LASIK Surgery

Dr. Mahanti is a specialist in refractive surgery. He is one of seventeen surgeons in the world and the only surgeon in Arizona to have studied in an extensive one-on-one fellowship setting with J. Charles Casebeer, M.D. Dr. Casebeer is considered by many to be the “father” of modern Radial Keratotomy Surgery. Dr. Casebeer also helped to introduce Excimer Laser Surgeries to American eye surgeons. Dr. Mahanti was one of the first surgeons in Arizona to perform PRK and LASIK with an FDA approved laser and was a founder of the first laser center using an FDA approved laser in the state. He seeks to educate patients regarding realistic expectations with refractive surgery. Our highly skilled, dedicated staff will do all we can to obtain the best result possible for each patient, as each eye is unique. Unlike many centers that are extensions of a corporate chain, Dr. Mahanti is here to personally care for you before, during and after your surgery. Next to you, no one cares more about your results than he does. This commitment to quality has earned our office an excellent reputation in our medical community, such that many local physicians, nurses, and their spouses have chosen Dr. Mahanti for their eye surgery. He also understands refractive surgery from a patient’s perspective. Dr. Mahanti has undergone refractive surgery in both eyes and enjoys excellent vision without glasses or contacts.

Patients must be a minimum of 18 years old (depending on the nature of their refractive error). You must also fit within the treatment range of the laser which encompasses most, but not all, corrections. A variety of other factors will be assessed during your pre-surgical exam, to determine your candidacy. Dryness, night vision problems, activities, age and how you use your eyes are all very important and will be considered carefully.

We have proudly offered LASIK and PRK in our Flagstaff center for over ten years, and since 2006 have operated with the Technolas 217z, which now has the most advanced eye tracking device available. The Technolas 217z 100 with ACE tracking, is the only laser system with a tracker that will actively follow a patient’s eye movements side to side, up and down, and twisting. This superior tracking device leads to the most accurate placement of the laser treatment, improving results.

We use a mechanical microkeratome for cutting the flap during LASIK. We have had tremendous success with a very low complication rate with our equipment. We see no advantage to purchasing the very expensive “no blade” systems. According to studies, the “no blade” or laser flaps “did not have an advantage in efficacy, accuracy, and safety measures over mechanical microkeratome LASIK”.* Ref: J Cataract Refract Surge 2011; 37:2151-2159 2011 ASCRS and ESCRS.

If you are wearing soft contacts they need to be out for at least one week before your evaluation exam and two days before your surgery. If you are wearing hard or gas permeable contact lenses they need to be out for at least three weeks prior to your exam and surgery. If you have little or no astigmatism we can try to get you into soft lenses to transition you during this period.

Hard and gas permeable lenses reshape the cornea, and even a soft lens can alter the shape by causing swelling. Leaving them out helps your cornea return to its most natural shape. By waiting this period of time, or even longer, we assure that we will get the most accurate results from your exam, which has a direct effect on the accuracy of your surgery. The goal is to get the best measurements for your vision correction.

Dr. Mahanti routinely performs laser surgery on both eyes on the same day. On the occasion that one eye is done at a time, this is often personal patient preference. It may depend, however, on the procedure you’re having. It is possible that at the time of surgery Dr. Mahanti will choose to not proceed with the second eye.

You will be at our laser center for an about an hour on the day of surgery. The surgery itself takes about 5-10 minutes for each eye. Prior to surgery, you may have a small dose of Valium to relax you if you wish. Upon your arrival your paperwork & instructions are reviewed. And after your procedure you will go home to rest.

There is little pain associated with the modern refractive procedures. Your eyes are numbed before the surgery with anesthetic eye drops. During the surgery, you may feel a small lid support holding the eye open and pressure from the suction ring during the creation of the flap (if you are having LASIK). Most patients do not report this as being painful. The laser portion of the surgery is painless. The anesthetic drops continue to numb the eyes for about 20-30 minutes after surgery. Once the anesthetic drops wear off, your eyes may burn and water for about 6 hours. Usually Tylenol and going to sleep will allow the eyes to heal well. Prescription pain pills will be given if you are having PRK, as this procedure causes more irritation.

Refractive surgery involves delivering a laser treatment from an FDA approved Excimer laser into the stromal layer of the cornea. With LASIK, a thin flap of the top two layers of the cornea is created to reach the stroma. The success rate in the creation of the flap in our practice is over 99%. If there is anything abnormal about the flap, the surgery is stopped and can be attempted again in three months. With PRK, just the very top layer of the cornea is removed to reach the stroma. The other critical part of the procedure is the laser application. The laser must be properly programmed, aligned and the patient must hold his attention on a blinking target light during the application. Do not be too concerned about your ability to hold your eye absolutely still, as our laser has a superior tracking device that will allows the laser beam to follow the small movements you cannot control. The consent form for surgery provides a more complete discussion of complications. Fortunately, in Dr. Mahanti’s experienced hands complications are truly rare, and he will discuss these with you at your eye evaluation.

Most refractive patients experience intermittent mild irritation for several days after the surgery. The vision can fluctuate from day to day, and it also may be different in each eye. This imbalance can be annoying in the early post-operative period. There are some patients whose vision takes several weeks to several months to improve to its maximal level. Dryness in the eye can be exacerbated by the surgery, requiring the frequent use of eye drops for a while. There are also some patients that will need to use lubricating eye drops for a prolonged period of time. Glare and light sensitivity can also occur, and night driving can be more difficult after surgery. Rarely the use of night driving glasses is required. These side effects usually resolve within several months.

Insurance companies, for the most part, still look at Laser Refractive Surgery as cosmetic in nature and so do not cover it. A few insurance companies are trying to be more progressive, so we always encourage you to call them and ask. Some vision plans may be contracted with one or two surgeons in the state to perform surgery at a discounted rate, and these surgeons are usually in Phoenix, so you need to calculate in your travel expenses, and take into account that you will not be developing any relationship with your surgeon. Many people have a flex-plan or health savings plan available with their workplace, which provides pretax dollars you can use for your surgery. We also have financing available if desired. The IRS considers Laser Refractive Surgery as reconstructive and eligible as a medical expense deduction.

You should not have any problems seeing up close after surgery until you reach your 40’s. Most people in their mid- to late 40’s naturally have trouble seeing up close, whether they’ve had surgery or not, and need to use store-bought readers or bifocals to read small print. The need for reading correction will occur for most patients regardless if they have Laser Refractive Surgery or not. Patients over the age of 50 may also have more difficulty with arms length or intermediate range vision.