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Patients who come into our office to talk about their vision correction options often have questions about the LASIK success rate. This isn’t surprising, given the laser vision correction procedure’s popularity and performance in improving vision and reducing – even eliminating – patients’ reliance on glasses or contacts. This article (link to https://americanrefractivesurgerycouncil.org/laser-eye-surger…sik-success-rate/)offers an indepth look at how LASIK success is measured and what the clinical evidence supporting its outstanding reputation for delivering visual outcomes and patient satisfaction. While research shows more than 96 percent of LASIK patients are satisfied with their experience, understanding what is important to you about your vision is essential to setting up your personal success with LASIK. We welcome your questions and look forward to learning if LASIK is right for you and your vision.
When researching laser vision correction procedures such as LASIK, it is important to understand both the benefits and the risks of the procedure. With so much information available online, it can be confusing and even scary researching LASIK complications. The good news for those looking into LASIK is the body of clinical research available to reaffirm safety, effectiveness and satisfaction for those who are good candidates. Here is a good article that plainly lays out frequently asked questions and facts about LASIK.
Did you know most Americans receive a tax refund? If you are among the 8 out of 10 expecting a refund this year, you may already have a plan for the money. Many people take advantage of tax refunds to travel, build their savings, or to improve their overall quality of life. Following are some options you may want to consider.
Invest In Yourself
Investing in yourself is an opportunity that doesn’t come along very often. And investing in crisp, clear vision represents a smart way to spend that extra money while providing perhaps the healthiest return ever.
If you’ve considered LASIK but are worried about the price, the average tax refund of $2,800 can go a long way toward the health of your eyesight. And with LASIK qualifying as a medical expense, some taxpayers are able to achieve a double benefit with a tax deduction.
Improving your vision with LASIK offers several benefits. Freedom from corrective eyewear, improved athletic performance, and eliminating the ongoing cost of glasses, contacts, solutions and drops are just a few. Today, LASIK is an extremely advanced procedure with the capability to correct a range of vision problems including nearsightedness, farsightedness and astigmatism, meaning more people and prescriptions can benefit than ever before.
Best of all, laser vision correction is a decision that can improve your quality of life. Great vision is a terrific way to invest in yourself and the first step is a visit with a highly-qualified surgeon to determine if you are a candidate.
Pay Off Debt
Buying your financial freedom by using your return to reduce or eliminate high-interest debt can be very satisfying. It can also boost your credit rating and improve your monthly cash flow. Put that refund to work by paying down private student loans, car loans, or credit card debt. You’ll be making a 13%-20% return on your investment, depending on your current APR. If you have several credit cards, pay down the one with the highest interest rate first.
Splurge On Your family
Many feel they’ve saved all year, and want to use their tax refund toward a vacation the entire family can enjoy. Studies show that we value memories much more than we value material possessions. So splurge a little — it can enrich your life and be a welcome reward for paying down debt and other expenses. But act responsibly – don’t use a $500 refund to take a $4,000 all-inclusive family vacation that results in running up additional debt.
It’s not often that we experience a windfall of extra cash, so it’s important to spend that tax return wisely. Whether you decide to pay off high interest debt, splurge on your family, or invest in clearer vision with LASIK, it terrific to have an option to invest in yourself and your quality of life.
This post originally appeared in the ARSC Insight Blog.
What You Need To Know About PROWL
Two new studies published online in the JAMA Ophthalmology shed new and important light on patient experiences after LASIK surgery.
What is PROWL?
The goal of the FDA’s PROWL (Patient Reported Outcomes with LASIK) studies was to validate a new questionnaire that gives patients an accurate and complete way to report their experience with vision and LASIK. The questionnaire – a first – provides a better, more consistent collection the patient’s reporting of visual symptoms, dry eye symptoms, as well as patient satisfaction after LASIK, overall satisfaction with vision, daily functioning and well being.
“The PROWL studies are important,” said American Society of Cataract and Refractive Surgery President Kerry D. Solomon, M.D. “This is the first scientifically validated patient questionnaire for LASIK and it has a lot of potential. It provides not only an entirely new set of data that we hope will provide more insights on LASIK outcomes for patients, but also a platform for better patient education and, ultimately, more educated decisions about vision correction. With time and use of the questionnaire, surgeons will get accurate and consistent information from the patient’s perspective.”
