What They Don’t Tell You About LASIK Surgery
January 20, 2012
BY KITT WALSH
You can’t take it anymore. You are done with glasses—taking them off, putting them on, losing that damn little screw and, truth to tell as we get older, often misplacing the glasses themselves. Contacts are their own pains-in-the-nether regions—solution bottles to carry, little cases to clean, and your eyes seem to be drier now that you hit 50. So you are considering LASIK surgery.
Laser in-situ keratomileusis, or LASIK, is used to correct vision in people who are nearsighted, farsighted, or have astigmatism, by reshaping the cornea. You will be handed reams of forms to sign. Read them all. But before you sign, there are a few things you should know:
• Before the surgery, if you have gas permeable contacts, you’ll have to forgo them for three weeks. I had coke-bottle bottom glasses and had to rock that lovely look before surgery.
• You’ll have a thorough eye exam beforehand. If glaucoma is detected (a distinct possibility as we age) back away from the surgery. By shaving the cornea (which is what happens in LASIK), the thinner cornea results in increased pressure in your eye. Increased pressure acerbates glaucoma. Better you wear glasses, than risk blindness.
• If you have diabetes, you should be turned down by the surgeon for LASIK, as you may have difficulty healing.
• You’ll be given Valium—a small dose—to keep you from anxiety when you “see” your vision go black as a flap is cut in your cornea. If you get nervous at the thought of this (I did), ask for more Valium. Have someone there to drive you home.
• You will be told it doesn’t hurt. The discomfort after surgery was certainly akin to pain in my case. Have someone there to wait on you for at least a day after surgery.
• LASIK, your doctor’s office may tell you, “rarely” affects your “best vision” (that’s the highest degree of vision that you achieved while wearing contacts or eyeglasses). My far vision was much improved (I went from Helen Keller to being able to walk around the world without smacking into walls) but my reading vision was ruined. Even the ubiquitous magnifying reading glasses can’t help my vision. I have to take my glasses off to read at all and yes, I still need glasses (albeit much thinner ones) to drive or watch TV.
• Potential side effects of LASIK include double vision, glare and halos, fluctuating vision, and trouble driving at night (age is also a factor in night vision, so you may be multiplying the problem with LASIK.)
• Minor dry eyes “may” occur, you are told. My ophthalmologist shakes her head every time she hears this warning. Your eyes may be so dry after LASIK that you might not only need wetting drops several times a day, but gel drops overnight and, in extreme cases, plugs put into your tear ducts to keep enough moisture in your eyes.
• Even scarier complications associated with LASIK flap complications include:
• Irregular astigmatism—resulting from the laster not being centered on the eye, may cause double vision (diplopia) or “ghost images.”
•Diffuse lamellar keratitis (DLK)—inflammation under the LASIK flap that feels like sand and can cause vision loss. It is usually treated with antibiotics and topical steroids. The flap also might have to be lifted to remove inflammatory cells that can cause tissue damage.
• Keratectasia or keratoconus—bulging of the eye’s surface resulting from the flap being cut too deeply or when too much corneal tissue is removed. The distorted vision can’t be fixed by laser enhancement and sometimes requires corneal implants (Intacs) to hold the cornea in place. There is a new treatment called corneal collagen cross-linking (CXL) which requires Vitamin B2 eye drops applied to the cornea, then activated with an ultraviolet light, making for a stronger link between the cornea and the collagen connective tissue, which helps with the bulging.
It is true that LASIK surgery is safer than in the 1990′s (when 5% of patients suffered complications. Now only about 1% do) but all surgery has risks. Research your surgeon thoroughly and to see if you are a good candidate for LASIK, go to AllAboutVision.com’s online LASIK screening test.
Kitt Walsh owns a web content company, Behind Blogs (www.behindblogs.com ), is a regular contributor to CNN Money, and freelances as a feature writer, editor and marketing consultant for magazines, newspapers and private clients around the world.