Corrective eye surgery

Factual Questions
21

[QUOTE=Spiff]
I opened this thread to say something similar. The docs don’t know yet if there are any long-term side effects.

Some patients say they have trouble with glare, for example. What if this sensitivity gets progressively worse over time? There are not enough data yet to answer this question.

I’d hate to have this side effect, especially as I’m already finding it difficult to drive at night due to street lights and oncoming headlights.

Really, I’d hate to have any of the side effects I hear about…
[/QUOTE]

I had the surgery 5 years ago, or so, and I have this “glare” problem. I don’t have to drive at night often, but it can be a pretty big problem when I do. If I had it to do over again knowing this, though, I’d still get the surgery. But it’s definitely something to consider.

22

I’ve been wearing glasses since I was 7 years old; obviously I’m used to it now. I consider my glasses part of my personality and my “look.” I enjoy choosing a new pair of frames every few years. I have enough goofiness going on with my eyes that I take my ophthalmologist’s insistence that I’m a good candidate with a shaker of salt. I also don’t have the four grand.

Most important, though, is that my ability to see absolutely clearly (for editing and proofreading) is what’s keeping this family out of the poorhouse. I say, if it ain’t broke, don’t fix it.

23

[QUOTE=gonzomax]
Why shouldn’t every body who can afford it, get it.
[/quote]

Because it’s surgery and we don’t force people to have surgery unless they consent to it.

While there were a few years were I needed frequent lens changes, these days I’m only getting them every 5-6 years or so, and very minor tweaks at that (in fact, I keep the old pair as spares, since they still correct my vision enough to drive with). Unless you’re prone to breaking them, even those of us with crap uncorrected vision don’t need a new pair every year.

IF everything goes right.

I have at least one co-worker who wound up worse than before.

In some cases, yes.

Sometimes, it’s money

Sometimes an individual is a bad candidate for surgery.

Possible side effects include loss of vision contrast, loss of acuity, glare, halos, and infection. These are not trivial. No one should get this surgery without a thorough and proper eye evaulation and no one should be pressured into getting this surgery.

When you have vision correction surgery your vision is (if all goes well) corrected at that point in time. Continuing changes due either to growth (which is why surgeons are reluctant to do this to the non-adult) or the effects of age (presbyopia) are unaffected by LASIK and the rest. Thus, at age 25 you may be corrected to 20/20 but will still wind up with reading glasses somewhere between 40 and 50, and perhaps bifocals if you live long enough.

As for “repeated corrections” - you can only shave so much off the front of the eyeball before structural weakness becomes a problem. Then, either you’re back to glasses/contacts or, if an eye surgeon keeps shaving away, you’ll get rather severe problems occuring. The number of corrections or “revisions” or “enhancements” that can be done are limited, and the risk of side effects goes up with each additional surgery.

24

There have been stories about athletes (Tiger Woods) getting enhanced vision. They can see better than normal. The argument is how different is this from steroids. Outside agent enhancing performance. In 20 years they will be doing it in kiosks at malls. They also can do what contacts do. Fix one eye for far ,one for close.This was my contact prescription and it worked well.
New developments in eye surgery keep happening. What is safest?

25

[QUOTE=gonzomax]
…snip…
New developments in eye surgery keep happening. What is safest?
[/QUOTE]

I have been told by three Eye Doctors that Custom Bladeless Lasik is the safest.

26

They keep getting better at it, so why not wait another few years? If I’d done it at 20, it would have been radial keratotomy, which was much more invasive. And of course, there’s the cost–which will also go down with time. And the side effects and possiblity of problems; I knew a woman who got an early LASIK and she wound up with permanently slightly blurry vision that nothing could fix. Eek.

Actually, I’m not a candidate for most surgeries anyhow. LASIK would leave me with no cornea at all, I’ve had inexplicable iritis so it would probably be a bad idea to insert lenses into my eye, and anyway I have a lot of eye surgery coming up in my future; I fully expect to have my retinas detach, and of course I’ll get cataracts. I figure we’ll just fix it when I get cataract surgery.

But for normal people, there are plenty of reasons not to get eye surgery.

27

I work for a surgeon who performs LASIK. He also teaches the procedure to other ophthalmologists. He performed the procedure on both my sister and her daughter. Prior to the surgery, patients are informed of all the risks. We provide national statistics, and our practice’s statistics. While LASIK is a fairly low-risk surgery, anyone who thinks it’s the answer to all their visual issues may be misinformed. LASIK changes the shape of the cornea, which is external. As we age, presbyopia sets in, which is due to changes of the crystalline lens, which is internal. LASIK will not prevent you from needing reading glasses at some point. We do have a number of patients who get “monovision” correction, which corrects the dominant eye for distance, and leaves the non-dominant slightly nearsighted so that you can see at close range. Any surgeon who suggests this type of correction should allow you to experience it with contact lenses. Most people know within a few hours if monovision is going to be comfortable for them. We allow patients to experience it for as long as they need to in order to make an informed decision. If your eyes change frequently, you might not be a good candidate for LASIK. However, if your vision remains stable for at least a year, and you meet all the other requirements, then, LASIK may be exactly what you’re looking for.

