Paula Blackburn asked:


You may be considering having your vision corrected through LASIKbut you may be worried about the risks with this surgery. Then you will be glad to know that complications from LASIK are rare, and permanent vision loss is virtually unheard of. For those minor complications that can occur, retreatment or eye enhancements can solve the problem. LASIK actually stands for Laser Assisted in situ Keratomileusis; LASIK reshapes the cornea to increase clarity of vision.

The most important step in undergoing LASIK is to choose a highly qualified eye surgeon. Your surgeon should have performed hundreds, if not thousands, of LASIK procedures before you commit. Competent eye surgeons will carry out proper screening before performing LASIK surgery to ensure the health of your eyes today and in the future.

LASIK Popularity

In the United States, LASIK is a popular procedure with a solid success rate that has been performed millions of times. Increasingly sophisticated technology provides very favorable outcomes for all patients. In fact, the U.S. military uses LASIK to help soldiers decrease dependence on eyeglasses and contact lenses. Overall, serious rates of complication are below one percent. This is due in large part to experienced LASIK surgeons who carefully screen and select patients based on best suitability for specific refractive procedures. Some patients are not good candidates for LASIK due to health problems, eye problems, age, pregnancy and nursing. This highlights the importance of speaking frankly with your eye surgeon during your vision consultation.

LASIK Complications

Most rare LASIK complications are associated with the creation of the corneal flap, an integral part of LASIK eye surgery. The April 2006 issue of American Journal of Ophthalmology indicates flap complications occur in .3 percent to 5.7 percent of all LASIK procedures.

Still, no surgical procedure is risk free. LASIK complications may include:



Double vision

Dry eye

Glares or halos at night

A sandy feeling in the eye

Removal of too little or too much corneal tissue



Since LASIK was approved in the 1990’s, it has continually improved. Many people who could not have LASIK in the past are now good candidates as the procedure has evolved so much. The original LASIK procedure is now referred to as Traditional LASIK and has been supplanted in popularity by the more sophisticated Wavefront-Guided LASIK.



Allison

Patricia Woloch asked:


LASIK is not a good option for everyone, and that has been known for many years. When the FDA first approved LASIK, in the mid 1990s, many ophthalmologists rushed to offer it to all and sundry. You could even say that some vision clinics operated like LASIK assembly lines, whisking people in one door and out the other without adequately screening them.

Some kept their expenses down by buying cheap equipment, not changing the microkeratome blade for each patient, not sterilizing instruments often enough, and keeping a small staff. The eye surgeon did not meet with patients before or after the actual surgery, but delegated that to assistants. With low expenses, such clinics were able to offer low prices to attract a lot of patients.

The result was that many people had LASIK who should not have had it. They were poor candidates.

How LASIK is Done

Briefly, it reshapes the eye’s cornea, the clear part in front. The cornea, being curved and transparent, bends light as it enters the eye. In a 20/20 eye, it bends it at just the right angle to give clear vision. If you are near- or far-sighted, it bends it at the wrong angle. If you are astigmatic, it bends light in multiple ways, giving blurry vision.

To reshape the cornea, a small, thin flap is first cut with a tool called a microkeratome. The flap is folded back out of the way, and the treatment laser (Excimer laser) vaporizes tiny pieces of corneal tissue beneath the flap area, according to a pre-determined plan. This gives the cornea a new curvature: flatter for nearsighted people and steeper for farsighted people.

The corneal flap is then replaced carefully and heals up by itself. Now that the cornea has a modified curvature, incoming light will be bent correctly and will focus clearly on the retina at the back of the eye. You will have clear vision at all distances.

LASIK Developments

More information has been gathered since the early days. More follow-up studies have been done, and modified forms of LASIK have been developed which are safe for people who cannot have standard LASIK.

• Wavefront-guided LASIK delivers a more precise treatment, preventing many of the side effects that often resulted from standard LASIK, such as halos and starbursts around light sources, ghosting (kind of double vision), and poor night vision.

• Intralase uses no microkeratome blade to create the corneal flap, but instead uses a second laser. This makes a thinner flap and enables those with thinner corneas to still have vision correction

• LASEK and epi-LASIK also do not use a blade to cut the corneal flap. They use alternative methods to make thinner flaps, making vision correction possible for more people.

