Lasik Surgery

[-bp-]

I have the opportunity to have lasik for free in exchange for talking about it on my show.
I've always been intrigued by it. But my wife is skeptical. I think she's afraid I'll be in the market for a German Shepherd and a cup of pencils afterward.
Just curious if anyone else here has had lasik surgery and your opinions of it.

Thanks much!

[JayKay]

There are many that have had wonderful results from Lasik. I'm in the process of applying to optometry school but with all the computer automation these days, its a wonderful and pain free procedure. I would highly recomend it and may contemplate getting it when I'm older. Just be prepared to wake up the next day and be able to see.

[Jim]

What show?

12 years ago I was 20/300 now I am 20/15 I personally know 4 people who had similar results.

I would not shop price on this.

[mjallen66]

I did it about 6 months ago; totally worth while in my opinion. I had mine done on a Friday and spent most of following Saturday squinting around the house. By Sunday, I could see just fine with only occasional irritation.

Since then, Ive had no problems.

[da0acer0]

I had my eyes done about 2-3 years ago in Tunisia (don't ask), and I couldn't be happier with the results...20/20 in one eye, and 20/15 in the other...

[ScottieWP09]

I had laser corrective surgery 2 months ago. It was not LASIK but the older PRK because I am in the Army and they like that better for aviation candidates. you should look at all of the options. LASEK, LASIK, epi-LASIK, PRK. It is really up to you and your doctor depending on your eye and other conditions.

I am just about 20/20 now and should continue to get a little better. I dont know what I was before, but my contacts were -7.00 and -6.50, pretty bad. I didnt have any problems with my surgery and love not having to wear glasses when I wake up in the morning.

[-bp-]

Great replies! Thanks so much for your insights. If anyone else has any comments pro or con, I'd love to hear them. I have about two weeks to decide if I want to do it or not.

[LASIKSharp]

As an Ivy League Trained Medical Doctor, having trained at a top 10 Post-grad Ophthalmology program (notice how I can spell Ophthalmology correctly), having completed a 2 year refractive surgical fellowship, and having performed over 4000 LASIK procedures. I am most certainly the most qualified member of this site to answer your question.

Yes the results are great...but not universally so. The complications are few and far between...but not nonexistent. Most importantly, not everyone is a candidate. Being a candidate comes down to three variables providing that you have a structurally normal cornea (not everyone does). These 3 variables are: size of your prescription, size of your night time pupil, and your corneal pachymetry (thickness). The fastest way to screw a patient over is to push the limits of what the procedure can do, or to try and reduce the treatment area to "fit in" a treatment (hello glare and haloes).

Secondly is the technology. There are lots of surgeons out there using 10 year old technology. There have been alot of advancements in the last 3-4 years that you should take advantage of. (on a personal note my wife had surgery 3 years ago, I made her wait for the equipment I am now using). Unquestionably the best available LASIK procedure involves Laser flap creation with the INTRAlase femtosecond laser (blade flap creation is for jerks who dont know better - although only 10% of surgeons have access to an INTRAlase) followed by a CUSTOMIZED, wavefront guided, corneal ablation (there are several laser platforms that do this and they are all good)

In short if your surgeon isn't offering laser flap creation and customized ablations take a pass.

Happy to answer follow-up questions

[-bp-]

Wow! Fantastic LASIKSharp. Seems I timed the asking of my question as well as I possibly could. Thanks for the PM. I will certainly use this valuable information in my evaluation of the doctors, their equipment and the procedure.

Thanks very much!

[verminaard510]

I hate when i spell Ophthalmology wrong!

[-bp-]

According to the Center's website:


the FemtoLDV (DaVinci) is used for Bladeless, All-Laser LASIK. This second-generation, solid-state laser produces a more focused, faster treatment than the Intralase™

This (according to the site) is the laser they use for all their treatments.

[kwk285]

I had it done over eight years ago. Years later I am still happy with the results.

A couple of things...
1) How good is the doctor doing the surgery? Has he done many procedures?
2) Is the doctor known for inexpensive procedures or quality?
3) Does the doctor offer a free evaluation? A doctor should do several tests to insure that you are a candidate for lasik. The people that I know that had problems were people that went against the doctor's recommendations.

