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Thursday, September 13, 2007

LASIK: 20/20 and Still Unhappy?
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Laser refractive surgery (LASIK) is enormously popular - over 2 million Americans undergo the procedure every year. Many ophthalmologists have re-engineered their practices to accommodate more of these patients - and for good reason:

  • Most LASIK patients pay cash

  • No insurance pre-approvals

  • Many patients apply for financing (doctor collects interest!)

  • No insurance paperwork

  • Candidates have healthy eyes, healthy bodies

  • Very high success rate

  • Prompt recovery

  • Complications are few, yet manageable

Given all this happy news, some postop patients are unhappy. Yes, they can read the 20/20 line without glasses, perhaps the smaller 20/15 line. Even so, some complain that surgery changed their eyesight...they just have a hard time explaining it.

Vision scientists don't have trouble explaining the situation.

Although most LASIK patients are very satisfied with their 'new eyes' some individuals are bothered by what's called higher order aberrations.

Some people are sensitive to extraneous noises in restaurants, traffic noise, right? Most of us are oblivious to it and carry on with life's activities.

Higher order aberrations pester some 'uncomplicated' LASIK patients.

These aberrations have to do with changes to the outer clear cornea that result from creation of the delicate flap that's created right before the laser energy is applied. Watch WebMD's video demonstration of laser refractive surgery.

Secondary astigmatism, spherical aberration, and something we call coma (no, not that kind of coma!) can interfere with both optimum image resolution and night vision. They can also cause LASIK patients to see more halos around bright objects day or night. For some this can complicate driving in the dark. Compared to individuals who never underwent eye surgery, LASIK patients were more that twice as likely to encounter this the halo phenomenon.

So, what should you do if you are considering refractive surgery? You should get as much information as possible! Have a thorough conversation with your surgeon before consenting to any surgery. Know all of the potential risks and the real-world chances that they might happen to you.

REFERENCE: British Journal of Ophthalmology, Aug 2007, pages 1031-1037.

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Posted by: Dr. Lloyd at 12:58 PM

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