Are You Right for LASIK?

Is LASIK surgery right for you? Ask yourself these questions to find out.

-Are you healthy and have no medical conditions that should interfere with healing?

-Are you ready to have your nearsightedness, astigmatism or farsightedness corrected?

-Are you ready for a minimal recovery time? Generally less than 24 hours.

-Are you ready for any refractive errors to be corrected?

-Are you ready to participate in outdoor activities or sports without worrying about your glasses or contacts?

-Are you ready to eliminate the expense that comes with contact lenses or glasses?

-Are you ready for any potential side effects or complications that may come with LASIK?

If you answered yes to these questions, you may be the right candidate for LASIK. Please consult with a laser eye surgeon for more information.

Dry Eyes? Is it the LASIK?

One of the side effects of LASIK is a decrease in the amount of lubrication in the eye. The nerves in the cornea are supposed to supply information to the gland that lubricates the eyes. However, in LASIK, the cornea nerves are cut and can't trasmit the need to supply lubrication to your eyes.

If your eyes are dry after LASIK, keep in mind that the corneal nerves should eventually heal and lubrication should return when the nerves have healed. There are instances when dry eyes continue to be a problem. If you suspect this is happening to you, please consult with your doctor.

Risks of LASIK Surgery

In every endeavor you'll experience risks. You think that driving another day with poor eyesight is a risk you're not willing to take. Losing your contacts and having your eyes irritated is a risk you don't want to take long-term.

You know that more than one million people in the United States have had LASIK surgery and been satisfied with the results. However, you need to know the risks of LASIK vision correction. The FTC cautions that LASIK eye surgery is too new to predict the effects five years after you have LASIK surgery.

LASIK risks and complications, according to the FTC, include:

* Not being able to see as well, even with glasses or contacts, as you do before surgery--even with new eyeball Wavefront mapping technologies
* Decrease in seeing objects clearly--you may experience blurry or fuzzy vision
* Problems with night vision--you may still require glasses for night driving
* Corneal flap problems such as buttonhole flaps, flaps cut off entirely, ingrowth of cells under the epithelium--LASIK operates in a small area--and dislocated flaps.
* Light sensitivity (may be temporary)
* Dry eye syndrome caused or worsened by LASIK
* Complications from diabetes or high blood pressure
* Corneal scarring
* Irregular astigmatism
* Under- or over-correction of your myopia, hyperopia, etc., so that you may need additional surgery or contact lenses

But, you think, I've acquired 20/20 uncorrected vision! 20/20 uncorrected vision on the Snellen eye chart may not always mean your LASIK surgery was successful. If these LASIK risks and complications occur, you may need:

* Contact lenses
* Retreatments, say with custom LASIK
* Eyedrops--for dry eyes
* Antibiotics for infections

Anything you do carries risk, but when it comes to your sight, you should know the LASIK risks, whether you have healthy eyes or are nearly blind. Discuss the potential LASIK risks with your LASIK surgeon, and ask if you need to consider refractive surgery alternatives.

The LASEK Procedure

Confused about LASEK vs. LASIK vs. PRK? PRK belongs in its own category--although all three procedures use an excimer laser to resculpt the cornea. Here's the skinny on LASEK:

1) You have a complete eye exam with diagnostic technology that gathers information about your vision and eye geography.
2) Nurses and an ophthalmologist apply a sterile drape to protect your eyes.
3) You get numbed with a sedative, and your eyes get numbed with eye drops.
4) A special instrument loosens the epithelium around the surgery area.
5) The epithelium is pushed to the side.
6) You look at a target light while a laser reshapes your cornea without disturbing the tissue.
7) A minute or two later, the laser eye surgeon smoothes the epithelium back into place and applies a contact lens bandage.

In LASIK, the ophthalmologist creates a hinged flap in the cornea. After the procedure, your eyes are examined with a slit lamp microscope, since there is an incision in your eye.

Does LASEK seem less complicated than LASIK now? They both carry risks and benefits. The one thing that won't cause you confusion: being able to read the paper without glasses.

LASEK and Astigmatism

You have healthy eyes but you need glasses, and you've developed an astigmatism--it's genetic, after all. In astigmatism, your cornea is shaped like a football. Your vision gets blurry because there's no single focus in the eye. Do you resign yourself to being four-eyes for the rest of your life?

Not necessarily. LASEK eye surgery can treat your astigmatism without the complications of LASIK. In the LASEK vs. LASIK debate, both reshape your cornea from a football shape to the normal basketball shape. The blurriness lifts, but with LASEK, your eye tissue is disturbed less, although there's a slight chance of scarring. Also, if you have wide pupils, you're probably a better candidate for LASEK eye laser surgery than LASIK.

So put away those glasses...and if your mom doesn't have cataracts or glaucoma but does have flat or thin corneas, you might encourage her to have LASEK and put away her glasses too.

Questions for the LASIK Surgeon

The success of LASIK, as with any other surgical procedure, starts with choosing the right LASIK surgeon. It's the same as shopping for a pair of eyeglasses--except, of course, that you want to scratch the specs.

When you're choosing a LASIK surgeon, bring a list of questions --this is good advice for any medical procedure. Some important questions for your LASIK surgeon:

* How long have you been performing LASIK surgery?
* How many refractive and custom LASIK surgeries have you performed, especially procedures like mine?
* What percent of your patients receive 20/20 vision or better?
* Can I achieve 20/20 if I have myopia, astigmatism or hyperopia?
* What's the margin for error in this procedure?
* What kinds of complications, for example, dry eyes, starbursts, "haloes," fluctuations, blurring of distance vision, and so forth, occur and how soon do they disappear?
* When do you decline a surgery procedure? How many procedures have you declined?
* What kind of laser do you recommend for my eyes and what are the advantages?
* Will you perform a wavefront technology diagnostic? (Hint: The answer should be yes.)
* What was the worst surgery outcome you experienced and how was it handled?
* What percentage of LASIK patients require enhancement or corrective procedures after surgery and what are the results?
* What will my vision be like after surgery and how long will it take to recover?
* When can I resume normal activities and what activities should I avoid?
* Will my eyes be completely examined before and after the procedure?
* What might prevent me from having the results I want?
* What is the cost and does it include pre- and post-op visits/exams?
* How many post-op visits does the cost include?

You may also ask to talk to patients who have had the procedure and have had complications similar to what the LASIK doctor predicts you might have. While there's the issue of doctor-patient confidentiality, it's worth a try. You have the right and the responsibility to ask questions before your LASIK procedure.