Advice When Choosing a LASIK Surgeon

In early November of 1994, Claremont Optometry was the first optometric practice in the Inland Empire to successfully co-manage LASIK laser vision correction patients. Since then we have managed hundreds of patients, all with excellent outcomes and we have not experienced any major complications. We only refer patients to top-notch surgeons, who have thousands of procedures of experience.

Laser Vision Correction or LASIK is becoming very competitive, especially in populated areas like Southern California. Please remember a few things:

Even a novice surgeon can have good results. It is the seasoned expert that can identify possible complications and deal with them immediately to avoid long-term side effects.
There are many ways a LASIK center can save money and lower the procedure cost. One way is to hire a technician to measure your eyes prior to surgery. Remember, your outcome is only as good as the numbers fed into the laser's computer. Pre-operative measurements are critical. The word "optometry" literally translated means "to measure the eye". We spend four years after college learning how to do this. Many centers do not include extended post-operative care, charge for enhancement procedures and do not pay the software royalties due to the laser manufacturers. When found and presented with a large bill for overdue royalties, many "fly by night" laser centers simply close and open up somewhere else. If you need follow up care, your surgeon may be gone. Low price, high volume centers are more prone to human errors and are known for re-using blades and for promising outcomes that are not realistic. You are gifted with only one set of eyes. As primary care optometrists, it is our job to counsel you on all options to correct your vision. For those of you who are interested, we hope you will place your confidence and trust in us to recommend the best option for you and your lifestyle.

Laser refractive surgery is only one of the many available surgical options to decrease dependence on spectacle lenses or contact lenses. Refractive Lensectomy or Clear Lensectomy, Implantable Contact Lenses (ICL), LASEK, Photorefractive Keratectomy (PRK), Monovision, and Conductive Keratoplasty (CK) are all available as options. As optometrists, we are not surgeons. It is our job to counsel each patient and to discuss all available options. We will help each patient assess all risks and benefits and support you with whatever decision you may make.

Here's a list of surgeons we recommend for laser vision correction:

Tom Tooma, MD, TLC, The Laser Center, Newport Beach, Ontario, CA
Jonathan Ramin Pirnazar, MD, TLC, The Laser Center, Ontario, CA
Robert Fabricant, MD, FACS, Pacific Eye Institute Laser Center, Upland, CA
Robert Maloney, MD, Maloney Vision Institute, Los Angeles, CA

Dr. Robert Fabricant, Medical Director at the Laser Center at Pacific Eye Institute in Upland, prepares patient James Baggarly for the LASIK procedure.

(Click to enlarge)

Dr. Ann Johannsen's Lasik surgery performed by Dr. Thomas Tooma. Ten minutes later she was sitting up and seeing!

Claremont Optometry Group's own staff member and LASIK Coordinator, Pamela Christley, had LASIK surgery in March 2007. She is pictured here with Dr. Thomas Tooma minutes after having her surgery. "It's so incredible and everyone at the TLC center has been great!"

What is LASIK?

The following information has been provided by TLC Laser Eye Centers. For more information please visit TLCvision.com.

LASIK (Laser-Assisted-In-Situ Keratomileusis) is currently one of the most frequently performed elective procedures in North America. It is a highly effective outpatient procedure that is suitable for most low, moderate and higher prescriptions. LASIK uses a cool beam of light from the excimer laser to gently reshape the front surface (cornea) of your eye.

What is Custom LASIK?

While conventional LASIK has been a complete revolution in vision correction, TLC also offers the latest in laser vision correction technology: Custom LASIK. Custom LASIK is a procedure that enables your surgeon to further customize the conventional LASIK procedure to your individual eyes. This customized procedure may result in patients seeing clearer and sharper than ever before. FDA studies show that Custom LASIK may produce better vision than is possible with contact lenses or glasses.

In clinical studies, Custom LASIK has been able to provide patients with:

A greater chance of having 20/20 vision
The potential for better vision than is possible with contacts or glasses
Less incidence of glare and halos
Potentially better overall vision, even at night.

Better Quality Vision

Clinical studies have shown that Custom LASIK may improve not only what you see but also how well you see it. In the past, all vision was measured using a standard vision chart. If you could see the letters, the doctor would use that measurement for how well you could see. But now, with Custom LASIK, doctors are able to focus on the quantity as well as the quality of your vision. Many patients who have had Custom LASIK are reporting the ability to see clearer than ever before.