If, after LASIK, your eyes change later, you may or may not be able to have an enhancement. Much of the success of your surgery and later enhancements is dependent on the thickness of your corneas. My sister went into it knowing that one surgery would probably be all she could have. She also knew that there was a strong likelihood that she would need some sort of correction afterwards. She was happy with the idea of being able to function in her home without correction, as she was functionally blind before surgery. She is currently 20/25, and uses no correction at all. Her daughter was also severely nearsighted, but with thicker corneas, has a better chance at enhancement if she needs it later on in life. Both of them still need yearly checkups to inspect the health of their retinas, as people who are very nearsighted have a higher risk of retinal detachment. Both are very happy with the outcome of their surgeries. My niece is 20/20 and 20/15, better results than even the surgeon anticipated.

As far as some of the aftereffects, yes, they do happen. However, as the technology advances, we see less and less of the complaints of just 5 years ago. Glare and halos seem to be less of an issue today than they were previously, due to the fact that more of the cornea can be treated today than before, and many surgeons use a “blending” technique to soften the area that resulted in the halos.

Refractive surgery should definitely wait until the eyes are fully developed. Men in particular often go through a post-pubescent growth spurt, and you would want to wait until that’s over with before changing the shape of a changing part of your body. Hormonal changes in women can also make things a bit strange. Many women notice that their vision changes after a pregnancy, for instance.

If you are interested in refractive surgery, but can’t have LASIK, there are other options including PRK or lens implants (just like cataract surgery, but before the natural lens loses elasticity). Again, not every patient is a candidate, but that’s what consults are for. If your prospective surgeon is not willing to answer all your questions frankly, then he or she may have something to hide. My boss tells people very honestly what he thinks their outcome will be, and he doesn’t sugar-coat anything just to line his pockets. If a patient comes to us for a pre-op exam, they pay for the exam only if they are in fact a candidate. The exam fee then comes off the surgery fee (for us, $3500 for LASIK, $4500 for Zyoptix LASIK).

I have not had, nor do I desire to have, refractive surgery. My vision is not “that” bad, though I do need correction just about all the time (I choose glasses over contact lenses). I was born with cataracts, so when they get to the point that they need to go, I will probably opt for the new implants that allow for clear vision at most distances (Restor is the brand most used in our practice). If my boss is still practicing at that point, he will be my surgeon of choice. I don’t think he’ll retire before I need it done.

28

I would love to have LASIK, but if you box, wrestle, or do any kind of martial art you can wind up with a detached cornea. LASEK would be great, but I think my eyesight is a little too bad for it. The technology is only going to improve, so I might as well wait.

29

I was all set to get Lasik a few years back, and then I found out that every other member of my family needed bifocals right around age 40. Sure enough, my arms are starting to get too short. I can either get the monovision correction WishIHadACoolName describes, or I could get both eyes done the same and have to wear reading glasses any time I read or work on the computer. Much of my life, both work and leisure, revolves around reading and computer monitors. I really wouldn’t gain much if I had to wear reading glasses, except an increased opportunity to lose my glasses because I could set them down now and then.

30

[QUOTE=gonzomax]
There have been stories about athletes (Tiger Woods) getting enhanced vision. They can see better than normal. The argument is how different is this from steroids. Outside agent enhancing performance.
[/QUOTE]

“Normal” is 20/20 – my eyeglasses corrected me to 20/15, and I image most people with current prescriptions (that use glasses) are probably corrected to better than 20/20. Remember, that’s just an average defined on the “norm” for the general population. With LASIK I’m noticeably not at 20/15 like with the glasses; I think I tested at slightly better than 20/20 though. I don’t imagine that you can intentionally correct to something like God-like 20/3 vision or anything like that without severely screwing something else up. Any ideas?

31

[QUOTE=WishIHadACoolName]
Many women notice that their vision changes after a pregnancy, for instance.

[/QUOTE]

This is actually a large part of the reason we aren’t having any more children. I lose a diopter every time, and I’m up to -14 now; I can’t afford to lose a lot more when my other vision issues are taken into account.

32

Actually, there’s another way to do this without going through surgeries and it’s very affordable. Though not every human would believe this because doctors are hiding it. Did you know that there is eye exercises to improve vision? You just need to be completely motivated enough to do this since it takes 3 months to see the result an a year to completely restore your vision.

33

Spam reported.