Lasik Surgery

Squinting or holding a newspaper at just the right distance to see the words are some of the behaviors exhibited by people with vision problems. That is why when Lasik surgery came along people flocked to their eye doctors hoping to get the procedure. The FDA received 140 complaints from people who underwent Lasik surgery. This prompted the FDA to review the issues and a year later the FDA panel ruled that the agency should require clearer warnings about the risks associated with Lasik surgery.

Lasik stands for laser-assisted in situ keratomileusis. Lasik is a refractive procedure indicated for patients who would like to correct their vision problem so that they no longer need to wear glasses or contacts lenses. People with nearsighted or farsighted vision have benefited from this procedure. Since the mid-90's, close to 8 million people have had Lasik surgery. The procedure involves using a device called a microkeratome (blade) or a keratome (laser) to slice a flap in the cornea. Once the flap is folded back damaged corneal tissue underneath is removed using beams of UV light. Reshaping the cornea in this precise way will help to focus light into the eye for clearer, better vision.

The FDA panel warns that consumers should understand that there are many complications associated with this procedure. Lasik's post-operative risks include loss of vision, double vision, glare, halos, painful dry eye, and night vision problems. The Vision Surgery Rehab Network has an image gallery demonstrating exactly what some of the visual problems look like for some patients. Some people may still need to wear glasses or contact lenses after the surgery as only a certain percent of patients actually get 20/20 vision. For some farsighted people their improved vision may even worsen with age. The FDA panel recommends that conditions should be listed for people who are not good candidates for the surgery (e.g. severe nearsightedness, thin cornea or large pupils).

Unfortunately, Lasik surgery appears to be the miracle procedure offering immediate results. Dr. Jayne Weiss, chair of the FDA advisory panel stated, "But aggressive marketing makes patients falsely believe clear sight is guaranteed. Lasik is not a commodity. It's a surgical procedure, but it is being sold as a commodity."

At least that is the impression people have and who can blame them. Lasik surgery gets the most advertising while there are many underrepresented alternative procedures out there to improve vision. Here is a brief overview of those procedures and the problems they aim to correct.

Indication: Thin corneas, irregular corneas
Photorefractive keratectomy (PKR) is a procedure that uses a laser to reshape the corneal surface while avoiding cutting a flap. Some doctors believe that the cut to the cornea also severs nerve receptors that increase the risk for painful dry eye. With this method some patients endured a hazy vision. However, the procedure has minimal side effects now since a PKR upgrade. The newer version uses a wave-guided method allowing surgeons to view a three-dimensional map of corneal irregularities.

Indication: Farsightedness or astigmatism
Conductive keratoplasty (CK) uses beams of radiofrequency waves around the edge of the cornea.

Indication: Severe nearsightedness
Hard plastic lenses called phakic intraocular lenses are implanted. The lenses are inserted through a small eye incision and implanted in front of the natural lens. The plastic lens helps to refocus light in the eye and improve distance vision.

Indication: Cataract-free patients who are poor Lasik candidates
An artificial refractive lens is used to replace the patient's natural lens. Patients have various lens options. One option is a multifocal lens type which helps to improve both distance and reading vision.

Indication: Mild nearsightedness
Corneal rings called Intacs are transparent crescents about as thick as a contact lens. Intacs are implanted to form a ring around the cornea's edge. These light-weight rings flatten the cornea without permanent damage so that if the patient experiences a glare the ring can be removed.

Considering any surgical procedure carries risks. The most important thing to do is find a surgeon that can evaluate your condition and provide you with the best option.

Sources: http://ap.google.com/article/ALeqM5i2oeTgEpOwRlLG1_hMYNkW2i6dqgD90B1SCG0, http://www.consumeraffairs.com/news04/2008/04/fda_lasik.html