Laser Eye Surgery Articles                

    It is Surgery, You Know............................23rd July 2009

It's time to stop being vague about things. Don't be caught in the rush of excitement and enthusiasm that so clearly beckons to you without glasses or contact lenses. It's a long road to get there and maybe you shouldn't even try. Refractive surgery is not for everyone who happens to be stricken with a current need for plastic lenses.

Sure, excimer laser surgery works. It works very, very well. But, it does have its complications and one of them is the lack of a guarantee of success. It is predictable but it is not perfect.

Everything is couched in percentages, i.e., chance of 20/20, chance of 20/40, chance of significant haze, chance of additional surgeries, chance of an infection, etc.

If you are a person who can firmly understand what percentages are, you are ahead of the game. For instance, say your right eye is -4.50 +0.75 axis 91 degrees. That is a moderate degree of myopia and mild astigmatism.

Here's the way this eye stacks up:

Probability of 20/20 vision: 80 % [CustomVue™ = 98%]
Probability of 20/40 vision: 98% [CustomVue™ = 100%]
Chance of significant glare: 1%
Need for additional operation(s): 5% [CustomVue™ = 1%]
Chance of infection: 0.03%

When the eye is more nearsighted, the possibility of 20/20 vision decreases, etc. What all this means is that you are gambling with your vision. The odds are definitely in your favor and the risks are few, but there are going be some patients who fall outside the 'normal range' of predictability. Sometimes this is due to miscalculations, individual variations, or surgeon inexperience, but for the most part this is just being lucky or not being lucky. You must understand what percentages mean; if you are the one out of one thousand, that's one out of one for you.

If you simply want to see better without glasses or contact lenses, you are going to be happy. At that point the percentages are tremendously in your favor. If you want to see as well after surgery as you currently do with glasses or contact lenses, do NOT have Ecimer laser surgery. The predictability is not 100%. Wait. Things will get better. Just like computers. You have been nearsighted a long time; there's no big rush.

There is also that problem of loss of best corrected visual acuity. It may not make a difference to some people but what it means is that a small number of persons will never, ever, ever be able to see 20/20 in that eye again. With or without glasses. Is this important? Well, do you fly an airplane, value your distance vision, operate on people's eye? If you do, you want the best vision possible even if it means getting a boost from those plastic things again. How important is this risk to you?

And what's wrong with being nearsighted anyway? I'm nearsighted. I'm not having the surgery. There are advantages to being mildly myopic. I don't wear glasses in the office. I can read in bed, check out the morning newspaper, and do spin hook kicks, all without glasses. It's cool... As you may know, most persons over the age of forty requires glasses for reading. Not me! I'm nearsighted! I'm good for a long time. There are advantages...

There's also the matter of money. Sure, glasses and contacts cost money too. Still a lot of money...

The bottom line is that this decision should not be made lightly. You should get a ton of information (I have had a patient come in with a very large, 3 ring binder full of refractive surgery web pages, reprints, etc.) You should have all of your questions answered. You should be able to talk in a straightforward fashion with your eye surgeon. You should understand, understand, understand. Those eyes of yours are the only ones that you will ever get.