[Must Dash]

Eye's down...

http://badgerandblade.com/vb/showthread.php?t=36269&highlight=Lasik

Cheers


Jeremy

[LASIKSharp]

Both are excellent systems (intralase and femtoldv) but femtoldv is more widely available in Europe than the US

[jlander]

As an Ivy League Trained Medical Doctor, having trained at a top 10 Post-grad Ophthalmology program (notice how I can spell Ophthalmology correctly), having completed a 2 year refractive surgical fellowship, and having performed over 4000 LASIK procedures. I am most certainly the most qualified member of this site to answer your question.

Yes the results are great...but not universally so. The complications are few and far between...but not nonexistent. Most importantly, not everyone is a candidate. Being a candidate comes down to three variables providing that you have a structurally normal cornea (not everyone does). These 3 variables are: size of your prescription, size of your night time pupil, and your corneal pachymetry (thickness). The fastest way to screw a patient over is to push the limits of what the procedure can do, or to try and reduce the treatment area to "fit in" a treatment (hello glare and haloes).

Secondly is the technology. There are lots of surgeons out there using 10 year old technology. There have been alot of advancements in the last 3-4 years that you should take advantage of. (on a personal note my wife had surgery 3 years ago, I made her wait for the equipment I am now using). Unquestionably the best available LASIK procedure involves Laser flap creation with the INTRAlase femtosecond laser (blade flap creation is for jerks who dont know better - although only 10% of surgeons have access to an INTRAlase) followed by a CUSTOMIZED, wavefront guided, corneal ablation (there are several laser platforms that do this and they are all good)

In short if your surgeon isn't offering laser flap creation and customized ablations take a pass.

Happy to answer follow-up questions

Excellent advice.

I had mine done 5 years ago (20/400 & 20/450). I am now 20/25 in both eyes. Best decision I ever made. I was just barely acceptable due to severe astigmatism in both eyes. I had worn "coke bottle" glasses since I was 7. Now I need them to read and that is all.

You only have one set of eyes. DO NOT PRICE SHOP ON THIS!!!

[Sue]

All I know to suggest is be very, very selecive of who you use. A best friend wasn't. Prior to the procedure he was told how inflammed his eyes were. This Lasik Center went ahead with it anyway!! They should have treated the inflammation first and then went ahead or at that point decided he is not a candidate. He's had nothing but problems since.
Sue

[ScottS]

It comes down to what sort of person/patient you are. If your job/livelihood absolutely depends on your best corrected vision, avoid corrective eye surgery. If you would feel personally cheated, devastated, or major league disappointed by any result short of perfect 20/20 vision with no glasses, this probably isn't for you.

I don't know what the screening procedure is these days, but I've seen enough phorias (a latent fusional deviation) change to full blown tropias (manifest fusional deviation complete with double vision) that if you have a large phoria I'd recommend passing on the surgery.

Also, I really don't like the idea of freebies like this. It skirts the line of advertising, and the FDA has very precise regulations on how medical procedures are allowed to be advertised. Personally, I wouldn't want to be operated on by anyone who would make that offer. Think about it this way. How happy would your LASIK provider be if in your show you mentioned that you were offered accepted free surgery in exchange for a mention on the show? If the answer would be "not very happy", then pass the offer by.

If you're still interested, tell the provider that you would feel compelled to make full disclosure during any discussion, and see what the result would be.

If I were a news guy, I'd be more interested with the investigative report on ethics than the free surgery.

[ScottS]

followed by a CUSTOMIZED, wavefront guided, corneal ablation (there are several laser platforms that do this and they are all good)




I agree with most everything else, but I'm not sure the custom wavefront has been demonstrated to be any more effective (I might not have read the most recent stuff)--- and I work down the hall from many of the people involved in the design of the custom wavefront technology, and like them a lot, and have served on the committees of their students. If they are using the most recent stuff, the surgeons are probably very experienced and trained to the bleeding edge, though.

To be more specific:American Journal of Ophthalmology
Volume 141, Issue 2, February 2006, Page 360


Results

More than 400 reports investigating wavefront applications in refractive surgery exist, but studies comparing the outcomes of wavefront-guided treatment with conventional treatment are few in number. Available studies do not overwhelmingly demonstrate superior visual results attributable to a wavefront-guided approach.
Conclusions

While wavefront-guided refractive surgery provides excellent results, evidence is limited that it outperforms conventional laser in situ keratomileusis that incorporates broad ablation zones, smoothing to the periphery, eye-trackers, and other technological refinements. However, it is evident that wavefront-customized ablation holds a promising future and merits ongoing investigation.

