Archive for September, 2006

“I have always said that if I were a rich man I would employ a professional praiser.”
The wisdom of Osbert Sitwell
Millions of people now consider themselves to be either grateful recipients or victims of Lasik surgery and many of them, for a variety of reasons, have either produced testimonials to laud the procedure or denunciations to criticize it. This is not a question of who to believe . . . there is no reason to suspect that either the testimonials or the denunciations are untrue, and together they give an accurate picture of the Lasik procedure from the patients point-of-view.
On the positive side, the testimonials tell the stories of people who, in some cases, have had vision problems since childhood and now, thanks to a successful Lasik procedure, have almost perfect vision. On the negative side, criticisms of Lasik range from mild disapproval because of unmet expectations, to angry denunciations because of serious problems after the Lasik procedure, to the extreme cases of catastrophic results.
From the point-of-view of the Lasik provider, a patient’s testimonial is invaluable evidence that they have not only improved the vision of that patient, they have improved the patients life to the extent that the patient has now, willingly, become a spokesman.
From your point of view, as a potential Lasik consumer, the testimonials and condemnations both need to be considered and taken at face value. These, in a very real sense, are not the praises or critiques of individuals as much as they are ‘The History of Lasik.’
It is because of some quirk of human nature that we are more fascinated by tragedy than we are by triumph and, consequently, tend to give more weight to criticism than we do to praise. We, too often, assume the negative is true and the positive is just hype. The news media certainly understands this quirk and they are quick to produce stories of tragic occurrences and tell tales of defeat and disaster while holding the positive stories for a ’slow news day.’ They understand that sad and negative news will hold our attention and motivate us to action while the happy, positive stories will soon be forgotten.
So it is with the testimonials and denunciations of Lasik:
The following is a testimonial excerpt from the Diary of a Lasik patient, found at Ienhance.com
(http://www.ienhance.com/community/diary.asp?diaryid=28):
“Let me tell you though, the best part of my day? The one thing that I will never forget? I heard my wife’s car in the driveway as she drove up to pick me up, and then something wonderful happened. When the door opened, my wife walked in and I could see her! No glasses, no squinting… my beautiful wife. I could see her smiling face, her beautiful eyes… the love of my life. I don’t think she realizes how much I have wanted to do this Laser surgery. I love her with all my heart. She is so beautiful. I am so happy she was one of the beautiful things I was able to see on the first day with my new eyes. I drove us home that evening… without glasses. ”
That’s so vivid and inspiring it could bring tears to the eyes of the unjaded reader.
Now this excerpt from a much less positive point-of-view, found at the SurgicalEyes site on their bulletin board: http://surgicaleyes.infopop.cc/groupee/forums/a/tpc/f/6541031211/m/3296066494
“I had lasik surgery on July 20, 2000. with enhancement October 26, 2000. Not a day goes by that I don’t blame myself for the temporary insanity I must have experienced when I decided to go ahead with the surgery. At all other times I am very cautious about my health, eat right, don’t take medications and I exercise regularly. How could I have done this to myself? I trusted the surgeon to give me the facts, all the facts, and he didn’t, in fact, he lied by omission.
“The complications I’m living with today: induced astigmatism in my left eye, starbursts, 1ľ lights, unpredictable fluctuation vision, dry eyes, foreign body sensation, floaters in both eyes (which I only very seldom experienced in my right eye before surgery), eye pain, eyes tiring easily when reading and working on the computer, right eye constantly shadowing (I have to turn my head to make the shadows go away). I had none of these symptoms before surgery.”
Actually this story of a Lasik failure and a bad doctor may not be as emotionally moving as the previous testimonial but this excerpt induces another, stronger emotion: fear.
Testimonials are important but so is the contradictory evidence, and only when considered together can you learn the whole story.

