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Laser eye surgery improves vision

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by Kenneth Todd Ruiz
Assistant Editor

Vision strained, bleary-eyed college students are considering increasingly affordable alternatives for improving their sight.

Recent technological advances have made laser eye surgery into a viable alternative, even though some of the long term benefits remain fuzzy.

While contact lenses have enabled the appearance-conscious to shed their spectacles, using them usually meant a headache of regular maintenance and expensive supplies.

After investing in exams, lenses, eye-drops, cases, cleaning solutions and a small laboratory’s worth in equipment, many lens wearers nonetheless settled into denial over how uncomfortable they were to wear.

Over the past two decades, surgical procedures have gone from a risky gamble offered by a few specialists to a mainstream alternative. Approximately one million laser eye surgery procedures are performed annually worldwide.

New advances have resulted in an alphabet soup of esoteric acronyms distinguishing different procedures and variations that have emerged.

The two most common are PRK (photorefractive keratectomy) and LASIK (laser in situ Keratomileusis).

Both are performed on an outpatient basis using anesthetic eye drops, which allow patients to remain awake during the procedure and go home afterwards.

PRK is the simpler of the two, and consists of reshaping the cornea of the eye by vaporizing microscopic amounts of tissue on the surface.

Because the procedure removes the protective layer that covers the eye, only one eye is done at a time and recovery takes a month.

LASIK, also known as the “flap and zap” procedure, has become the preferred alternative for 95 percent of clarity seeking clients thanks to dramatically reduced recovery time.

According to Stephen Kilmer, a spokesman for TCL Laser Eye, the LASIK procedure requires the surgeon to cut a small flap in the cornea using a small knife called a microkeratome.

The doctor then peals the flap back and burns away the tissue underneath with the laser.

“It’s like when you shine a light through a prism,” Kilmer said. “LASIK reshapes the cornea, creating the proper shape to properly focus light passing through.”

After the procedure, patients are sent home with blinders taped to their head and should not expect to do anything but lie in bed and let the tears roll for the next 24 hours.

According to Kilmer, LASIK corrects nearsightedness, farsightedness and minor astigmatism.

An able surgeon is essential, a steady hand being indispensable for the manual eyeball-slicing endeavor.

“The skill and experience of the surgeon is paramount,” Kilmer said.

Obtaining meaningful statistics on success rates can be a Sisyphean task; the Food and Drug Administration rates effectiveness based on clinical studies of each of the many makes of lasers in use.

“Most laser patients with mild to moderate prescriptions do achieve 20/20 vision or are within 1 to 2 lines of 20/20 vision on an eye chart,” according to the Web site of TLC Laser Eye, one of the major LASIK providers.

Yet even with the advances made in laser eye procedures, prospective patients need to accept that there are risks.

Although less than one percent of patients have any serious side effects, the FDA said that some patients experience varying degrees of side effects.

While daytime visual acuity is usually improved, it is often coupled with decreased night vision, including large halos around light sources and loss of detail, according to the FDA.

“Patients with especially large pupils can experience issues with night vision, but these usually correct themselves after one to three months,” Kilmer said.

According to Kilmer, eye dryness and under or over-correction can also result.

Those considering the laser solution need to take several factors into account before rushing, credit card in hand, to the nearest strip-mall for a few minutes of eye burning fun.

Because eyes change size and shape as people age, the procedure is not for teens.

The FDA and most professional doctors recommend the procedure for patients 21- to 39-years old.

If your vision quality or prescription has changed in the past year, it is better to wait until it has stabilized before considering surgery. Patients should be forthcoming with their doctor about any prescription drugs being taken and any existing eye problems.

Contact lens users should stop wearing them prior to the evaluation exam. The length of time depends on what type of lenses worn ­ ask your eye doctor.

At the evaluation, you are unlikely to speak to the doctor who will actually perform your procedure. Prepare every question you might have and be persistent in getting them answered. If you are not comfortable with the responses offered, take your business elsewhere.

LASIK proponents tend to underplay the actual procedure as producing “minor discomfort,” when it can be nothing short of painful. Find out exactly what will be expected of you during the actual procedure as some patients report confusion muddying the already anxiety-rich event.

The price tag for LASIK runs around $3,000. Few health insurance plans cover the procedure, making it usually an elective out-of-pocket expense.

Included in most fees are a pre-op evaluation, eye exam, follow-up visits and any medications required. Many surgeons also offer free “touch-up” surgery if needed.

For more information, visit the relatively objective allaboutvision.com.

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