Resources:Q & A

Questions and Answers

What is laser vision surgery?

Surgery done with a laser, most often an excimer laser, to remove corneal tissue in order to reshape the surface of the eye to bring it into better focus and reduce or eliminate the need of corrective glasses or contact lenses.

What's the difference between Lasik & PRK?

The difference between PRK and LASIK is the location on the eye that the laser treatment is applied. In PRK, the laser pulses are delivered to the surface of the cornea, whereas, in LASIK a corneal flap is created and the laser treatment is placed beneath this flap. Patients undergoing the LASIK form of treatment recover quicker, which has always made it the more popular form of laser treatment.

Are Lasik and PRK safe?

Both PRK and LASIK have been found to be safe and effective by the FDA.

What are implants?

Implants are lenses, smaller than a dime, that are made of various materials, purified plastics, silicone, and synthetic combinations, that can be placed inside the eye to either replace the natural lens (cataract removal) or correct nearsightedness, farsightedness, etc.

How does laser surgery differ from RK & implant surgery?

RK was a procedure employing surgical micro-knives to make small incisions in the cornea to induce a shape change. There was no removal of tissue in the RK procedure. RK was less accurate and had a smaller treatment range than either laser or implants. Lasik uses an excimer laser to directly alter the shape of the cornea by removing tissue, and implants are lenses placed inside the eye to alter the power of the eye.

How do I know if I'm a candidate?

If you are 18 years old or older, feel that your glasses or contact lenses prescription is not changing significantly anymore, and have no serious medical or eye conditions, you may likely be a candidate for some form of laser eye surgery in Milwaukee. There are still factors that may disqualify you for surgery. Our consultation and evaluation process is designed to complete the process of determining your candidacy for one of the various treatment modalities we employ. The best thing is to call our office and speak to one of our technicians/counselors for more information.

What is the current minimum age for having Lasik?

The labeling of the WaveLight excimer laser system that we use states that patients should be 18 years or older to have Lasik. PRK and secondary treatments fall under the category of "Off-Label". See under GLOSSARY in RESOURCES.

How long do I have to have my contacts out before my exam and surgery and why?

It is important for your eyes to return to their most normal shape and healthy condition. FDA guidelines vary by type of contact. For Wavefront Optimized procedures and CONTOURA treatments, all soft style contacts have to be removed for one week while hard and gas permeable lens must be removed for a minimum of three weeks. These are minimums and depending on how out of shape your eyes are it could take much longer.

If I start the process today, how soon can I have surgery, and what do I do first?

If you don't wear contact lenses, have no medical or eye problems, you may be able to complete the consultation, complete examination and surgery within a period of one week, perhaps slightly less in ideal circumstances. You start by scheduling either a consultation or a combination consultation and comprehensive examination. Otherwise, the main factor is the period of time required to stabilize the eyes after contact lens use. See the above answer about contact lens removal.

Can I do both eyes at once?

Yes you can, if you wish. Most of our patients prefer this simultaneous treatment, however, there can be circumstances in which one eye at a time may be preferable. There are some surgeons that prefer the one eye at a time treatment, but most surgeons and patients do not.

How long does it take?

For the advanced All-Laser Lasik procedure, you will be at the office for about one hour to an hour and fifteen minutes. In terms of the actual surgery time, it takes approximately 5-6 minutes to create two corneal flaps with the Intralase device, and another 5-6 minutes to reshape the cornea with the waveLight EX500 excimer laser system. Surface laser procedures take shorter time, usually about 45-60 minutes. When we begin with the phakic lens implant procedures we expect them to take approximately the same as All-Laser Lasik.

Does the surgery hurt?

There is little to no discomfort with the Lasik procedure. Your eyes are numbed prior to surgery with anesthetic eye drops. You will feel a small lid support holding your eye open during the procedure, and there is a short period in the flap creation part of the Lasik procedure where there is a pressure sensation that most patients report this as "uncomfortable", but not painful.

What happens on the day of the surgery?

