Friday, February 27, 2009

LASIK Eye Surgery

In our previous article about laser eye treatments, we've been talking about two types of laser eye surgery: PRK and Lasik. Now we are going to go deeper with our investigation and see what the Lasik procedure is all about, what are the major benefits, the risks and how to start asking questions whether or not Lasik surgery is for you.

Purpose of Lasik Eye Surgery

This operation has the goal of vision correction, so persons which are either nearsighted or farsighted, or suffer from astigmatism can have these corrected, allowing them to stop wearing the glasses or the contacts. One may say that wearing glasses is not that painful. However, think of those people seriously affected, who are forced to wear those extremely thick lenses, heavy glasses that look very much like bottle bottoms. For them, going lighter can translate into a much better quality of life.

How Lasik Eye Surgery Goes

This modern type of laser surgery consists of permanently re-shaping the cornea surface, thus correcting the vision faults caused by that shape. This is done with the help of an excimer laser ad overall, the surgery may take as little as one minute, then the patient may go home for the post-surgery stage. After healing, the eye will have its diopters reduced as much as to allow the patient to see normally without glasses or contact lenses.

Am I Eligible for Lasik Eye Surgery?

Although this is a very easy and rather routine procedure, Lasik has some cases in which it is not indicated. Such cases can be:
  • frequent change of the glasses prescription. This means that you have refractive instability. The doctors cannot therefore determine how much to ablate from your cornea, because their measurements done today may change in a few months, resulting in poor vision, despite the fact that you've been through this corrective surgery.
  • diseases that affect wound healing. This may happen in diseases such as rheumatoid arthritis, diabetes, lupus or HIV. You can't undergo surgery because your wound would have troubles in healing, thus endangering your life.
  • you have an active job. If you are a wrestler, you can't have Lasik vision correction surgery. You are too exposed to kicks in your face, therefore your eyes are endangered to be hit as well.
  • you are under 18 years of age. This is the regulation in the US: only adults can have Lasik surgery. I don't know about other countries, but if anybody knows more, please feel free to discuss this in the comments.
  • you suffer from dry eyes. This may not be an impediment, but you should be aware that Lasik usually tends to exacerbate this condition.
First of all, if you intend to have Lasik surgery, the best advice I can give you is to discuss this with an eye surgeon, or with your ophthalmologist. He will explain you all the risks involved and he'll be able to assess your health staus, in order to determine if you are eligible or not for undergoing laser vision correction through the Lasik method.

What Are The Risks Of Lasik Eye Surgery

We are going to list a few risks below. However, if you go to the doctor, you'll find out more details about each chapter. In order to be better informed, you could prepare a list of questions and take it with you when you go for your preliminary medical consultation. These are the Lasik risks as described on the FDA official website: (I quote them because I couldn't have said it better and because it is very important that you understand all the risks involved before going for Lasik or any other type of surgical intervention)

  • Some patients lose vision. Some patients lose lines of vision on the vision chart that cannot be corrected with glasses, contact lenses, or surgery as a result of treatment.
  • Some patients develop debilitating visual symptoms. Some patients develop glare, halos, and/or double vision that can seriously affect nighttime vision. Even with good vision on the vision chart, some patients do not see as well in situations of low contrast, such as at night or in fog, after treatment as compared to before treatment.
  • You may be under treated or over treated. Only a certain percent of patients achieve 20/20 vision without glasses or contacts. You may require additional treatment, but additional treatment may not be possible. You may still need glasses or contact lenses after surgery. This may be true even if you only required a very weak prescription before surgery. If you used reading glasses before surgery, you may still need reading glasses after surgery.
  • Some patients may develop severe dry eye syndrome. As a result of surgery, your eye may not be able to produce enough tears to keep the eye moist and comfortable. Dry eye not only causes discomfort, but can reduce visual quality due to intermittent blurring and other visual symptoms. This condition may be permanent. Intensive drop therapy and use of plugs or other procedures may be required.
  • Results are generally not as good in patients with very large refractive errors of any type. You should discuss your expectations with your doctor and realize that you may still require glasses or contacts after the surgery.
  • For some farsighted patients, results may diminish with age. If you are farsighted, the level of improved vision you experience after surgery may decrease with age. This can occur if your manifest refraction (a vision exam with lenses before dilating drops) is very different from your cycloplegic refraction (a vision exam with lenses after dilating drops).
  • Long-term data are not available. LASIK is a relatively new technology. The first laser was approved for LASIK eye surgery in 1998. Therefore, the long-term safety and effectiveness of LASIK surgery is not known.