What was learned and why it matters?
First, the studies acknowledge the body of clinical evidence confirming the safety and effectiveness of LASIK. With that knowledge, the study’s authors wanted to further explore the patient experience with LASIK, including reports of visual and ocular symptoms and satisfaction with vision and LASIK. Their findings suggested that with a valid questionnaire, patients more accurately assess and report symptoms and satisfaction.
In order to test the performance of the questionnaire – validate it from a scientific perspective – two small sample populations of LASIK patients were given the survey of patient reported outcome (PRO) questions.
- PROWL-1 was conducted at a military center with 262 active-duty Navy personnel (ages 21-52 years of age).
- PROWL-2 had 312 civilian participants (ages 21-57 years of age) located at five private practice and academic centers around the country.
The observational study focused on the functionality of the questionnaire. However, as a result of the LASIK procedures being performed, some additional data was reported:
- Both groups reported high satisfaction rates, between 96 and 99 percent
- A small but significant subset of patients – those without symptoms prior to LASIK – experienced new visual symptoms such as glare, halos, or starbursts, or mild, moderate, or severe dry eye symptoms, 3 months after surgery.
- Overall, the prevalence of visual symptoms and dry eye decreased after having LASIK and improved over time.
- Through the questionnaire, very few patients reported their symptoms impacted their daily activities or well-being.
Has our understanding of LASIK side effects changed?
From a clinical perspective, absolutely not. LASIK side effects are well-known and understood through a huge volume of research. However, what is significant is that patient reported methods offer an entirely new set of data for clinicians and researchers to tap into. This helps to characterize the experience with LASIK more broadly and, perhaps, more accurately moving forward.
Side effects from LASIK are rare, recent studies suggest fewer than 2 percent of patients undergoing modern LASIK report symptoms. This relatively low percentage of patients experience side effects during the recovery and healing process and these include dry eye and visual symptoms such as glare, halos and starbursts. Typically, these symptoms resolve with time or, occasionally, with additional treatment. In particular, those patients who choose to have the most advance treatment profiles with the latest technologies have been shown to have higher levels of satisfaction with the procedure.
“As we have said many times before, LASIK is surgery and can produce post-operative effects,” said Dr. Solomon. “Factors such as the patient’s expectations and understanding of LASIK have an important bearing on outcomes. It’s also true that not all people who undergo LASIK are good candidates for the procedure. The ultimate key to steady improvement in LASIK outcomes is patient education, effective counseling before and after the procedure, and effective screening to make sure that people who undergo LASIK are good candidates. LASIK is one of many vision correction options, and patients should choose and be guided toward the options that are right for them.”
Importantly, doctors want to thoroughly understand those patients who do experience symptoms and the PRO questionnaire may well represent an important advancement in accurately reporting and characterizing symptoms.
The PROWL survey instrument consists of more than 68 questions intended to help patients self-assess and report a range of issues including, satisfaction with current vision, satisfaction with LASIK surgery, and the existence, bothersomeness, and effect on usual activities of visual symptoms including: double images, glare, halos and starbursts. The questionnaire incorporates both written definitions of symptoms and images to help illustrate the symptom and severity levels. The baseline PROWL questionnaire took study participants on average of 20 minutes to complete.
So, what’s the bottom line?
The PROWL study affirms our ongoing commitment to careful, thorough patient counseling about the risks for side effects and symptoms from LASIK. Using validated questionnaires, such as the one created for the PROWL study, is an excellent vehicle for collecting accurate and consistent information from patients. LASIK practices will have access to the PROWL questionnaire (LINK) and should strongly consider incorporating its use as it may allow eye care professionals and patients to make more educated decisions about vision correction. If you are among the thousands of people considering vision correction options, you owe it to yourself and your vision to become as informed as possible about LASIK and other procedures. If you are reading this, you have found the ARSC Insight blog and we encourage you to subscribe.
Earlier this year, a team of researchers wanted to determine if modern LASIK had improved patient outcomes when compared to when LASIK was first approved by the FDA. The team reviewed more than 4,400 clinical studies from around the world and concluded in a paper published in the Journal of Cataract and Refractive Surgery that LASIK is among the safest and most effective vision correction procedures. This vast data review on LASIK is the latest to be added to the library of more than 7,000 peer-reviewed, published studies.
