Anybody who has met Dr. Gulani knows his desire to educate each and every patient. He loves to say “Grill me with questions” to every new patient and it is strict rules at our institute that a patient can proceed for surgery only after all their questions are answered.
Having pioneered and honed Lasik surgery over three decades along with award-winning surgical inventions to safer and less invasive techniques like NexGen LASIK and LaZrPlastique which are “No-Blade”, “No-Cut” and “No-Flap” surgeries; Dr.Gulani is able to treat a full spectrum of glasses/contact lens prescriptions (nearsighted, farsighted, astigmatism and reading glasses) including those patients called” Not A Candidate” by most Lasik surgeons.
What Do I Need to Know Before Laser Vision Correction Surgery?
- How do I know if I am a candidate?
- Am I nearsighted or farsighted and can laser vision correction treat it?
- I’ve heard so much about astigmatism. What is it? Does Lasik correct it?
- Is there a vision correction procedure to help me get rid of my reading glasses?
- What is monovision?
- What is Wavefront technology and Custom Lasik?
- Who can benefit from Wavefront Lasik?
- What is the difference between Lasik and PRK/LASEK?
- What is IntraLase™?
- What is the difference between LASEK and PRK?
- What are the risks?
- How long has laser vision correction surgery been performed?
- What is the cost…and will my insurance cover it?
- What’s the first step?
What Will Happen During Lasik Surgery?
- How long does the Lasik procedure take?
- What if I blink during the laser treatment?
- Am I awake during the procedure?
- What if I don’t keep looking at the red target light?
- Is the Lasik procedure painful?
- Can I have both eyes treated at the same time? Do I have to?
- How much time do I need to take off from work?
What Can I Expect After Lasik Surgery?
- What kind of results can I expect?
- What precautions do I have to take after surgery?
- Are there any visual side effects?
- What is an “enhancement” and will I need one?
- Will I need to have this surgery repeated in the future?
- Will I ever have to wear glasses again?
GULANI VISION Difference
- Am I good candidate for Lasik Surgery?
- I do not want to be number in a Lasik factory, how can I get personal care?
- What if I am not a candidate for Lasik or Laser Vision Surgery?
- Should I wait for technology to improve?
- What is the kind of surgical skill that we as patients should be looking for?
- Even though Lasik complications are rare, what if I do have a complication?
- With all the misleading advertising out there how does one find the truly best and most reputed Lasik surgeon?
- If I live outside of the Jacksonville area does that make me ineligible to have Dr. Gulani as my surgeon?
- What about financing plans and options?
What Do I Need to Know Before Laser Vision Correction Surgery?
How do I know if I am a candidate?
Most people who are in good health and are either nearsighted or farsighted or have astigmatism are candidates for some form of laser vision correction. In general, you should:
- be at least 18 years of age or older
- have had stable vision for at least a year
- have no health issues affecting your eyes
- be in general good health
With advanced diagnostics, Dr. Gulani in a personal consultation with you, dedicates his focus to picking one among nearly 20 Laser vison techniques and technologies designed for your unique eyes.
Am I nearsighted or farsighted and can laser vision correction treat it?
As long as your prescription falls within FDA-approved limits, LASIK or other procedures including NexGen LASIK and LaZrPlastique can correct either nearsightedness or farsightedness.
Being nearsighted, or myopic, means you cannot see things clearly in the distance. Nearsighted people need glasses to drive or to watch television, and some people with more extreme prescriptions may need glasses even to see the alarm clock in the morning.
If you are farsighted, or hyperopic, you may have trouble seeing things up close. Without glasses or contacts, reading, eating or even talking to friends can all be difficult.
I’ve heard so much about astigmatism. What is it? Does Lasik correct it?
Astigmatism refers to an asymmetric curvature of your cornea. A “normal” cornea is round, like a basketball. If you have astigmatism, your cornea is shaped more like a football. Astigmatism can occur alone or in addition to either nearsightedness or farsightedness and can be corrected with Lasik.
