Should You Have Laser Eye Surgery?
Today, with Laser-Assisted in Situ-Keratomileusis (LASIK) virtually all of the common vision disorders of the eye (nearsightedness, farsightedness and astigmatism ) can be corrected. More than 600,000 Laser eye surgeries to eliminate the dependency of glasses and or contact lenses are performed each year in the United States. Although complications can occur, it is a very safe procedure. Knowing you are a candidate is more than half the battle. Just because you or someone you know, where’s eyeglasses and/or contact lenses, does not mean they necessarily can have LASIK surgery to eliminate their need for glasses.
Factors to Consider When Deciding on Having LASIK
1. Does my prescription qualify / Can the laser remove all of my prescription?
The more important question is “how thick are my cornea’s?”
Knowing you have adequate tissue (thickness) to be removed to correct your vision is the most critical piece of information the doctor needs. Let’s say for example we have two patients, both with similar prescriptions, about -4.00 (the minus sign means the patient is nearsighted, and 4 units of nearsightedness…think of perfect vision as 0.00 and -4.00 is four units from perfect vision). If one patient has corneal thickness of 600 microns and the other 450 microns, the one with the 450 microns would not in fact qualify for the surgery because we need to remove a significant amount of tissue to help the -4.00 patient see clearly.
Too many times have I seen patients told they are candidates simply based on their prescription number….this is a dangerous way of performing surgery without knowing how much tissue you can remove without permanently damaging the eye. Typical corneal thickness is around 535 microns. The higher this number the better the outcome and outcome for repeat/age related prescription changes if needed down the line.
Dryness
Many patients tolerate dry eye disease without even knowing they have this problem. Redness, Itching, scratchy feeling of the eyes and contact lens intolerance are all signs of dryness. Many patients place an artificial tear in the eye to help with the dryness. Laser surgery will further dry out the eye, and in some cases this can be permanent and very debilitating. I always recommend a full dry eye panel study, including:
Tear break up time: how long do your tears stay on the eye before you need to blink. This is completed with a painless yellow colored eye drop that glows your tear film and we study the evaporation time with a special cobalt blue light.
Meibomian gland function: tiny pores that release special oils to keep your tears from evaporating. For more information on Dry Eye, click here.
Blepharitis: a mild to moderate to severe disease of the eyelids that about 55% of Americans have. Bacterial mites live on the eyelashes and feed of the dead skin causing bouts of itchy swollen eye lids that never seem to just go away. For more information on Blepharitis, click here.
We will typically start a patient on higher doses of Omega 3 such as EZ tears about 2 weeks to a month before the schedule surgery, and continue about 1 month after the surgery. For more information on EZ Tears, and to place an order, click here.
Pupil Size
You may have heard that some patients do not see as well far away at night time after LASIK. Again, this may be to an oversight in terms of measuring the patient’s DAYTIME pupil size and NIGHTTIME pupil size. There’s always a difference, being night time pupil size is always larger. We need to determine if your pupil enlarges past the “laser zone” which typically is about 6mm in size (can be larger in some cases depending on the laser).
Retina
Your retina is lining the inside of your eyeball. It is in all senses, the “film” of the camera that our eyes are. If the retina is weak, or has a tear or break without knowledge before having the LASIK procedure done, the pressure from the laser can actually cause the retina to detach, or come away from the back part of the eye. This can result in permanent blindness. Get your retinal evaluation with the latest in retinal imaging from Optos.
For more information, click here.
The question, “Is LASIK right for me?”, should only come after all the above items have been thoroughly examined and discussed with your eye doctor. Ask how many LASIK surgeries they've done (not how many surgeries…but specifically how many LASIK surgeries have they done. Ask if they are board certified surgeons. Ask how old the actual laser instrument they are using is. Then ask yourself, am I happy with glasses? With contacts? This is considered as an elective cosmetic surgery. We've all seen the fees advertised for very low prices, and we've heard of higher prices. Never accept a “bargain”’ for something as precious as your
eyesight. Lower fees represent older equipment, lower experienced staff and doctors, minimal pre-testing and minimal follow up, lower priced medications, non-calibrated instruments, poorly maintained equipment and more. There is no substitution for quality, thoroughness and follow up using the latest and greatest in technology. Dr. Chander has turned away as many candidates for LASIK as he’s accepted as he treats every patient as if you were family considering this procedure. Stop by today for a complimentary discussion and testing for candidacy for laser eye surgery with Primary Eye Care Associates.
Dr. Chander and the new Allegretto Wavelight Laser