IamA (LASIK Surgeon) Here to answer any questions AMA!

I live in California so this thought is on the top of my head. What happens if there happens to be an earthquake during the surgery? Does the laser detect it and has some sort of safety shutdown?

The laser has a safety feature. It has happened twice in my clinic. The laser will stop any treatment if you move your eye or it detects movement. Even if it loses power it has a backup generator. It will come back and resume where it left off treating. It remembers where it left off as well. I've had it happened twice and though scary for the patient it was perfectly safe.

Hello dr Lin,

I have albinism and about 50% reduced eyesight. I have a higher sensibility to light than the average person, but nothing extreme.

Could LASIK do anything to help my vision?

LASIK would be able to correct whatever your current glasses can correct since it's only treating the front surface of the eye. It would not help with the albinism. Obviously, this depends on certain factors.Do talk to a doctor who can check your records and can perform exams so they have the full information in hand to make a more accurate observation. Feel free to shoot me a message if you want and I can see if any of my colleagues have ever dealt or have good experience with this problem. Would love to help you and I have various colleagues throughout the country assuming you are located in the USA.

Is it true that the "skin" of the eye never fully heals and rubbing it can cause it to tear and you might even go blind?

The flap can be dislodged but that's usually a rare case and can only be caused by severe trauma to the eyes. Most athletes like boxers will opt with PRK because of this. Rubbing it will not dislodge it and make you go blind. You should never go rub your eyes in the first place, it's very bad for you regardless if you had surgery or not.

You should never go rub your eyes in the first place, it's very bad for you regardless if you had surgery or not.

Can you explain why it is so bad for you?

You can scratch or permanently damage your cornea over time.

So if my eye starts itching what should I do instead? Just wondering because I rub my eyes all the time :|

Use preservative-free eye drops instead,

IANAD, but I had LASIK in 2004. As a chronic eye-rubber, I can tell you that I have not personally gone blind from rubbing my eye. I do believe, though, that the rubbing has undone some of the vision correction so that I'm considering going back in for another LASIK procedure or sucking it up and going back to glasses. YMMV.

Yes, rubbing in any case either with surgery or not can cause problems with vision.

I heard it never heals 100% but that after a few years any damage that would dislodge it would probably have damaged your eye anyway. If you want to be a MMA fighter or figher pilot etc they recommend you go with PRK. That said I'm curious to hear a more official answer on this too! I got LASIK done a few years ago myself and the flap and risk was actually the part that scared me the most.

Yes, athletes like boxers will opt for PRK because they experience severe trauma in the eys.

So why choose Lasik over PRK?

Faster healing factor than PRK. With LASIK you are good to go the next day for normal activities. The chance of LASIK flap to be dislodged is very minimal and most people don't do extreme sports to cause this. In my 20 plus years in the industry, I have not treated someone that has their flap dislodged due to severe trauma.

So for someone in the military would PRK be a better bet?

I recommend PRK and also I believe the Army has their own criteria for what kind of surgery you can or can't have.

I've never heard this before. IIRC, my LASIK doc told me not to rub my eyes for a month or two when I got LASIK, but then it was fine.

Thank you. That is correct.

When you say rub your eyes, like is rubbing your eyelids(waking up, being tired, etc.) bad for you?

Yes, if you feel sensation in your eyes or you feel it being itchy I recommend using preservative free eye drops instead of rubbing them.

Formaldehyde drops, got it.

My mistake. Meant preservative free. Thanks for catching me!

This is terrifying. Please answer this man.

Answered.

I think it’s the incision for the flap they make for lasik that doesn’t heal.

Yes, the flap can be dislodged if severe trauma to the eyes.

I had Lasik on both eyes about 10 years ago. Last week I had PRK on one eye. Does that eye still have a flap?

Yes, it does.

Get PRK

Yes, athletes will opt for PRK if they get trauma to the eyes like boxers.

RemindMe! 1 day

Reminded.

Ffs man, I can't sleep now

Please check my answer.

Have you ever had a patient experience long time negative side effects from the surgery procedure? Thank you!

Over the year's that I've performed refractive surgery I've not have complications. I've had heard stories from other people and also online where their surgeon had cause problems that arose later in time.

You've never had a single complication?

I've never had a patient have severe problems over a prolonged period of time like the questioned asked. I've had patients with problems after surgery like all doctors have but they were fixed over time.

I'm considering LASIK, but I get very anxious with anything regarding my eyes (I can barely use eye drops). Would I be aware/remember the procedure?

You need to be awake during the procedure. I recommend go watching one live, some patients feel less nervous once they see one. Doctors also offer medicine for nerves. The procedure does sound scary but the thought is scarier than the actual thing.

Do you mean they feel less nervous after seeing one?