Is there a vision correction procedure to help me get rid of my reading glasses?
As we age, our eyes lose the ability to focus on images up close. We continually move an image, such as a book or newspaper, farther and farther from our eyes in order to bring it into focus. This condition is called presbyopia. When presbyopia progresses to the point that our arms are not long enough, we need reading glasses or bifocals. NexGen LASIK, LaZrPlastique, LenzOplastique and other presbyopic techniques of Dr.Gulani can be designed to offset the effects of presbyopia.
What is monovision?
Monovision is an option to help correct both your distance and near vision. The procedure corrects the focus of one eye for distance vision and the other eye for near vision. One eye will see things close up, the other eye will see things farther away, and the brain will integrate the visual information from both eyes and filter out any blur. It is similar to the sound you hear from stereo speakers. A different sound comes from each one, but they work together to provide the entire range of sound. Monovision has been used successfully for over 20 years but given Dr.Gulani’s advanced Binocular Blend techniques, he reserves this for patients who are used to it in their contact lens and glasses wear.
What is Wavefront technology and Custom Lasik?
Wavefront Lasik or Custom-Lasik: No two eyes are alike, and like your DNA or fingerprint, your vision is unique. For hundreds of years, glasses correct vision by eliminating nearsightedness, farsightedness and or astigmatism. However, advances in optics have demonstrated that these three basic elements are only part of the picture. There are tiny imperfections or distortions in every eye, even when the perfect glasses or contact prescription is used.
This technology is the same that has been used in the Hubble space telescope. Custom laser correction involves diagnostics that map the entire optical path of your eye, including the tiny distortions and imperfections naturally present in all eyes. This is effectively a unique “fingerprint of your vision,” providing extremely precise and detailed information in the form of a customized map of your eye which is then loaded into the computer of the excimer laser which generates a wavefront customized treatment appropriate for the individual “fingerprint” of your eye.
FDA clinical trials of this technology demonstrated its applicated option and Dr. Gulani cautions that this may not be indicated in all patients and a thorough evaluation is essential to determine its application.
What is Dr. Gulani’s training and experience with Wavefront?
Florida Custom Lasik Surgeon Dr. Gulani was among the first in the entire country to perform Wavefront Lasik surgery abroad and was invited by the faculty at Cleveland Clinic to publish his experience in the Clinics of North America (Prestigious Peer Reviewed Publication). Dr. Gulani teaches Wavefront/ Custom Lasik courses to Lasik surgeons throughout the world and is a medical advisor to the Wavefront Laser Industry itself.
Who can benefit from Wavefront Lasik?
Most people, including those with higher-order aberrations, can benefit from Wavefront Lasik. Until Wavefront was developed, those patients with a significant amount of higher-order aberration had less satisfactory results with conventional Lasik than others. Over 90% of people who currently wear glasses or contact lenses for nearsightedness, farsightedness or astigmatism can now benefit from some form of laser vision correction. The best way to determine how a customized procedure may benefit you is to have a comprehensive eye evaluation and obtain a WavePrint™ map of your own individual visual “fingerprint.”
What is the difference between Lasik and PRK/LASEK?
Lasik (laser-assisted in situ keratomileusis) and advanced surface ablation procedures like LASEK and PRK are all laser vision correction techniques used to correct nearsightedness, farsightedness, and astigmatism. They each use a computer-controlled Excimer laser to reshape the cornea, and each has excellent post-operative results in designated cases.
Lasik involves the creation of a thin corneal flap and the use of the laser on the internal tissue of the cornea. The surgery takes only a few minutes per eye and is generally painless. Afterwards, there is very little discomfort, and patients are often able to return to work the next day. Post-operative care typically involves at least three office visits.
