In our office, one of the most frequently asked questions is "So Doc, am I a candidate for laser vision correction?". Our answers below are not a substitution for a consultation with your eye doctor, however, the more you know the easier it is to make an informed decision.
Is Laser Vision Correction safe?
The FDA has determined that Laser Vision Correction is a safe and effective means of treating myopia, hyperopia or astigmatism. It is, however, not without risks or potential complications.
What Are The Long-Term Effects Of LASIK?
Excimer laser procedures have been prevalent in many countries around the world since the late 1980's. Many clinical studies have investigated the long-term effects (15 years) of the Excimer laser on the cornea. All of these studies, without exception, have failed to demonstrate any long-term negative effects on the integrity of the eye. Patients who require an enhancement procedure or develop a complication will typically do so within the first few months following the procedure, not years later.
It is essential that a patient considering a refractive surgery understand as much as possible about the risks associated with the Excimer laser procedure. The Excimer laser procedure, like all surgical procedures, has limitations and risks. However, the risk of having a serious vision-worsening complication with LASIK is less than 1%.
Will I Have Perfect Vision After The Procedure? Will I Still Need My Glasses?
Experience has shown us that Laser Vision Correction has been overwhelmingly successful in significantly reducing nearsightedness (myopia), farsightedness (hyperopia), and astigmatism. While vision improves following the procedure, the degree of improvement may vary from individual to individual. Overall, studies have shown that 98% of patients achieve 20/40 vision or better after one procedure (ie before any enhancements) which means they can drive legally, enjoy sports, and join the police or fire departments, all without their glasses.
Does The Procedure Hurt?
No, the procedure is painless, however, some people notice a sensation of pressure.
After the procedure, most patients experience only some irritation (usually reported as a burning sensation), light sensitivity, and watering of their eyes for a day or two.
Can Anyone Have LASIK? Am IA Candidate?
LASIK and PRK will not work for everyone, however, most nearsighted patients are candidates as well as many patients with astigmatism and / or farsightedness. An evaluation for refractive surgery should include counseling as to the risks and benefits of the procedure as well as a presentation of alternative options. Some of the criteria used to determine if a patient is a candidate for refractive surgery includes their prescription, corneal thickness, post surgical expectations of visual acuity, occupation and contraindicating ocular and medical conditions.
Patients over 40 often hope that LASIK will allow them to see clearly at both near and far without reading glasses (like when they were 30). In most cases this is not possible. Typically a patient over 40 will need reading glasses when their eyes are corrected for distance regardless of whether that correction is achieved via contacts or refractive surgery. Most patients are familiar with monovision (one eye corrected for distance and one eye corrected for near), however monovision is usually best achieved through contact lenses, not refractive surgery.
Does Insurance Cover The Costs Of Laser Vision Correction?
Typically, very few insurance companies will cover the cost of refractive surgery. Insurance companies usually look at refractive surgery as an elective procedure. Many employers have "flex accounts" or cafeteria plans for unreimbursed medical expenses. Flex plans cover laser vision correction as a reimbursable expense.
Can I Wear My Contact Lenses Before The Procedure?
The use of contact lenses directly affects the shape and hydration of the cornea. Therefore, it is necessary to remove contact lenses prior to both the pre-operative eye exam and prior to surgery.
Soft contact lens wearers should remove their contacts one to two weeks prior to both the pre-operative exam and surgery.
Rigid contact lenses (gas permeable and standard hard lenses) should be removed for approximately four to six weeks (or until your eye doctor says that your refractive error is stable) prior to both the pre-operative examination and surgery. Many patients are related to wear glasses for this period of time, therefore, we can usually fit patients with soft contact lenses to help with the transition.
What Is Presbyopia? (Or, Why Do I Need Reading Glasses Or Bifocals?)
As we mature, the crystalline lens of the eye loses its elasticity, thus reducing our ability to focus on near objects. You will notice this as your "arms get too short". This change is called presbyopia, meaning that a different correction is needed for close work than for distance vision. Presbyopia usually occurs in the early to mid-forties. Laser vision surgery will not affect the progress of presbyopia, however, it will change how one copes with it. Typically a nearsighted person can remove their glasses to see up close. After refractive surgery, they will no longer be nearsighted, so they will not be able to remove their glasses to read.
Patients in their forties or older will most likely require reading glasses after refractive surgery. The need for reading glasses would be necessary regardless of whether they have laser vision correction surgery.
Laser vision correction is one of the many options available to patients wishing to correct their vision. A consultation with an eye doctor will give an unbiased opinion as to the many options available