What’s it all about?

You’re most likely familiar with the term LASIK surgery. It has become very popular for athletes, along with many of your friends and co-workers, to have this procedure. In the past, when correcting vision problems such as nearsightedness (myopia), farsightedness (hyperopia) or astigmatism (distortion), you wore eyeglasses so the lenses could “reshape your vision” or contact lenses to physically reshape your cornea.
But over the last couple of decades, LASIK (laser-assisted in situ keratomileusis) has become the treatment most often performed to correct these common eyesight problems. This surgical procedure involves the use of a laser to reshape the cornea of your eye. This change then redirects the light that enters your eye to focus more properly on the retina, providing you with clearer vision.

What’s for you not to like? Laser eye surgery is short and sweet. It is said to be pain-free, to last for only about 15 minutes for both eyes and to result in improved vision within as short a period as 24 hours. All without eyeglasses or contact lenses.

Start at the very beginning —
find an experienced surgeon.
Your surgeon should be a board-certified ophthalmologist, experienced in this particular field and technique. This means you should not have surgery on your eyes by a technician or assistant or medical doctor who has attended a weekend of show-and-tell. These are your eyes you’re entrusting to someone. You can ask for recommendations from your eye care professional and your friends and family and access the Texas Medical Board website to verify credentials.
Does the surgeon have any malpractice investigations in the past or present, or any restrictions noted regarding his or her medical license or practice? Is the surgeon a resident, or does he or she fly in and out to perform multiple procedures once a month or so? Do you have meetings with the surgeon prior to the day of surgery? Are the costs just too good to be true, compared with other surgeons in the area?

Schedule some free consultations. Ask about any risks or complications you might have, how these will be handled, what services will be provided before and after the surgery, and, of course, costs and payment options.

Once you have chosen your surgeon, you should be given a thorough eye examination prior to LASIK surgery where your doctor will determine if you are a candidate for the surgery. He or she will evaluate:
• the shape and thickness of your cornea
• the size of your pupil
• the type of correction to be made
(nearsightedness, etc.)
• the moistness of your eyes
• the measurement of the curvature of
the front surface of your eye and the
“mapping” of your eye, using a
special instrument
• your medical history and any
medications you’re taking.

You may not be a candidate for LASIK surgery if…

• you have any eye problem, like cataracts, glaucoma, persistent dry eyes, an infection or an injury that might affect how you respond to the surgery or the healing process.
• your corneal surface is too thin or irregular to accommodate the surgery.
• you have very large pupils, which can increase the risk of side effects like halos or starbursts when driving.
• your eyes require a very strong prescription to correct your vision.
• there are age considerations to address. You must be over 18, sometimes over 21, to assure your vision has stopped changing and the prescription has remained stable for at least 12 months. Although there is no particular upper age limit, after age 40 a normal, age-related condition called presbyopia occurs that may mean you’ll require reading glasses even after you’ve had a LASIK procedure. As we age, our eyes become drier. This condition can become worse, so it must be treated and resolved before LASIK surgery.
• your general health is compromised because of a degenerative or autoimmune disease like AIDS, HIV, Type 1 diabetes or rheumatoid arthritis. If you take certain medications including steroids, Accutane and immunosuppresents, these will increase the risks involved with this type of surgery.
• you are pregnant or nursing. Hormonal changes many times lead to temporary changes in your vision. In addition, any medications prescribed post-surgery could affect the health of your baby if you’re nursing.

The LASIK procedure itself
It begins with some numbing drops in your eyes so you won’t have any discomfort during the surgery. Your eyes will be secured in a manner where you won’t be able to close your lids or move your eye around while an ultra-thin flap is created on the surface of the eye (cornea). The pulsing laser light then reshapes your cornea according to the computerized instructions for your individual eyes. You may feel pressure, but not pain, during the procedure and will hear a “clicking” sound as the laser does its work.
The flap is then returned to its normal position, where it acts like a “bandage” for protection and eliminates the necessity for stitches. Each eye is worked on separately, around 5 minutes per eye. After a brief rest, you’ll be on your way home with your designated driver.
You may experience a little itching or burning in the eyes and maybe some blurring that day. Don’t scratch or rub your eyes! You will probably experience improved vision as early as the next day and continued improvement over the next few days. Your physician may release you to return to work in a day or so but will caution against any strenuous exercise for a week or more.
There will be a follow-up visit or two, along with a mandatory eye test to show the state you can legally drive without glasses or contacts, usually requiring your vision to be 20/40 or better.
Even though LASIK surgery has been highly successful for millions of Americans, including our military personnel, there can still be complications. Most complications can be resolved through medications or a second “enhancement” surgery.

By Anne Moore