Higher Order Aberrations

Several types of visual imperfections, referred to as lower- and higher-order aberrations, exist within the eye and may affect your vision (the amount of these aberrations vary from person to person). Previously, only lower-order aberrations (such as nearsightedness, farsightedness and astigmatism) could be measured and treated. Higher-order aberrations may also have a significant impact on vision and have been linked to glare and halos. Now Custom LASIK may help to further customize your treatment of these higher-order aberrations that, in the past, could not be adequately treated with glasses, contacts or conventional LASIK treatments. Your doctor will recommend the best procedure for you based on your personal aberrations.

The Technology of Custom LASIK

Custom LASIK uses a wavefront analyzer to measure the way light travels through your eye. The wavefront analyzer creates a customized 3-D map of your eye that looks at your entire optical system. This map provides information about the unique visual characteristics of your eye which adds an additional level of data about your vision, enabling your TLC surgeon to further customize your vision correction.

The LASIK Procedure

Anesthetic drops are applied to the eye.
A protective flap is created and gently lifted by the surgeon, revealing the inner corneal tissue.
Computer-controlled pulses of cool laser light are applied to the inner layers of your cornea. As the laser pulses, it makes a ticking sound. The inner corneal layer is reshaped with the laser to mimic your contact lens or glasses prescription.
The surgeon gently replaces the flap and aligns it to its original position. It heals naturally and securely.
Some patients may feel slight irritation for a few hours, but most are quite comfortable after a nap and rest.

Am I A Candidate for LASIK?

Good candidates are at least 18 years of age, in good general health, and with no eye diseases such as cataracts or glaucoma. A screening with your TLC eye doctor is the best way to determine if you are a candidate and what your probable outcome may be. TLC Laser Eye Centers also offer complimentary consultations.

Good candidates should be free of eye diseases including keratoconus, glaucoma, advanced cataracts and certain retinal and optic nerve diseases. Candidates should be free of certain eye viruses including herpes simplex and herpes zoster. Good candidates should also be free of certain health problems including uncontrolled diabetes, autoimmune or collagen vascular disease, and any medication or condition which renders the patient immunocompromised.

Patients should make their doctor aware of certain eye problems including amblyopia (lazy eye), strabismus (muscle imbalance), severe dry eyes, previous eye surgery or injury, or any recurrent, residual or active eye conditions which may affect healing. Other conditions that should be related to the doctor include keloid scarring with previous surgical healing, back problems, claustrophobia or other psychological problems, which may affect the surgery or recovery.

It is critical that a potential laser vision correction candidate has obtained a stable prescription for at least one year. Since hormones may affect the stability of your prescription, pregnant or nursing women are not eligible to pursue laser vision correction until two menstrual cycles after nursing has been discontinued. This is to make sure that the best results are achieved with the surgery, and to try to limit fluctuations in prescription that can occur with hormonal shifts.

What is Bladeless or All Laser LASIK?

LASIK surgery may be elective, but good vision is not. We understand how valuable your sight is to you, and we keep our sights set on providing safe and advanced technologies for our patients. That is why All-Laser LASIK using the IntraLase(R) laser is a technology that is used in some of our centers in North America.

With All-laser LASIK, the surgeon uses a laser to create the corneal flap. This technology enables the surgeon the ability to customize the corneal flap for every individual patient. In recent studies done by IntraLase, this technology may now make it possible to treat those who were previously dismissed as non candidates due to thin corneas.

Our doctors can offer customization for you in all parts of the procedure: custom diagnosis (before the procedure), custom flap (All-laser LASIK), and custom treatment (to complete the procedure).

Confidence in Your Decision

As with all technologies that TLC uses, please consult your local TLC Laser Eye Center for guidance. A comprehensive consultation will determine what is the best treatment for you.

Studies have shown the incidence of dry eye symptoms may be reduced with All-laser LASIK
With All-laser LASIK and its customization components, surgeons can treat a wider variety of patients, including patients with thin corneas.

All-laser LASIK has been used in more than 500,000 LASIK procedures worldwide.