Since its development in the early 1990s, the popularity of laser eye surgery or LASIK (short for Laser-Assisted in Situ Keratomileusis) has soared; the procedure is used to treat various common ocular conditions. However, LASIK retains some of its status as a “newfangled” and slightly controversial procedure because of its inherent delicacy. Though there are acknowledged risks that attend LASIK, accredited practitioners have very high success rates, results are long-term and the surgery generally ends the daily fuss and discomfort of contact lenses or the (debatable) aesthetic drawbacks of glasses. Recently I caught up with Dr. Elizabeth Ryan, a practitioner at West Springfield’s NorthEast Laser Center, to learn a little more about LASIK, its drawbacks, and its potential benefits.
Q: What ocular conditions does LASIK treat most effectively?
A: Nearsightedness (myopia), farsightedness (hyperopia), and astigmatism, all of which are known as lower-order aberrations. Wavefront technology also treats higher-order aberrations, which comprise 5 to 30 percent of total corneal aberrations.
Q: What does the procedure typically entail?
A: Two hours at the center, including relaxing medication and eye drops, wavefront readings, Intralase flap creation, and re-sculpting the cornea with the Ladarvision excimer laser, a comfortable recovery room for 15 to 20 minutes and final evaluation before release home.
Q: What makes someone a good LASIK candidate? What variables affect the effectiveness of the procedure most drastically?
A: A good candidate has a prescription that falls within the FDA guidelines, good physical and ocular health, adequate corneal thickness and moderate-sized pupils.
Patients may be as young as 18, with proven prescription stability, or into their late sixties, with proven ocular health. The best candidate is one who has proper vision expectations post-operatively. Poor candidates are people with irregularly shaped corneas, large pupils, various ocular or systemic conditions that delay healing and outcome, and unrealistic expectations.
Q: What populations might the procedure not be recommended for? Would those whose livelihoods depend on the perception of visual detail (artists, for instance) be good candidates?
A: LASIK is an excellent choice for anyone who desires less dependence on glasses or contacts for faraway tasks- such as driving, or an activity or occupation that requires distance vision, or for people with very strong prescriptions whose general vision is poor beyond one to three feet, or for anyone who desires better distance vision. LASIK is less desirable for people who perform close detail work for two reasons: nearsighted people may have excellent uncorrected close vision which they might not want to give up for their distance vision, and secondly, their primary occupation may only require near vision, and that’s most important to the patient. So LASIK may not be the best choice for their needs and desires.
Q: Are athletes good candidates for LASIK?
A: Athletes could be excellent candidates, as sports generally requires good distance vision. LASIK can be an excellent option for athletes of any skill level, as contacts and glasses are often precarious on the playing field.
Q: What kind of recovery time does the procedure generally require?
A: Vision recovery is 80 to 85 percent on day one. – This means most people who could not drive without glasses can drive to their one-day appointment without vision correction. Over the next three to six months the other 15 to 20 percent of vision gradually recovers and improves. However, it should be noted that healing rates are individualized and this is just the average.
Q: Are there any cutting-edge technologies your practice implements?
A: We use the latest technologies available, such as the Intralase no-blade Femtosecond Laser procedure to create the protective flap, and Ladarwave Wavefront Guided Custom Cornea analysis, which provides a highly customed treatment based on each eye’s refractive aberrations. When combined, these two technologies offer patients the best, most predictable visual outcome.
Q: Any promising new technologies on the horizon?
A: New technologies coming down the pipeline may include upgrades to the Intralase no-blade laser, which may create a more perfect flap, and improvements to the Wavefront technologies, providing more accurate treatments. To date, the LASIK correct is the safest it’s ever been and the visual outcomes have been outstanding. Several of our clients have achieved better than perfect (better than 20/20) vision.
Q: What are some common side effects of the procedure?
A: Side effects are most common in the first three months as the vision and eye are stabilizing after surgery. They may include dryness, foreign body sensation, mild light sensitivity, glare and halos around lights, and mild fluctuations in vision. All are explained before the procedure and all are generally mild and well tolerated.
Q: Do you advocate for operating on both eyes at once or a single eye at a time?
A: It is more convenient to do two eyes at once, as the recovery time and restoration of functional vision are as immediate as 12 to 24 hours.
Q: What proportion of patients require additional vision correction after LASIK?
A: About three to five percent of eyes require a refinement after the initial procedure.
Q: I’ve heard prices for LASIK can be prohibitive, and that the procedure is typically not covered by medical insurance. Do prices vary based on the invasiveness of the procedure or the severity of the patient’s condition?
A: Prices are based on the procedure, Intralase vs. a bladed flap creation, or Customize vs. non-customized treatment. The great majority of people choose Intralase with Customization as results tend to be more predictable and accurate.
Q: Are any financing options offered by NorthEast Laser Center?
A: Financing options include 18- to 24- month interest-free financing based on personal credit scores.
Q: What are the primary motives of most of your clientele for seeking laser eye surgery?
A: The number one reason people prefer LASIK is their desire for independence from eyeglasses and contact lenses. Many people also select the procedure because of its ability to improve their distance vision drastically.