Unlike Lasik, PRK and LASEK do not involve the creation of a flap. With PRK and LASEK, the epithelium (skin layer of the eye) is either removed (PRK) or moved gently aside (LASEK), and the laser operates on the surface of the cornea rather than internally. Again, surgery takes only minutes per eye and is generally painless. Post-operative recovery for PRK and LASEK, however, takes a little longer than recovery from Lasik. To assist healing after PRK/LASEK surgery, a clear bandage contact lens is placed over the cornea during the 3-5 days needed for the epithelium to re-grow. Additionally, LASEK/PRK patients typically use steroid drops for 3-6 months, and there is somewhat more discomfort during the healing process.
There are some patients who prefer LASEK/PRK, as well as some medical conditions that make advanced surface ablation more suitable. Dr. Gulani will help you determine which procedure is best for you.
Dr.Gulani’s advanced Lasik techniques of NexGen LASIK and LaZrPlastique have superseded PRK, ASA and Lasik itself in outcomes and experience for patients.
What is IntraLase™?
IntraLase™ (also known as IntraLasik and All-Laser Lasik or Blade-less Lasik) is an innovative new procedure designed to make corneal flaps for Lasik surgery with a laser rather than a microkeratome (blade).This can also be used to make a small incision flap in SMILE surgery (RELEX) which is done by Visumax and Zeimer lasers.
Dr. Gulani has experience with all these Femtosecond laser technologies and continues to evaluate while recommending for certain patients who would be appropriate for such less invasive flap procedures.
What is the difference between LASEK and PRK?
LASEK (laser epithelial keratomileusis) and PRK (photo-refractive keratectomy) are both advanced surface ablation procedures to correct vision by using the excimer laser to gently reshape the surface of the cornea. With PRK, the epithelium (skin layer of the eye) is fully removed and the laser is applied to the surface of the corneal tissue. During the LASEK procedure, the epithelial layer is lifted gently to the side and then replaced after the laser treatment. In each case, a clear bandage contact lens is placed over the cornea for 3 to 5 days to allow the epithelium to re-grow. Each procedure can be suitable for certain prescriptions and under certain conditions. Dr. Gulani will help you decide which procedure is best for you.
What are the risks?
As with any surgery, there are certain risks. Fortunately, however, the risks of laser vision eye surgery are low and patient satisfaction is high. The main risks include infection, overcorrection or undercorrection of your prescription, halos, a flap that shifts after eye surgery, and dry eyes.
· Infection – The risk of infection is low, affecting only about 1 patient in 5000 procedures. Besides our state of the art Laser suite and sterile precautions with disposable instruments, Dr. Gulani will prescribe antibiotic drops for use after surgery and monitor your eyes to ensure that there is possibly no chance of infection.
· Overcorrection or undercorrection of your prescription – Since the cornea is living tissue and everyone’s eyes are different, it is possible for your vision to be slightly overcorrected or undercorrected after surgery. If your eyes are over- or undercorrected, it is usually possible to do an enhancement to correct the remaining prescription.
· Halos – After surgery, patients may see a “halo” of light around bright lights at night. For most patients, this occurs only for the first week or two after surgery, but some patients continue to see halos longer.
· Shifting flap – It is possible that the flap created during Lasik may shift slightly immediately after surgery. This is most often a result of bumping or rubbing the eye early in the post-operative period. Twenty-four hours following surgery, the risk of the flap shifting decreases greatly. You should contact our office if you experience any sort of eye injury within the first day or two after surgery. Since there is no flap creation in NexGen LASIK and LaZrPlastique, this complication is non-existent.
· Dry eyes – The eyes are typically drier than normal for the first week or two following surgery, though some patients may experience dry eyes for a longer period of time. It is important to use lubricating drops frequently. If the eyes are uncomfortably dry for a prolonged period of time, Dr. Gulani can prescribe other drops or suggest among his proprietary m.o.i.s.t. techniques that can help.
How long has laser vision correction surgery been performed?
The FDA approved the use of the Excimer laser for laser eye surgery in the U.S. in 1996, although the microkeratome that creates the corneal flap has been used in other types of eye surgery since the late 1950s. Since the mid-1990s, Lasik has become increasingly popular with leading eye surgeons throughout the world, with over 6 million successful procedures performed to date.
