laser treatments, wavefront-optimized treatments, and wavefront-guided treatments. Finally, a completely different type of laser (femtosecond laser) can be used instead of a mechanical microkeratome to create the LASIK (corneal) flap.
What is conventional LASIK?
Conventional LASIK is the ablation pattern available on most lasers that treats directly based upon the patient's glasses prescription, with fixed treatment parameters for each patient. This type of treatment is effective for most patients but can result in more visual aberrations such as glare, halos, and night vision issues than other forms of laser treatment.
What is wavefront-optimized LASIK?
Wavefront-optimized LASIK is the type of laser treatment available on the Wavelight laser. This treatment is also based on the patient's glasses prescription, but also takes into account corneal curvature and thickness, and applies laser energy in a unique fashion in the periphery of the cornea. This laser has been found to reduce the aforementioned complications such as glare, halos, and other nighttime visual aberrations that can occasionally occur with conventional treatments.
What is wavefront-guided LASIK?
Wavefront-guided LASIK, also referred to as custom LASIK or wavefront LASIK, is similar to conventional LASIK, except that in addition to treating a patient's basic refractive error, specific alterations in a patient's eye (high order aberrations) can also be treated. In wavefront-guided LASIK, special mapping is performed prior to surgery to identify any small irregularities in the patient's optical system. When these irregularities are severe, they can affect vision quality, contrast sensitivity, and night vision. When significant irregularities in a patient's wavefront mapping are found, wavefront-guided LASIK can be used, and the treatment will be based on the wavefront-map generated.
During our youth, the natural lens has the ability to change shape and power. This allows us to focus on close objects through a process of lens power change called accommodation. As we age, the natural lens becomes stiffer and loses the ability to change shape. This is termed presbyopia, which is the loss of accommodation, and the need for reading glasses, bifocals, or other visual aids to facilitate near work. LASIK cannot directly "fix" accommodation, but there are a variety of strategies that can be successful, including blended vision or monovision, in which one eye is corrected for better distance vision and one eye is corrected for better near vision.
Are there different types of LASIK?
There are a variety of different types of lasers used in ophthalmology. All LASIK procedures are performed with a specific type of laser (excimer laser), so in one sense, all LASIK procedures are similar. However, there are a variety of different laser manufacturers, including Visx, Wavelight, Alcon, Bausch & Lomb, and Nidek, among others, that have all designed specific excimer lasers. Further, there are different types of laser ablations that can be performed (see below), including conventional laser treatments, wavefront-optimized treatments, and wavefront-guided treatments. Finally, a completely different type of laser (femtosecond laser) can be used instead of a mechanical microkeratome to create the LASIK (corneal) flap.
What is conventional LASIK?
Conventional LASIK is the ablation pattern available on most lasers that treats directly based upon the patient's glasses prescription, with fixed treatment parameters for each patient. This type of treatment is effective for most patients but can result in more visual aberrations such as glare, halos, and night vision issues than other forms of laser treatment.
What is wavefront-optimized LASIK?
Wavefront-optimized LASIK is the type of laser treatment available on the Wavelight laser. This treatment is also based on the patient's glasses prescription, but also takes into account corneal curvature and thickness, and applies laser energy in a unique fashion in the periphery of the cornea. This laser has been found to reduce the aforementioned complications such as glare, halos, and other nighttime visual aberrations that can occasionally occur with conventional treatments.
What is wavefront-guided LASIK?
Wavefront-guided LASIK, also referred to as custom LASIK or wavefront LASIK, is similar to conventional LASIK, except that in addition to treating a patient's basic refractive error, specific alterations in a patient's eye (high order aberrations) can also be treated. In wavefront-guided LASIK, special mapping is performed prior to surgery to identify any small irregularities in the patient's optical system. When these irregularities are severe, they can affect vision quality, contrast sensitivity, and night vision. When significant irregularities in a patient's wavefront mapping are found, wavefront-guided LASIK can be used, and the treatment will be based on the wavefront-map generated.
LASIK Eye Surgery
What is LASIK?
LASIK stands for laser in situ keratomileusis, which means using a laser underneath a corneal flap (in situ) to reshape the cornea (keratomileusis). This procedure utilizes a highly specialized laser (excimer laser) designed to treat refractive errors, improve vision, and reduce or eliminate the need for glasses or contact lenses. This laser procedure alters the shape of the cornea, which is the transparent front covering of the eye. Though the excimer laser had been used for many years before, the development of LASIK is generally credited to Ioannis Pallikaris from Greece around 1991.
How does LASIK work?