Yes, good catch! I've corrected it.

Is there a reason you have to be awake? Do you think in the future there will be an option for people to go under? I'd love to get it done but I freak out just getting eye drops.

The laser won't treat if no awake and your eyes need to be open. With technology anything is possible and I hope there is but for right now there isn't.

I've been considering getting lasek, but when my optometrist checks my eyes, I always tear up when he shines light on them. He says my eyes are likely too sensitive for lasek. Is this a true concern and if so why? Thanks!

There is a chance you can have glare and halos after the surgery but for the most part, it does go away after a couple of months. He is worried it will get worse after the surgery, that is why he is not recommending it. There is a chance of that but there are also treatments for it if it does happen. If you do plan on doing this, be aware of that.

Thanks for doing this! I got lasik about 5 years ago, it is hard for me to see at night and bright lights look like I'm wearing smudgy glasses. What's up with that?

It could be halos and glares or dry eyes. Have you gone back to get your eyes check? Dry eyes can cause this and it's on of the side effects of the procedure. Most patients don't notice this because it goes away over time but you can still experience it from time to time. Using preservative free eye drops helps a lot. Have your doctor check to make sure.

preservative FREE eye drops. Come on, doc.

Yes, sorry I keep messing up on that one. Thanks for having my back friend!

How bad would you say your vision should be for Lasik to be worth the risks? I think I'm like -2.5 or something and I'd love to get Lasik but on the other hand it's not like contacts are that big of a deal

It will depend on the person and the circumstances. Is it worth for you? Do you hate glasses and contacts? If you don't and can live with them, then I would spend the money somewhere else. Just be conscious of your eye health. If you do use contacts, use dailys to diminish infection problems.

DR, is it possible today to have good result with -12.00 ?

Yes, but it will be a different procedure like ICL depending on age. I've treated higher cases before, I would check with your doctor about your options.

Dr. Lin, with all the new lasers coming out and competition in your field, there seems to be a lot of "snake oil" and advertisement shenanigans. What should a patient shopping around truely care about?

You should have at least 3 consultations with different doctors before you decide. Look for experience. If the doctors have done a lot of cases and how long have they been performing surgery. Look for reputation online and what other people are saying. With the internet and social media today this is so much easier than before. Some people only look at the price and don't go to the more experienced doctors then end up having problems down the road. LASIK Surgery is like any other business. The top end, experienced places will charge more because they have built their reputation on it and for the most part have the latest technology and the staff to accommodate this.

I've heard that LASIK can worsen the near-vision degeneration that happens naturally as you age, is that accurate? How bad is it?

No, I am curious where you heard this from. Our eyes naturally age, yes and over time, usually after 40 we develop presbyopia.

Is it safe to get it done more than once? I had it 10 years ago but one eye is a little out of focus for reading and I've been thinking about getting it fixed.

It's safe depending if you meet certain criteria. Your doctor or a consultation with a doctor can determine that. If your cornea is too thin then you might not be able to get it, but ask your doctor to be sure.

I decided to get LASIK done about 6 months ago and I regularly recommend it to anyone I hear complain about contacts and/or glasses. I had fantastic results. That said, I find it interesting that so many optometrists as well as my LASIK surgeon wear glasses. Seems to be a big point for those that are so adamantly opposed to LASIK. What's the deal?

There are many reasons, such as a few that the people below have answered. Some people just need close vision glasses due to age-related problems such as presbyopia. Some are financial reasons. Others are fears, if you treated or see the worst cases from time to time you start fearing the worst result. I personally took the dive in 1997 and had LASIK myself. I'm in my late 40's and I will start needing close vision glasses soon. It's inevitable. It can be fixed nowadays with things like the Kamra Inlay, so I have options like other people.

Are there any major differences between how it was done in 1997 and how it's done today?

The technology used. It has advance tremendously over the years. The laser used and how the flap cut is made.

During the procedure, do you have to not move your eye at all by yourself? I know it sounds like a dumb question but I'm a very twitchy person even my eyes. Or would I be passed out?

The laser will stop treatment if you move your eyes. There are clamps that keep your eyes open. Almost all patients don't even notice the time passing by. If you need to adjust, ask your doctor and he can accommodate if you do it. You need to stay awake for the procedure.

I had LASIK back in 2004. It was one of the best things I've ever done for myself. Inevitably, I've rubbed my eyes quite a bit since then, and my vision is starting to get worse again. I bought an "insurance plan" that would let me get my eyes re-done if it ever became an issue, but since the first procedure resulted in increased photosensitivity, difficulty driving at night, and difficulty reading street signs, I'm a little wary about going back and making the side effects worse.

My question is this: Has the LASIK procedure changed over the last 13 years? Are side effects less likely to occur today than they were in 2004, or are the risks the same?

