Online Health Chat with Ron Krueger, MD

Date March 16, 2015

Description

Laser vision correction, also known as refractive surgery, has improved dramatically since its early days. Today, ophthalmologists have a wide range of procedures available to free you from the hassles of glasses and contact lenses. Cole Eye Institute laser vision correction specialists are among the most experienced in the world. Your eyes are too precious to trust to anyone else.

Laser vision correction uses laser technology to modify the shape of the cornea to improve nearsightedness, farsightedness and astigmatism. The excimer laser, used in vision correction procedures, is approved by the U.S. FDA as safe and effective.

Specialists at Cleveland Clinic Cole Eye Institute use the most advanced technology available, including bladeless technology, which increases accuracy and precision. We were among the first centers in the United States to use such state-of-the-art technology and continue to be pioneers in the field.

Take this opportunity and have your questions answered by our physician specialist Ronald Krueger, MD, as well as our operations manager. They will discuss laser vision correction, the different procedures available such as LASIK, PRK, Monovision and ICL (implantable collamer lens), who is a candidate, and scheduling and financing options.


About the Speaker

Ronald Krueger, MD, is board certified in ophthalmology and specializes in laser vision correction. He has performed more than 20,000 laser vision correction procedures, and has authored more than 100 peer-reviewed manuscripts and many more abstracts, book chapters and trade journal articles. He has 30 years of experience in excimer laser research, including the first physical descriptions of the effects of the excimer lasers on corneal tissue and many more developments, including the early principles of ocular wavefront customized laser vision correction.


Let’s Chat About Vision Correction Procedures

Moderator: Welcome to our chat about laser vision correction with Cleveland Clinic Cleveland Clinic’s specialist, Dr. Ronald Krueger.

Dr.Krueger, thank you for taking the time to be with us to share your expertise and answer our questions.

Moderator: Let's begin with the questions.....


7135David: Am I, a 70-year-old man who wears contact lenses for astigmatism, a candidate for LASIK vision correction. Would I still need reading glasses?

Ronald_Krueger,_MD: We have completed successful surgeries on 70+ year olds. If you qualify we perform mono-vision surgery which is one eye for near and one eye for far. This should help not needing reading glasses in most cases.

pan: Can Presbyopia be successfully corrected today? Thanks.

Ronald_Krueger,_MD: Yes, monovision can be targeted to give both distance and reading vision.

Chaco15: Can Lasik vision correction be done along with cataract removal surgery? Are there disadvantages to combining the two?

Ronald_Krueger,_MD: Cataract surgery is a form of vision correction, so if you need cataract surgery, LASIK may not be necessary.

Cork: What is the difference between LASIK and PRK?

Ronald_Krueger,_MD: Lasik is where you make a flap and then perform the treatment on the eye and the flap is laid back. Some people who do not qualify for Lasik due to thin corneas or being too flat or steep, might qualify for PRK. They slough off the cells of your eye and perform the same correction after. The difference with PRK is that you will have a slower healing time as well as a little more irritation. The long tem outcome is the same.

camuh: If you happen to have a small swellings on your eyelids that causes you have headache, what could possibly be the cause?

Ronald_Krueger,_MD: Small swellings may need to be evaluated to see the nature of your ocular surface, and then factored in to see why the headaches.

Bunnie: Is there an age limit to have this surgery?

Ronald_Krueger,_MD: From 18 years to any age, but one must make sure there are no cataracts.

serendipity: For my glasses, my reading is bad and distance is barely bad - plus there is an astigmatism. I have tried contacts but the reading strength blurs the distance. I have tried monovision and my brain cannot make the adjustment to using the eyes separately for reading/distance. Then again - I only last maybe an hour. If I cannot tolerate monovision - does that also eliminate laser correction surgery options?

Ronald_Krueger,_MD: We can personally evaluate how you might do with various monovision scenarios or you could just consider vision for distance in both eyes, and wear just reading glasses.

Bunnie: How long is this surgery?

Ronald_Krueger,_MD: Once you are in the laser room, the procedure is done in about 1/2 hour.

pan: Is presbyopia corrected effectively and safely today?
2) Myopia corrected in past 25 years can have negative results for eye function and sight. Thanks in advance.

Ronald_Krueger,_MD: Presbyopia is most effectively treated with monovision LASIK today. Other options, such as corneal inlays may be considered outside the United States.

squirrel23: Can both eyes be done at the same time or do I need two different appointments?

Ronald_Krueger,_MD: Typically, both eyes are done at the same time, but if someone wishes, it can be done sequentially.

Bunnie: What is the recovery timeframe?

