It all started with the large, thick and unwieldy glass-brown scleral contact lens introduced to correct severe myopia. Then it progressed over the years to finally take shape as a virtually invisible and light weight contact lens. This was adorned by people for experiencing a wider field of vision while looking attractive, and alleviating the necessity of wearing bulky eye glasses that come in the way of sports or any other activity.
Then came Lasik, which was first introduced in 1950, when a Spanish ophthalmologist found a way to cut flaps in the cornea to alter the shape. He also told the world how much of the cornea needs to be left unaltered to provide long-term vision.
Lasik, which means “laser-assisted in situ keratomileusis,” is a form of refractive laser eye surgery done to correct myopia (short-sightedness,) hyperopia (long-sightedness) and astigmatism (blurry vision.) The actual procedure involves the creation of a thin flap on the eye, then folding it, to be able to remodel the tissue underneath using laser. The flap is then repositioned and the eye is left to heal in the postoperative period.
Although, Lasik has become very popular, there are certain complications associated with it. There is the risk of patients suffering from side effects like double vision, foggy vision, halos, dry eyes, visual activity fluctuation, light sensitivity, wrinkles in the flap, growth under the flap, floaters, macular hole, posterior vitreous detachment and a few others.
It is understandable that people are worried about the side effects of Lasik surgery. Although serious complications are rare, which affect about 1% cases, 5% of the customers who underwent Lasik are not fully satisfied.
But the fact is, every form of eye surgery has its risks and it also depends a great deal on the surgeon. Doctors say that there is no one-size that fits all, and some people are perfect candidates for this surgery and may not suffer from any side effects at all.
Since Lasik is the most popular eye surgery, most people are not even aware of the alternatives to Lasik, because they are not advertised. The other type of eye surgeries range anywhere from a simple laser approach to implantable lenses.
Among the alternatives, the method that tops the list is the pre-Lasik laser that is making a strong comeback, thanks to the precision-improving computer software. This form of surgery is known by two names: Advanced surface ablation (ASA,) or wavefront-guided PRK, which stands for photorefractive keratectomy. This requires less time for the recovery of the patient and the patient feels less pain. What’s more important is that it does not require cutting a flap into the cornea like Lasik does; whish is what is considered to be Lasik’s riskiest step. “There are a lot of us that are doing more and more surface ablation and much less Lasik,” says cornea specialist Dr. Craig Flower of the University of North Carolina.
There are indications where PRK/ASA is considered to be medically a better alternative to Lasik. PRK surgeries have increased from 5% when Lasik was at its peak in popularity to 15% of all the laser vision correction surgeries performed this year.
Doctors feel that the popularity of Lasik is based on the aggressive marketing that makes patients believe, albeit falsely, that clear sight is guaranteed. Dr. Jayne Weiss of Detroit’s Kresge Eye Institute, who chaired the FDA advisory panel, says, “Lasik is not a commodity. It’s a surgical procedure, but it is being sold as a commodity.”
Let us take a look at the real rub: one in four patients who seek Lasik surgery and undergo a battery of pre-surgery tests is deemed a poor candidate. Maybe the cornea is too thin, the pupils too large, near sightedness too severe or their expectations from the surgery are unrealistic. In spite of that, most people forge ahead in the hope that it will cure them.
Dr. Kerry Solomon, a spokesman for the American Society for Cataract and Refractive Surgery says, “Some patients are just not a cornea laser eye surgery patient. There are still other options for them and some are, quite frankly, better suited to staying with the glasses and contacts.”
Doctors strongly believe that it is time people understood that Lasik is not for everybody and is not a guaranteed form of treatment, it has the same risks as the other forms of eye surgeries have. It is wise to look into all the alternatives available before going ahead and trusting a surgeon with the eyes.