  • We ask that you arrive promptly at the time you are scheduled.
  • Please wear comfortable clothing.
  • Abstain from wearing makeup, perfume, fragrant body lotions, cologne or aftershave, since vapors from these scents may interfere with the delivery of the laser beam.
  • Avoid drinking any products containing caffeine, as you need to go home and sleep after the procedure.
  • You will need to arrange for transportation. We recommend you have someone you know assist you in getting you home safely.
  • Expect to be at the Center for approximately one hour and fifteen minutes.
  • You will be asked to sign the consent for surgery form that you have read prior to your arrival. Should you have any questions, be sure to ask prior to signing.
  • In The Preoperative Area
    • Upon arrival, you will be escorted to the preoperative area where the preop person on duty will greet you and take care of you.
    • You will be given a mild sedative to relax you, followed by a series of your antibiotic eye drops, prior to entering the laser suite. A gentle cleaning of the area around your eyes will be performed. Anesthetic drops to numb the cornea are instilled just prior to entering the laser suite.
  • In The Operating Room
    • Laser vision correction is performed in a two main steps.
    • Patient will be guided to lay down on a bed that swivels between two Lasers.
    • The first step is to create a (blade free) flap with the WaveLight FS200, which will take approximately five or six minutes for two eyes.
    • The second step is the treatment laser (WaveLight EX500) which is programmed with your surgical plan before you even arrive for surgery.
    • After the surgeon has you positioned properly under the microscope the laser will be guided for your treatment.
    • This second step will take no more than another five or six minutes.
  • Immediately after Surgery
    • We ask that you go directly home and sleep. The healing begins while you are sleeping. It is best to go to sleep while your eye(s) are still numb.
    • You will leave wearing sunglasses provided for protection and take your sleeping pill in the car about ten minutes from home.
    • A follow-up appointment will be scheduled for the very next day. This visit will be brief in nature, but is very important. At that time, the doctor will verify that the flaps are healing well and measure your vision.
  • What Is Normal After Surgery?
    • Tearing, burning, and foreign body sensations are normal and are usually gone by the following morning.
    • A few patients may be light sensitive following surgery, and if so, this should go away several days to a week or two. Sunglasses may be worn to ease the discomfort if needed.
    • Some mild initial soreness may occur due to the suction ring. This also should quickly diminish.

When can I resume driving?

Since 99% of our Lasik patients will be at least 20/40 or better (legal driving vision) without their glasses the morning after surgery, most patients can resume normal activities the day after surgery. Occasionally, a patient may be somewhat light sensitive or still feeling the effects of the medications used the day before. Also, don't forget to change your drivers license status.

PRK patients may have a somewhat more delayed recovery, especially if both eyes are done at the same time, as it generally takes longer to regain sharp vision.

When can I go back to work?

Depending upon the nature of your job you can often return the day after surgery. Most patients prefer surgery on a Thursday or a Friday to have the weekend to recover, although it is usually not really necessary. You will need to protect your eyes from injury or rubbing. If you work in an environment that causes eye irritation it may be necessary to wear eye protection and use eye lubricants liberally.

When can I resume wearing makeup?

We feel it is best that patients should refrain from makeup use for one to two weeks. It is the rubbing action required to remove the makeup that concerns us, not putting the makeup on. Other facial makeup is fine, but not those items involving eye rubbing to remove.

How many checkups do I need after surgery?

The typically postoperative follow-up regimen is as follows:
  • First day after surgery
  • Three to five days after surgery
  • One month after surgery
  • Three months after surgery
  • Thereafter as indicated

What if it doesn't work as well as it should?

While laser treatments are highly accurate when fired into plastic testing plates, plastic doesn't heal and change shape afterwards, as some patients do. There is always the small possibility that the initial treatment will not adequately correct the refractive error. While this may be apparent immediately, is not usually of such a magnitude that it requires glasses correction, but needs to stabilize before being addressed by an enhancement procedure. This stabilization period is typically three months for nearsighted patients and six months for farsighted patients.

A few patients will do well initially but slowly change over a longer period of time as their personal healing may affect the result. We will wait until this stops and, again, perform an enhancement as needed.

What if my vision changes years later? Can I have it again?

If the vision changes slowly over many years, this is related to changes in the eye that are unrelated to the original laser treatment, but instead, reflect ongoing structural shape changes biologically programmed into the eye, or some other medical condition affecting the eye. These can, where safe and appropriate, also be addressed by the retreatment process even if many years later.

What if I had RK years ago and now my vision has changed? Can I have laser surgery?

It is important that our patients understand the theory behind our policy on retreatments, enhancements, re-operations, etc., on our previous RK patients, especially those who have been happy with their vision for many years but are now starting to notice a change in their vision. See RK Retreatment Policy below
Late RK Retreatment Policy

I've heard that your eyes get dry after the surgery.

Yes, temporarily. Laser vision correction causes a transient decrease in tear production that results in dry eye symptoms. This problem can generally be alleviated by the use of artificial tears until the eye begins to produce an adequate quantity of tears on its own. If there are particular dry eye concerns found during your preoperative examination, steps can be taken to minimize the effects of the dryness.

I've heard that Lasik makes your near vision worse.

If you are under the age of 40, you should not experience any trouble seeing up close after surgery for some time. However, due to the natural aging of the eye, around age 40, people usually have trouble seeing up close and must resort to store-bought magnifying glasses to read small print.

This reduction of near vision will develop eventually regardless of whether or not you undergo laser eye surgery. If you do not have surgery, nearsighed patients will need to wear reading glasses over their contacts or go into bifocals. If you already need reading glasses prior to surgery, your dependence upon them will remain and may even be increased as a result of your distance vision being improved.

Monovision is one option for patients over 40 who would like to see up close and far away. With monovision, one eye is treated for distance and the other eye is treated for near vision.

New technologies are becoming available that will try to solve this age-old problem and restore reading vision as well as distance vision in patients as they age.