Ronald_Krueger,_MD: For Lasik, it's normally you go rest the day of surgery and go back to work the next day as long as you do not have a job that you will take a chance of bumping or rubbing your eyes. PRK you would have two to three days to get back to what you normally do.

DebNsatx : Thank You for doing this webcast. My son is soon to be 24 years of age and would like to get Lasik Surgery soon as he has been nearsighted since he was in fourth grade and would like to get rid of the glasses once and for all. What age is advisable to have this procedure done as he was told once he is done growing is the best time, so is this true? Also since most people have to wear cheaters or glasses once they are in there forties to fifties years of age then can you tell me how Lasik Surgery affects a person's vision at that age if they were to get the surgery done in their twenties? Will their farsighted vision be better or worse in their fifties? How can you find the best Doctor to perform this surgery, for when you do decide to have this procedure done? Thank you for your responses!

Ronald_Krueger,_MD: Any time after 18 years of age is approved for Lasik surgery, however we would like to see three years of stable vision from 18 to 20 years old. With the age of your child it should not be a problem performing the surgery. Just about everyone in their 40's and 50's will need reading glasses but they can come back to get one eye corrected for reading later in life.

nonames: Do you have to have a certain prescription to be a candidate?

Ronald_Krueger,_MD: A good candidate needs to have 3 things
1) Proper range of prescription, central corneal thickness and proper corneal shape
2) Healthy eyes
3) Motivation greater than anxiety in having the procedure

connection: What is the cost and what is included in that?

Ronald_Krueger,_MD: For PRK it is $4550.00 and Lasik is $4950.00 for both eyes, which includes all pre-op and post-op appointments, surgery kit including drops and enhancements for one year if needed.

Dufresne: I had PRK back in 1991 and am pleased with the outcome over the last 24 years. When the procedure was performed, the doctor slightly over corrected one eye and slightly under corrected the other. Now in my 50s, I am not comfortable with reading glasses because of the difference in prescription between the two eyes. Is it typical these days to correct the eyes to a different prescription such as occurred with my procedure?

Ronald_Krueger,_MD: Yes, this is called monovision or blended vision, and is the most acceptable way for patient to maintain both reading and distance vision.

ron: I’ve heard about bladeless LASIK, do you offer that and is it better than regular LASIK?

Ronald_Krueger,_MD: Bladeless refers to not using a blade to make the flap. At Cleveland Clinic we have gone bladeless years ago and would never use a blade. Some facilities may still use a blade just to keep the cost down but it is not top technology.

Annie: How long does it last once you have the surgery? Are touch ups needed?

Ronald_Krueger,_MD: This is a permanent change to your eyes. Normally only about 5% of the people need an enhancement however when you reach the age of 40 and beyond all people lose their close up vision. When that happens you can wear glasses or one contact in one eye to correct the reading or come back in to have the one eye enhanced. Normally the distance eye does not change but usually can be enhanced if it does.

Flute: What kind of pain is expected after the procedure and for how long?

Ronald_Krueger,_MD: Lasik is relatively painless. You go home, take a nap for a few hours and when you wake up you really feel nothing. PRK would display some pain and irritation usually around the third day but only lasts a short time as you heal.


Closing

Moderator: That is all of the time we have for questions. Thank you everyone for participating today; and thank you, Dr. Krueger for your insightful answers to our questions about laser vision correction.

For Appointments

Laser vision correction is offered in its own suite on the second floor of Cole Eye Institute, directly off the skyway. Your initial evaluation is free.

To schedule your free consultation appointment or for more information, please call 216.445.8585 or toll-free at 800.223.2273 ext. 58585. You can also visit us online at clevelandclinic.org/lvc.

For More Information

Cleveland Clinic Health Information

Learn more about symptoms, causes, diagnostic tests and treatments for Laser Vision Correction

On Your Health

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A remote second opinion may also be requested from Cleveland Clinic through the secure Cleveland Clinic MyConsult® website. To request a remote second opinion, visit eclevelandclinic.org/myConsult.

Contact Information

If you need more information, click here to Live Chat with a health educator (click on Questions and then Live Chat) or call the Center for Consumer Health Information at 216.444.3771 or toll-free at 800.223.2272 ext. 43771 to speak with a Health Educator.

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This information is provided by Cleveland Clinic as a convenience service only and is not intended to replace the medical advice of your doctor or health care provider. Please consult your health care provider for advice about a specific medical condition. Please remember that this information, in the absence of a visit with a health care professional, must be considered as an educational service only and is not designed to replace a physician’s independent judgment about the appropriateness or risks of a procedure for a given patient. The views and opinions expressed by an individual in this forum are not necessarily the views of the Cleveland Clinic institution or other Cleveland Clinic physicians. ©Copyright 1995-2015. The Cleveland Clinic Foundation. All rights reserved.