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LASIK
Eye Surgery Information to help the
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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 is 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.
Additional
Risks if you are Considering the Following:
Monovision
Monovision is one clinical technique used to deal with the
correction of presbyopia, the gradual loss of the ability of the
eye to change focus for close-up tasks that progresses with age.
The intent of monovision is for the presbyopic patient to use
one eye for distance viewing and one eye for near viewing. This
practice was first applied to fit contact lens wearers and more
recently to LASIK and other refractive surgeries. With contact
lenses, a presbyopic patient has one eye fit with a contact lens
to correct distance vision, and the other eye fit with a contact
lens to correct near vision. In the same way, with LASIK, a
presbyopic patient has one eye operated on to correct the
distance vision, and the other operated on to correct the near
vision. In other words, the goal of the surgery is for one eye
to have vision worse than 20/20, the commonly referred to goal
for LASIK surgical correction of distance vision. Since one eye
is corrected for distance viewing and the other eye is corrected
for near viewing, the two eyes no longer work together. This
results in poorer quality vision and a decrease in depth
perception. These effects of monovision are most noticeable in
low lighting conditions and when performing tasks requiring very
sharp vision. Therefore, you may need to wear glasses or contact
lenses to fully correct both eyes for distance or near when
performing visually demanding tasks, such as driving at night,
operating dangerous equipment, or performing occupational tasks
requiring very sharp close vision (e.g., reading small print for
long periods of time).
Many patients cannot get used to having one eye blurred at all
times. Therefore, if you are considering monovision with LASIK,
make sure you go through a trial period with contact lenses to
see if you can tolerate monovision, before having the surgery
performed on your eyes. Find out if you pass your state's
driver's license requirements with monovision.
In addition, you should consider how much your presbyopia is
expected to increase in the future. Ask your doctor when you
should expect the results of your monovision surgery to no
longer be enough for you to see near-by objects clearly without
the aid of glasses or contacts, or when a second surgery might
be required to further correct your near vision.
Bilateral Simultaneous Treatment
You may choose to have LASIK surgery on both eyes at the same
time or to have surgery on one eye at a time. Although the
convenience of having surgery on both eyes on the same day is
attractive, this practice is riskier than having two separate
surgeries.
If you decide to have one eye done at a time, you and your
doctor will decide how long to wait before having surgery on the
other eye. If both eyes are treated at the same time or before
one eye has a chance to fully heal, you and your doctor do not
have the advantage of being able to see how the first eye
responds to surgery before the second eye is treated.
Another disadvantage to having surgery on both eyes at the same
time is that the vision in both eyes may be blurred after
surgery until the initial healing process is over, rather than
being able to rely on clear vision in at least one eye at all
times.
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