Laser eye surgery - is it worth the risk?

[medstar]

@Selkie

Has anyone here gotten the surgery after being diagnosed with a case of dry eye syndrome? My body already produces almost no natural moisture for my eyes, and it can be downright miserable. I don’t know whether the surgery would worsen an already severe case, or whether the damage is already done and the surgery wouldn’t make a difference.

Folks, do not let anyone minimize how uncomfortable the condition can be. Be sure to educate yourself on other non-surgical causes, too (such as menopause, long-term computer use, and long-time contact lense use), just in case surgery + other risk factors = eyes drier than the Sahara.

Selkie, I have dry eye syndrome also. Even though I’ve got high blood pressure and I’m experiencing presbyopia, my nearsightedness is so bad that I would be a great candidate for lasik, according to the doctor who evaluated me. He said that my dry eyes would worsen and that was the only factor standing in the way. However, I’ve seen ads on television that mention Restasis, a prescription eye drop that purportedly makes your tear system work again. I plan to make an appointment for an eye exam and mention this Restasis to my doctor so maybe I can get a prescription and see what it does for me. You might want to investigate further.

[observer11]

Qadgop raises an interesting and obvious question. Laser vision correction has become so common and so heavily advertised that it’s really all most people think about when they hear “laser” and “eye” in the same sentence. But lasers are used for many other purposes. I guess the difference is that LASIK is elective and basically cosmetic, so prospective patents have lots of time to think about it, but retinal detachment, acute glaucoma etc. are medical emergencies. A doctor isn’t likely to propose treatment for them unless you really really need it, right now.

So to the original poster, did you really mean Lasik, or something else, and to folks who have had laser eye treatment for retinal detachment, glaucoma and other problems, is there anything you’d like to say/suggest/warn about?

[Tower_Dweller]

To spare the hamsters some:

http://boards.straightdope.com/sdmb/showthread.php?t=245659&highlight=LASIK

http://boards.straightdope.com/sdmb/showthread.php?t=247406&highlight=LASIK

http://boards.straightdope.com/sdmb/showthread.php?t=243040&highlight=LASIK

http://boards.straightdope.com/sdmb/showthread.php?t=241488&highlight=LASIK

http://boards.straightdope.com/sdmb/showthread.php?t=240330&highlight=LASIK

http://boards.straightdope.com/sdmb/showthread.php?t=237771&highlight=LASIK

http://boards.straightdope.com/sdmb/showthread.php?t=192952&highlight=LASIK

http://boards.straightdope.com/sdmb/showthread.php?t=191195&highlight=LASIK

http://boards.straightdope.com/sdmb/showthread.php?t=173478&highlight=LASIK

http://boards.straightdope.com/sdmb/showthread.php?t=148273&highlight=LASIK

http://boards.straightdope.com/sdmb/showthread.php?t=26869&highlight=LASIK

http://boards.straightdope.com/sdmb/showthread.php?t=18169&highlight=LASIK

Popular subject, apparently.

[whiterabbit]

I quit wearing contacts last year because my eyes had gotten so dry, after several years. I’ve found glasses to be a much easier compromise. Because of the dryness problems I had, and the fact that even if that wasn’t a problem I’m too cowardly to let them near my eyes, I’ve never considered it. Even if I could afford it, I wouldn’t do it.

[marky33]

@Qadgop the Mercotan

To which laser eye surgery do you refer?

Vision correction, specifically.

And to all those who have pointed to the many previous threads on the subject, you’re right I should have done a search before posting.
Thanks to everyone for your thoughts.

[Ferret_Herder]

@observer11

Related to the above, the flap doesn’t “heal” in the sense that healing usually means, as for a cut finger or even a surgical incision. It adheres mostly by suction. The doctor can lift the flap for additional lasering months after the initial surgery. The flap can also be displaced by a fairly minor blow, like an elbow in the eye during a basketball game.