Public FDA Hearing today

Today, April 25, 2008, the FDA is beginning a second look at LASIK. The plan is to work with eye surgeons and do a major study on many hundreds of people who have complained about their LASIK results. What exactly are their complaints? Were they poor LASIK candidates to start with? Depending on their findings, they may issue a new warning about LASIK.

About 7.6 million people have had a LASIK procedure in the U.S., and the percentage of people who achieve 20/20 vision or better is in the high nineties. LASIK is truly something of a miracle for anyone who has lived their lives with poor vision and suddenly has clear vision. It is almost always a huge success. But the first line of defense against any complications afterwards is to choose a good LASIK surgeon.

The FDA’s website has a page on all the LASIK devices and systems they have approved. There are links to more detail on each one, and to warning letters issued by the FDA, press releases and patient information. If you are considering LASIK for yourself, this would be a good place to start your self-education about it.

Be sure and choose an experienced and highly-trained LASIK surgeon, who will give you a thorough eye examination, check your medical history and general health, and listen to your goals and concerns. Make sure that this same surgeon will personally do your follow-up checks. If you feel any reservations or discomfort about working with a particular eye surgeon, move on and schedule a consultation with another surgeon. An educated patient is always the best kind, so do your homework, choose a good surgeon, and you will likely be jazzed and delighted at the results.



Erin

Patricia Woloch asked:


In the 1990s, in the rush to offer this miraculous new vision correction to the public, some ophthalmologists failed to screen potential patients well enough. LASIK is not safe for everybody. This was quickly realized, and screening became more careful and strict.

If a LASIK surgeon has said you are not a good candidate for LASIK, there could be various reasons for that – related to your eye health, general health, prescription stability, or expectations. But there are also various ways of doing LASIK that have been developed to correct vision for people who are not good candidates for traditional LASIK.

If you have corneas which are too thin or too steep in curvature for LASIK, you can consider Intralase, LASEK, or epi-LASIK, all of which have modified ways of creating the corneal flap. That flap is done to expose the next layer down in the cornea, the stroma, where your LASIK surgeon will direct the laser. Intralase, LASEK and epi-LASIK cut the flap more thinly so as not to weaken the cornea.

Complications vs Side Effects

Keep in mind that complications are different from side effects. A side effect is temporary and minor, although it may be annoying or uncomfortable at the time. LASIK side effects are such things as dry eyes, itching, or a scratchy feeling, which last only a few days, if you have them at all. If you tend to have dry eyes before LASIK is done, that is a disqualifying condition.

Complications are more major conditions which may require a second surgery, or more long-term treatment, and some can even give permanent trouble, but this is very rare.

Wavefront-Guided LASIK

In the early days of LASIK, before wavefront technology was developed, there was a higher rate of complications after LASIK. Wavefront technology is an extremely precise way of diagnosing the eye’s refractive error. It gathers detailed information from which it creates a 3-D map of each eye. Your LASIK doctor then bases your treatment on this information. Most LASIK surgeons now offer LASIK in this form.

Use of wavefront-guided technology gives a more precisely customized treatment for each eye – in fact each treatment is one-of-a-kind. Nobody ever has or ever will receive the same treatment that your right eye will receive. Not even your left eye. By being so exact, it prevents some of the vision distortions that used to be side effects or complications from traditional LASIK. They are things like:

• Poor night vision

• Double vision (also called ghosting)

• Halos

• Starbursts

• Glare around light sources

Potential LASIK Complications

No matter how sophisticated technology becomes, or how many LASIK techniques are developed to expand the pool of safe candidates, LASIK is still a surgery. All surgery brings a certain amount of risk. It is one of the requirements of good candidacy that you accept that fact, and are willing to take a very small risk to obtain a very large and amazing improvement in your vision.

LASIK complications are very rare, less than one percent.

• Infection beneath the corneal flap – usually prevented by antibiotic eyedrops, but sometimes a person doesn’t use them according to the LASIK surgeon’s directions

• Faulty flap healing – can often be corrected by subsequent surgery

• Corneal ectasia – can be an ongoing problem, treated as keratoconus

• Irregularities resulting from faulty flap creation – these can give you those vision distortions listed above

The best way to minimize any chance of LASIK complications is to choose a highly-trained and experienced LASIK surgeon. Choose one who screens patients very thoroughly, answers your questions clearly, has invested in a wavefront-guided LASIK system, and does not pass you off to an assistant.



