Is ASA Surgery right for you?
Assessing whether you are a good candidate for ASA laser eye surgery
If you’re considering Advanced Surface Ablation (ASA) laser eye surgery to correct your vision, step one is determining your eligibility!
There are basic requirements that all patients must meet to be a candidate for ASA. More on this below, but in general, they constitute being a healthy adult with a stable prescription and good eye health despite having myopia (nearsightedness), hyperopia (farsightedness) or astigmatism.
Beyond that, a clinic’s thresholds for determining your suitability for laser eye surgery vary widely from practice to practice. Herein lies the importance of choosing your surgeon to ensure a safe and effective operation.
As an ophthalmologist who values one-on-one time with patients and is super-focused on safety and outcomes, my threshold for who I accept for surgery can be more conservative than other practices. Why? Because I want to ensure that you will be happy with your long-term results.
When other practices stretch the definition of a “good candidate” from the outset, complications are far more likely to emerge in the long run. I am committed to avoiding patient complications however possible. That means not hesitating to turn away business. By contrast, many LASIK centers accept up to 95% of all prospective patients for surgery.
Regarding the core criteria for having surgery, most individuals between 18 and 59 years old are eligible for ASA. Many people are surprised to learn that more patients are eligible for ASA than they are for LASIK. Since ASA doesn't involve cutting a corneal flap, we can treat higher prescriptions and individuals with thinner corneas. ASA is a procedure that loosens the cornea's outer layer and uses a laser to reshape the deeper corneal tissue.
Learn more about the main guidelines below to see if you qualify.
Basic Requirements for ASA Eye Surgery
Each patient should consult their ophthalmologist about their eligibility for laser eye surgery. But in general, here are the main requirements to be a candidate for ASA:
You are at least 18 years old
You are nearsighted, farsighted, or have astigmatism
Your eye prescription is stable (within .5 Diopters for ≥ 12 months)
You have good basic eye health
You don’t have other high-risk health factors
You’re not pregnant or planning to be pregnant in the next six months
You’re At Least 18 Years Old
Most ophthalmologists only accept patients 18 years and older for laser eye surgery because your vision can change in early adulthood. You can receive eye surgery as late as your 60s, but often, an additional eye issue prevents surgery from being prudent, such as the formation of a cataract. If you’re in your late 50s or 60s, talk with your ophthalmologist about your eyesight to determine if laser eye surgery is safe and recommended.
You Are Nearsighted, Farsighted, or Have Astigmatism
While the other criteria on this list are straightforward, eye prescription and eye health are patient-specific factors. ASA surgery can tremendously improve your daily living, whether you’re nearsighted, farsighted, or have astigmatism. But having these conditions alone doesn’t guarantee eligibility, even if you fall within the prescription thresholds below. To determine safety and risk, a trained ophthalmologist must evaluate your prescription, corneal thickness, and eye health.
In general, these are the prescription limits I accept for ASA surgery at Moskowitz Eye Care:
Nearsightedness: up to -8.00 diopters
Farsightedness: up to +3.00 diopters
Astigmatism: up to 6 diopters
But again, the amount of prescription I can treat depends on each patient’s corneal thickness and eye health. The above limits provide a framework for what I can treat with confidence, but every patient is different and will be evaluated upon your initial consultation. Unlike many LASIK centers, I prioritize patient safety to ensure that you’ll be happy with your vision for many years to come. No regrets!
You Have a Stable Prescription
To have ASA surgery, your eye prescription needs to have changed no more than .5 Diopters for at least 12 months. A consistent prescription means your refractive errors are stable, and you’ll have good long-term results.
You Have Good Basic Eye Health
If your eyes are in good health and you don’t have a condition like Keratoconus or a cataract, you’re likely a candidate for laser eye surgery. If testing shows that your cornea has enough healthy tissue and is regular and symmetrical in steepness and shape, ASA remains on the table.
You Don’t Have High-Risk Health Factors
In some cases, additional health factors may prevent us from moving forward with ASA surgery out of safety concerns. If you have systemic collagen issues or uncontrolled diabetes, you may not be eligible for ASA. But I am happy to refer you to a different service or solution. Being on certain medications like Accutane are relative contraindications for laser vision correction.
You Are Not Pregnant or Planning to Be in the Next 6 Months
To protect your baby, it’s best to wait until after pregnancy to get laser eye surgery. If you’re pregnant or planning a pregnancy in the next six months, hold off on surgery for now. Most of the drops that are used during the procedure and afterward have not been tested on pregnant women so we are not certain about their effects on the baby. Beyond that risk, your vision can change during pregnancy, so it’s best to wait until you’re not pregnant to correct your vision.
Additional Conditions That Still Make You Eligible for ASA
You can still be eligible for ASA surgery even if you have qualities that make you ineligible for LASIK. ASA can treat higher prescriptions and thinner corneas than LASIK can.
Your Cornea is Too Thin for LASIK
ASA doesn’t involve cutting a flap in your cornea, like LASIK does, meaning that you may be eligible for ASA even if you have a thin cornea. ASA preserves 100-150 microns of cornea tissue by not cutting the flap, meaning the surgery can treat more diopters of prescription than LASIK can. There are other options for patients with inadequate corneas, and I never hesitate to redirect patients, even if it's not a part of my practice.
You Have Dry Eye Syndrome
With ASA, the chance of dry eyes is significantly reduced compared to LASIK. So, if you have mild dry eyes pre-surgery, you may still be eligible for ASA. Also, remember that a big cause of your dry eyes may be from wearing contact lenses, a piece of plastic on your eyes! Because LASIK can cause dry eyes, ASA is a much safer option than LASIK for patients with dry eyes. Still, if you suffer from advanced dry eyes, laser vision correction surgery may not be the best option for you.
You Play Contact Sports, Serve in the Military, or Have an Active Job
If you have an active lifestyle, ASA surgery is an excellent fit because it allows you to forgo wearing eyeglasses and contact lenses. More than just contact sports, it’s not unusual for a toddler to have their fingers near your eyes. A small event like this can sometimes have big effects on the flap. ASA is safe and doesn't involve cutting a flap. Whether you play contact sports, serve in the military, or work a blue-collar job, ASA can transform your lifestyle.
Payment Methods and Criteria
Most vision and medical insurance plans do not cover laser eye surgery, as it’s considered an elective procedure. The initial consultation in our office is complimentary. The operation itself will run you either $4,100 or $5,100. Other procedures in the city are priced comparably (see more info on pricing).
Next Steps for ASA Surgery
If you’re interested in ASA surgery and you live in the New York City area, schedule a free consultation with me to discuss your vision and confirm your eligibility.
Unlike other practices and LASIK centers, I personally sit down with each patient to discuss surgery, outcomes, and possible risks. Don’t just take my word for it. Read or watch testimonials from my previous ASA patients.