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					8 Keys to LASIK Laser Eye Surgery


The number of people treated with laser eye surgery in the United
States has risen from a few hundred-thousand per year in the late
90s to well over a million a year in this new millenium. However,
surveys show that people generally know very little about laser eye
surgery - about what the procedures aim to accomplish as well as
about the risks involved. Here are 8 keys that will help you determine
whether you or a loved one are a good candidate for laser eye
surgery, and that will help you prepare for and recover from the
procedure should you decide to go through with it:


1. Educate yourself about your vision problems and what treatments
are available.


2. Understand the risks involved with laser eye surgery.


3. Determine whether you are truly a good candidate for laser eye
surgery.


4. Find a good doctor to oversee your surgery.


5. Have realistic expectations concerning your results.


6. Know how to prepare yourself before the surgery.


7. Know what to expect when you go in for surgery.
8. Know how to properly recover from the procedure.


1. Educate yourself about your vision problems and what
treatments are available.


Your regular doctor and/or your regular optometrist/ophthalmologist
should be a key part to your exploration of laser eye surgery. Not only
will he or she probably have good information concerning the
procedures, but he or she also knows your personal medical history
and could be a valuable resource in determining whether you are a
good candidate for surgery. Additionally, your doctor may be able to
recommend a good doctor to perform your laser eye surgery.


There are a few types of laser eye surgery. LASIK stands for Laser
Assisted In-Situ Keratomileusis and is now the most common type of
corrective laser eye surgery. In LASIK, a knife is used to cut a slit in
the cornea, forming a flap which is folded back. The laser is then
used to reshape surface of the cornea. PRK, or Photorefractive
Keratectomy, though performed less often than LASIK, is still
commonly used. PRK is similar to LASIK in that it uses a laser to
reshape the cornea, but different in that instead of using a knife to cut
a slit in the cornea, some of the top layers of the cornea are scraped
off before the laser is employed.


LASIK and PRK are both used to treat the three most common vision
problems - myopia, hyperopia, and astigmatism - all of which are
caused by irregularities of the cornea, which in turn cause distortion
or blurriness of the image projected onto the retina. Myopia is what
we commonly call nearsightedness and hyperopia is also known as
farsightedness. Astigmatism is a further distortion that is commonly
found in combination with myopia or hyperopia. Other sorts of vision
problems, such as cataracts or glaucoma, have just recently started
to be treated using laser surgery and this article won’t be covering
such procedures in-depth, though much of the information here is still
relevant.


Chances are if you are considering LASIK (and from this point on,
instead of speaking of laser eye surgery, I will just call it LASIK, since
LASIK is by far the most common procedure) you know what other
options are available for correcting your particular vision problems.
You will have to determine for yourself whether the convenience of
not having to use glasses or contacts outweighs the potential risks of
surgery. There are also a few other corrective surgeries available
including lens implants or corneal ring implantations.


2. Understand the risks involved with laser eye surgery.


As with any surgical procedure, there are a number of risks
associated with LASIK and other laser eye surgeries. The goal of
doctors performing LASIK is that patients never lose lines off of their
vision. Some people might have LASIK done and then have much
better uncorrected vision than they had previously, but they might still
require glasses or contacts. While the majority of people who have
LASIK report an improvement in their vision, there is a percentage
that find their vision to be worse afterwards. For example if a woman
had 20/200 uncorrected vision, but 20/20 with contacts, had LASIK
surgery, and then after the surgery she had 20/40 vision uncorrected,
but could only get to 20/25 with contacts. A doctor might be willing to
do additional treatment, but LASIK is generally a procedure which
doctors think should not be done more than once on any given eye.


Some people who have LASIK also develop additional vision
problems such as glare, halos, or double-vision. There is also an
incidence of people who have trouble with nighttime vision after
LASIK. Sometimes these symptoms can be severe enough to be
debilitating which has led to a number of lawsuits against doctors and
their clinics in recent years. Most people undergoing LASIK
experience dry eyes for a while afterwards, and if you have dry eye
problems already, there is a significant chance that your dry eye
problems will only get worse.


Finally, it must be noted that long-term effects of LASIK are just now
being discovered due to the recent development of the procedures
involved, and so it is yet to be seen whether LASIK could potentially
cause long-term problems further down the road.


3. Determine whether you are a good candidate for laser eye
surgery.


There are some factors that might make laser eye surgery more risky
for some people than others. If you are not yet an adult, there are
some likely complications involved with LASIK. First, it is only legal if
you are 18 or older; and second, if your eye still has growing to do,
your eye might change shapes a bit, and your vision might turn for
the worse. Since LASIK is for the most part a one-time-only kind of
surgery, most doctors recommend that you wait until you are done
growing. In the same way, anyone who has frequent prescription
changes for their glasses or contacts should wait until their vision
stabilizes before undergoing LASIK.


If you have a disease or disorder that would affect how well you heal,
or if you are taking any medications that might affect how well you
heal, you should think twice about any surgical procedure.
Additionally, any pervious eye wounds or surgeries or eye diseases
should be caution flags as you determine whether you are a good
candidate for LASIK. You should have your optometrist or doctor
examine your eyes for any other potential risk factors - people with
large pupils or thin corneas both tend to have more complications
from LASIK. As mentioned above, dry eyes tend to be aggravated by
LASIK.


Another factor that you will have to consider is that laser eye surgery
can be quite expensive - if you find a very good deal, you might want
to ask yourself why it is so much less expensive than other places or
doctors. And most insurance companies don’t pay for LASIK even if
they do have vision coverage. Some people choose to have one eye
done first and then the other. The reasons they do this are 1) cost - if
you can only afford to have one eye at a time; and, 2) risk - if you
have one done and it doesn’t turn out as well, you still have one good
eye - if it does turn out well, you can still have the other one done.


