Has anyone undergone LASIK (Laser-Assisted In Situ Keratomileusis) corrective surgery that can share their experience? I've lived with severe near-sightedness since the age of 8 or so. Without glasses, I see in focus only within a foot or so in front of my face. It's been annoying not being able to wear sunglasses and having to accommodate glasses in the various sports I've been involved with in the past (surfing/swimming, climbing, bicycling, motorcycles, etc).

So, obviously Lasik is very exciting, but I just keep waiting since I'm so used to living my life with glasses and I know that as time passes the procedure will improve. Is now the time?

I know a few people who've had it done, but only one of their stories I've heard to great lengths. He had it done 10-15 years ago, and I know from the others that the technique has greatly improved. More recent subjects tell me they've gone in the morning, have the surgery done, and are back at work that afternoon.

The FDA's website on the subject is a little daunting. They talk about the recovery time frame, and I'm wondering if that's accurate:

http://www.fda.gov/cdrh/lasik/
http://www.fda.gov/cdrh/lasik/expect.htm#after

Any insight would be appreciated.

-Chris

My wife had LASIK surgery in January. She had no complications and now has 20/15 vision. Two weeks before the surgery she started using two different types of eye drops. I think they were the hardest part of the whole procedure. The drops were very saline and stung. The drops are designed to firm up the cornea (at least that is my understanding).

The procedure itself was every quick. I was able to watch from another room, and the whole thing took about 5 minutes.

After the surgery they gave my wife a valium and strongly recommended that she try to sleep as much as possible that afternoon (I think this was to try and keep her from looking around). Of course as soon as we left the doctors office she was looking around amazed at how well she could see. Right after the surgery her vision improved by the minute, as her eyes absorbed the saline solution trapped under the flap made during surgery. I had to force her to put the blinders back on.

She had to use more eye drops for several weeks after the surgery. One to prevent infection, another to keep the eyes moist. She had follow ups visits the next day, next week, next month and at six months.

She is very happy with the results and can see great. Only problem she has had is some halos at dusk, but that is getting better as time goes on. I have had to wear glasses since I was 15 and never thought I would get LASIK. But my wife has had such a great experience, I plan on getting LASIK done after the first of the year.

One thing I want to point out. My wife did a great deal of research, and choose the best doctor in our area. Since this is your eyes we are talking about, I would stay away from any of the places the advertise heavily, and instead find the best doctor in your area.

We are in Memphis and choose: http://www.southerneyeassociatespc.com/

Darley

I'm in much the same situation as you, Caker: terribly nearsighted since the second grade. I've found that contact lenses (for me) have been a great compromise between the inconvenience of wearing glasses and the risks / expense of surgery.

If you haven't tried them, you should. A good optometrist can work with you on finding just the right soft lenses that your eye likes. When I got mine, it truly was a "eureka" moment, much like the LASIK success stories describe, except it was surgery-free. You can see just as well with contacts as you can after LASIK. It's just that you have to put them in and take them out each day, and throw them away before they get crufty (the disposable kind, of course).

Prehaps the most important thing is to find a good doctor, over where I am, its a hotspot for such surgery. Mostly because of the higher standards of medical care, a good doctor would be able to get your operation done in a minimum amount of effort (less passes with the laser, and less material affected), leading to less complications. Which if you manage to avoid, the entire operation is usually quick and painless. Grandmom had the operation done a few years back..

Yay I win, i've had glasses since 11 months (yay bifocals), but I dont particularly plan on having LASIK any time soon. If it involves a laser and my eyes, I think I'll let it mature a bit longer.

I haven't had LASIK or a need for it yet (though eyesight is slowly going on its way out), but have had lots of friends whom has had it. I've also read various literature on it, too.

From my perspective, now is certainly a good time as any.

The concern with earlier LASIK surgical equipment was that they could only apply it uniformly without being able to match the exact contours of your eye perfectly (they're often not perfectly uniform).

So that sometimes had side effects -- too much, too little, etc. For this (and others) reason, the rate of complications was somewhat higher than some people were comfortable with.

But the current generation of equipment do indeed profile the contours of your eyeball precisely and commands the laser to cut 'just so', taking the mapped shape into account. This helps with making a much better job done (though surgeon's skills still do count for a lot, especially where judgement is required).

It's also had the happy result of further reducing the rate of complications. In general, LASIK has been around for long enough that the technology has significantly matured. Even the FAA and the Navy now allows pilots to have LASIK done -- used to be a VERY firm NO.

Despite the improvements in the technology and the now stunningly small complication rate, it's not zero.

What this means is that perhaps (made-up number as an example) 990 out of 1000 times, you'll sail through with the desired results... but if you're unlucky enough to be one of the few that has serious complications, then you might be really unhappy.

