LASIK - better eyesight at the speed of light
Feb 27 '05 (Updated Mar 19 '05)
The Bottom Line Check it out and learn all you can beforehand. There are certainly very real risks to otherwise healthy eyesight, so do not decide on LASIK without careful forethought.
Surprisingly, not as many previous reviews on LASIK as expected inasmuch as there are millions of these surgical procedures done annually. LASIK has been FDA approved for over ten years. I'm not one to be overly enamored with high tech - don't even own a cell phone - but use of the excimer laser for human eye surgery to greatly improve visual performance, is truly an amazing marvel of modern medical science.
I'm 55 and have been very badly nearsighted (myopic) with astigmatism in both eyes from an early age. Most of my life I have been wearing eyeglasses with prescription lenses as thick as the bottom of a Coke bottle; so bad was my distance vision, driving without them was illegal if not a major threat to safety.
One of the worse day of my life was going to school (6th grade) with eye glasses for the first time. That was the age I was first beginning to notice girls and the idea of becoming a "four eyes" was pure mental anguish.
Forty five years later I finally decided to put my faith in medical science and try something that promised to improve the quality of the rest of my life. At my age, obviously I did not have LASIK for vanity sake - although many people probably do - but probably waited far too long. LASIK first became available to the masses, albeit at a premium price, in the 90s. Unfortunately, for those people that can least afford it, I really think laser correction eye surgery is of most benefit to young adults. That age group can achieve the maximum benefits, long before they develop presbyopia (loss of ability to read without glasses that occurs to almost everyone around the age of 45).
As a hedge against possible complications, I did one eye at a time about a year apart, after consulted four different refractive surgeons before committing to Wavefront Custom Ablation of the first eye. I like to play the field. I had two different surgeons, one for each of my eyes, and a total of three different manufacturers' lasers after all said and done. For my second eye I "upgraded" lasers and went for Intralase, the "all laser" LASIK surgery. Suffice to know, the latter is also known as the "bladeless" LASIK procedure. I changed doctors for the second eye only because my first eye surgeon did not (yet) offer Intralase in his practice.
Intralase LASIK involves creation of the corneal flap with what they call a femtosecond laser. A femtosecond is a very small unit of time; a billionth of millionth of a second, which is the pulse rate used by this new laser eye surgery technology. It is supposedly much more accurate and safer than using the microkeratome (surgical blade), and less likely to produce any vision threatening complications. There are many horror stories about such things happening to certain LASIK patients, however serious post-operative infections that may lead to loss of sight are extremely rare, so much so that they are statistically insignificant. Nevertheless, one botched surgery is all it takes to ruin a refractive eye surgeons reputation in the field.
In my opinion, the creation of the corneal flap, the first step of the LASIK procedure is clearly the most critical, and there is virtually no margin for error. Any inaccuracy here - with the depth, size and consistency of the flap itself, will likely have an adverse effect on the outcome of the procedure. This is why I choose Intralase; seemingly the best way to insure the absolute most possible surgical "cutting" accuracy, capable of 0.25 microns (or a millionth of an inch). Traditional LASIK is done with a mechanical device called a microkeratome, which is also highly accurate but certainly less expensive to use vs. a femtosecond laser for "cutting" the flap. Intralase cost several hundred dollars more per eye, mostly paid in royaly fees to the laser manufacturer, but surely that should not be the sole reason for choosing traditional LASIK surgery. I paid $4800 for both eyes; two hundred more for the second eye with Intralase.
I also had Wavefront guide laser surgeries in both eyes. This also costs hundreds more per eye, but for someone with all but the mildest vision impairment, probably well worth it. Wavefront "attempts" to address complex, third order abberrations within the optics of the human eye; something that regular prescription eye glasses or contacts lenses simply cannot do. This is one possible advantage of modern laser eye surgery; a "better" degree of visual acuity. Hence the goal of refractive eye surgeons: 20/10 by the year 2010!
