Laser Eye Surgery- Is it Really Safe?

Factual Questions
1

After a nightmarish experience with an eyeglass place (“For Eyes”, to be exact. The biggest bunch of incompetent assholes I have ever dealt with) and the fact that I hate wearing contacts, I am seriously looking into laser eye surgey. Despite all the glowing radio celebrity endoresements, I have questions:

-Do these radio celebrities REALLY get their eyes operated on?
-Is it true you have to redo the surgery every 10 years?
-What is the REAL failure rate? (IE patients go blind or suffer permanent damage)
-How much does it cost?

Plus any other info you might have, dopers!

Here’s the only objective site I could find:

http://www.fda.gov/fdac/features/1998/498_eye.html

2

I had laser eye surgery on both eyes about two years ago. The total cost was about two or three thousand dollars, but my grandparents paid for it as a gift and I can’t quote the exact price. My left eye, which was mildly farsighted, is fine now. My right eye, which was very nearsighted, is now just nearsighted. I didn’t suffer damage to either eye, but I did have a couple days of discomfort. The doctor told me that I would need glasses again when I reached my forties or fifties. I feel I could still use a pair of glasses, for things such as reading road signs and blackboards during class.
This was just my experience with laser eye surgery. I’m sure it varies from person to person.

3
      • This question has been asked here before more than once so check the archives. There’s even a website link in one thread somewhere with two “comparative” images of an eye chart, to try to show what you’ll see before and after. If that’s an improvement or not depends on your own condition. - The procedure does generally have a low risk of injury, but it isn’t permanent (5-7 years later you may need it again) and it doesn’t restore perfect vision. Most people making huge complaints center on the machine being improperly set resulting in far overcorrection. - MC
4

I’m assuming that we’re talking about LASIK surgery (refered to as “Flap and Zap” in the trade)…

These are all excellent questions, and you should bring them - and any other questions you can think of - to any doctor you interview who might perform this procedure on you. He’s used to answering them, and will give you sounder medical opinions than most of us can. Never being one to let a silly thing like that stop me, however…

**-Do these radio celebrities REALLY get their eyes operated on? **

I’m assuming “yes” to this one, although I don’t really know. I know all of the doctors and assistants where I had my LASIK suorgery done had had it done, but I suspect this was a free “perk” there.

**-Is it true you have to redo the surgery every 10 years? **

No. The surgery reshapes your corneas by physically removing portions of them, and corneas don’t grow back.

What does happen as you grow older is your need for reading glasses - that has to do with your corneas losing their flexibility as you grow older, and LASIK surgery doesn’t address that situation at all. Perhaps this situation has some folks confused.

In my case, I had my surgery performed when I was 50, and already needed reading glasses (or, in my case, bifocals), so this was nothing new.

**-What is the REAL failure rate? (IE patients go blind or suffer permanent damage) **

When I had my LASIK surgery, I had to sign a medical form that claimed (among other things) that I understood that I could go blind or even die as a result of the procedure. I asked the doctor how often that happened, and he said that in the 10,000 or so surgeries that they had performed (I’d selected them precisely because of their experience) nothing like that had ever happened. He said they’d had a few cases of mild infection and cases where the flap started to grow back with folds in it, and that all of those cases were correctable (and which they’d corrected). IE, they’d caused no permanent disabilities as a result of any of their operations.

**-How much does it cost? **

I had my surgery done a year ago at what happened to be the most expensive place in the nearby area, and it cost me $5000 for both eyes. The same place is now charging less than $2500 for both eyes, presumably because of the increased competition (and they’re still the most expensive folks in the area).

5

My girlfriend just had the Lasik surgery done. Both eyes, $5000, covered by insurance (!). She was an excellent candidate for the surgery, and there were no problems. She now has better than 20/20 vision, which is pretty cool.

6

There is one VERY serious risk from LASIK surgery, and it has a pretty high incidence rate: significant degredation in night vision. I was all set to undergo LASIK when the news about this started breaking.

In England, a new study tested the night vision of several hundred post-LASIK patients, all of whom had had the surgery more than 2 years previously (so all temporary effects should be gone). Almost half of all those people had night vision so bad that they couldn’t pass the driver’s license exam.

Canada just issued a general warning about night vision and LASIK. Apparently, studies in the military here have shown the same thing.

Some surgeons are claiming that the newest lasers are much better than those used a few years ago, and this problem will be much less pronounced. However, it appears that almost all LASIK patients lose some amount of low-light sensitivity and contrast. If that’s important to you, be very careful.

7

That was an excellent post Will, but the cornea does not lose flexibility, the lens and its ligamentous attachments do. That’s what causes presbyopia (“old sight”): unable to see close objects due to rigidity of the lens. You can eliminate that problem by just having one eye done to 20/20 and the other to around 20/40 or 20/50. Your brain will accommodate. Presbyopia begins at around age 40, and worsens, so that at first you may need a correction of only 1/2 a diopter or 1 diopters, but eventually you will need a correction of a couple diopters. Hence, bifocals if you wear glasses or reading glasses if you don’t. If you correct only one eye to 20/20 and the other to 20/40 you won’t need reading glasses. Similarly, for those who are only slightly nearsighted, they can remove their glasses to read without bifocals.

