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Unstabilized Cornea

How Integrated Eyecare Improves Your Chance for Success

As with all new technologies, there have been significant innovations since the technique was first introduced. Initially, LVC was promoted as a procedure that produced results about as good as glasses or contacts. Now, as technology and surgeons' skills have improved, some outcomes are as good as - and sometimes better than -- glasses.

Patients with low to moderate near- or farsighted vision achieve the best results. The procedure also may be used to correct astigmatism, although the type and degree of the condition may affect the outcome. While LASIK reshapes the cornea, it does not affect the lens of the eye, which is crucial for near vision. Therefore, if you currently use bifocals or reading glasses, you will still need them following LVC.

To help achieve maximum visual results, schedule a minimum of four follow- up appointments after your surgery. These exams should occur:

  • 1 day after surgery
  • 1 week after surgery
  • 3 months after surgery
  • 6 months after surgery
  • If you have complications, more visits may be necessary.

How Integrated Eyecare Works with You

Systemic Diseases

For patients considering laser vision correction (LVC), Integrated Eyecare provides independent outcome assessment. Our training and expertise will help guide you in determining whether laser surgery is right for you. If you select LVC, we will serve as your professional advocate throughout the entire refractive surgery process.

Consider these advantages:

  • Integrated Eyecare does NOT have a financial interest in any laser center. We don't work for refractive surgeons - we work for you, helping you select the very best approach. Whether you need glasses, contact lenses or LVC, we can help you weigh options, risks and benefits.

  • Integrated Eyecare does not refer patients to surgery centers that try to perform this procedure at the lowest possible cost. Although LVC is marketed as fast and easy, it is a highly technical surgical procedure. When your vision may be at risk, it is not wise to save money by cutting corners.We establish high standards to ensure the best possible clinical outcome. The process begins by carefully qualifying candidates. We have screened hundreds of patients, advising many to consider LVC, and cautioned others not to proceed based on risk factors. Drawing on our deep experience, we will guide you through the process. Integrated Eyecare patients experience the following benefits:

The clinical outcomes of patients of our LVC processes far exceed national averages because we take extra time and measures. We are the preferred provider for many nationally recognized LVC centers and surgeons due to our commitment to the highest level of care. As your professional advocate throughout the LVC process, your surgeon knows that we will carefully evaluate his or her work and expect optimal results.

Cornea Shape

Frequently Asked Questions

Post operative follow-up visits are critical to achieve an optimal LVC experience. Integrated Eyecare performs the following essential services:

  • Monitors corneal healing by recognizing and managing expected or abnormal post-surgical changes
  • Evaluates early signs of corneal infection and flap complications, which can lead to sight-threatening problems
  • Manages recovery of the cornea and ensures that it is properly lubricated until optimal tear function returns
  • Provides prescription lenses for reading or night driving or any condition not fully treated by LVC​

Pre-procedure Testing and Evaluation

During LVC, the refractive surgeon uses an excimer laser to reshape the cornea, the front surface of the eye. Pulses of cool ultraviolet light remodel the tissue to match the prescription of your glasses or contact lenses. The two most common refractive procedures are laser-assisted in-situ keratomileusis (LASIK) and photorefractive keratectomy (PRK).

Some people's corneas are too thin to tolerate the procedure well; after surgery not enough tissue remains. Early results from FDA trials indicated that a thin post-operative cornea causes serious postoperative complications. Integrated Eyecare uses a corneal pachymeter to measure thickness.

Clinical studies are beginning to demonstrate that LVC has not increased, or reduced, the risk of eye disease. At the same time, consumer behavior research indicates that most people associate good eyesight with good eye health. Since vision is expected to improve following LVC, patients are not as motivated to consult with a professional for regular eye exams. Don't neglect this important aspect of your health.

Who Qualifies for Laser Vision Correction

Autoimmune diseases, such as rheumatoid arthritis, will delay proper corneal healing. In addition, LVC is not recommended for patients with a history of herpes in the eye, since the laser procedure can exacerbate a reoccurrence

Patients with significantly flat corneas are universally disappointed because of persistent vision distortion and blurring. We use the corneal topographer to ensure your cornea falls within an acceptable curvature range.

Cornea Curvature

Determining Whether You are a Candidate

One of the most critical components of your pre-surgical care is to confirm that your cornea is stable. If you have worn or are currently wearing contact lenses, we look for subtle "warping" of the cornea. Each eye must be carefully and repeatedly measured to ensure that corneal shape and refraction has stabilized and is not continuing to change after discontinued contact lens use. While "rules of thumb" exist, indicating how long a patient should go without using contact lenses before surgery, our experience demonstrates that these guidelines might be off base if you desire exceptional surgical results.

Although Integrated Eyecare does not perform the surgery, we help evaluate and prepare patients for LVC, as well as provide follow-up care. We have offered these services since the FDA approved the procedure in 1995.

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Do I need to visit Integrated Eyecare after my surgery?

Following LVC, annual exams are a crucial to maintain your overall eye health:

  • LVC does not lower the incidence of cataracts, glaucoma, macular degeneration or other eye diseases.
  • Unfortunately, most eye diseases don't affect sight until the end stages. It is important for patients who have enjoyed excellent vision following LVC to have regular eye health examinations.
  • Integrated Eyecare is in the best position to provide your ongoing care based on our established relationship and our knowledge of your eyes and health conditions prior to LVC.​

Refractive Surgeon Referral Assistance

What can I expect after surgery?