Is it worth the risk? Mathematically, I'd say so. But emotionally? That's something only you can decide. I don't blame folks whom ends up deciding that it's not yet within their comfort zone for the risk. Speaking only for myself, I believe that I would probably do it if I became a good candidate for it.

I definitely do second the strong recommendation to find one of the best doctors in the area to do it, or to consider travelling to a reputable place to have it done. In the area, there are lots of decent providers but the best is in Toronto.

So, yes, people do make the 3 hour drive (or 45 minute plane flight) to have it done by the best in Toronto. The Toronto doctors were some of the first to have done the procedure many years ago, so they had extensive experience.

The cost of procedure can be somewhat cheaper outside of the U.S., partly because of a less litiguous system -- not as much overhead with insurance driving up costs of equipment and people.

The other advice passed along from folks who's done it is to meet with your potential surgeon well in advance of the surgery, and ask LOTS of questions to figure out suitability and find out if your eyes has specific features that makes success harder.

Some of the LASIK places are honestly a lot like an assembly line. Show up, sign in, wait, apply a powerful anesthestic to the eye, procedure done, sign paperwork and pick up some meds to take home, go home. Boom, boom, boom. They spend very little time with individual consultation well before surgery is scheduled.

Watch out for these places!

Their interest is financial; shepherding as many people through as possible. These places will also tend to not inform you about things that might stand out as red flags in terms of suitability for the surgery because it might scare you off and they lose money. Their master is the Almighty Dollar, and not you.

Also, do research on the surgeon you've chosen. There are websites that, for a small fee (USD $10 or $15), will list all known information about your surgeon or doctor from all gathered sources -- where he/she went to school, when, what field, any subspecialities, any lawsuits filed against them, any special certifications earned, sometimes ratings of them from previous patients, where they have worked (and when), and more.

Do also keep in mind that even if successful, it may not restore you to 20/20, but should at least improve things. Most people do get to 20/20, though. (65-70%, I think?)

Also, you might need to have minor surgical adjustments known as enhancements after the initial surgery. Keep that in mind, mostly so that it's not unexpected if it's indeed required. About 5-8% of patients needing this is common at various places.

The numbers by themselves don't tell you much about the quality of the surgeon. Some will do it to make sure patients are happy with an even more refined vision. Some will do it because they want to do it a bit more gradually through one or more enhancement surgeries to correct any regression over time instead of as one big cut.

Long-term implications is not quite fully known yet. So far, there's about 10-15 years of great quantities of gathered data on patients. But who can say what happens 25 years out? 30? 50? Not known. I haven't heard of any red flags in this area so far, FWIW.

A site listing some of the potential issues or complications:

http://www.ftc.gov/bcp/conline/pubs/health/lasik.htm

Yes, the recovery time at the FDA site you mentioned, sounds about right, based on friends' experiences. They generally got the worst of it out of the way within a few days, and indeed sometimes a few months to fully adjust... but the friends I know didn't have any real significant problems during the adjustment period. The halo and stuff was manageable and temporary. (For 'failed' surgery, this may become permanent.)

If you do decide to do it, hope it goes well -- which I'm reasonably confident it would. If you still feel uncertain, then the best advice is to simply wait until the risks falls within comfort levels.

I didn't want to sugarcoat one of the most important decisions you'd ever make in your life. If your question is just 'comfortable enough to do it? Would you?', my answer would generally be a strong 'yes' -- or at least, meet a good surgeon to review your medical data for suitability.

I actually had lasiks surgery about 4 months ago. I was wearing contacts before hand, but I got annoyed by that quickly. I has worn glasses though since I was 7, and Lasiks is really the answer I can see perfectly fine and I would reccommend it to anyone. I live in the Daytona BEach Florida area, and there are tons of places in florida I hear that do a great job. I went to a place in Jacksonville by a Doctor named Dr. Snipper (lol).

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James Lenhart.

My vision prescription is something like 6.25 in both eyes (near-sighted, is that -6.25 then? I forget...), which means I see about as well as you do. Things are out of focus more than about 10 inches from my eyes.

A friend of mine who had something like 8.25 near-sightedness got it done last year, and she was very happy with the results. Said she could see perfectly.

Last time I asked about it for myself at the eye-doctor (several years ago), they said that because of my strong astygmatism, I might have to expect to still need corrective lenses even after the procedure, but might get away with a year or two before needing it, and even then, the prescription would be extremely light. I think that's valuable, that the glasses could become optional when reading, or using a computer, or just lounging around the house.

An important detail to keep in mind is whether or not your eyes are still changing. Mine are still gradually getting worse, but it has slowed dramatically in the last few years. It might make sense for me to wait a few more years.

They say that in your 30's or early 40's is the prime time to do it, since you're young enough to enjoy it for a long time, but old enough that your eyes probably aren't changing so much anymore.

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Ed/Bones.

My prescription sounds similar to yours, around -6.0. I'm also considering it, though nothing to rush into.