What is the cost…and will my insurance cover it?
The cost of your Lasik or any Laser Vison procedure including NexGen LASIK and LaZrPlastique is determined at your personal evaluation. Most insurance plans consider LASIK to be elective surgery, but there are a few that offer some benefit that can save you money on the cost of the procedure. Your employer’s flexible spending or cafeteria plan may also offer tax advantages for Lasik. We can help you understand your options and what questions to ask your benefits administrator. In addition, Gulani Vision Institute offers access to nationally reputed credit offering companies like CareCredit.
What’s the first step?
Schedule a Lasik eye evaluation. This evaluation allows you to have access to Dr.Gulani himself in a detailed exam with advanced diagnostics and Dr. Gulani and the staff at Gulani Vision Institute can explain all of the refractive procedures available and help you determine the best option for you.
What Will Happen During Lasik Surgery?
How long does the Lasik procedure take?
The procedure itself takes 5-10 minutes per eye in our State of the Art Laser suite with the actual laser treatment time lasting less than one minute per eye in most cases. Patients are usually in the surgery suite for 15 minutes or more and at the center for an hour and a half usually because Dr.Gulani likes to see you himself before and after the procedure.
What if I blink during the laser treatment?
A small restraining device (gentle speculum) is used to keep your eyelids open during the procedure and prevent blinking. You will not be able to blink so you can comfortably relax during the brief procedure.
Am I awake during the procedure?
Yes. All you need to do is relax and focus on the red light. The Excimer Laser we use – VISX STAR4 will track and compensate for any eye movements during the surgery. Dr. Gulani will talk to you throughout the procedure so that you know what to expect. You may elect to take a mild, oral sedative before surgery to help you relax but given the comfortable and non-rushed ambience at our institute, patients do not take anything at all.
What if I don’t keep looking at the red target light?
The procedure is performed using a VISX STAR4 ActiveTrak™ eye-tracking laser. These advanced systems will track any small eye movements and automatically make any needed laser adjustments. Dr. Gulani is in full control of the laser at all times during the procedure. The laser will not fire if your eye movements take you outside the treatment zone.
Is the Lasik procedure painful?
Patients experience virtually no discomfort during LASIK, and eye drop anesthesia to numb the eye is administered prior to the procedure. If you experience post-operative discomfort, you may use Tylenol or ibuprofen during the first day or two after the procedure.
Can I have both eyes treated at the same time? Do I have to?
Dr. Gulani performs bilateral (both eyes) procedures on the majority of his Lasik patients because he believes it is safe, and patients prefer the convenience. Because the Lasik procedure affords a rapid visual recovery, you can comfortably enjoy the convenience of having both eyes treated at the same time. However, it is always an option to have each eye treated on a different day and there are many cases (since Dr. Gulani does work on very complex eyes too) where he may suggest one eye at a time.
How much time do I need to take off from work?
On the day of the procedure, you will be at the laser center for about 1-1/2 hours. After surgery, we recommend that you go home or to your hotel (if out of country/state) and rest, keeping your eyes closed as much as possible. Most patients do not require medication for pain. Sleeping or listening to the radio or a book-on-tape is a good way to pass the time. Watching TV or going out to dinner is not recommended. On the day following surgery, you will be seen by Dr. Gulani himself and then we recommend 4-5 days of rest and since Dr. Gulani performs so many different , individually designed techniques, we shall prepare you for your exact postoperative care accordingly.
What Can I Expect After Lasik Surgery?
What kind of results can I expect?
Many people notice an immediate improvement in their vision when they sit up after surgery, although there will be an initial haziness. We do advise rest for 4-5 days when vision is recovering and then plan for work (with decreased screen time) over next week (individual cases may vary depending on your complexity)
Dr. Gulani can provide more information regarding your potential outcome after he examines your eyes.
