Who Should Not Have Laser Eye Surgery?
Refractory vision problems such as myopia (nearsightedness), hyperopia (farsightedness) or astigmatism can often be corrected with laser eye surgery. While many people have great results with laser eye surgery, it is not for everyone. Only an ophthalmologist (eye doctor) can tell you if you are a good candidate for PRK or LASIK procedures, and with any surgery, there are possible risks and complications.
Photorefractive Keratectomy was one of the first procedures using a laser in eye surgery. With this procedure the cool ultraviolet laser reshapes the cornea through ablation (removal) of minute membrane layers from the cornea’s surface. Reshaping the cornea improves vision by allowing light to hit the retina in a more accurate way.
Laser-Assisted In Situ Keratomileusis is a newer form of refractive surgery that is utilized to correct the cornea’s contour. As mentioned above, when the cornea is even slightly misshapen, light cannot focus as directly on the retina (light sensitive cells on the back of the eye), and the images are blurry. With a LASIK procedure, the cornea membrane is gently cut, using a blade called a microkeratome. This creates a little flap where the doctor can assess and utilize a computer controlled laser to reshape the cornea. Once the surgery is finished this small piece of membrane is reattached.
While initial recovery takes only a few days, it can take up to six months before you have reached the maximum in vision improvement. Your ophthalmologist will schedule several follow-up appointments during that time to check your vision improvement and to make sure your eye is healing correctly.
Most patients are happy with the results of both PRK and LASIK surgery. However, it is important to be a good fit for the surgery and to carefully weigh the risk and benefits of such a procedure before proceeding.
Laser Eye Surgery is Not for Everyone
For one thing you have to be at least eighteen years old to have laser eye surgery. The use of some types of lasers will require you to be twenty-one years old. This is because until you are eighteen your vision will still be evolving.
You also can not have laser eye surgery if you are:
- Pregnant or breastfeeding – these conditions can change eye refraction measurements.
- Taking Accutane or oral Prednisone – or certain other drugs.
- Suffering from diseases such as cataracts, diabetes, glaucoma, herpes infections in or around the eye, lupus, retinal disease, and rheumatoid arthritis.
- Suffering from Dry Eye – is a condition that may prevent you from getting laser eye surgery. You will need to talk to your doctor about how dry eye can impact laser surgery if you have this issue.
To have laser eye surgery you must be:
- Healthy – This includes your eyes, and other physical and mental health. It is also important that your eye prescription be well-established. If you are nearsighted, you should postpone surgery until your refraction has stabilized, because nearsightedness may continue to increase in some patients until their mid- to late 20s.
- Prepared – Which means you have to weigh the risks and rewards, consider surgery versus your level of ease with glasses or contacts, and have realistic expectations of the results. This can mean that you may need more than one surgery to get the results you desire.
Although rare, some people lose vision after surgery. This loss of vision may uncorrectable even with glasses, contact lenses, or further surgery. When contemplating this risk, many people are happy to stay with contact lenses or glasses.
A small percentage of people notice unusual vision complications after surgery, including a halo effect, glare, and/or double vision. These complications can all seriously impair vision, especially at night. After having these procedures, some patients do not see as well in situations of low light and contrast. This might be helped with corrective lenses, and may or may not diminish over time.
Severe dry eye syndrome can be another side effect of laser eye surgery. When the eye cannot produce enough tears to keep it moist and comfortable, it can be an acutely uncomfortable symptom, causing intermittent blurring and other visual problems. This condition can be permanent and may require the use of intensive drop therapy and further surgical procedures to correct the problem.
Results Differ from Person to Person
Although many people achieve 20/20 vision after surgery without glasses or contacts, not everyone does. Additional treatment may be required to achieve better vision, but it may not be recommended. Others experience improved vision but still need to wear corrective lenses. It is also likely that if you used reading glasses before surgery, you will still need them after surgery.
Most people experience better vision with laser eye surgery, but as there are always risks to surgery, it is wise to discuss the risks thoroughly with your eye doctor. People who should not have laser eye surgery include those with certain health problems, if you are under the age of 18, if you are pregnant or nursing. Some serious complications can include irregular healing that may lead to a misshapen cornea, infection of the cornea, improper reattachment of the flap (requiring additional surgery), and uncomfortable severe dry eyes.