My eyesight is now "plano" or 20/20 in both eyes, however I still have about -0.5 dipoters of astigmatism in one eye small degree of night vision glare, halos and starbursts. I recently had the Intralase - all laser - LASIK procedure in the second eye. It has been a couple weeks since the Intralase LASIK surgery and all is well. With Intralase and Wavefront combined, my second eye turned out to be 20/15 with no residual astigmatism. I'm thrilled!
It usually takes a few weeks or months for the cornea to completely heal and correction to fully stabilize. In my case healing and stability were reached in a matter of days. It only took about 24 to 48 hours for my eyesight to recover sufficient to go about my everyday routine. I now see BETTER THAN 20/20 collectively with both eyes, even with the small amount of remaining astigmatism in my first eye.
Needless to say, I am very pleased with the results of the all laser, wavefront guided LASIK procedure compared to the results obtained sans the Intralase procedure.
I had no post-op problems in either eye whatsoever, and both flaps healed very quickly without incident. Both surgeons did their individual jobs very well in that respect, although I may return to my first surgeon for an enhancement to try and get rid of the residual astigmatism. In my case, this is not really necessary, but the option still exists and the surgeon will do the enhancement, if he is confident a "touchup" could achieve the desired result. The best part is the original flap is "reusable" for the enhancement procedure, and there is no charge for the additional corrective eye surgery.
My surgeon is part of the TLC network of Laser Vision Correction Centers, which "guarantees" the availability of follow up refractive corrective services (nationwide) for the rest of my life, at no additional charge.
The good thing about an enhancement, is the surgeon does not need to recut another flap on top of the old one; just lift the original flap and touch up or "redo" the corneal tissue reshaping laser procedure underneath. Obviously, there is still no guarantee your vision will actually improve, (in fact, it possibly may get worse), however the thicker your cornea to start with, the more likely you are medically not at risk to have an enhancement.
For the sake of older people who may be consider LASIK, I should make some additional comments about an alternative called Monovision for nearsighted patients. This is having a full distance correction in your dominate eye and intentionally under correcting the other eye to about -1.50 to -2.00 diopters (mildly nearsighted).
I seriously considered having "monovision" before having LASIK surgery to my second, less dominate eye. I decided to try a monovision trial with a contact lens to evaluate in advance if that would be worthwhile and something I could adapt to. Turns out I think I could, but there would then would be obvious compromises to the overall quality of vision. I could not easily make such a trade off, so after much consternation - thoroughly evaluating all the pros and cons, I decided against monovision just one week before surgery. It was a very hard decision!
As a result, I now MUST wear reading glasses for most all indoor activities involving any close up vision, i.e. for just about any form of reading, or working on a computer, which is a necessity in my line of work. With monovision, I am fairly certain I could have adjusted without ANY need for additional prescription (reading) glasses. But then the quality of my regular distance vision, due to my eye's being unbalanced, would still made it hard to make out the road signs at a distance. Another compromise, probably most noticeable, is loss of peripheral vision.
With monovision, I would have probably still wanted to wear prescription glasses and/or sunglasses solely for driving purposes. I may still wear the latter, but only because I want to wear them, not because I have to, to see where I'm going with the best possible clarity.
In the final analysis, I did not feel having monovision was truly my best option; even though I do not spend nearly as much time driving as I do working on a computer. Because of that one fact alone, again, my personal decision was a very hard choice.
Perhaps for someone else nearing the age of 40 or well over, monovision may very well be the right approach to laser eye correction surgery. This is especially true for someone who leads a less active lifestyle. In my case, I ride a motorcycle and best corrected distance vision in both eyes just seemed like the more logical choice for my personal lifestyle. Fortunately, for younger patients under age 40, there is only one choice, since Monovision is not even an option.
Bottom line, laser eye surgery is truly a miracle of modern medical science to improve human visual performance that can be of benefit to millions of people. It is well worth considering, if you can afford it, to reduce or eliminate dependence on wearing troublesome everyday prescription eyeglasses or contacts.
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Epinions.com ID:
dsinned
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Location: Sunnyvale, CA
Reviews written: 12
Trusted by: 0 members
About Me:
Californian born, SF Bay Area native. College graduate. 55 years young.
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