There has never been a better time to have LASIK. The American Refractive Surgery Council recently wrote, “There are as many reasons [to opt for LASIK] as there are candidates. But all of them want what LASIK has to offer – superb vision correction without the hassle of glasses or contact lenses.”
Should I consider LASIK today?
LASIK today is the best it’s ever been. In addition to continuous improvements in technology and technique, surgeons also draw on an extensive base of knowledge to evaluate the patient and perform the procedure.
The scientific literature reports patient satisfaction rates (globally) of more than 98 percent. And, data from a recent three-year study showed contact lens wearers who chose LASIK were more satisfied with their vision than those who stayed in contacts, and that LASIK patient satisfaction also increased over time (while the satisfaction rate among contact lens users decrease).
Is LASIK for everyone?
No, and any reputable LASIK surgeon will use everything at their disposal to evaluate and determine if an individual is a good candidate.
Surgeons today will discuss the procedure in depth with you and will ensure you understand the risks as well as the benefits. A range of medical conditions, including thin corneas and other eye deformities, can mean that LASIK won’t work well for you.
(If you are told you are not a good or even excellent candidate for LASIK, do not be discouraged. It means you are working with a qualified surgeon who has your best interest at heart. There are likely other alternatives to help you achieve your vision goals.)
Opting for LASIK means understanding what the experience will be like – what happens in surgery, what you’ll experience afterward, how long until side effects disappear, and how your vision might continue to change over time.
Do your homework and ask questions.
Ultimately, and only after you have all of the information, you need to determine if LASIK is right for you. If you are a good candidate for LASIK, think about what you want out of the procedure, and be prepared with questions to ask. Articles like this can help you get ready for your consultation. Candidates who come to see us and discuss their vision correction options have done their homework. They have independently confirmed that LASIK is safe and effective, and they know the advantages it offers over other forms of vision correction. We are here to help and will answer any question you may have.
By Dr. Eric Donnenfeld,
Contact lenses are a wonderful invention. They enable people to see better, to shed cumbersome eyeglass, and feel better about how they look.
But contact lenses can also cause inflammation, pain and dry eyes. More than fifteen percent of people suffer from a problem called contact lens intolerance, where discomfort and dryness is so great they have to give up their lenses.
Moreover, contact lenses can also cause dangerous eye infections. A recent report from the Centers for Disease Control warns that 20 percent of infections linked to wearing contact lenses led to serious eye damage.
Many of my own patients are upset and frustrated because they can no longer wear contact lenses.
Fortunately, I can help them, thanks to several new approaches, including an innovative new eyelid cleanser called Avenova.
The most common cause of contact lens intolerance is dry eye, which occurs when the eye doesn’t have a sufficient film of protective tears. That problem, in turn, is caused or exacerbated by bacteria and tiny parasitic mites that live on the eyelids. The microbes not only irritate sensitive eye tissue, causing pain and inflammation (and sometimes, serious eye infections), they also make enzymes that break down a crucial oil layer that protects the tear film.
But we can now successfully tackle these problems. A new device called LipiFlow applies heat and controlled pressure to the inner eyelid, unblocking the glands that produce the crucial oil. Another device, named BlephEx, deep cleans the lid margins with a disposable sponge.
In addition, I’ve had great results with Avenova® with Neutrox from NovaBay Pharmaceuticals. This has become first line therapy. Avenova uses a formulation of pure hypochlorous acid (named Neutrox) to remove the bacteria and mites, reducing chances of infections. It also inactivates the bacterial enzymes, helping to stabilize the tear film and improve comfort. So far, every single one of my patients suffering from contact lens intolerance or other chronic eye conditions has been helped by simple twice-daily wipes with Avenova. It truly is a breakthrough.
A leader and innovator in eye care, Eric D. Donnenfeld, MD, FACS, is a board-certified ophthalmologist, clinical professor of ophthalmology at NYU and past president of the American Society of Cataract and Refractive Surgery
If you’re considering LASIK, you’ve no doubt asked yourself important questions: Is it safe? Is it effective? Is it right for you? Maybe you’ve already asked the same questions of your LASIK surgeon. If not, you should.
Here’s another question that might be on your mind – when your surgeon responds to those questions, how does he or she know what to tell you?