As you can see, Lasik can be very dangerous if you don't choose a good surgeon. The smallest error could cost you the vision, so it is important not to jump on the first doctor you meet and ask for laser eye therapy to get you rid of your prescription glasses. Read a lot, ask a lot more, ask for testimonials from former patients before committing into any kind of agreements.

Last but not least, be aware that laser procedures are not cheap. They are expensive and they are not reimbursed by health insurance companies, so you need to make sure you have the money before thinking of Lasik eye surgery.

Thursday, February 26, 2009

Laser For Eye Treatments

Eye surgery is one of the most delicate medical interventions. The eyes region is rich in blood vessels and nerves, so even the smallest mistake during a surgery routine may have catastrophic consequences, resulting in blindness, massive bleeding or other complications. This kind of procedures were very difficult to make with classic techniques. The invention of lasers and their development as medical, surgical tools decreased the risks of those patients who had to go through eye surgery, either for correcting a vision impairment, or for stopping progressive diseases such as cataract or glaucoma.

Laser Eye Surgery Types

The first laser eye surgery ever used was PRK, which is the acronym for photo refractive keratectomy. It is also known as ASA, or Advanced Surface Ablation. Invented somewhere in the 1980s, PRK was introduced in the US only in 1995. Before that, Americans needed to go on medical tourism trips in Canada or in other countries in order to benefit from this type of surgery. The basis of this surgical procedure is an excimer laser which is used for removing little fragments of the cornea surface, with the purpose of reshaping it, in order to correct sight vices. PRK is suitable for both nearsighted and farsighted patients, as well as for astigmatism correction.

The decision whether or not you are to be elected for PRK eye surgery belongs to your eye doctor. The ophthalmologist will run a series of tests on your eyes, such as making a topographic map of your cornea, in order to determine how severely you are affected and how much of your corneal tissue will have to be ablated in order to give you back your clear sight. If you suffer from other medical conditions, you should inform the eye specialist, because some of those diseases may forbid you go through an eye surgery of this kind.

This laser treatment is done ambulatory, which means that you don't need hospitalization after the surgery. In fact, the whole operation takes about one minute, more or less, depending on how bad your vision defect is. Together with your surgeon, you'll decide whether you want to have surgery on both eyes in the same day, or you'll come back after a week or so for the second eye. Beware that you won't be able to drive after the surgery, so you have to ask somebody to take you home from the hospital.

Another type of refractive laser eye surgery is LASIK, the laser-assisted in situ keratomileusis. This procedure can also correct myopia, hyperopia and astigmatism. Lasik gained a lot of popularity, because it is less painful than PRK and because the patient recovery is faster. Roughly, the Lasik procedure consists of removing a thin flap off the eye, folding it, then using an excimer laser to ablate and remodel the corneal tissue beneath the flap. After adjusting the eye curvature as required, the flap is put back in place, then the eye is healing by itself, in a natural process. This three steps eye surgery is done without putting the patient asleep. It is also ambulatory. The postoperative care mainly consists of an antibiotic and anti-inflammatory eye drops. Sometimes, dark shades are needed to protect the eyes from bright sunlight.

There are several types of Lasik surgery. One of the variations is the wave-front guided Lasik, in which the surgeon is guiding the laser movement with the help of a wavefront sensor. Some eye surgeons claim that this procedure decreases the probability of visual artifacts caused by spherical aberrations induced by the laser correction. However, there are no scientific studies to support this statement.

Before going for eye surgery, patients tend to inform themselves about the complications that may occur during and after a Lasik or PRK intervention. We are going to talk about these in a future article. for now, I can tell you that the satisfaction range of the patients who were subject to Lasik surgery is between 92% and 98%. This satisfaction rate was measured in medical studies.