Archive for October, 2006

Lasik vision correction surgery is a widely performed procedure designed to help improve the eyesight. This procedure can often completely eliminate the need for corrective lenses in some patients with a good surgical outcome. While the Lasik procedure is a relatively quick and easy surgery, there can be risks and complications. With Lasik vision correction surgery becoming a popular option for people who depend on glasses or contacts, many wonder about the long-term effects.
The Lasik surgery can often drastically improve the vision of many people. About 94 percent of all patients find that they have improved vision almost immediately after the surgery. Many times, patients can have 20/40 eyesight or better after Lasik. A few patients do reports complications with this procedure including seeing halos around lights at nighttime, worsened vision and infections. The laser technique procedure is relatively new, so many patients are curious about the long-term effects of Lasik.
Modern Lasik surgery was first performed in the United States in 1991. A sort of Lasik procedure was performed much earlier than this though. In 1948 eye vision correction was performed. This procedure was much more involved than the current technique. It involved cutting and stitching the cornea back in place. This early procedure was only performed in very extreme cases and at the time was very experimental. Early eye correction surgeries had results that were often unpredictable and risky. Now, many people can have Lasik without the worry of major complications. Lasik procedures today are highly effective and are very precise.
It is important to understand that since the modern technique of Lasik has only been used for about ten years, doctors do not know the long-term effects. Scientist who research and track Lasik complications, believes that there are probably no significant long-term effects from this surgery. It is known that early forms of vision correction seemed to work well and did not have negative long-term effects. The excimer, which is the laser used during these procedures, have been used since the early 1980s. The technique of making a flap in the cornea to correct vision has been performed in the late 1940s. Neither has shown negative long-term effects on patients.
One possible long-term side effect could be reduced night vision or seeing what are called halos around lit objects in low light. One research shows that some Lasik doctors no longer use the laser technique for Lasik procedures because of the patient’s complaints of reduced night vision. The US Food and Drug Administration also warn of these effects on patients. The FDA warns that after Lasik surgery, some patients will no longer be able to drive at night. This side effect can be a major problem for some people.
Another possible long-term effect that the FDA cautions potential patients about is that the benefits of improved vision may not be permanent. They feel that the improved vision could be temporary especially for those who already depend on reading glasses. Many Lasik patients find that they still need reading glasses after the surgery is complete. Even with the surgery an immediate effect of the surgery may include the need to still wear glasses. The surgery is not designed to completely eliminate the need for glasses, but to reduce the need for them after surgery. Additionally, the need for reading glasses is caused by natural maturity of the eyes and Lasik cannot improve the need for reading glasses.
The most important part of the Lasik procedure is to make certain that you are a good candidate for the surgery. Most of the complications and side effects of Lasik are on patients who are not properly screened or who have not had proper education. A Lasik surgeon should be prepared to tell you every aspect of the surgery and determine if you can have a good outcome. People who should not have the surgery include those who suffer from diseases of the immune system, those who are under eighteen years of age, those with certain eye diseases and people who are pregnant or nursing.
Proper education about the surgery can help many potential patients understand the risks and complications prior to surgery. There are no guarantees for those who choose to have Lasik. The best Lasik patients are those who are fully informed and have realistic expectations of the procedure.

When you are thinking about having Lasik vision correction, it is important to not only understand the procedure, the benefits and the risks, it is also important to find a good Lasik surgeon. There are so many eye care professionals that do Lasik surgery so it is wise to find one that is educated in the latest technology and who is experienced in the type of Lasik procedure you are having.
Choosing a Lasik eye care professional can be difficult. There are so many types of Lasik techniques and doctors. Before you make an appointment with any Lasik doctor is always good to get the opinion of your regular eye care physician. By doing so, you will get a better idea of who to go to in your area and who is trusted. Do not consult the first Lasik doctor in the phone book or pick one according to price. Instead, choose one for experience.
Although there is no right or wrong way to choose a good Lasik doctor, here are some basic guidelines to help you pick the right one.
The Lasik surgeon should be your doctor from the start to the finish. Many Lasik eye centers run patients through quickly, one right after another. The result of this is that the actual doctor may not see you until the surgery. They may have staff that performs the health history and initial eye exam. Avoid these types of doctors. Your Lasik doctor should be the only one involved in your eye care. He or she should perform the initial exam, perform the surgery and do all of the follow up appointments. This ensures more customized and personalized surgery and often means a better outcome.
Choose a surgeon who specializes in Lasik. There are some eye care doctors who do many different types of procedures. That doctor may or may not specialize in Lasik. Before choosing a doctor, find out if a particular doctor specializes in Lasik. One who does is probably knowledgeable in the latest technology used in Lasik procedures. While one who does not specialize in Lasik may still give you good results, it is always good to know. Some experts believe that the magic number for doctors is 1000. That means that some people believe that the best Lasik surgeons have performed over 1000 Lasik procedures. Experience is always the best practice so ask your Lasik doctor how many procedures he or she has performed.
A good Lasik doctor explains the risks and complications associated with Lasik. While it is true that Lasik procedures often have good results, there are some risks and complications. As with any medical procedure, you should always fully understand these risks and complications. You should not expect perfect vision and you should never use a Lasik doctor that tells you otherwise. An experienced Lasik surgeon will also explain to you that there is the possibility of having reduced night vision and in rare circumstances can lead to worse vision than before the procedure.
Don’t rely on Lasik centers that advertise heavily. We have all heard or seen the Lasik ads promising clear vision with an experienced Lasik doctor. While these Lasik doctors may very well be experienced, sometimes they do not offer personalized care. These doctors tend to see many patients everyday and rely on office staff for your care.
Don’t go by the price. When choosing a Lasik doctor, do not let the price be the deciding factor. While Lasik is pricey, your vision is worth more than any amount of money. Choosing an experienced doctor should not be dependent on the price alone. If you see Lasik advertised for a very low price, it is probably too good to be true. Most of these prices do not include everything. You will have to read the fine print to see why they are offering Lasik for such a low price. Choose a doctor for the experience.
Choose a Lasik surgeon in your area. While that may not concern some patients, it may be very important to others. Remember that you will probably need to see your Lasik doctor at least five times-one for the initial appointment, one for the surgery, a one week check up and a check up at three and six months. After your surgery, you will need to depend on another person to drive to and from your appointment. Having a surgeon in the area can be very convenient.