The answer is science. LASIK, like all other medical procedures, drugs, and medical devices, is the subject of extensive research. The research – we call it “clinical research” – is carefully designed to tell us whether medical treatments work, how well, and for what kinds of patients.
How does clinical research work?
Clinical research is a scientific medical exploration or investigation into the performance of a drug, medical device or treatment regimen with the primary goal of determining whether it is safe and effective for patients. It is conducted over an extended period of time – months and sometimes years – by scientists. The reports of these studies are incredibly detailed, running 20 to 100 pages or more.
The research begins with a hypothesis. A hypothesis is an educated guess about the treatment and its ability to provide a certain benefit. Research is then conducted to test whether the hypothesis is true or false. Research can take many different forms, but essentially data is collected, analyzed in the context of the hypothesis and then the findings are reported. The findings of clinical research determine which drugs, devices and treatments are approved for use and often compares them to previously approved treatments. Importantly, clinical research serves to build our knowledge about prevention, treatment, and diagnosis.
LASIK has been the subject of a tremendous amount of clinical research. In fact, LASIK is one of the most studied elective procedures performed today. More than 9,000 patients participated in FDA clinical trials alone from 1993-2005. Over time, a tremendous amount of clinical research into LASIK has been conducted – to date more than 7,000 peer-reviewed published studies, in fact – to confirm the procedure is both safe and effective as well as look into other important aspects of LASIK. This includes studies that help refine what makes a patient a good or bad candidate for the procedure, and techniques and technologies that can reduce the potential for side effects such as dry eye, glare and halos.
Clinical studies have tested the many improvements in LASIK since the procedure was first approved. In medicine, technologies and techniques evolve and advance over time. LASIK is no different. Today’s excimer lasers – the lasers that reshape the cornea to improve vision – are more precise and easier to work with than earlier models. Newer lasers and technologies are able to customize the procedure to the specific shape and thickness of a patient’s cornea and treat a broader range of vision impairments. All of these advances lead to better visual outcomes and a safer procedure for more people.
Research doesn’t just answer your questions – it answers ours as well. The clinicians – the scientists – who work with LASIK are committed to an ongoing process of improvement in the procedure. We continually ask questions as a means of finding potential in LASIK. There is a reason “quest” is the root of the word “question.” This illustrates that scientific exploration is a process, a path – not necessarily a destination. The question is the beginning, not the end.
It is important to understand what clinical findings say – and what they don’t. This can be difficult, because news stories about new clinical studies often grab a dramatic headline, but miss the details and the nuance that are part of every research report. No one study has a final, definitive answer about any medical treatment, device, procedure or drug. By definition, a study has a very specific scope – a specific question it is trying to answer. While the results of a single study can be compelling, interesting and encouraging, they are only a piece of a bigger and growing body of science. This is why you have to be cautious about any reporting that describes dramatic conclusions from a single study.
In the case of LASIK, there is tremendous confidence, based upon an extraordinarily large amount of clinically-based evidence, that the procedure is safe and effective. It isn’t perfect, because nothing is. However, it ranks among the most thoroughly investigated, most effective and safest procedures performed today.
To find out more about LASIK, start here. Then contact us, so we can start a conversation about what LASIK can do for you.
Your eyes need specific nutrients to stay healthy and function well. Good nutrition is important for your overall health and wellbeing, but many don’t realize the importance it has for the eyes where specific nutrients can help prevent or delay the onset of certain conditions as well as protect an investment in vision correction procedures such as LASIK. The good news is that today it is easier than ever to make good, healthful diet choices that help you make sure you get all the nutrients your eyes and vision need.
Not surprisingly, it starts with lots of fruits and vegetables. We often talk about “eating a rainbow” every day, because the compounds that give fruits and vegetables their colors are chalk full of powerful nutrition for your overall health and vitality, including your eyes.
But the eye diet doesn’t end there. Certain foods contain nutrients that are important for helping to reduce your risk of age-related eye diseases and conditions including cataracts and macular degeneration, which are leading causes of blindness and visual impairment in the world.
So what should you be adding to your grocery shopping list to ensure you have a healthful eye diet? Below you will find a list of the nutrients that offer the most eye health benefits and the foods that are rich sources:
Antioxidants such as vitamins C and E help protect cells against damage from exposure to harmful elements such as UV rays, cigarette smoke and air pollution. Dark leafy green vegetables like chard, broccoli, spinach and collard greens and citrus fruits and berries such as oranges, grapefruit, strawberries, blueberries and apples (with the peel). Almonds, egg yolks, sunflower seeds and wheat germ oil are other good sources.