Lasik vision correction surgery is not cheap. Those considering the procedure can expect to pay at least $2000. The price of your procedure can vary either more or less, depending on the area where you live, the type of procedure you choose and the extent of your vision problem. The Lasik procedure is considered elective, so most insurance companies will not pay for the surgery. The good news is that most Lasik surgery centers do offer financing.
Before you decide on having Lasik surgery, you should always think about the cost. You should never choose a doctor based just on the price. But, you should ask lots of questions about your surgery. You should also know what is included and what is not included in the price of your procedure.
You should always check into your insurance plan before having your Lasik procedure. Most insurance companies will not pay, but it never hurts to make sure. Also, consider checking into what your employer can offer. Some companies offer their employees a special discount when having Lasik surgery. Often, certain Lasik surgery centers are working with the company to operate on their employees. If you have a cafeteria plan or a flex plan at work, check to see if this will cover your Lasik procedure. Many times, a flex spending plan can help pay or defray the cost of the Lasik surgery.
Another option when paying for your Lasik procedure is to check with the finance plans and options offered by the Lasik centers. Most of the time, they can offer payment plans to fit nearly every budget. Sometimes, they can also work in partnership with banks or other loan centers to offer financing with low interest rates.
When you have decided on a payment plan for your Lasik procedure, it is important to work with your doctor to find out what in included in the total cost. Some things to think about are:
Appointments: When you are given the total cost for your Lasik surgery, check to make sure all of your appointments are included in the price. You will have at least five appointments with your Lasik doctor. One will be your first initial appointment and then you will have your surgery and at least two to three follow up appointments. Most Lasik centers do include the price of this appointment in their final billing, but it is always good to double check.
Medications: You will probably be given special eye drops to use for several days after your Lasik surgery. While the cost could be minimal, you should always check to see if the eye drops or any other necessary medications are a part of the final cost of the surgery. Also, if you request a mild sedative to be used during your procedure, see if this is included in the price.
One or two eyes: While it seems simple enough, make sure that the price you are given reflects both eyes. Often advertisements make Lasik seems so affordable by announcing “Lasik for $500″. You should always read the fine print and see that the low price usually only covers one eye. If you need both eyes done, make sure your price reflects that.
Additional Surgeries: Sometimes doctors or patients choose to have one eye done and then the other eye done a couple of month later. If this is the case, make sure you have the final price for both surgeries. Sometimes, additional Lasik surgeries are required if the outcome does not improve the vision. These are sometimes called “repair” or “enhancement” surgeries. Many times, the price you are given does not reflect additional surgeries that may be needed. Some doctors will give enhancement surgeries at no extra cost when they are done in a specified time frame. Other Lasik doctors will give patients a reduced price for these additional procedures. The need for these surgeries is common so it is always a good idea to find out if the price is included.
When you get ready to have a Lasik surgery procedure, you should always check with your eye care professional and ask many questions. It is important to know and understand what is and is not included with the price of your procedure. If you do not feel comfortable with the pricing package being offered, remember that many experienced doctors now perform the Lasik procedure. Look around and do some research before making an appointment for any surgery.

As with all forms of surgery, Lasik has the potential for side effects. Although these side effects are not considered life threatening, they can affect the overall health of the eye, or eyes, as well as the quality of vision. In addition, complications with Lasik are less likely to occur with a surgeon who is experienced and who has performed the procedure many times.
Statistically Speaking
A study that took place in the late 1990’s showed that nearly 5% of people who underwent Lasik surgery encountered some sort of problem. Experienced surgeons, however, are currently reporting a complications rate of below 1% if candidates are screened and selected carefully.
When Lasik complications do occur, most are resolved by re-treating the eye with lasers or by using eye enhancements. Rarely are the complications of Lasik permanent or significant.
Flap Complications
The most common form of complications associated with Lasik is problems with the flap. The flap is what is created when the clear front covering of the eye, or the cornea, is cut and lifted to assist in the reshaping of the eye. After the reshaping is completed, the flap is replaced and serves as a form of natural bandage.
On rare occasion, this flap is cut through. This most often occurs when a microkeratome is used for this procedure rather than an IntraLase laser. In fact, IntraLase has been shown to increase the accuracy of the procedure and, therefore, reduce the number of flap complications.
If the flap is cut incorrectly, it may not adhere correctly to the surface of the eye. In addition, the flap can be cut too thinly or too thickly. When the flap is put back in position over the eye, it can start to wrinkle. These flap complications can cause the eye surface to be irregularly shaped, thereby creating irregular astigmatism and vision distortions.
Dead cells can also get trapped beneath the flap. This phenomenon, called Diffuse Lamellar Keratitis (DLK) or, “Sands of the Sahara,” causes the cornea to react to the presence of this foreign matter, which leads to inflammation and scarring. This can potentially lead to permanent vision loss if not treated promptly with topical steroids and antibiotics. In addition, the flap might need to be lifted and scraped in order to remove the infiltrates and the resulting growth.
Irregular Astigmatism
Irregular astigmatism can also result from Lasik surgery. This complication results when the corneal surface. This happens when the laser correction is improperly centered on the eye. The symptoms of this complication include double vision, or diplopia, or ghost images. This can generally be remedied by re-treating the eye or by using enhancements.
Irregular healing of the cornea or swelling after the surgery is complete can also cause ghost images or double vision. In this case, the symptoms are likely to disappear without additional treatment once the healing process is finished.
Overcorrection and Undercorrection
A person with severe visual problems is more likely to encounter a gradual decrease in visual acuity over a period of time after Lasik. This is known as regression.
The healing response of each person receiving Lasik can also determine whether or not overcorrection or undercorrection occurred. Both of these situations can also lead to less than perfect results.
With all of these scenarios a follow-up procedure with Lasik, known as enhancement, can alleviate the problem.
Keratectasia
If the flap is cut too deeply or if too much tissue is removed from the cornea during the Lasik procedure, keratectasia can occur. This condition causes the cornea, which has been weakened, to bulge. This can result in distorted vision that is unable to be corrected with laser enhancement. In this case, a rigid contact may be put in place to help hold the cornea in place.
Dry Eye and Other Problems
Dry eye can also occur after Lasik surgery. In addition, infection, inflammation, redness, irritation, and visual distortion can occur. Some patients report seeing glares or halos around objects that are brightly lit at night. The Lasik treatment zone being too small can cause these complications, because it is unable to accommodate the larger size of the pupil while in a lowly lit area.
As surgeons become more and more skilled with performing Lasik eye surgery and technology continues to advance, the likelihood of developing complications from this innovative procedure decreases.