The LASIK update

Men's Fitness, Sept, 2003

FOR THOSE WHO never buy software until the debugged second generation comes out, it might be time to take another look at laser in-situ keratomileusis, better known as LASIK.

THE PROCEDURE, which involves removing tissue to reshape the cornea, is the most commonly performed type of laser surgery. Millions of Americans have undergone LASIK to treat a range of moderate vision problems, including myopia (nearsightedness), hyperopia (farsightedness) and astigmatism (blurred vision caused by an irregular cornea).

THE GREAT MAJORITY of patients have been pleased with the results, but minor complications have occurred in as many as 15% of patients. Serious side effects, such as scarring and distorted night vision, trouble up to 2% of patients.

EYE SURGEONS now believe that they can improve the success rate for new clients and possibly improve reparative procedures for former ones with "wavefront-guided LASIK" or "custom ablation." This technique measures waves of light bounced off the eye to create a three-dimensional map of subtle distortions in each person's cornea. Being able to see these "higher-order aberrations" allows doctors to fine-tune their work, leaving a smoother surface for better results.

BUT LASIK, wavefront or otherwise, is not for everyone. Since the new process removes even more tissue than regular LASIK, it is imperative that patients have sufficient corneal thickness. Conditions that would preclude candidacy include severe myopia, hyperopia or astigmatism; dry eyes; immune disorders; the taking of steroids or immune suppressants; cataracts; advanced glaucoma; corneal diseases or thinning disorders; or a recent history of ocular herpes.

RESULTS WILL vary, based on the suitability of the patient and the caliber of the surgeon. Both versions of LASIK can result in painfully dry eyes, though the nerve damage that causes the condition will usually heal without intervention in about six months, according to a study at the University of Washington.

WHEN SHOPPING for LASIK, consider the following:

* Evaluate your provider. LASIK is a young technique, and wavefront LASIK has only recently been approved by the FDA. Find out the extent of your doctor's training and how many operations she or he has performed.

* Get screened. Your surgeon should personally examine your eyes and discuss your prognosis in full, including any uncertainties.

* Know the risks. Be aware of all potential complications. For more info, check out www.surgeryeducation.org and www.surgicaleyes.com.

* Check the warranty. The cost of the operation should include corrections should they become needed.

* Keep it real. Only half of LASIK patients end up with 20/20 vision. LASIK may be able to help you only somewhat or not at all.

* Get multiple referrals and check out more than one provider. Make sure all your questions have been answered. Take your time before making any decisions.