Yes, the technology has advanced tremendously and it continues to advance especially outside of the USA. Due to FDA approvals, certain things are not available yet in the USA but should be coming soon. Consult your doctor about your problems and see what he says. I recommend going to at least 2 or 3 places and see what they say.

Obviously I'm not asking for a medical opinion, but in general, are people with astigma candidates?

Yes, people with astigmatism are eligible for the surgery. I've treated thousands of cases with this problem.

The day after my LASIK procedure a few years back, I lost vision for about 30 seconds. In the days that followed, I noticed more and more "floaters", which have built to the point that they interfere with my vision while reading or using a computer. I called my LASIK office, and they said I had an "ocular migraine", and it's unrelated to my procedure. That seemed like BS. Were they just covering their butts?

Also, I was told by some follow up docs (not at the same office) that I'm pretty much stuck with the floaters. Is that still the case?

Over time most floaters will fade away. In rare cases, if it is causing severe problems then treatment is needed but that treatment can cause further problems. If you can live with it then I would. If you can't and it's a severe problem, I would be looking into vitrectomy and laser vitreolysis treatments.

What's the most ridiculous misconception you've ever heard about LASIK? Bonus question: Best pizza topping?

That I am not a good candidate for LASIK when you have never gone to see a doctor if you are. Most people go online nowadays and find things and instantly believe them without fact checking or making sure by double checking.

Best pizza topping would probably be pineapple.

How often does it happen that you refuse patients for a lasik surgery? And what are the common reasons not being suitable for a lasik surgery?

It happens from time to time. Not all patients qualify for LASIK or are suitable for it. They may qualify for another procedure such as PRK, ICL, LASEK, IOL, SMILE, etc because of various reasons. Some reasons you can't have LASIK are as follows. The cornea is too thin, you are pregnant or nursing, vision is not stable, poor eye health from previous accidents, etc. The best way to check is to go to a doctor and have yourself examined. For the most part all clinic's offer free consultations, so I would take advantage of that.

Hello Dr. Lin,

How important are the check ups post surgery? I had my 1 day and 1 week check up. However, I moved away from where I had my SMILE surgery and I won't be able to do any more check ups there. Is it okay to go without check ups or should I find another doctor in my area for checkups?

I recommend doing checkups yearly if possible. You should find a doctor in your area and go to him. Ask the place you had your surgery at to send the records to your new home and take it from there.

Hi, My 12 year old has been wearing glasses since 9 months old. He hates it. I believe his vision is -6.0 if it matters. At what age would he be eligible for corrective surgery?

The FDA approved age is 18 but the vision needs to be stable and other tests need to be administered. Have you considered Ortho-K? I've seen a huge increase in usage over the years for kids in my clinic through this. Basically, the kids need to wear overnight contacts and they don't need contacts or glasses during the day. That can be an option for him/her as well.

Have you heard of the SMILE procedure? I was interested in Lasik due to my astigmatism, and my optometrist recommended SMILE. He described it as Lasik without the cutting off the cornea.

Yes, but only certain patients qualify for it. Don't tell anyone but I may or may not be offering it soon. The flap cut is less than typical LASIK so recovery is faster and side effects are lessened. Obviously, because it's a newer procedure in the USA not all doctors offer it or have as much experience with it. Find one that you feel comfortable with.

Dr Lin I'm in desperate need of lasik because I get horrible migraines as a result of the pressure from glasses frame on the sides of my head. I can't afford better frames and certainly can't afford lasik. Do you foresee the cost of lasik coming down anytime soon? I have a very common astigmatism.

The cost of LASIK is coming down but that is also causing problems like someone else mentioned here. Like all business the people who charge more have more experience and better equipment for the most part. Those people will increase their prices over time. If money is an issue I would wait until you find an experienced doctor to do it with.

How do you feel about people getting corrective eye surgery done in foreign countries? I know several people who have gotten surgery done in Tijuana for a fraction of the cost of what it would be in the US and they all have had great results. Is there really that big of a risk?

It will depend on where and with who. Outside of the country, the laws you need to abide by are less strict so chances for problems are bigger. The upside is that countries outside the USA do offer better equipment and procedures, not FDA approved yet in the USA. If the price is an issue but you are getting the same procedure than the one you would get in the USA, I would do it here. The regulations in place in the USA are more strict and problems faced are much easier to be resolved since you are still in the country.

What's for dinner?

I'm not sure yet, probably a Chinese dish or steak.

How is your prescription measured when doing a consultation is it like a regular exam and measured by what looks best to you or is it measured by the a machine?

It's measured by the machine and also by a doctor. Then we measure again during surgery day to make sure nothing has changed.