There are only 5 papers that cite this 2005 work to date, and none of them take on a comparison to traditional LASIK. I think the wavefront guided stuff might take on a real promising role with severe higher order aberrations that occur with things like corneal transplant, but I think the jury is still out for plain vanilla myopes. It doesn't hurt, though.

[phronq]

The whole idea of using a little planer to shave a flap into the cornea creeps me out. :eek:

I'm sure it's safe and sound, lots of people have had it done... but it's certainly not for me.

[Johnny Dale]

The whole idea of using a little planer to shave a flap into the cornea creeps me out. :eek:

I'm sure it's safe and sound, lots of people have had it done... but it's certainly not for me.

It's even creepier that you are wide awake and watching it happen to YOU!

I had LASIK done six years ago and am happy with the results. I did not know (it may be different now) is that if you have it done in your late 40's you may need to have it done twice for perfect results. I still wear corrective lenses at night and reading glasses but I am happy with the results. 20/250 before 20/25 recently.

On a funny note, while preparing for the procedure the nurse gave me a small pill and said it was a 5mg of Valium. I did not know they made it in that small of a dosage plus I'm a big guy (6'1" 240lbs). I asked her if I get a pill for the other eye. Wrong thing to say! No humor tolerated in medicine I guess.

JD

[jastclark]

i had Lasik done last year and now see 20/10 i see better now than i did with contacts in.

[-bp-]

Great advice all. Just to be clear, I'm not price shopping. I was offered the opportunity to have the proceedure done free of charge. In return, I talk about (presumably) the wonderful, life-changing benefits of Lasik on my radio program and in commercial endorsements.
The doctor performing the surgery is excellent and has performed RK and Lasik for well over 15 years.
Based on the great information from LASIKSharp, I was able to discern that they are using the latest technology. Now I just have to decide if I want to have the proceedure done.

Here's the doctor's bio blurb from their website:

His ophthalmology residency was at the University of Florida. He was certified by the American Board of Ophthalmology in 1985 and was one of the first ophthalmologists in the country to be certified in the subspecialty of cataract/lens implant surgery (1989) and refractive surgery (1995) by the American Board of Eye Surgery (ABES). In March 2000 he received certification by the Council for Refractive Surgery Quality Assurance (CRSQA), and most recently received LASIK certification by the American Board of Eye Surgery. He is the ONLY surgeon in Ohio to be LASIK certified by CRSQA, and the only eye surgeon in the country to be TRIPLE certified by ABES (lens implant, incisional refractive, and LASIK).

So, with all the pros and cons in mind, I have to make a decision. As a side note, my dad is 80. Today, I took him to have cataract surgery on his right eye (the left was done some months ago). After this, he won't need glasses anymore.

Thanks again to everyone for sharing your experiences. It will certainly help.

[letterk]

Brian, PM me.

Oh, what would it take for you to talk about B&B on your radio show? :wink:

[-bp-]

Will do letterk.
I do talk about my shaving hobby when and where appropriate.
We had quite the lively discussion about shaving "down there" with Lisa Neeld, Playboy's Hot Housewife who happens to be from my area. She's featured in the special issue of Playboy with Kim Kardashian on the cover.
Needless to say, I work for a rock station.:biggrin:
A full-on plug usually takes a boatload of money placed in the right salesperson's hands.:lol:

[Buzz]

My wife and I both had the surgery done 7 or 8 years ago.

Hers was an outstanding success. She had been a coke-bottle glasses wearer for years and it was a life changing event.

Based on that, I did it also even though my vision wasn't as bad as hers. My experience was not as good. The cornea flap on my right eye had some abrasions and wrinkles. I forget all of the details after all this time. It eventually got worked out to an acceptable (but not perfect) level, but there were some scary times along the way.

Check out some of the websites on Lasik failures and bad experiences.

Here is one: http://www.visionsurgeryrehab.org/

Most people have a good experience with Lasik. However, there are risks and some people definitely have a bad outcome. Are you willing to take the chance? Only you can answer the question. Just be honest with yourself about the risks.

[letterk]

Will do letterk.
I do talk about my shaving hobby when and where appropriate.
We had quite the lively discussion about shaving "down there" with Lisa Neeld, playboy's Hot Housewife who happens to be from my area. She's featured in the special issue of Playboy with Kim Kardashian on the cover.
Needless to say, I work for a rock station.:biggrin:
A full-on plug usually takes a boatload of money placed in the right salesperson's hands.:lol:

Hmm...how about a B&B Essential brush? Of course, I'm speaking for Nick or Joel, but I think I can twist their arm. :lol:

[bbqncigars]

I still wish I'd had it done sooner, but I wanted to wait until it had more history to back it up. That, and NOW the company covers %80 of it, dammit.

