Is Laser Surgery for You?

For some, like Goldstein, laser surgery has been the ultimate freedom from the everyday hassles of contact lenses, and a second chance at having normal eyesight. But can everyone expect such dramatic results?

"The answer is no," says Rosenthal. "It's not a foolproof procedure and people need to know that some can end up with worse eyesight than before they went in."

Mary Ann Duke, M.D., a general ophthalmologist practicing in Potomac, Md., adds that there are other reasons why the expectations for laser surgery vary from person to person.

"People who are slow healers or who have ongoing medical conditions [such as glaucoma or diabetes] are not good candidates for laser surgery," she says. "That's why it's so important for patients to undergo a thorough examination with their doctor."

Poor candidates for this surgery also include those with uncontrolled vascular disease, autoimmune disease, or people with certain eye diseases involving the cornea or retina. Pregnant women should not have refractive surgery of any kind because the refraction of the eye may change during pregnancy.

Looking Ahead

At present, a number of other lasers for eye surgery are currently being tested in FDA-sanctioned studies to determine their safety and effectiveness. Investigational Device Exemptions (IDEs) filed with FDA allow for clinical studies involving the excimer laser and the correction of farsightedness. The IDE process is designed to investigate the safety and effectiveness of a device, or a new procedure with an already approved device, either to obtain information for publication or to generate the data needed to obtain marketing approval from FDA.

"If the refractive surgery center says the laser is approved by FDA, it probably is," Waxler concludes. "Still, it is wise for consumers to check that the device being used for their surgery is FDA-approved," he says, or that they make sure they are being treated with a laser that is under study in an FDA-sanctioned clinical trial.

During the first few weeks immediately following laser surgery, Goldstein says, "Every week I kept thinking, 'this is as good as it gets'?" Then, she discovered by the sixth week, as predicted by her surgeon, that her eyesight was noticeably better and eventually stabilized.

"I would tell others to be patient about their expected outcome," she advises. "Even though with LASIK you can expect quicker results, I'm happy with the choice of PRK."

Are You a Candidate for Laser Eye Surgery?

You may be a good candidate for laser eye surgery if you:

• are at least 21 years of age for a Summit laser or 18 years of age for a VISX laser, since the eyes are still growing to this point
• have healthy eyes that are free from retinal problems, corneal scars, and any eye disease (refractive errors are considered eye disorders, not diseases)
• have mild to moderate myopia (nearsightedness) within the range of treatment (see your doctor to determine your range)
• have a way to pay for the treatment since laser procedures are costly and probably not covered by health insurance policies
• are fully informed about the risks and benefits of laser surgery compared with other available treatments.

Frequently Asked Questions About Laser Eye Surgery

Is it painful?

There is little if any discomfort during surgery because the cornea and eye are anesthetized by drops. Some patients experience a "scratchy feeling." After the anesthetic wears off, the amount of discomfort varies with each individual, but any irritation is minor and usually disappears within a few hours. You may be sensitive to light for a few days.

When will I be able to return to work?

Most people can return to work one to three days following surgery, but a rule of thumb is to wait until you feel up to it. Most return to normal activities as soon as the day after surgery.

What are the side effects and risks?

The most common side effects are a halo effect and some glare at night around lights.

How long does the treatment take?

Laser treatment itself takes only about 15 to 40 seconds, based on the degree of correction necessary. Recovery is minimal, and usually the patient is able to be driven home after about 30 minutes. Typically, you will notice improved sight in 3 to 5 days following treatment.

Is the treatment permanent?

According to the results of the U.S. clinical trials and results reported internationally, the treatment appears to be permanent. As people age, however, their eyes change and re-treatment may be necessary.

Are there any activity restrictions following surgery?

Following surgery, do not rub your eyes. Other than that, patients can do whatever they feel up to as long as they follow their doctors' instructions.

What if I move my head during surgery?

This is the number one question that patients ask when undergoing laser treatment. The surgeon is skilled in the technique of removing his foot from the pedal that controls the ultraviolet beam as soon as a patient moves his or her head. This allows him to realign the beam with the corneal "target" and proceed with the surgery.

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Tags: Eyes and Vision

About the Author

FDA is A United States government body that oversees medical devices, including contact lenses, intraocular lenses, excimer lasers and eyedrops. In the US, these products must be approved by the FDA before they can be marketed.