What precautions do I have to take after surgery?
You will be given plastic shields to wear over your eyes immediately after surgery and for the five nights following surgery to protect your eyes while sleeping. For the first month, care should be taken to not touch your eyes for any reason, and patients should avoid getting sweat, dust, or smoke in their eyes. It is also better to avoid swimming for two weeks, but with care, there is usually no problem with showers.
Are there any visual side effects?
Any visual side effects from Lasik are usually temporary though based on your individual eyes the outcomes may vary. The most common ones are a “ghosting” or lighter second image around the edge or border of objects, nighttime halos (a rim of light around bright lights at night), mild fluctuations of vision, and light sensitivity. These effects can last anywhere from days to weeks and in some cases may last for months. There is also a possible decrease in your ability to see well in low contrast situations, such as driving at night. Dr. Gulani will discuss the possibility of these visual side effects in more detail after he examines your eyes based on your individual situation and level of complexity.
What is an “enhancement” and will I need one?
There is no guarantee of 20/20 vision following Lasik or any of the other Laser vision correction procedures including NexGen LASIK and LaZrPlastique. It is possible, however, to have enhancement surgery if Dr. Gulani feels that it is medically safe and will improve your vision. Common in Cookie Cutter Lasik “Mills” where only one or two techniques are offered and patients run through on a conveyer belt, you shall be pleased to know we have had a “Zero” percent enhancement history.
Will I need to have this surgery repeated in the future?
The intention of Lasik including NexGen LASIK and LaZrPlastique is permanence and hence Dr. Gulani carefully determines candidate eligibility to begin with. The vision achieved with Lasik is generally permanent. The correction achieved with Lasik is long lasting in clinical studies. Age related changes continue like Presbyopia (Losing reading vision) , cataracts etc with time and not caused by or directly related to Lasik.
Lasik does not, however, prevent presbyopia, the age-related condition that makes people need reading glasses.
Will I ever have to wear glasses again?
Since almost 98% of conventional Lasik patients in clinical trials achieve 20/40 vision or better very few choose to wear glasses again. Those who do, generally use them only in certain circumstances such as driving at night or in the rain. For most people in their 40s, though, whether they have had Lasik or not, reading glasses may be necessary. This too can be addressed with Dr.Gulani’’s innovative NexGen LASIK, LaZrPlastique and LenzOplastique surgeries.
The GULANI VISION Difference
Am I good candidate for Lasik Surgery?
Dr. Gulani does not believe that information on telephone can determine good candidacy for laser Vision Surgery (Lasik or otherwise).
Being a World Renowned Teacher to Lasik surgeons and an Industry consultant, Dr. Gulani has strict criteria with which he selects patients.
He has advanced Diagnostics and each patient must pass each of these extensive tests after which they will have a personal consultation with Dr. Gulani to determine their candidacy.
I do not want to be a number in a Lasik factory, How can I get personal care?
Dr. Gulani’s approach is unique in that despite his world renown and reputation, he is extremely personal and takes great interest in educating his patients and selecting what is best for them. There is no vested corporation to intervene in his philosophy of personalized patient care, which highlights his “High Tech and High Touch” approach.
What if I am not a candidate for Lasik or Laser Vision Surgery?
After you have been through a thorough diagnostic testing, you will have a detailed consultation with Dr. Gulani personally. He will then decide if Lasik and other laser vision techniques are or are not the best surgical choice for you.
The advantage of having Dr. Gulani as your surgeon is that he is not limited to Lasik and has the expertise and experience to perform the whole spectrum of refractive surgery (Surgery to decrease dependence on glasses), thus he can select which surgery or technology is best suited for you (provided your eyes do not have any disease).
With over 3 decades of experience, Dr.Gulani has designed his surgical system (The KLEAR ™ System) and offers the full spectrum of advanced surgeries that can help people lead a life free of glasses and contact lenses.
