Lasik Eye Surgery Answers dot Com

Lasik Eye Surgery Pros and Cons: Making an Informed Decision

This site is for those who have not quite made up their mind about whether to have Lasik or not - and for those who have but are not quite sure about which procedure.

Here you'll find some answers that could help you balance the pros and cons, and then make an informed decision on whether to have surgery that could fundamentally change your life.

Lasik eye surgery, one of the fastest-growing areas in the field of opthalmology (the medical branch that specializes in the eye) is a highly technical subject. The object of this website is to present useful and relevant information in a non-technical way, so that you are in a better position to make an informed decision on whether to go ahead with the procedure or not.

Lasik and other related procedures have achieved good results for many millions - so much so that they have taken on something of the dimensions of a miracle cure-all.
The reality, of course, is somewhat different, and potential patients need to think carefully about their next step.

All about Refractive Errors

People with refractive errors have eyes with a faulty focusing system, so that incoming images are not focused perfectly on the retina (which is the light-sensitive part at the back of the eye) as they should be.

Eye diagramme - Refractive Errors

​There are three types of of what are called lower order refractive errors that Lasik (the word Lasik is an abbreviation of Laser-Assisted In Situ Keratomileusis) can treat successfully, but you will need a pre-operative examination to determine whether you are a good candidate or not for lasik.

  • People with myopia suffer from nearsightedness because the incoming images are focused slightly in front of the retina instead of right on it. The result is that objects further off look blurred.
  • People with hyperopia have the opposite problem; incoming images focus behind the retina, making it easier to see distant objects, but nearby ones become blurry. It is not unusual for hyperopia to run in families and children can be born with the problem; fortunately, many of them outgrow it.
  • The third category concerns people with astigmatism. In their case, the problem is the cornea, the transparent tissue that covers the front of the eyeball. Ideally it should be smoothly curved, rather like a soccer ball.

When the curve is not perfect (or when the lens inside the eye is itself distorted), the incoming light rays are not focused properly, and once again the result can be blurred vision.

Before Lasik

Before the advent of lasik the normal treatment for all three conditions was to use glasses or contacts to bend the light rays before they entered the eye; the skill lay in compensating properly for each eye's particular refractive error.

The lasik approach is different; it actually changes the shape of the cornea to correct the refractive error, and offers the possibility of doing without glass or contact lenses entirely.

Accordingly, most people who undergo Lasik surgery do so because they want (or in some cases must have) freedom from the need to wear glasses or contact lenses.

Presbyopia

There is also a fourth refractive error - presbyopia.

  • This something that starts to affect most people somewhere between the ages of 40 and 50 - in fact, one of its common names is "aging eye". As you get older your eyes lose their flexility, and it becomes more difficult to read things up close (a typical symptom is the need to hold something at arm's length to read it).
  • Presbyopia can be corrected with glasses, but normally cannot be treated by Lasik unless you opt to to the monovision route (see separate article on Lasik Monovision). Note also that if you have a Lasik treatment at a younger age, you are still quite likely to suffer from presbyopia as you get older, and may well have to use reading glasses even if your long vision is still fine.

Advantages and Disadvantages

As with most things in life, there are advantages AND disadvantages to undergoing a lasik procedure.

  • On the plus side, in the vast majority of cases it delivers what it promises, and about 95% of patients end up with the improved vision and/or lifestyle they were looking for - which usually revolves around a reduced (or eliminated) need for glasses or contact lenses.
  • The procedure is very quick and there is very little pain.

On the downside:

  • Lasik is forever and irreversible.
  • Lasik eye surgery is complicated and technically demanding, and there is a high correlation betwen the surgeon's experience and the success rate - which means you need to choose your surgeon carefully.
  • And finally, sometimes the outcomes are not good; vision may be worse than before and there may be adverse side effects.

This video from the FDA (Food & Drug Administration) gives a good background to Lasik eye surgery - and also some warnings!

Not everyone is a good candidate for lasik vision correction (or lasek - a slightly different procedure).

  • First, you need to suffer from one of the three conditions listed in the section on refractive errors;
  • You must be over 18, and not pregnant or nursing;
  • You should not be suffering from any one of a number of diseases or conditions. These could make the surgery less effective or make you heal more slowly.