If you wear contact lenses there are some things you should consider before making the decision to have Lasik surgery.
Similarities. Both Lasik and contacts are able to correct nearsightedness, farsightedness and, to some extent, astigmatism. Both Lasik and contacts can eliminate the effect of minification and peripheral distortion that might have been evident if and when you wore glasses, because both options correct your vision right at the surface of your eye.
Convenience. Extended wear contact lenses, introduced in the late 1970s, made contact lenses far more convenient than they were previous to that. Extended wear contacts, however, did not quite live up to their claims; it became evident that they could not be worn continuously for the length of time that had been claimed (usually 30-days) without problems occurring. When “disposable” contact lenses were introduced it made wearing contact lenses much more convenient but they were still a daily concern. In the past few years, thanks to advances in contact lens research and manufacture, the “30 Day Lenses” have returned. Time will tell how successful these will be in providing the convenience that contact lens wearers desire. The Lasik procedure, for those who can take advantage of it is, of course, the ultimate in convenience with no lenses to worry about at all.
Comfort. Certainly Lasik wins the comfort ‘derby’ after, that is, the initial discomfort of post-op recovery which, in more extreme cases, may last up to six months. Contact lenses are more “comfortable” for some people than for others because of the varying degree of tolerance for discomfort between individuals and new advances in the materials used to manufacture contacts have made the lenses even more comfortable. The fact remains, however (as reported in the Contact Lens Spectrum at http://www.clspectrum.com/article.aspx?article=12787) that an estimated 2-3 million people of ‘drop out’ of contact lens wear each year due to comfort and inconvenience factors. That number equals approximately 10% of contact lens wearers.
Lifestyle issues. Again, as far as being able to go about your daily activities without the inconvenience and worry that may be caused by contact lenses, gives Lasik another win in the Lifestyle column.
Safety and Risk. The two most important factors in any decision you make in life are safety and risk. This varies by individual; some people enjoy living their life “on the edge” while others (probably the majority) prefer to keep a “safety barrier” of some sort around them. Such is the choice between continuing to wear contacts and electing Lasik surgery.
Wearing contact lenses, in spite of convenience, comfort and lifestyle issues, is not normally ‘risky business’ . . . not normally! Even when used as directed by your optometrist, some complications can arise — nothing normally sight-threatening or remotely life-threatening but still problematic. Some contact lens wearers have contact lens “fit” problems and some develop ‘dry eye’ or ‘giant papillary conjunctivitis.’ Dry eye usually occurs in contact lens wearers who had dry eye (insufficient natural eye lubrication) before wearing contacts. The conjunctivitis problem usually occurs in patients who have been wearing lenses for some number of years and who have not been as careful as they possibly can to keep their contacts clean. Both conditions are fairly easily treated.
According to the United States Food and Drug Administration (see http://www.fda.gov/fdac/features/1998/298_lens.html), “The most serious safety concern with any contact lens is related to overnight use. Extended-wear (overnight) contact lenses–rigid or soft–increase the risk of corneal ulcers, infection-caused eruptions on the cornea that can lead to blindness. Symptoms include vision changes, eye redness, eye discomfort or pain, and excessive tearing.”
Another contact lens concern that is potentially sight threatening is the chance of a parasitic eye infection called “Acanthamoeba Keratitis.” This difficult to treat infection is primarily caused by not taking proper care of your contacts and may be complicated by using hot tubs or by swimming.
Contact lenses have been marketed as “care free, trouble free and risk free,” you can clearly see that these claims are subjective.
Lasik while it may win under the headings of convenience, comfort and lifestyle requires some risk taking. Any type of surgery presents a risk and while an estimated 96% to 98% of the many millions of Lasik patients have no serious concerns, even years after surgery, there are a great number of them who have found that Lasik did not fully meet their expectations (they still needed glasses or contacts after surgery). Some small percent of Lasik patients are left with minor vision problems and a very small percent have had catastrophic problems. Such is the nature of any surgical procedure.
The choice is yours but it’s not an easy one: contacts or Lasik?