Laser eye surgery is intended for people who want to minimize their dependency on glasses or contact lenses. Laser surgery can provide vision correction similar to what would be obtained with glasses or contact lenses. People under the impression that surgery can improve their vision beyond what they can see with glasses or contact lenses, however, likely will be disappointed.
By far, the largest increase in laser eye surgery interest recently has been in a procedure called "laser in situ keratomileusis," popularly known as LASIK. Advertising for this technique appears prominently on broadcast outlets, including the Internet and in newspapers and magazines. Fortunately, says Terrence P. O'Brien, M.D., a spokesman for the American Academy of Ophthalmology (AAO), most surgeons and medical centers are doing a good job of educating the public about the risks and benefits of LASIK. "But patients need to be very well-informed in advance," he says.
LASIK permanently changes the shape of the cornea, and is performed for varying degrees of nearsightedness, farsightedness, and astigmatism. A surgical knife, called a microkeratome, is used to cut a flap in the cornea, leaving a hinge at one end of the flap. The flap is then folded back to reveal the middle layer of the cornea, called the stroma. Pulses from a computer-controlled excimer laser vaporize a portion of the stroma and the flap is then replaced. By removing this tissue, the shape of the central cornea is changed, and the refractive error is reduced.
O'Brien, who is also director of refractive surgery at the Wilmer Eye Institute at Johns Hopkins University in Baltimore, has performed over 10,000 eye surgeries. Still, he warns that people considering LASIK need to be wary of ads that make excessive promises.
"Price should not be the first factor" in considering to have delicate eye surgery, he says. "People fear blindness second only to cancer, and just as they wouldn't consider a discount open heart operation or budget brain surgery, they shouldn't take a chance with their eyes." The real struggle, he says, is in training doctors. "The most advanced technology and precise laser will give poor results if you don't have an experienced, capable surgeon."
This latest hype about LASIK's now-more-affordable advantage, coupled with some pretty appealing results, makes surgery one of the most exciting vision correction options available. Doctors say that LASIK gives a rapid visual recovery, with minimal pain, and little or no post-operative discomfort. In fact, most people who undergo LASIK, like Beth Polazzo--one of O'Brien's patients--can see well enough to drive immediately after surgery, and usually have excellent vision within a week.
"I had good vision immediately," says the 54-year-old Brooklyn, N.Y., resident, even though eventually one eye had to be retreated. "This is the best I've seen since I was seven years old." The laser does its work on each eye in less than a minute, and patients are typically back to work or normal activities within three days.
