Friday, October 15, 2010

How Safe is Lasik?

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.
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