Carotenoids, including beta-carotene, lycopene, lutein and zeaxanthin, are a class of nutrients that make up the bright red, yellow and orange hues in many fruits and vegetables. Remember the rainbow we spoke of eating earlier? Lutein and zeaxanthin may help protect against cataracts. There is some evidence that people with high amounts of lutein and zeaxanthin in their diet have a reduced need for cataract surgery. Beta carotene has been shown to help the retina and other parts of the eye to function properly. Foods rich in carotenoids include carrots, leeks, tomatoes, sweet potatoes, Brussel sprouts, kale, egg yolk, and orange peppers.
Minerals like copper, zinc and selenium are vital for eye health. Selenium, found in Brazil nuts, tuna, eggs and cottage cheese, can help prevent cataracts. Zinc and copper need to be taken together for proper absorption and a recent study into age-related eye diseases found that taking them in combination with high doses of antioxidants or carotenoids can slow the progression of the wear and tear of retinal cells, known as age-related macular degeneration.
Liver, shellfish, wholegrain cereals, nuts and legumes are all excellent sources of copper. You can find zinc in red meat, shellfish, dairy products and eggs.
Omega-3 fatty acids have been a popular topic of study, particularly for their benefits in supporting the healthy development of eyes and vision in infants. Omega-3 fatty acids may help protect adult eyes from macular degeneration and dry eye syndrome, which has been linked to low levels of DHA, a fatty acid found in the retina. For diabetics, omega-3 fatty acids are important for preventing retinopathy, a prevalent complication of diabetes that leads to vision impairment. To bolster the amount of omega-3 fatty acids in your diet, choose fatty fish such as salmon, which are rich in DHA, dark green leafy vegetables, walnuts, soybean oil and avocadoes.
Polyphenols are powerful plant-based micronutrients that can help defend against the damage to your eyes caused by exposure to ultraviolet radiation – primarily from sunlight.
Polyphenols can be found in some of your favorite foods and beverages including dark chocolate, tea, coffee and red wine. You can also find polyphenols in whole grain cereals and beans.
Vitamin B complex levels must be replenished every day, because the body doesn’t have the ability to store it. Protein from as eggs, dairy products, meats and poultry are important sources of vitamin B that help prevent and treat cataracts as well as reduce the risk of AMD. Vitamin B nutrients help support a strong cornea, the surface of the eye, which can delay the onset and progress of eye disorders such as keratoconus.
Ideally, all of your nutritional needs come from a healthy diet, but some people may benefit from taking vision supplements. As part of your annual eye exam, you should discuss your diet with us to determine if you should consider adding a supplement to benefit your eye health.
During the exam, it will be important to discuss any changes to your vision so we can evaluate and make recommendations for vision correction, if needed, as today there are surgical options for nearly every type of prescription.
For those of us who live here, Long Island is a paradise full of quaint seaside villages, historic homes, white sandy beaches, museums, parks, wineries…the list goes on. It’s a place where having good vision can enhance your experiences, both indoors and out. And having LASIK means your vision will let you do and see all the things you want to without relying on contact lenses or prescription eyeglasses.
We’re betting you’ll be surprised by your response to your new vision in everyday experiences and adventures such as these:
Head to the Great Outdoors
If you love spending time outdoors at places like Heckscher State Park, which is great for deer spotting and bird-watching, after LASIK you’ll have a new appreciation of Mother Nature. You’ll be able to see the breathtaking scenery, animals and birds all around you, with clear vision unfettered by glasses or contacts.
Invite Friends and Neighbors to a Barbecue
What a great way to celebrate your new eyesight: Invite all your neighbors and friends over for a barbecue. With you vision corrected with LASIK, not only will you not have to deal with babies knocking off your glasses, you can spend time at the grill or pool without worrying about your corrective lenses getting wet or steamed up.