Ann

Michelle Beck asked:


Lasik surgery has been around in some form for over 20 years. However, there have been many changes made to it, and it is not the same as it was in the past. This is a good thing, because the evolution of the procedure has made it much safer and much more precise. In the past, the Lasik procedure worked relatively well, but the complication rate was higher than eye doctors liked it to be, the cost was excessive and the results were not always as good as expected. The procedure was good, but there were improvements that needed to be made. Now, those improvements have been made and the Lasik procedure is safer and more effective than ever. Recent studies have even indicated that Lasik is safer over the long-term than wearing contact lenses — which were considered the standard for a long time among eye doctors and their patients.

New Technology — Bladeless Lasik

One of the most important technological advances where Lasik is concerned is the new style of bladeless Lasik. In the past, a microkeratome blade was used to make a cut in the cornea, which would allow a corneal flap to be folded back, exposing the inner corneal surface to the laser for reshaping. This is still used quite often, and is certainly not obsolete. However, the bladeless technology has been found to be safer and even more precise than the current style of Lasik, making it the wave of the future. Like Lasik itself, though, there is a learning curve, and it may be some time before bladeless Lasik is used more often than the standard kind.

More New Technology — CustomVue

The CustomVue system is able to give Lasik patients a much more customized experience. In the past, Lasik was done based on a person’s prescription and nothing else. This worked relatively well, but each person has some subtle nuances in his or her eyes that the Lasik could not adjust for. This meant that not everyone got the sharpest vision they could get, and a lot of that depended on whether their eye just happened to be ‘normal’ for that prescription — in which case their Lasik would generally have a better result. Now, with the customized Lasik option, a person can get that better result because the Lasik procedure is calibrated specifically for the contours of that individual’s eye. This is a significant change from the way that Lasik used to be performed, and it holds a lot of hope for an even better future for Lasik and the patients who choose to have it.

Future Advances Are Coming

Given the fact that CustomVue and bladeless Lasik have done so well, eye doctors and researchers, as well as Lasik surgeons, are all working toward new ideas for improvements and procedures. If individuals keep working in that way, the chances that Lasik will continue to evolve and improve are extremely high. No one really knows, however, what the future holds for Lasik. Since it has been around for a relatively short time, and it is still being perfected in the eyes of many people, there is no real knowledge of whether there will be long-term complications with the procedure. Only time will tell if the Lasik procedure changes much in future years or if the people that have had it continue to have successful vision correction throughout their lifetime.



Curtis

John Jacob asked:


Lasik stands for Laser-Assisted in situ Keratomileusis.As the name suggests, Lasik is a laser eye surgery used to correct different eye defects such as myopia , astigmatism and hyperopia.

How much does Lasik eye surgery costs in Los Angeles?

In Los Angeles Lasik eye surgery varies from surgeron to surgeon.There are other,more advanced techniques ,that can be more expensive that a traditional Lasik eye surgery.For example IntraLase.IntraLase is a newly developed technology that uses a laser beam to create a corneal flap instead of using a metal blade.This technique raises the costs of the lasik surgery by $300 per eye.

In Los Angeles the costs of Lasik varies from $1000 to $2500-$3000 depending on the lasik eye surgery center and surgeon.The best (and most expensive) lasik surgery centers are in Beverly Hills and Santa Monica area.

What are the other alternatives?

Some of the alternatives for Lasik eye surgery are PRK (photorefractive keratectomy) and

LASEK (laser epithelial keratomileusis).LASEK is a newer procedure similar to PRK.

There are also alternatives to laser eye procedures like Refractive Lens Exchange (your eye’s natural lens is replaced with an artificial one) or CK for Hyperopia (Conductive keratoplasty).Conductive keratoplasty is a new

procedure that uses heat form radio waves to shrink the collagen in the periphery of the cornea.It’s important to know that RLE ( Refractive Lens Exchange) does not have U.S. Food and Drug Administration approval yet.

Lasik complications

Every surgery has risks and Lasik eye surgery is no different.Here are some frequently reported complications of LASIK :

- Overcorrection or undercorrection

- Dry eye

- Infection

- Double vision

Although there are some risks involved , patients having unresolved complications six months after surgery has been estimated to about 3%.



Ellen