Lasik - modern miracle or risky business?

Laski is an eye surgery which is done, outpatient, with a laser to supposedly correct your vision so you can get rid of your contact lenses or glasses.

It's a refinement of an earlier surgery called "radial keratonomy" in which a surgeon 'corrected' vision by cutting slits in the eye ball with a scapel. In Lasik, a flap is cut on the eyeball and then, the laser is used to remove a layer of cells or so to 'reshape' it.  The surgeon then replaces the flap and everyone hopes it heals.

The most immediate complication you might get is an infection. This requires drops in the eye several times a day.  Don't figure on being too productive at work for a couple of weeks, if you get an infection. 

About 20 percent of people who have lasik get a condition known as "dry eye".  They must put drops in their eyes several times a day because somehow the tearducts have been damaged.  And about 5 percent of people who get lasik get visual impairment (or blindness) instead of better vision as promised.

Worse yet, the biggest risk factor for glaucoma, a painful condition, is eye surgery, so guess what?  Lasik IS eye surgery.  The predecessor of lasik was also observed to significantly raise the risk for cataracts, a condition which without surgery, will cause blindness.

Lasik like its earlier cousin, doesn't work well for everyone.  Very near sighted people may need additional procedures to bring their vision to a level which enables them to dump their "eye wear".  People may also require "re-ups" (additional surgery) as they age. 

Finally, the visual acuity after lasik may be somewhat lacking.  i.e. you may have places in your field of vision where things are not so clear.  This can really bother those who use their eyes a lot.

Lasik is not cheap - (and you don't want to get a cheap eye surgeon - not a good idea).  It's also not really guaranteed despite the infomercials about it.

The Federal Trade Commission and the FDA have had a problem with Lasik, however, because it seems that the promises made in the ads don't meet up to the reality of the surgery.

To try and inform the public better, the FDA has set up a website giving a more realistic view of Lasik. Additionally the FTC has a brochure on the procedure which can be downloaded from their website.

We all have seen the glowing testimonials about how great Lasik is. Here is the list of complications and side effects from the FTC website brochure:

Risks and Possible Complications
Before the surgery, your surgeon should explain to you the risks and possible complications, and potential side effects, including the pros and cons of having one or both eyes done on the same day. This is the "informed consent" process. Some risks and possible complications include:

• Over- or under-correction. These problems can often be improved with glasses, contact lenses and enhancements.
• Corneal scarring, irregular astigmatism (permanent warping of the cornea), and an inability to wear contact lenses.
• Corneal infection.
• "Loss of best corrected visual acuity" — that is, you would not be able to see as well after surgery, even with glasses or contacts, as you did with glasses or contacts before surgery.
• A decrease in contrast sensitivity, "crispness," or sharpness. That means that even though you may have 20/20 vision, objects may appear fuzzy or grayish.
• Problems with night driving that may require glasses.
• Flap problems, including: irregular flaps, incomplete flaps, flaps cut off entirely, and ingrowth of cells under the flap.

The following side effects are possible, but usually disappear over time. In rare situations, they may be permanent.

• Discomfort or pain
• Hazy or blurry vision
• Scratchiness
• Dryness
• Glare
• Haloes or starbursts around lights
• Light sensitivity
• Small pink or red patches on the white of the eye

Not everyone is a good candidate for Lasik. Here is the list of contraindications which include diabetes:

Are You a Good Candidate for Lasik?
Lasik is not for everyone.

• You should be at least 18 years old (21 for some lasers), since the vision of people younger than 18 usually continues to change.
• You should not be pregnant or nursing as these conditions might change the measured refraction of the eye.
• You should not be taking certain prescription drugs, such as Accutane or oral prednisone.
• Your eyes must be healthy and your prescription stable. If you're myopic, you should postpone Lasik until your refraction has stabilized, as myopia may continue to increase in some patients until their mid- to late 20s.
• You should be in good general health. Lasik may not be recommended for patients with diabetes, rheumatoid arthritis, lupus, glaucoma, herpes infections of the eye, or cataracts. You should discuss this with your surgeon.
• Weigh the risks and rewards. If you're happy wearing contacts or glasses, you may want to forego the surgery.
• Understand your expectations from the surgery. Are they realistic?
• Ask your doctor if you're a candidate for monovision — correcting one eye for distance vision and the other eye for near vision. Lasik cannot correct presbyopia so that one eye can see at both distance and near. However, Lasik can be used to correct one eye for distance and the other for near. If you can adjust to this correction, it may eliminate or reduce your need for reading glasses. In some instances, surgery on only one eye is required. If your doctor thinks you're a candidate, ask about the pros and cons.

Does "eyewear" really look so bad now?