I had the scapel done 10 years ago, before the lasers. My vision was terrible, -8 diopters. Now one eye is astigmatic at -3, and the other is both nearsighted (-2) and astigmatic (-2). So I still need glasses. 16 cuts in each eye! (Most doctors won’t and wouldn’t do more than 8.) As a result, I had a terrible time with glare and night vision, but that has been practically resolved now. I don’t know if lasik interferes with night vision, but the old scalpel (called radial keratotmy) will not if you only need a few cuts. Even in my case, with a total of 32 cuts, I now have no problem.

8

My wife had it and it was totally worth it (as she puts it) - her vision was corrected from 20-800 to better then 20-20. As for can they re-do it, My understanding is yes. Even though the cornia doesn’t grow back, there is plenty of room to cut more out. The side effect of thinning the cornia is glare and halo effect around bright objects.

9

I seem to remember reading that the halo effect was due to scarring of the layer of cells above the cornea, and to circumvent that laser surgery now involves cutting a circular area of that layer away, lifting it up, and lasering the area beneath.
Anyone know more about any recent modifications to laser eye surgery procedure?

10

I have had it- and can recommend it without reservation- if your eyes are pretty bad, that is. I have mininmal “haloing”- and do not know anyone who has had a significant problem with the nite-vision/halo effect. However- DO get it done by the best Dr. in that field in your area.

11

The “old” laser surgery scalped away some portion of the outer cornea cells. However, in Lasik, a flap is created in the cornea and some inner cells are nuked. Then the flap is reinserted. I don’t know if that eliminates the glare.

12

I’ve posted in the earlier discussions of LASIK, but thought I’d jump in with my two cents about the nighttime glare issue. I had the surgery done first in December '98. I went from 20/800 and 20/1200 to roughly 20/40 in both eyes. For about three weeks afterward, I had the halo effect at night. It was noticeable while driving and in dim restaurants, etc. It was irritating, but I did not feel that it was unsafe for me to drive at night. After three weeks or so, it was gone.

I had the surgery again in July '99 to correct to 20/20. I had no problems with glare after that surgery at all. Or anything else, for that matter.

YMMV. Also, what Daniel said–get the best doctor you can find!

13

Right, that’s what I was referring to. Cutting away the outer layer, burning the inner, then replacing outer.
Didn’t know it was called Lasik - sounds like a trademarked name.

14

Lasik is an acronym (?) for laser amplified situs in keratosis, or something like that.

15

I got that wrong. Laser assisted *** something, and the last work is keratomileu, or something like that. Not keratosis. I just don’t recall. Anyway, it stands for something. :slight_smile:

16

I am 39, and have been very nearsighted (can’t quote you a diopter amount) since childhood. I was evaluated on Jan. 4, and here’s what I was told:

They are going to do both eyes at the same time, in part because they said I am too nearsighted for the brain to reconcile having just one eye corrected. They explained that they don’t guarantee perfect vision, or that I might not need glasses to correct farsightedness as I age. They also said that needing glasses for night vision was a possibility because in dim light your pupils dialate, letting light pass through a wider area of your cornea which increases the chance of misfocusing.

I am scheduled to have the procedure done on Feb. 8. so I’ll let you know how it turns out.

17

The Laser Eye Instititute, which has offices nationwide, has an ed avery Sunday in the paper advertising laser eye surgery (I believe it’s LASIK,) for $599 at our local office, with payments as low as $15 per month, which includes follow-up visits and and initial consultation. I believe the procedure and price is right, but I’m not sure. I know it is close. It will be in the Augusta Chronicle in the morning edition. It sounds might tempting to me, since I am extremely myopic in my left eye, and it isn’t getting any better over time.

18

I had both of my eyes done. My experience was very positive and now I have 20/30 vision (It was at -14 diopters with an astigmatism). I have no idea what a diopter is, but all the folks at the eye zapper place were reasonably impressed by a -14. Overall the only problem I did have was due to my own sqeamishness. I hate things to get near my eyes, never have worn contacts for that reason. When they were doing my right eye I was fidgety and I have a little scarring (which is the cause of the 30 in 20/30. I did suffer a little night blindness though. Well, not really blindness, I actually see far better at night than I could before. Teh problem is in the presence of bright lights which create stars. Oncoming traffic is really anoying. My cost was 1750 per eye.

19

I was thinking of getting this done in my one near-sighted eye, but was told by a friend that it was best to have this done in my late twenties since my eye hadn’t reached it’s final shape or something like that.
Any truth to this?

20

How do they create the flap?

What happens if you move your eyes when they’re doing it?