This KLEAR ™ system includes the full range of techniques and technologies like Lasik (Laser Vision Surgery/NexGenLASIK/ LaZrPlastique/PRK/Wavefront Lasik/Bladeless, Lasik/Lasek/PTK/Smile/Relex/SBK/EpiLasik/ Corneoplastique techniques etc), Myopia (Nearsightedness)/Hyperopia (Farsightedness)/ Astigmatism, Presbyopia (After 40 reading glasses/Readers/Cheaters/Progressive glasses/Kamra), Cataract (Multifocal lens implants/Panoptix/Trifocal/ReStor/Crystalens/Tecnis/Symfony/Premium Cataract Surgery or, Cataract surgery complication correction), Radial Keratotomy Correction/RK, Pinguecula/Pterygium/ Red Eye, Keratoconus/Collagen Crosslinking /C3R/Intacs, ICL (Implantable Contact Lenses/Visian ICL), Corneal Scar/ Lasik Complication (Glare/haloes/Ghosting), Dry Eye/MGP/m.o.i.s.t., Corneoplastique®
Also, if there is no technology in the present times that he feels is best for you and since he is constantly involved in advanced technology and futuristic research internationally, he can confidently inform you about what would be available in the near future in your best interest.
Should I wait for technology to improve?
This is elective surgery and the decision to have the procedure is yours. Most patients who have sought us were happy with finding the technology and technique best suited for their eyes.
If you are determined to be a good candidate following Dr. Gulani’s evaluation then you can proceed with surgery.
Since Dr. Gulani himself is involved in new technology and research, he has first-hand information about future developments across the world and if needed, can guide his patients accordingly.
What is the kind of surgical skill that we as patients should be looking for?
Lasik is a corneal (clear front part of your eye) surgery. Your surgeon should be comfortable operating on the cornea and have a proficiency to address corneal diseases.
Dr. Gulani is recognized all over the world for his expertise in corneal surgery including the highly complex Artificial Corneal transplant surgery for which he was selected to be among the first in the world and first in the entire state of Florida. He teaches his corneal surgical techniques and has invented instruments for advanced corneal surgery for eye surgeons from all over the world.
In fact, he has taken corneal surgery to a new height by inventing a Superspecialty of LASIK surgery called “Corneoplastique™”
Even though Lasik complications are rare, what if I do have a complication?
Like any surgery, Lasik too can have complications. It is important that your surgeon be capable and highly proficient in management of these situations if they were to arise.
Dr. Gulani is a world resource for Lasik surgeons and patients who seek his opinions and expertise in complication management following Lasik surgery.
He has successfully corrected a number of affected patients and has been publishing his work, inventing instruments and teaching courses and workshops for Lasik complication management to Lasik surgeons at National and International meetings.
With all the misleading advertising out there how does one find the truly best and most reputed Lasik surgeon?
Research your surgeon. This may still not be possible by visiting their websites (Since the surgeons themselves endorse their own websites).
Word of mouth is paramount. Ask other eye doctors. With the transparency of the internet today, you may type your surgeons name in any search engine on the web (Google etc) and see what comes up. This way you can determine your surgeon’s reputation, publications, contributions, presentations and recognition for the surgery of your interest.
Also, insist on meeting with your surgeon before surgery and ask direct questions. Don’t settle for vague or blanket answers. Ask for proof if they say they are pioneers or teachers or world famous.
These are your eyes. Selecting the right surgeon is your utmost responsibility.
If I live outside of the Jacksonville area does that make me ineligible to have Dr. Gulani as my surgeon?
Actually we do see a number of patients who come to us from outside of Jacksonville and even from all over the country and world seeking Dr. Gulani’s expertise. You can call in advance and we will happily guide you towards your local accommodations.
There is a wide range of patient financing options available:
Affordability is often a concern. We feel there should be a reasonable way to finance your refractive procedure, just as you would other important things in life. As an added service to our patients, we are pleased to offer affordable financing options. All financial arrangements must be completed prior to the day of eye surgery.
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