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Choose your LASIK surgeon carefully Careful homework and an informed choice of surgeon are the best ways to minimize any risk in LASIK eye surgery. Below is information about possible risks, and some guidance as to how to choose your eye surgeon. Safety records have improved LASIK surgery began in the 1980s. During the 1990s, some safety studies were done which showed that up to about 5% of people who had LASIK done had some kind of problem afterwards. More recently, some LASIK surgeons are finding that such problem outcomes have dropped to about 1%. A Canadian study done in 1997 on 5000 patients found that in only 0.08% of cases was there any loss of 2 lines of vision from the eye chart. And further, studies are finding that: • Some less-than-optimum outcomes can be resolved by follow-up laser treatments • Many others can be remedied by the use of contact lenses or glasses Some of this increase in positive outcomes is due to IntraLase, or “bladeless” LASIK, where a second laser is used to create the little corneal flap. This eliminates the use of the microkeratome, the hand-held blade, for that purpose, and thereby reduces risk. Profits at the expense of your safety In those first years of laser eye surgery, in the 1980s there was an initial surge of hopeful patients and some doctors latched onto this technique as a quick way to make money. Claiming a very large number of treated patients may make the eye doctor appear reliable and productive, and may entice you to trust him or her. But look more closely at how those LASIK centers operate before making a choice. You might find that: • They’re including re-treatments in the number – a re-treatment is done when the initial outcome was less than optimal • They’re skimping on patient evaluation – by spending less time on evaluation of each new patient, they can push more people through the mill • They’re neglecting patient follow-up – by not scheduling any follow-up appointments they hope to save money and spend the time on processing more patients • They’re skimping on equipment and personnel – by purchasing cheaper equipment and hiring less qualified staff, they can increase profits Risks of LASIK treatment Although some studies have been done on LASIK outcomes, there still isn’t a lot of data as to long-term safety and effectiveness. There are several possible downsides to laser eye surgery that you should keep in mind when deciding whether to have LASIK: • Dry eye syndrome – your eyes may have trouble after surgery in producing enough tears to stay moist and comfortable. This could be a permanent condition and ongoing use of eye drops may be necessary • Visual symptoms – some people develop double vision, halos and glare which affect their night vision or ability to see in foggy conditions. • Under-treatment or over-treatment – if insufficient pre-surgical examination is done, your eyes could be under-treated and require a second surgery, or over-treated and require use of glasses or contacts to compensate. Treating both eyes at once It’s a convenient prospect, to have both eyes treated at the same time. There’s less cost and only a single healing period. But there’s risk to it also: • If you do both at once, you’re giving up the opportunity of assessing how one eye responded before treating the other eye • After surgery, your eyes might be blurred for several days, and that’s more troublesome if it’s both eyes rather than just one The monovision option Monovision is a technique first tried with contact lenses. One eye is given a lens which corrects distance vision and the other eye is given a lens which corrects near vision. This means that the two eyes don’t work together any more. There’s an adjustment period required, while your eyes learn how to function this way. For some people this has worked well. But contact lenses can be removed and changed. When this technique is used by a LASIK surgeon, your two eyes will be permanently different. Test this with contact lenses So before having monovision done on your eyes, give it a test run with contact lenses. • You might want to see if you can pass your state’s driving license requirements • Ask your eye doctor how long it might be before aging again causes deterioration in your close-up vision • Even with monovision correction, you might need to wear glasses or contact lenses in low light conditions or for extended reading of small print Safety precautions to ask about When you’re looking around for a good laser eye surgeon, and gathering information about your candidates, ask about these items: • Is sterile surgical protocol used? • Is there an uninterruptible power backup? • Are the laser(s) and microkeratome(s) maintained and serviced only by the original manufacturers, and to FDA-approved specifications? • Are patients prepped with Betadine before surgery, and are they given antibiotic eyedrops to reduce the likelihood of infection? • Does this eye surgeon ever turn people away, as being poor candidates for LASIK? (Hope for a Yes answer to this; not everyone is a good candidate.) • Is there pupil measurement to assess the risk of subsequent glare and halos? • Is Wavefront CustomVue technology used, and is the laser a Visx Star S4 laser with 3-D eye tracking and auto-centering? (Hope for a Yes answer here too because Wavefront and Visx are the premier equipment for a laser eye center. “Auto-centering” refers to the laser being centered on the eye by the computer, as opposed to being manually centered.) Please click here for more information regarding LASIK surgery and other ophthalmology procedures in the Sacramento area
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