Why do I need to continue annual eye exams after my vision has been surgically corrected?

Discomfort varies depending on the procedure. You will not experience discomfort or pain during the procedure itself. After surgery, less than one patient in ten has pain, which is treated with medication for 24 to 48 hours. Most patients experience minor irritation, light sensitivity and watering of their eyes for a few days. There is typically less chance of discomfort with LASIK than with PRK.

Laser vision correction (LVC), also known as refractive surgery, refers to laser surgical techniques that modify the shape of the cornea to improve vision. LVC offers safe correction of many common vision problems, including nearsightedness, farsightedness and astigmatism.


Laser Vision Correction

Before laser vision correction (LVC), the cornea must be carefully evaluated. Among the important factors we consider:

  • Collect and carefully review your eye and medical history
  • Repeated refractions over time confirm corneal and prescription stability
  • Cycloplegic refraction to ensure no "hidden" changes exist
  • Slit-lamp exam, which highly magnifies the cornea, enabling us to carefully screen for surface irregularities or problems
  • Complete dilated eye health exam to evaluate comprehensive eye health and identify current or early conditions
  • Pachymetry to determine corneal thickness
  • Topography to map corneal surface and determine its exact shape and contour
  • Pupil size evaluation in regular and low-light situations
  • Baseline tear function and dry eye testing​

How Laser Vision Correction (LVC) works

Post-op Follow Up

What You Can Expect

Chronic dry eye is not an absolute contraindication, but it must be aggressively addressed pre- and post-operatively so that proper healing is not delayed. If subtle corneal degenerations or "map dot dystrophy" exists, surgery is not recommended.

If a cornea's shape is too irregular, a patient will be disqualified for LASIK surgery. The condition, known as keratoconus, refers to a cone-shaped or very steep cornea. A certain amount of irregularity is acceptable, such as mild to moderate astigmatism. Integrated Eyecare examines your cornea with a corneal topographer to make sure you qualify.

Annual Visits

LVC and the Cornes

Symptoms you may experience include:

  • Blurry and hazy during the first day. Plan to have someone drive you home after your procedure.
  • Vision may fluctuate between clear and blurry for the first few weeks.
  • Your eyes will be dry even if they do not feel that way. Do not use unapproved drops.
  • Light sensitivity while driving at night during the first month.

Poor Surface Quality

Cornea Thickness

Integrated Eyecare of Bend, Oregon
  • Integrated Eyecare can provide you with a list of recommended surgeons.
  • Not every provider can produce exceptional results. Refractive surgery is a highly technical procedure, dependent on the skill and experience of the surgeon.
  • As with any surgical procedure, we recommend selecting a surgeon who does this procedure almost daily and dedicates a significant portion of their time and practice to LVC. We prefer surgeons who have proven skill and expertise, as well as have invested in the best technologies to deliver outstanding clinical outcomes.
  • Integrated Eyecare provides the surgeon with your eye history, test results and target prescription.​

There are some risks associated with all surgical procedures, including LVC. These may include pain or discomfort, night glare, regression, scarring, under- or overcorrection of vision and infection. Other risks include loss of best-corrected vision, which occurs in about one percent of patients.

Does the LVC procedure hurt?

If glasses or contact lenses interfere with your work or recreational activities, you may want to consider laser vision correction. As with all elective surgeries, you should make an informed decision, weighing the benefits, disadvantages and potential risks. Integrated Eyecare is an excellent resource to help you determine whether you are a good candidate. Click here for more information on what makes a good LVC candidate.

Individualized, in-depth consultation about laser vision correction (LVC) and other vision correction alternatives.

Your Advocate for Success

What risks are associated with laser vision correction (LVC)?

While many individuals are excellent laser vision correction (LVC) candidates, some do not meet generally accepted medical criteria. A thorough pre-operative examination is required to determine eligibility.

The optimal candidate:

  • Is 18 years of age or older
  • Is dependent on glasses or contact lenses
  • Has healthy eyes
  • Is well-educated about LVC, knowing the benefits and risks

Has reasonable expectationsLess-than-ideal candidates include those with:

  • Dry eyes
  • Corneal surface disorders or scarring
  • Unstable vision

Expectations that no further enhancement will be requiredYou would not be a candidate if you currently have any of the following conditions:

  • Pregnant or nursing
  • History of ocular herpes
  • Refraction outside of FDA-indicated treatment guidelines
  • Keratoconus (thin corneas)
  • Uncontrolled thyroid
  • Long-term use of steroids or chemotherapy
  • Use of Accutane or Cordarone
  • Uncontrolled diabetes
  • Active autoimmune disorder
  • Collagen vascular disease

Another important issue concerns presbyopia, an age-related condition that diminishes the eyes' ability to focus on close objects. If you are age 40 or older, it is likely that you will need reading glasses relatively soon after the procedure. While LVC changes the shape of the eye's surface, presbyopia causes a normal loss of lens flexibility inside of the eye, diminishing your near-focusing ability. LVC does not change or prevent this condition. Please consider this carefully when determining whether to pursue surgical vision correction.