Wayne

[MoulinDePita]

My vision, with glasses or contacts, is great, and my lenses aren't terribly thick (~-4 in each eye). Contacts often dry out my eyes, and it would be great not to have to wear glasses, but if anything went wrong with the surgery, my quality of life would suffer greatly.

I'm actually trying to convince my fiance NOT to have the surgery. To me, glasses and contacts are a minor inconvencience, and surgeries have risks. The consequences are too major to risk on fixing a very minor inconvencience.

If she does do it, I've requested that she does one eye at a time. That may seem silly to some, but if the surgery fails in some way, having vision problems in one eye is a lot better than in both eyes.

Question: if you get Lasik done in your late 20s / early 30s, how common is it to need glasses again, by your late 40s or 50s? Most people I know who were glasses-free throughout their lives, developed the need for them by that age -- some just for reading, but many with bi-focals.

[LASIKSharp]

you need more recent data

[LASIKSharp]

Just so you know, with the exception of the American Academy of Ophthalmology membership in these societies is meaningless, especially CRSQA.
But It sounds like your surgeon has the right technology and experience, you just need to find out if you are a candidate

[letterk]

LASIKSharp, do you work in the industry? Just curious. If you do, PM me.

[ScottS]

you need more recent data

I assume you're talking to me. Can you send along a name of a reference-- particularly one regarding patient satisfaction would be useful. I can read the comparative studies (few out there), but I can't find the stuff about how happy the surgeons feel their patients are. If there's anything better than anecdotal, I assume its out there.

J Cataract Refract Surg. 2008 Mar;34(3):389-97.
CONCLUSION: Although both wavefront-guided and wavefront-optimized LASIK gave excellent refractive correction results, the former induced less higher-order aberrations and was associated with better contrast sensitivity.
**Note of my own-- the relationship between higher order aberrations and vision isn't really established. The improved contrast sensitivity seems real, though--"Contrast sensitivity improved at the low and middle spatial frequencies (not statistically significant) and worsened significantly at high spatial frequencies after wavefront-guided LASIK; there was a statistically significant worsening at all spatial frequencies after wavefront-optimized LASIK."

J Refract Surg. 2003 Mar-Apr;19(2 Suppl):S217-20.
CONCLUSION: Postoperative visual outcome with both conventional LASIK and wavefront-guided customized ablation was not significantly different. Higher order aberrations did not significantly increase postoperatively in either group.


J Refract Surg. 2004 Sep-Oct;20(5):432-8.
CONCLUSIONS: Wavefront-guided customized ablation reduced the increase of high order aberrations resulting from LASIK. In terms of visual acuity, patient preference, and mesopic contrast sensitivity, wavefront-guided customized ablation produced slightly-but not statistically significant-better results.


American Journal of Ophthalmology
Volume 141, Issue 2, February 2006, Page 360
Results

More than 400 reports investigating wavefront applications in refractive surgery exist, but studies comparing the outcomes of wavefront-guided treatment with conventional treatment are few in number. Available studies do not overwhelmingly demonstrate superior visual results attributable to a wavefront-guided approach.
Conclusions

While wavefront-guided refractive surgery provides excellent results, evidence is limited that it outperforms conventional laser in situ keratomileusis that incorporates broad ablation zones, smoothing to the periphery, eye-trackers, and other technological refinements. However, it is evident that wavefront-customized ablation holds a promising future and merits ongoing investigation.





Summary-- it doesn't look like there's any difference in Best corrected visual acuity, but the contrast sensitivity is real, and could certainly make a patient happier, but the articles suggest that with time, contrast sensitivity improves after normal LASIK. The jury seems sort of out on glare. The wavefront guided methods seem superior for corrections, maybe because higher order aberrations are bigger on operated eyes (the latter being my own guess). The 2006 article has only been cited about 7 times. The 2008 article, which is the most positive of the bunch, is based on 27 patients, and only went out one month post-op. I see no evidence that there are any disadvantages to the wavefront guided procedure. For me, while I don't consider myself a candidate, I'd probably factor respective cost into the decision.

[ScottS]

HERES (http://www.poynter.org/content/content_view.asp?id=85652) an interesting article on blurring the line between ads and news in health news.