A view on the pros and cons of LASIK

A view on the pros and cons of LASIK

Since 1999, the FDA has authorized LASIK for vision correction. Today, around 600,000 LASIK operations are performed annually in the United States. The great majority of persons who have this operation get 20/20 vision, and the vast majority – more than 95% – express satisfaction with the outcomes.

Nonetheless, complications include as glare and halos are prevalent after LASIK. And, in rare occasions, individuals have lost eyesight, had long-term discomfort, or experienced other complications.

Morris Waxler, PhD, a former FDA official who was a member of the panel that authorized the operation, has alleged in recent years that the FDA overstated the hazards. He has requested that the agency withdraw LASIK from the market. The FDA answered that the data did not warrant a recall, but that it would continue to evaluate LASIK safety.

Is LASIK a safe procedure? Yes, according to Edward Manche, MD, an ophthalmology professor at Stanford University School of Medicine and division head of Cornea and Refractive Surgery. “It has been authorized by the FDA and its safety has been verified,” he adds. “While some individuals have had difficulties, the great majority of people fare exceedingly well.”

LASIK Pros

Laser-assisted in situ keratomileusis, or LASIK, is a kind of refractive surgery. The surgeon begins by cutting a tiny tissue flap from the front of the eye. The cornea is then reshaped using a laser to improve light focus on the retina at the rear of the eye. LASIK is a procedure that may be used to address visual abnormalities such as nearsightedness, farsightedness, and astigmatism.

Over the last two decades, physicians in the United States have done more than 19 million LASIK treatments. Although there have been few high-quality, long-term studies on the results, the evidence that exists indicates that the operation is safe and successful.

LASIK is an excellent operation,” says Jennifer Ling, MD, a clinical assistant professor in the University of Iowa Hospitals & Clinics’ Cornea and External Eye Disease Clinic. “It has been able to significantly improve the lives of a large number of individuals by providing them with good vision and liberating them from their glasses or contact lenses.”

Over 90% of patients who get LASIK obtain 20/20 vision, which means they can see well from a distance of 20 feet what a person with normal vision should be able to see without glasses or contact lenses. Over 99 percent of individuals get 20/40 or greater vision, which is sufficient for passing the driver’s license test.

Daniel Sklar, 56, of Smyrna, GA, had the operation in 1999 to treat severe nearsightedness and astigmatism. Following that, he moved from wearing heavy spectacles to having eyesight that was better than 20/20. “It has resulted in a significant increase in my quality of life,” he adds. “To be able to wake up, wash, and see, as well as swim or snorkel without prescription goggles.”

LASIK has been even more successful over the years due to advancements in the treatment. “The outcomes have consistently improved over time as more modern technology has become available,” says Joshua Frenkel, MD, an associate surgeon at Wang Vision Institute in Nashville. The femtosecond laser, launched in 2001, cuts a flap in the cornea using light pulses. The method has been transformed by femtosecond lasers, which provide higher safety and accuracy than a blade.

Other technological advancements enable the production of a personalised map of the cornea, resulting in more accurate vision correction and improved results. “The goal is to eliminate higher-order aberrations, which may result in glare, nighttime halos, and other effects,” Frenkel explains.

Cons of LASIK

The most common adverse effects of LASIK are moderate — including dry eye, burning, and itching, which occur in 20% to 40% of patients. These symptoms often peak about three months following surgery and subside between six to twelve months — although this is not always the case.

Holly Strawbridge, a 68-year-old freelance writer from in Fort Lauderdale, FL, has suffered dry, red eyes since undergoing LASIK eye surgery around 17 years ago. “It’s been an issue,” she admits. “It seems as if I’ve been pulling a lot of all-nighters.” She claims that even if she had been aware of the dryness beforehand, she would have proceeded with the procedure. “To be honest, when compared to the inability to see, dry eye takes a second place.”

Additionally, glare and halos surrounding lights at night, as well as trouble with contrast, are prevalent. Around 20% of those who get LASIK have these complications. They may also improve over six to twelve months, but only a tiny percentage of individuals experience them long-term, Manche explains. If you have one of these problems, you may either return to glasses or contacts or undergo revision surgery.

Additionally, there is a potential that LASIK may not entirely restore your vision, particularly if you were very nearsighted or farsighted to begin with. If this occurs, you will need glasses or contacts in order to see well. “If you are not completely fixed… you may return in three to six months for more surgery,” Manche explains. “The great majority of patients get 20/20 vision in such instances.”

It is very unusual for a vision chart to lose lines of vision. “Even with glasses or contact lenses, eyesight cannot be restored to its pre-LASIK state,” Ling explains. “The likelihood of it occurring is very remote. This is often the result of infection, scarring, or inadequate recovery.”

Even though your eyesight is 20/20 immediately after LASIK, it may not remain thus. Vision may regress. And as you age and the structure of your eye naturally changes, you’re likely to require reading glasses. “As I’ve grown older, the impact of LASIK has waned,” Strawbridge explains. “However, I have had at least ten years of flawless eyesight.”

The majority of LASIK-related complications are transient and provide only little inconvenience, but in some individuals, they are severe enough to be life-changing. John Christian, 44, had the operation in May 2015. He visited a respected hospital and had tests to see if he was a suitable candidate. However, he experienced dry eye shortly thereafter. Treatments such as tear plugs and prescription eyedrops were ineffective, and the dryness became worse.