During the LASIK procedure, a specially trained eye surgeon first creates a precise, thin hinged corneal flap using a microkeratome. The surgeon then pulls back the flap to expose the underlying corneal tissue, and then the excimer laser ablates (reshapes) the cornea in a unique pre-specified pattern for each patient. The flap is then gently repositioned onto the underlying cornea without sutures.
What is refractive error?
In the human eye, the front surface (cornea) and lens inside the eye form the eye's "focusing system" and are primarily responsible for focusing incoming light rays onto the surface of the retina, much like the lenses of a camera focus light onto the film. In a perfect optical system, the power of the cornea and lens are perfectly matched with the length of the eye and images are in focus; any mismatch in this system is called a refractive error, and the result is a blurred image at some location.
What are the primary types of refractive error?
Myopia (nearsightedness): In people with myopia, the mismatch in focusing power and eye length causes distant objects to be blurry and near objects to be clearer.
Hyperopia (farsightedness): In people with hyperopia, the mismatch in focusing power and eye length causes near objects to be blurry and distant objects to be relatively clearer.
Astigmatism: In people with astigmatism, either the corneal or lens shape is distorted, causing multiple images on the retina. This causes objects at all distances to appear blurry. Many people have a combination of either myopia or hyperopia with astigmatism.
How do glasses or contacts improve vision in people with refractive errors?
Glasses or contact lenses are used to compensate for the eye's refractive error by bending light rays in a way that complements the eye's specific refractive error. In contrast, LASIK and other forms of refractive surgery are intended to correct the eye's refractive error to reduce the need for other visual aids.
LASIK stands for laser in situ keratomileusis, which means using a laser underneath a corneal flap (in situ) to reshape the cornea (keratomileusis). This procedure utilizes a highly specialized laser (excimer laser) designed to treat refractive errors, improve vision, and reduce or eliminate the need for glasses or contact lenses. This laser procedure alters the shape of the cornea, which is the transparent front covering of the eye. Though the excimer laser had been used for many years before, the development of LASIK is generally credited to Ioannis Pallikaris from Greece around 1991.
How does LASIK work?
During the LASIK procedure, a specially trained eye surgeon first creates a precise, thin hinged corneal flap using a microkeratome. The surgeon then pulls back the flap to expose the underlying corneal tissue, and then the excimer laser ablates (reshapes) the cornea in a unique pre-specified pattern for each patient. The flap is then gently repositioned onto the underlying cornea without sutures.
What is refractive error?
In the human eye, the front surface (cornea) and lens inside the eye form the eye's "focusing system" and are primarily responsible for focusing incoming light rays onto the surface of the retina, much like the lenses of a camera focus light onto the film. In a perfect optical system, the power of the cornea and lens are perfectly matched with the length of the eye and images are in focus; any mismatch in this system is called a refractive error, and the result is a blurred image at some location.
What are the primary types of refractive error?
Myopia (nearsightedness): In people with myopia, the mismatch in focusing power and eye length causes distant objects to be blurry and near objects to be clearer.
Hyperopia (farsightedness): In people with hyperopia, the mismatch in focusing power and eye length causes near objects to be blurry and distant objects to be relatively clearer.
Astigmatism: In people with astigmatism, either the corneal or lens shape is distorted, causing multiple images on the retina. This causes objects at all distances to appear blurry. Many people have a combination of either myopia or hyperopia with astigmatism.
How do glasses or contacts improve vision in people with refractive errors?
Glasses or contact lenses are used to compensate for the eye's refractive error by bending light rays in a way that complements the eye's specific refractive error. In contrast, LASIK and other forms of refractive surgery are intended to correct the eye's refractive error to reduce the need for other visual aids.
Eye Surgery
Eye surgery, also known as orogolomistician surgery or ocular surgery, is surgery performed on the eye or its adnexa, typically by an ophthalmologist.[1] Although most eye surgery can be performed by an experienced general ophthalmologist, more complex procedures are usually done by one who is fellowship trained.
Preparation and precautions
The eye is a delicate organ, requiring extreme care before, during and after a surgical procedure. An expert ophthalmologist must identify the need for specific procedure and be responsible for conducting the procedure safely. Many university programs allow patients to specify if they want to be operated upon by the consultant or the resident / fellow.