4. Find a good doctor to oversee your surgery.


Perhaps your regular doctor or one of his or her affiliates will be able
to recommend someone - doctors often know which other doctors are
the best. Don’t feel obligated to stick with a certain doctor just
because you started with him or her. When it comes to medical
procedures it is often best to stick with your instinct, even if you aren’t
a medical expert. If you are uncomfortable at any point in time, its ok
to back out.


Find out how long the doctor has been using the particular laser that
he or she is going to use for your surgery. Also find out what kind of
follow-up care is provided for patients, whether you will continue to be
seen by the same physician or another. Doctors who are associated
with an academic medical center are often the most up to date on
research or the latest technology available. Choosing a doctor based
on price might not be a good idea - but you yourself must determine
how valuable your sight is to you. Don’t be taken in by flashy
advertisements or too-good-to-be-true deals. If the place guarantees
you a successful surgery or your money back and they screw up…
You aren’t going to be wanting your money back, but you are going to
be wishing you still had what vision you previously had.
5. Have realistic expectations concerning your results.


Laser eye surgery has its risks, as discussed above, and it also has
its limitations. In some cases of extremely poor vision, it is possible
that your vision might not be possible to completely correct even if the
surgery does go ideally. There is good reason to expect your surgery
to produce good results, as the majority of LASIK procedures do, but
good results don’t always equal perfect results. Statistics vary, but of
the 95% or greater that have improvements in vision, somewhere
between 40% and 75% improve their vision to 20/20 while most of the
remainder improve to 20/40 or better. That means that most people
undergoing LASIK see 20/20 afterwards, but there is still a fair
percentage that still require some minor correction from glasses or
contacts to see 20/20. You should also realize that your vision will not
be crystal clear immediately after surgery - in fact, it will probably be
several days before you start to see improvements.


6. Know how to prepare yourself before the surgery.


There are a few things that you must do before having LASIK
surgery. If you regularly wear contact lenses, you should stop wearing
them for a few weeks before your scheduled surgery. Contacts affect
the shape of the cornea and it can take a while for your corneas to go
back to their natural shape. Not doing this could negatively affect the
outcome of your surgery.


Try not to use and lotions, creams, or makeup on your face,
especially around your eyes, in the two days before your surgery.
Having debris of any sort on your face can increase the chance of
infection. Get plenty of rest and arrange to have someone drive you
home after the surgery. It is possible that if your job requires use of
your vision you will have to arrange for some time off of work.


7. Know what to expect when you go in for surgery.


Before you go in to have the procedure done, it is a good idea to be
familiar with what you will be experiencing because 1) it will help you
to remain calm and relaxed throughout, and 2) you will know if
anything is going wrong or seems to be less than satisfactory.


The entire procedure should not last longer than 30 minutes and the
actual surgery will probably be about a minute long. Your eyes are
numbed with anesthetic drops, so it shouldn’t be painful, though
some patients do experience a small amount of discomfort. A device
is used to hold your eyelids open. The surgeon will probably use a
marker to mark out the spot, and then make the incision for the flap
into the cornea.


After this, the laser is used to reshape the cornea. You will probably
have to stare at a light in order to keep your eye trained on the same
spot, which means that if you can’t stare at the same spot for a
minute or two, you might not be a good candidate for LASIK. The
laser will probably make a small clicking noise as it releases bursts of
energy and you may be able to smell the acrid odor of the cornea as
it is burned away bit by bit. If you are having both eyes done at the
same time, the doctor might take a short break before continuing on
to the other eye.


After the procedure itself if over, you will probably rest for a little while
before being sent home in the care of the person whom you
previously arranged to have drive you home. The doctor should give
you an eye shield to protect your eyes and keep yourself from
rubbing them. The eye shield should remain on until you return to see
your doctor after 1-3 days.


8. Know how to properly recover from the procedure.


After LASIK, you should continue to be careful about rubbing your
eyes for a couple of days. For at least the first three days you should
avoid all sports - even non-contact, non-strenuous activities. After that
you should consult your doctor and see how you are feeling before
resuming regular activities, but generally speaking, you should count
on avoiding strenuous activities and contact sports for at least 4
weeks following the surgery. During this time, you should continue
wearing the eye shield at night and avoid using make-up, lotions, or
creams near your eyes. Avoid swimming or hot-tubbing for 8 weeks.


If the initial dryness, itchiness, or soreness doesn’t seem to be going
away, contact your doctor. He or she may prescribe lubricating drops
that will help. If the doctor prescribes antibiotics to prevent post-
operation infection, be sure to fill and use the prescription. Also,
remember the basics of healing well: Eat extra protein and get extra
rest; make sure you stay well hydrated.


And again, realize that your vision might not be perfect, especially
immediately after surgery. It usually only takes a couple days for
vision to improve, but some patients report that their vision continued
to improve through a couple of weeks. Your vision might fluctuate
over the first couple of months while your eyes heal - potentially for
as long as 6 months. If your gains in vision are not satisfactory, it is
possible that you could have another procedure done to try to
improve on your first results, but most of the time, doctors don’t
recommend repeating LASIK.


Conclusions


Laser eye surgery, such as LASIK, is fast becoming one of the most
common medical procedures in the United States, but it is still a
surgical procedure and with it come a number of risks. Many of these
risks can be minimalized by making sure that you are a good
candidate for the procedure, by selecting a good doctor, and by being
familiar with the proper ways to prepare for and recover from surgery.
Additionally, having realistic expectations should help you to have a
more positive experience with LASIK because it means that you fully
understand the aims of the procedure as well as the potential pitfalls.

				
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