The reality is that some people make a bad candidates and should probably not risk the treatment.

How does lasik eye surgery work?

Lasik uses procedures that make permanent changes and reshape the cornea.

In one technique, your doctor will use either a laser or a microkeratome blade to create a small flap on the front of your eye, fold back that flap and remove some of the corneal tissue underneath it using another instrument called an excimer laser, and then replace the flap (which will normally heal within a few days).

Alternatively, your doctor might use a technique called PRK which also involves the rehaping of the eye, but without creating a flap first.

Lasik Complications

What about the risks of complications and side effects?
Although that success rate is improving, some people do have problems after a Lasik procedure.

Sometimes a lasik surgeon don’t get it quite right and there can be problems with the flap that is cut at the start of the procedure.

And sometimes the result is perfect eyesight, at least according to an eye chart, but the patient suffers from other complications such as loss of sharpness of vision, or an after-effect such as dry eyes.

Sometimes surgeons will over- or under-shoot the degree of correction needed, making a second treatment called an enhancement necessary.

Lasik Side Effects

Lasik side effects, on the other hand, are usually temporary and should disappear as healing takes place. Possible side effects include:

  • dry eye;
  • sensitivity to glare;
  • problems with night vision;
  • and/or blurred vision.

Another side effect is contrast sensitivity, which is the difference between the lightest and the darkest part of what you’re looking at.

​How much does lasik eye surgery cost?

Part of your investigation must include an assessment of whether you can afford the cost of the operations.

It is an elective procedure (which means you choose to have it) so it is normally not covered by Medicare or normal insurance, although you may have specific eye surgery insurance.

But do be very cautious about buying on price; eye surgery is forever!
Prices vary from $1000 to about $3500 per eye (the average cost of lasik is about $2000), but the final cost depends largely on the extent of the surgery you may require and any follow-up treatment or postoperative care. (See this page for more detailed information).

More...

Once you’ve decided to go ahead, how do you choose a suitable surgeon and eye clinic?

  • Do your research.
  • Be cautious about advertising.
  • Be just as cautious about "guarantees".
  • Get more than one estimate.
  • Check out more than one eye clinic.

What To Expect After LASIK Eye Surgery

Your eyes will temporarily be dry even though they do not feel that way. Your doctor will give you prescription eye drops to prevent infection and inflammation and eyedrops to keep your eyes moist. These drops may cause a momentary slight burn or blurring of your vision when you use them. Do not use any eye drops not approved by your eye doctor.

Healing after LASIK eye surgery usually occurs very rapidly. Vision may be blurry and hazy for the first day, but most patients notice improved vision within a few days of surgery.

Specific follow-up after the surgery varies from one surgeon to another. You should expect to revisit the doctor for an evaluation 24 to 48 hours after LASIK eye surgery, as well as at regular intervals within the first six months.

Here is the FTC's view of Lasik Eye Surgery

"Before you sign up for this surgery, here are a few things to think about:

  • LASIK is surgery to a very delicate part of your eye, and cannot be reversed.
  • As with any surgery, there are risks and possible complications.
  • Millions of people have had LASIK, many very successfully, but it’s not for everyone.
  • LASIK may not give you perfect vision. The American Academy of Ophthalmology (AAO) reports that nine out of 10 patients achieve somewhere between 20/20 and 20/40 vision, but 20/40 vision may not be sharp enough for certain work or leisure activities. Even 20/20 does not always mean perfect vision. Detailed, precise vision may be slightly diminished.
  • Even with LASIK to correct your distance vision, you are likely to need reading glasses in your mid-40s. LASIK surgery cannot correct or prevent presbyopia, the age-related loss of focusing power for seeing near objects.
  • If you are nearsighted and don't yet need reading glasses, having LASIK may mean you will need reading glasses earlier than if you had not had the surgery.
  • The benefits of the LASIK procedure may diminish over time. More than 10 percent of LASIK patients in the U.S. require a second surgery, called “retreatment,” to restore the desired vision correction. This is more likely for people who were more nearsighted or farsighted, or had higher astigmatism before LASIK.
  • Most insurance plans don’t cover the surgery."

(See the full document at the Federal Trade Commission Website)

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