Is laser eye surgery right for you?

Source: Web exclusive, October 2010

If you begin every morning by fumbling for your glasses, then you may have already fantasized about having your vision corrected with laser eye surgery. The procedure involves re-shaping the cornea, which plays an important role in allowing your eye to focus correctly. Laser eye surgery has proven highly effective in most people with vision problems’in fact, as many as 70 percent of patients will experience better than 20/20 vision once they’ve had the procedure. However, despite the fact that approximately 75,000 laser eye surgeries were performed in Canada last year, not everyone is an ideal candidate. Here are a few factors that can help you determine if laser eye surgery is right for you.

1. You have a stable prescription and healthy eyes

If your prescription fluctuates every couple of years, then laser eye surgery probably isn’t for you. It’s also important that you have healthy eyes. ‘The corneal shape needs to be normal,’ explains Dr. Guillermo Rocha, an ophthalmologist and Medical Director of GRMC Vision Centre in Brandon, Manitoba. He says there should be no evidence of a condition called ‘keratoconus,’ which is a degenerative disorder that causes the cornea to be thin and more conically shaped. The laser essentially reshapes and thins the cornea, so if it’s not thick enough to begin with, then it won’t hold the new shape.

Also, if dry eyes are a problem for you, laser surgery is not your best bet, because you need a good ‘tear film.’ The process is also not suitable if you suffer from cataracts.

2. You’ve got the right motivation

Because it’s an elective surgery (in other words, it’s seen as non-essential, or cosmetic) having the right motivation is key. ‘You have to really want to do the procedure,’ says Dr. Daryan Angle, an optometrist with IRIS, the Visual Group in Waterloo, Ont. If you have a high prescription and you don’t like the restriction of glasses, if you don’t want the trouble of contact lenses, if you’re a sports enthusiast, or if you just prefer the way you look without glasses, laser eye surgery may be for you. But if your glasses are only a minor inconvenience, you may not be sufficiently motivated. After all, while laser eye surgery is considered low risk, it is still surgery and should not be taken lightly.

3. Your overall health is good

If you suffer from collagen vascular disease, rheumatoid arthritis or lupus, Rocha recommends avoiding laser eye surgery. That’s because, he says, people with diseases that affect the immune system may have complications when it comes to healing.

4. You have the right kind of prescription

Laser eye surgery tends to work best for people who have myopia, or near-sightedness‘meaning they can see things up close, but everything else is blurry. It can also be used to correct hyperopia (far-sightedness) and astigmatism. But if you’re over 45 and are finding yourself squinting when you read’a condition called presbyopia, which becomes more common as we age’laser eye surgery may not be the best solution. ‘It can be corrected in certain circumstances,’ says Rocha, ‘but it’s not as well established.’ In some cases, you may still need reading glasses, even if you’re had your distance-vision corrected.

5. You’ve explored the options

The two most common types of laser eye surgery in Canada are LASIK (laser-assisted in situ keratomileusis) and PRK (photo-refractive keractectomy). Though both procedures have been in use for at least 20 years (PRK since 1986 and LASIK since 1990), LASIK has become the most popular in North America. While both surgeries use the same kind of laser, the difference is in how the surgeon goes about preparing the eye. With PRK, the surgeon removes the outer layer of the cornea with a blade, then uses the laser beam to vaporize the tissue just under the surface of the cornea. With LASIK, the surgeon cuts a flap in the cornea, then lifts that flap to let the laser in. Though LASIK surgery may be viewed as more complicated for the surgeon, the eye recovers more quickly and doesn’t take as long to heal. In fact, Rocha says you can be ‘back in business’ by the next day.

6. You know the risks

Though complications from laser eye surgery are rare (current statistics indicate less than one percent of surgeries), they can happen. ‘Basically, when you remove that flap [in LASIK], and send the laser into that middle tissue [of the cornea], it can become inflamed,’ says Angle. ‘But it’s not serious as long as it’s treated appropriately with steroid drops and careful monitoring.’ Rocha says that with PRK, there can be a small risk of scarring, but that overall, it is very rare to completely lose vision with any kind of laser surgery.

Once you’ve had eye surgery, you’ll still need to have your eyes examined regularly to make sure they’re still in good shape. And no matter what kind of laser eye surgery you’re considering, you should start by consulting a qualified optometrist who can advise you on what’s best for your eyes.

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