Risk Free LASIK?

by Dr. Dean Dornic of Laser Eye Center of Carolina

 

            LASIK is the most commonly performed elective eye surgery in America.  One of the biggest reasons for the renewed interest in LASIK is the improved safety and outcomes that have resulted from the continued refinements in laser and flap making technology.  Still, surveys suggest that the main obstacle to patients proceeding with LASIK is fear.  Many patients who could benefit from the visual freedom afforded by LASIK fail to make the final commitment because of the perceived risk of the procedure.  Most patients overestimate the risks associated with LASIK and many will continue wearing poorly tolerated contact lenses which have a higher risk of profound vision loss than LASIK.

 

            The LASIK procedure is a two step process which is a refinement of an earlier eye surgery that has been around since 1958.   The first step involves the creation of a corneal flap and the second step is the reshaping of the underlying tissue with a laser.  Both steps have had numerous refinements over the years maximizing safety and precision.  Flap creation has become more automated and involves a computerized device or a laser (all-laser LASIK).  The reshaping step has also had numerous improvements including such innovations as eye trackers, and wavefront-guided procedures that include iris registration.  Significant flap complications are now rare and visually adverse side effects such as night driving difficulties are 20 times less likely to occur compared to the pre-wavefront era of laser vision correction.  The net result is a better, safer procedure.

 

Just as there are a group of people who will refuse to jump in the ocean for fear of a shark attack, there will be patients who will forego refractive surgery because they are waiting for LASIK to be "perfected" i.e. they want a no risk guarantee.   Of course, this time will never come as there has never been a medical procedure for which the risk is zero.  However, there is plenty of evidence that the enormous benefits and the elimination of other risk factors, such as those associated with contact lenses, far outweigh the risks associated with LASIK.    It is no wonder why the one group with the highest penetration of LASIK is eye doctors themselves.

 

There are two parts of the LASIK procedure to which risk is associated; that associated with the equipment and that associated with the patient.  Some patients have eye characteristics that increase risk and it is important that these characteristics be identified before the procedure.  Changes in technique such as switching from conventional to wave-front guided LASIK or a switch to all-laser LASIK can then be made to ensure the best visual outcome.   Alternatively a completely different refractive procedure such as implantable contact lenses can be offered.  Of course, the patient or doctor can make the determination that the risk identified may make refractive surgery impractical.        

 

            Patients can ensure their chance of success is maximized by choosing an experienced surgeon with access to the latest technology and who can perform procedures other than LASIK.  It is important to meet with the surgeon ahead of time so that risk characteristics and surgical options that will give patients the best visual outcome can be discussed.  When it comes to something as valuable as your sight it is wise to be as informed as possible.   Many surgeons offer free consultations so patients have nothing to lose and a wealth of information to gain.