I've heard that Lasik makes your night vision worse.

For many people, glare and halos are a fact of life regardless of whether or not they have had laser vision correction. Scientific studies on the cause of glare, halo and overall night vision issues are confusing. Some believe pupil size is critical in the issue of night disturbances, while some do not. Night vision problems are, most likely, related to multiple factors, one of which is what's called higher-order aberrations. We feel that the main thing that we can do to prevent the increase in night vision problems is to minimize the increase of these higher-order aberrations during surgery. In the flap making step of LASIK, the use of the WaveLight FS200 femtosecond laser to produce a more precise flap helps in reducing the induction of aberrations. During the main laser treatment, the use of either WaveFront Optimized or the latest CONTOURA treatment system helps to insure that we are inducing as few of these aberrations as possible. The new CONTOURA treatments were the first treatments found by the FDA to actually IMPROVE night vision in a number of patients.

How many vision correction surgeries has Dr. Hale personally performed?

Dr. Hale has been a board certified Ophthalmologist for 35 years and 31 of those years have been spent performing refractive surgeries including Radial Keratotomy (RK), Astigmatic Keratotomy (AK), Automated Lamellar Keratoplasty (ALK), and now, the procedures of choice: LASIK, LASEK, and PRK.

The estimated number of refractive procedures Dr. Hale has performed over the past 20 years exceeds the 25,000 mark. LASIK cases performed by Dr. Hale are estimated at about 20,000 (Mar. 2012)with approximately 15,000 performed with the Intralase & WaveLight femtosecond, bladefree teachnologies. While the high number of cases Dr. Hale has performed is reassuring to the patient, equally valuable is his comprehensive experience in all refractive procedures.

Will I be 20/20 after the surgery?

No surgeon can guarantee the outcome of a surgical procedure beforehand. However, our rate of success is extremely high, as evidenced by the fact that we are one of the only centers in the nation to publish our exact success rates online:

For a general review of our results, please see the Success Rates page in our Statistics section under the "Procedures" menu.

What about these $299 Lasik ads? What's that about?

There was purposeful price confusion interjected into the LASIK arena a number of years ago by discounting organizations hoping to attract patients with a "too good to be true" low price. Once you were in the door and had given up your credit card number, you would suddenly find the actual price to be much higher. Often patients found themselves in too deep to get out without a fight and decided to just go through with it. Please visit our "Other Providers" page and learn more about the various organizations that make laser vision correction services available to the public.

Why have you switched to the femtosecond laser to make flaps after all these years of using a different method?

Time marches on and so does technology. When we starting creating flaps in 1992 (before lasers and LASIK), we used what we thought was the best keratome (instrument used to cut corneal flaps) available at the time, it was also the only unit available to us at the time. In 1998, a new, improved model keratome was introduced by the same manufacturer. While it still worked on the same basic principle, an oscillating blade, we tried it and immediately saw the advantages of the new modifications. To our satisfaction, we put aside our old, trusted keratome and proceeded with the more modern one. In 2002, we saw the introduction of a revolutionary new way to create corneal flaps, an ultra high speed laser system known as the Intralase. Using infrared light pulses, we could create a flap without a metal blade. However, we were not easily convinced as the early results were not clearly superior to what we were currently providing. As this device was tested and improved, it became clear that it was superior to any other existing method for the creation of a corneal flap. Therefore, in the summer of 2004, after attending a major medical meeting at which scientific papers were presented that documented the superiority of this method, Hale Vision invested in this new technology. Since then, we have gone through several improvements in the technology and in 2015 we switched to the WaveLight FS200, the most advanced system for Lasik flap making available in the US today. While the older blade technology is still used today by some providers, and has proven to be safe and effective, the improved healing and customization capability of laser created flaps still make the laser the method of choice for TLC Milwaukee/Hale Vision. We are proud to be the technology leader the Milwaukee area for the past 20 years and will always strive to make the most advanced technology available to our patients.

What are the risks and potential complications associated with laser vision correction?

We have listed the most common concerns elsewhere on this website. Please Book for a general discussion of these issues and the Success Rates page of our Statistics section for our actual numbers.

Prior to surgery, you will be given an Informed Consent document that lists the risks and possible complications of your procedure comprehensively.

May I speak with any of the patients on whom you've done this procedure?

Definitely. We have a long list of past patients who have offered their phone numbers to anyone considering surgery. In fact, we have such a collection of patients that we can often connect you with past patients who are of similar prescription, age, or who enjoy the same recreational activities, such as golf or tennis.
(262) 789-9179
BROOKFIELD, WI

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I am so happy I found Dr Hale. After years of wearing contacts or glasses I am so pleased with the results of my intralase surgery. I was very comfor... Read More

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TLC Milwaukee/Hale Vision
20350 Watertower Blvd, Suite 200
Brookfield, WI 53045
Phone (262) 789-9179
langelroth@vgroupholdings.com

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