A patient’s account after LASIK

A patient’s account after LASIK

“By 12 to 15 months after the treatment, the dry eye feeling had morphed into throbbing agony,” a patient reports. “I had the distinct impression that someone was poking knives into my eye and all the way through my mind.” Only after he fell sleeping did the discomfort subside.

John consulted a specialist two years after his treatment, who diagnosed him with ocular neuralgia — discomfort caused by damaged nerves in the cornea. It’s an uncommon but devastating adverse effect that has been connected in a tiny number of instances to LASIK treatment.

He is now receiving a battery of therapies, including eye drops manufactured from his own blood, steroid drops, and painkillers. “My daily pain level decreased from 9 to 2 on a good day to 6 to 7 on a poor day.”

Despite his perfect eyesight, he responds, “Never.”

“Certainly, my attitude on risk-reward has shifted.”

Hearing experiences like John’s from individuals who have been harmed by the procedure motivated Waxler to advocate for more explicit warnings about the hazards of LASIK, which he has been doing for over 12 years. Jessica Starr, a Detroit meteorologist who died by suicide in December 2018 at the age of 35, after discussing her experience with LASIK problems with her audience, was one of the most prominent of these examples. (It is unclear if her suicide was caused directly by her operation.)

Another disadvantage of LASIK is its high cost — around $2,200 per eye. “With few exceptions, insurance does not cover it,” Manche explains. You may pay for the procedure using a flexible spending account (FSA) or a health savings account (HSA). Get more detail about LASIK eye surgery cost on https://www.personaleyes.com.au/costs/lasiklaser-eye-surgery-cost

Obtaining the Best Possible Outcome

LASIK is not suitable for everyone. “The most critical thing is to ensure that you are a qualified applicant,” Manche explains. “Some persons may have issues not as a result of the operation, but as a result of their ineligibility.”

“Every individual should have a comprehensive one-on-one examination and consultation with their doctor to ensure that LASIK is a good fit,” Ling advises. Prior to your operation, the doctor should do a complete eye exam, assessing the shape of your cornea and searching for abnormalities such as dryness or other undiscovered eye disorders.

Certain individuals are not candidates for LASIK. If your cornea is excessively thin or uneven, you may need to avoid this surgery; if you have cataracts or glaucoma; if you have uncontrolled diabetes or an inflammatory condition such as Sjögren’s syndrome or rheumatoid arthritis; if you are pregnant; or if you are under the age of 18

Finding an experienced physician is one of the keys to a good result. You may seek recommendations from friends and family members who have had LASIK, or you can contact the American Academy of Ophthalmology. Manche recommends that you seek a second opinion. “That way, you’ll feel more secure if two physicians agree.”

The doctor should take their time and thoroughly explain the operation, including any potential dangers. “You do not want a physician who promises, ‘This is 100% sure to work.’ ‘You’re going to adore it,’ Ling declares. “That is a really large red flag.” Choosing a university medical facility over a private practice, she argues, may be a safer decision.

Additionally, you must enter LASIK with reasonable expectations. Around 90% of patients will attain 20/20 uncorrected vision or better, while 10% will not, and up to 40% will have negative effects. “Generally speaking, the higher the prescription, the greater the danger of adverse effects,” Ling explains.

“I feel that a large number of individuals assume that LASIK is completely assured. It is a very effective operation for the great majority of patients. However, nothing in medicine is 100 percent certain,” she explains. “If someone enters LASIK believing they will be assured 20/20 vision with no dangers, they have been misinformed and may be disappointed.”

The following are the most common eye conditions that may be addressed by LASIK laser surgery:

Nearsightedness is referred to as myopia.

Myopia, or nearsightedness, is caused by an abnormally long eye shape and/or an abnormally steep cornea. As a consequence, light entering your eyes does not concentrate on the retina as it should, but on pictures in front of the retina. Nearsightedness causes distant items to look fuzzy, while close ones appear distinct.

Hyperopia, or hyperopia, is a condition in which one is farsighted.

If you have hyperopia, or farsightedness, it is due to either an abnormally small eye shape or an abnormally flat cornea. Farsightedness occurs when light entering the eye focuses on pictures beyond the retina. Farsightedness causes close items to look fuzzy, while far ones appear clear. In rare circumstances, hyperopia may result in blurriness both at a distance and up close.

Astigmatism

Astigmatism occurs when the cornea of your eye is not spherical or basketball-shaped, as it is in a normal eye. Instead, your cornea is often shaped more like a football. Astigmatism causes the items you are observing to be distorted or hazy because they are not focused into a single picture. Astigmatism may occur alone or in conjunction with near- or farsightedness.

Presbyopia

If you have presbyopia, you lack the capacity to concentrate on near things. This is a natural process of aging and often becomes noticeable in adults in their forties. Presbyopia occurs when the internal lens of the eye loses its capacity to focus on close-up things. While laser vision correction significantly improves distant vision, the majority of individuals will continue to need glasses for close-up tasks, especially as they age. 

Presbyopia may be treated using reading glasses or multifocal lenses. For appropriate applicants, surgical treatments for presbyopia such as monovision LASIK are available. Consult one of our surgeons about repairing presbyopia during your eye checkup.

Cornea Remodeling

If you use glasses or contacts, they will bend the light to suit your prescription. The LASIK Vision Institute’s experts perform a laser vision correction surgery in which they rebuild the cornea to appropriately refract light for corrected vision. The laser shoots cold, invisible ultraviolet light to precisely reshape the cornea without causing damage to surrounding eye tissue. After that, the cornea correctly refracts light, allowing you to see normally. These are the most modern FDA-approved lasers available, ensuring the most accurate eye correction possible.