Walk Along the Beach and Watch Wild Seals
After you have LASIK, you’ll be able to go to the beach – our favorites ones are Jones Beach, Fire Island and of course Cupsogue Beach, with its adorable wild seals – and not have to deal with your usual worries. Forget about getting sand in your contacts when you lie down to sunbathe, your glasses falling off while wading in the water, or stumbling along the shore with blurry vision because you decided not to wear corrective lenses. You’ll be able to see everything around you, including the beautiful colors of the ocean and sand, in perfect clarity wearing fun, stylish sunglasses (rather than your pricey prescription pair).
Camp and Watch the Sunrise and Sunset
Sunrises and sunsets are two of the most beautiful sights in nature. If you go camping at Wildwood State Park or ocean-front Hither Hills State Park, or one of Long Island’s many other campgrounds, after LASIK, you won’t have to bother with fumbling for glasses or putting in contacts. Instead, you’ll be able to immediately see the world in a new light full of the eye-catching yellow, orange, red and purple colors that spread across the sky at dawn and dusk. There’s plenty do – and enjoy with your improved eyesight – during the day as well, including swimming in the Sound, picnicking, fishing, hiking and cross-country skiing.
See Clearly from the Moment You Wake Up
Do you wish you could open your eyes first thing in the morning and immediately see the faces of your loved ones clearly, with no blurry vision? After LASIK, you’ll be able to see from the moment you wake up, without having to reach for eyeglasses or contacts. It’s an excellent way to start the day.
Play Sports Or Get In Shape Without Distractions
It’s true: glasses and contacts just don’t mix with sporting and athletic activities. They definitely don’t with contact sports like football, or recreational sports such as tennis and golf. The same goes for running or even just working out in an exercise class. It’s too easy for your contacts to get dislodged and hard to keep eye glasses in place. LASIK frees you from these distractions and your new clear vision will let you focus on what’s really important: enjoying yourself. And if you want to relax afterwards, we recommend heading to the North Fork wine trail to sample some vintage and new varieties.
LASIK vision correction offers a permanent solution to common vision problems including nearsightedness, farsightedness, and astigmatism. It’s a quick, and safe procedure that improves your vision so you don’t have to rely on contacts or glasses to see well. Interested in learning more? Give us a call and let’s talk about your vision correction options.
Parents who are considering LASIK usually have more questions for our Long Island ophthalmologists about the procedure than single people and couples without children. This is because they need to prepare their family, as well as themselves, for the day of their surgery and the brief recuperation period that follows. Here are three questions we get asked most often:
When will I be able to return to taking care of my kids?
Parents will find the operation barely interferes with their normal routine. They do need to have someone else be responsible for their kids on the day of their surgery so they can focus on themselves and resting once they get home. The most important time is the first 6 hours after the procedure when the parent should keep their eyes closed. They will also need for someone to act as taxi driver, taking them to surgery and picking them up afterwards. The parent having LASIK should be able to resume their normal parenting activities, with certain limitations, the next day. Most patients can drive the next day but may be a little blurry for night driving for 1 or 2 days. Small children, particularly 1-2 year olds, have a habit of poking mom or dad in the eye so I recommend patients wear protective glasses around their children for the first 5 days after surgery.
Can I bring my children to watch the surgery?
This is, surprisingly, not an uncommon request and allowing children to watch the surgery can be a good idea if they’re 3 years of age or older. It reassures them that nothing scary is happening to their parent and that everything’s going to be okay. In our practice, we explain the procedure to your family before the surgery starts and then have a staff member sits with them during the operation to answer any questions or concerns. Families can watch the procedure on TV or through a window into the surgical suite. Afterwards, we bring the children to visit the parent in post-op and get them on board with “playing nurse” and helping out at home for the next few days. I like to let the child place the protective shields on the parent’s eyes, I find it reassures them their mom or dad is OK and takes away any potential fear of the shields.
How old does a child who wears glasses have to be to have LASIK?
Many parents will come back to the office the day following their procedure and the first question they ask is how old does their son or daughter have to be to have LASIK. Now that LASIK has been around for 20 years an enormous number of our new patients have parents who have had the procedure. The requirements for these “legacy” patients are the same: the child should have stable vision and be a good candidate based upon their preoperative evaluation. The youngest age we generally perform LASIK is 18 but some surgeons prefer to wait until the child reaches the age of 21.
If you are a parent considering LASIK, ask your surgeon these questions and any others you have about taking care of your family and parenting duties before, during and after the procedure. This will give you peace of mind so you can concentrate on your surgery and the benefits it will deliver.