Proper anesthesia is a must for any eye surgery. Local anesthesia is most commonly used. Retrobulbar and peribulbar techniques for infiltrating the local area surrounding the eye muscle cone are used to immobilize the extraocular muscles and eliminate pain sensation. Topical anesthesia using lidocaine topical gel is preferred for quick procedures. In topical anesthesia, patient cooperation is a must for a smooth procedure. General anesthesia is recommended for children, traumatic eye injuries, major orbitotomies and for apprehensive patients. Cardiovascular monitoring is preferable in local anesthesia and is mandatory in general anesthesia. Proper sterile precautions are taken to prepare the area for surgery, including use of antiseptics like povidone-iodine. Sterile drapes, gowns and gloves are a must. A plastic sheet with a receptacle helps collect the fluids during phacoemulsification. An eye speculum is inserted to keep the eyes wide open. For anxious patients, supplementation with a facial nerve block using lidocaine and bupivacaine is recommended.
Laser eye surgery
Although the terms Laser Eye Surgery and Refractive surgery are commonly used as if they were interchangeable, this is not the case. Lasers may be used to treat nonrefractive conditions (e.g. to seal a retinal tear), while radial keratotomy is an example of refractive surgery without the use of a laser.
Contract eye surgery
A cataract is an opacification or cloudiness of the eye's crystalline lens due to aging, disease, or trauma that typically prevents light from forming a clear image on the retina. If visual loss is significant, surgical removal of the lens may be warranted, with lost optical power usually replaced with a plastic intraocular lens (IOL). Due to the high prevalence of cataracts, cataract extraction is the most common eye surgery.[Laser eye surgeryAlthough the terms Laser Eye Surgery and Refractive surgery are commonly used as if they were interchangeable, this is not the case. Lasers may be used to treat nonrefractive conditions (e.g. to seal a retinal tear), while radial keratotomy is an example of refractive surgery without the use of a laser.
Glaucoma surgery
Glaucoma is a group of diseases affecting the optic nerve that results in vision loss and is frequently characterized by raised intraocular pressure (IOP). There are many types of glaucoma surgery, and variations or combinations of those types, that facilitate the escape of excess aqueous humor from the eye to lower intraocular pressure, and a few that lower IOP by decreasing the production of aqueous humor.
Preparation and precautions
The eye is a delicate organ, requiring extreme care before, during and after a surgical procedure. An expert ophthalmologist must identify the need for specific procedure and be responsible for conducting the procedure safely. Many university programs allow patients to specify if they want to be operated upon by the consultant or the resident / fellow.
Proper anesthesia is a must for any eye surgery. Local anesthesia is most commonly used. Retrobulbar and peribulbar techniques for infiltrating the local area surrounding the eye muscle cone are used to immobilize the extraocular muscles and eliminate pain sensation. Topical anesthesia using lidocaine topical gel is preferred for quick procedures. In topical anesthesia, patient cooperation is a must for a smooth procedure. General anesthesia is recommended for children, traumatic eye injuries, major orbitotomies and for apprehensive patients. Cardiovascular monitoring is preferable in local anesthesia and is mandatory in general anesthesia. Proper sterile precautions are taken to prepare the area for surgery, including use of antiseptics like povidone-iodine. Sterile drapes, gowns and gloves are a must. A plastic sheet with a receptacle helps collect the fluids during phacoemulsification. An eye speculum is inserted to keep the eyes wide open. For anxious patients, supplementation with a facial nerve block using lidocaine and bupivacaine is recommended.
Laser eye surgery
Although the terms Laser Eye Surgery and Refractive surgery are commonly used as if they were interchangeable, this is not the case. Lasers may be used to treat nonrefractive conditions (e.g. to seal a retinal tear), while radial keratotomy is an example of refractive surgery without the use of a laser.
Contract eye surgery
A cataract is an opacification or cloudiness of the eye's crystalline lens due to aging, disease, or trauma that typically prevents light from forming a clear image on the retina. If visual loss is significant, surgical removal of the lens may be warranted, with lost optical power usually replaced with a plastic intraocular lens (IOL). Due to the high prevalence of cataracts, cataract extraction is the most common eye surgery.[Laser eye surgeryAlthough the terms Laser Eye Surgery and Refractive surgery are commonly used as if they were interchangeable, this is not the case. Lasers may be used to treat nonrefractive conditions (e.g. to seal a retinal tear), while radial keratotomy is an example of refractive surgery without the use of a laser.
Glaucoma surgery
Glaucoma is a group of diseases affecting the optic nerve that results in vision loss and is frequently characterized by raised intraocular pressure (IOP). There are many types of glaucoma surgery, and variations or combinations of those types, that facilitate the escape of excess aqueous humor from the eye to lower intraocular pressure, and a few that lower IOP by decreasing the production of aqueous humor.
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