The National Institute for Clinical Excellence (NICE) advises the British goverment and decides what treatments can end up on our health care system. You might want to read their guidance:
http://www.nice.org.uk/page.aspx?o=87527

On that note, does anyone know how to convert between my prescription (-6) and the numbers (e.g., 17/27) used in these guidances? That's important because the worse your prescription, the less likely the procedure is to work.

My biggest fear of it is going through all the hassle, expense and risk and still having to wear glasses. I don't care that they're thinner glasses, I want rid of the damn things!

I agree completely about the "thinner glasses". What's the point? Doesn't matter to me how thick they are.

My dad and brother have much better vision than I do, in fact I call their glasses "window panes". But that turns into a disadvantage, because when glasses are optional, you have to keep track of where they are, decide whether or not to wear them for different situations, keep extra pairs all over, etc etc.

If you have to leave them on your face no matter what, problem solved!

I still think it's useful to drop back to say 20/30 or 20/40 or something, since you could still drive in a pinch (say you broke your glasses away from home), as an example. I don't really mind my glasses, I just don't like how completely reliant I am on them. I generally get about 20/30 with my glasses anyway.

That scale of measure stops getting used once you get to about 20/400, and I'm beyond that without the glasses.

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Ed/Bones.

I read about 30 online newspapers each day. (It's not really a big deal because they only make a handful of articles available, as an incentive to buy the paper editions.)

All sorts of papers... BBC, Dallas-Forth Worth Star-Telgram, Anchorage Daily News, New York Times, Washington Post, etc.

I noticed an interesting article on the long-term risks of LASIK in the Los Angeles Times just now, and how it might be addressed. No politics involved.

Might be good to be aware of it:

http://www.latimes.com/features/health/la-he-vision7nov07,0,5390241.story

If an user/password is requested, perhaps visit:

http://www.bugmenot.com

to get an user/pass for latimes.com.

I'm sorry, but the article you link doesn't mention any long-term risks of LASIK. The focus of the article is on conductive keratoplasty (CK), and that procedure can benefit most anyone past 40. The article simply clarifies that: "by middle age, virtually everyone develops presbyopia, the inability to read or focus close-up". This includes people who had LASIK, yes, but the risk of getting old affects us all equally. In other words, think of LASIK as shaping your cornea to match your glasses/contacts prescription. Eventually we all get presbyopic and need new glasses.

caker, are you still interested in having the surgery performed? I had it done myself about 6 years ago. I had just started working at an optometrist office then. My prescription was milder than yours (-2.50), but still annoying enough that I went ahead and did it. I'm very pleased with the results, my vision is 20/20 on the right eye and 20/25 on the left eye. I did have to take a day off work, that was all.

Nowadays there's improvements to the LASIK procedure. The best type of surgery is WaveFront LASIK. It's also called Custom LASIK, CustomVue, and a few other names. This procedure is different from regular LASIK in that a sophisticated machine measures more than just your glasses prescription (also known as higher aberrations) into the machine that will perform the surgery, but also smaler defects that your optometrist can meassure (lower aberrations). The end result is a procedure that corrects even the smallest defects of your cornea. Many people who have this procedure end up having vision better than 20/20.

Another cool improvement is the so called Intralase machine. This machine is used by the surgeon to cut the flap in your cornea with a laser instead of using a surgical blade (microkeratome). The benefit is that you end up losing less corneal tissue and healing time is shortened.

I've tried to stay as non-technical as possible, and part of that includes not linking my references , but if you want to talk to me in more detail feel free to PM me or email me.

PS: I know it seems kind of odd for this to be my first post, but I've been lurking/thinking of getting a Linode 80 for a while now, and this topic pushed me to finally register.

Well, my Mother had Lasik a couple years ago and has had no trouble. The key is to get a good surgeon and afterward give plenty of time to let your eyes heal. As my Mother was using bifocals she still has to carry around reading glasses. She was told to use the protective sleep goggles and not swim for six weeks, she did it for six months.

I work for a nonprofit that evaluates Lasik doctors and provides a ton of Lasik information. We are neither cheerleaders for surgery or naysayers. We just provide the information and let you make up your own mind.

It is very difficult to gain true insight from the comments of individuals, even well intended comments. You would not expect to put on the contacts of any of the people posting here and get a good result. Nor should you expect the same results if you were to decide to have surgery. Your eyes are unique, as are your requirements for a good outcome. What you need is a comprehensive evauation by a competent surgeon.

Visit our website at http://www.USAEyes.org and look around. We have an article on Lasik Details, and you will love our 50 Tough Questions For Your Lasik Doctor. We also explain the other types of surgery including IntraLasik, PRK, Epi-Lasik, etc.

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Glenn Hagele
http://www.USAEyes.org
Patient Advocacy Surgeon Certification