I don’t believe this is the case - it will take a little while to heal up, certainly, but it doesn’t remain “flapping in the breeze” for everyone. That might be a bad surgical result, possibly.

http://www.visionrx.com/library/enc/enc_lasik.asp

No sutures are used, and the surface of the eye will normally heal itself. Most patients can see quite well within 24 hours or less. Complete healing of the cornea takes about one month.

http://www.mayoclinic.com/invoke.cfm?objectid=13CAE512-516E-4B1D-B09B6D6C7C00215D&dsection=7

After removing the thin, protective layer of your cornea, your surgeon flattens the curvature of your cornea. This layer grows back and conforms to the new shape of your cornea.

So in fact, it may only be the inner part of the cornea (the part being lasered/cut) which does not regrow.

As to needing glasses later on anyway, I would trade needing to wear glasses from shortly after I wake in the morning, for only needing to wear them when reading. Even a lighter prescription would be a welcome change. However, I haven’t had this done; my eyes are still worsening and I’m hoping they’ll stop changing at some point. My husband is considering having it done.

Full disclosure: I work for a medical center’s ophthalmology department but not in our LASIK division. I have never mentioned the name of my medical center here, and I am not promoting them with this post. I don’t work with corneas. My job is in no way affected by gaining/losing LASIK patients.

[observer11]

Also, because of the nature of cell structure the flap never truly heals, it is simply placed in position and can be lifted years after the operation.

http://www.lasereyedoctor.co.uk/html/history.htm

…the flap never really reunites with the deeper stroma following LASIK,

Furthermore, the flap that is created in Lasik, though resting on the corneal bed underneath, does not weld to that corneal bed for several years, further reducing the cornea’s tensile strength.

Above taken from two different pages at http://www.lasikdisaster.com

I believe the thin layer that heals quickly is the epithelium, the cells on the outer surface. But apparently the corneal flap doesn’t actually reattach itself to the cornea for a long time, if ever.
Also worth thinking about:

“Just in the United States, there are 60,000 eyes…of patients who are dissatisfied with their results from standard LASIK.

http://www.lasikinfocenter.net/Webpages/Articles%20of%20General%20Interest%20Webpage.htm

[Ferret_Herder]

@observer11

I believe the thin layer that heals quickly is the epithelium, the cells on the outer surface. But apparently the corneal flap doesn’t actually reattach itself to the cornea for a long time, if ever.

So you have a loose part underneath a solid layer of cells, not hanging open. Cutting into or through the cornea isn’t exactly an uncommon surgery - if you want to fix a detached retina or do cataract surgery, you’re pretty much cutting the cornea. In the words of one of the ophthalmologists I work for (and he’s a retina specialist, not a cornea/LASIK guy), “cataracts are so common, they’re barely considered a disorder any longer.”

@observer11

Also worth thinking about:
Quote:

“Just in the United States, there are 60,000 eyes…of patients who are dissatisfied with their results from standard LASIK.

http://www.lasikinfocenter.net/Webpages/Articles%20of%20General%20Interest%20Webpage.htm

If you read the quote in context, it appears to be taken from an article describing how about 30,000 patients expressed some kind of dissatisfaction with their results after standard LASIK, and how physicians using the wavefront LASIK might look at this with regard to building their practice. “Dissatisfaction” could mean anything from “it wasn’t corrected enough” to “I still have to use reading glasses” to “I have these faint haloes around lights at night” to “my ophthalmologist is an incompetent quack.”

LASIK definitely isn’t for everyone, but I think patients should talk to a doctor about their concerns instead of reading stuff like “your cornea never heals!” and rejecting the idea completely. Get a second opinion, even, and tell the doctor that he or she is the second opinion (and thus not necessarily getting your business) if you’re concerned about them just trying to make a profit off you.

[Smeghead]

@Ferret Herder

LASIK definitely isn’t for everyone, but I think patients should talk to a doctor about their concerns instead of reading stuff like “your cornea never heals!” and rejecting the idea completely. Get a second opinion, even, and tell the doctor that he or she is the second opinion (and thus not necessarily getting your business) if you’re concerned about them just trying to make a profit off you.

Hear hear. My doctor was very clear and upfront and determined to make sure I understood all the risks and potential complications. Like I said before, any doctor you see should be willing to tell you the exact number of patients he’s treated and the number that have been satisfied or dissatisfied. If you go to a doc who won’t tell you, find another one.