Laser Eye Surgery (LASIK)

 

The Cornea

The cornea is the transparent, protective 'front window' of your eye, allowing light rays to pass through to form an image on the retina. When the cornea is too steep, too flat or damaged through illness or injury, vision will be out of focus to varying degrees. Nearsightedness, farsightedness, and astigmatism are the result.

For many years, imperfections in the cornea could only be corrected with eyeglasses or contact lenses. Now, patients are beginning to use today's modern technology to correct their vision in a new way.

 

The Excimer Laser

The excimer laser is a breakthrough in laser technology. Unlike other lasers, the device allows the surgeon to remove tissue from the cornea with precision, using it to literally reshape the cornea. Laser surgery (LASIK) seems quite simple and safe, and most people think of it as less invasive and risky than traditional surgery. Make no mistake though, LASIK is a combination of traditional surgery with a blade, and the additional use of the laser.

The laser's energy is directed by a sophisticated computer, programmed by the physician and customized for each patient following a thorough examination. The procedure itself is virtually painless and requires only that the patient remain still for approximately 30 seconds to complete the treatment. The eye is numbed and held open with a speculum. In instrument called a microkeratome is then placed on the eye. A blade then slices a thin layer off the surface of the cornea, and the laser is applied to the exposed surface. Then the thin layer (the "flap") is returned to its original position. There may be some mild irritation for the first couple of days after surgery.

The excimer laser has been quite effective in reducing nearsightedness, with 92% of all patients achieving 20/40 vision or better. That is the level of vision required to drive without vision correction, although you may still need contacts or glasses to sharpen things up completely.

In addition to reshaping the cornea, the excimer laser can be used to remove corneal scar tissue due to illness or injury.

 

Side Effects

The more common side effects include:

Of importance is the fact that most side effects are due to how a particular eye heals, rather than the surgeon's skill or laser used. Therefore, advances in surgical skill and newer lasers will never make LASIK perfect. As long as people are individuals, their eyes will heal differently, and some will have good outcomes while others will not.

 

Considerations

As you can tell, I believe in taking a conservative approach to laser surgery. There are several things to seriously consider before deciding whether to go ahead with it.

First, the cost runs about $1500 per eye, and insurance plans will not cover it. And what about newer, more refined laser procedures that are currently under investigation--they may be more accurate than the current procedure is. Long-term effects are still largely unknown; what will happen as your eyes age. Will they deteriorate in some way that isn't anticipated? Finally, you may need to wear contacts or glasses after the surgery anyway, and you certainly will after age 40. Weigh all of these issues carefully before making your decision.

Although you can go to a LASIK seminar to find out more about the procedure, keep in mind that most of these meetings are put on by the surgeon, and you are likely to hear about the positives, rather than negatives, of the surgery. For a more complete view, I recommend you schedule an appointment with an optometrist, such as myself. We are prepared to give you a more balanced view of the benefits and drawbacks, and whether you are a good candidate for the surgery. I also strongly recommend a visit to

http://www.surgicaleyes.org/explinks.htm#table

There, you will read testimonials from people who have had problems with the surgery. You'll read their stories in their own words. On my links page, you will find other interesting sources of information on LASIK.

Try to tone down the 'hype' that surrounds this procedure--don't get too 'pumped up' about getting LASIK done. You must realize that while there is the potential for a great outcome, this is serious surgery and there are risks involved.

My own vision is poor without contact lenses. I've been told by several surgeons that they would do LASIK on me for free… …but I am not ready to take chances with my most precious sense--my vision.

 

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