Dry Eyes and LASIK

Dry eyes are one of the most common LASIK complications, affecting nearly 50% of all patients who undergo laser vision correction. Fortunately, this condition is temporary in most LASIK patients and will gradually subside within 6-12 months after surgery. However, a small percentage of patients experience long term dry eye issues which may impact them for the rest of their lives.

Patients who suffer from dry eyes after LASIK fail to produce a sufficient amount of tears to keep their eyes properly lubricated. This is commonly caused by nerve damage to the cornea during laser vision correction. When the corneal flap is created allowing your eye surgeon to reshape your cornea during LASIK, there is a chance the corneal nerves responsible for tear production can be cut, resulting in dry eyes.

Common symptoms of dry eyes include:

  • Scratch or sandy feeling in your eyes
  • Stringy discharge from the eyes
  • Heaviness of the eyelids
  • Stinging or burning sensation in the eyes
  • Blurred, changing, or decreased vision
  • Periods of excess tearing followed by extended periods of a dry sensation
  • Pain and redness in the eyes

Because dry eyes are such a common LASIK complication, patients who suffer from dry eye syndrome prior to surgery may not be suitable candidates for LASIK. During your consultation, your LASIK surgeon should discuss these risks with you in detail before recommending the ideal procedure to achieve your refractive surgery goals.

Please contact eyes.com today to find an experienced LASIK surgeon in your area.

Uncle Sam Wants You . . . to Get Your Eyes Checked!

One of the interesting things about looking at publications from WWII is the way the whole country’s cultural apparatus geared itself up to be part of the war effort. And Popular Science was no exception.

In fact, practically the entirety of the magazine’s content in the February 1944 issue is directed at promoting the war effort, and its article on understanding vision is no exception. The article not only explains how our vision works, it tells us that “in wartime poor vision is more than ever a calamity. It not only can dull our minds, contort our faces, and even lead to total blindness: it also cheats our country of our best services.” Just like our minds, we have to get our “eyes right” if we’re going to win the war against fascism.

The article gives some shocking statistics that show us how prevalent neglected vision was at the time. According to a study by the Better Vision Institute profiled in the magazine, at least 7 million American war plant workers were neglecting their vision. A full 70% of workers were found to have defective vision, but only 30% of them had sought treatment. This was considered unacceptable. The Institute actually described neglecting your vision as “housing a saboteur.”

But criticism was not reserved only for the workers. Employers were also criticized. The article said that only 20% of plants recorded the eyesight of workers involved in accidents, and only 25% actually took the time to see if a person had the vision necessary to do delicate work before assigning him or her to the job. In the words of the article, “They, too, house potential saboteurs.”

The article then goes on to rhapsodize about the wonder of the eye, with its ability to regulate light and focus on different images, not to mention move independently and regulate its intraocular pressure.

The article gives some practical information as well, in the form of this easy test for astigmatism, and an explanation of how lenses correct nearsightedness and farsightedness.

If the patriotic language of the article seems a little jarring to modern readers, there is at least one part of the article that remains current. After chastising workers for their failure to seek eye care, it says:

There’s no excuse for this dangerous civilian laxity. Eye specialists in sufficient numbers, are available. They have the proper equipment and knowledge. And the benefits of eye care far exceed the efforts involved; for good vision, with our without the aid of glasses, is one of our greatest physical wonders.

How much more this is true now in the days of LASIK and refractive lens exchange.

You may not be a saboteur, but there’s still no excuse for avoiding routine eye care. Please contact a local ophthalmologist today to protect one of our nation’s most precious natural resources.

Wavefront Diagnosis for LASIK Procedures

While Wavefront technology has been used by astronomers for many years, the technology is relatively new to LASIK procedures. It is used by eye surgeons to more accurately diagnose irregularities with your eye. As a result, Wavefront diagnosis allows LASIK surgeons to achieve greater levels of precision with your procedure.

Wavefront diagnosis creates a three-dimensional map of your eyes, allowing your eye surgeon to customize your procedure based on your eye’s unique measurements. Each eye is mapped independently since no two eyes are exactly alike. This provides you with a significant improvement in the quality of vision correction that can be achieved with your LASIK procedure.

Traditional LASIK diagnostic methods were only able to correct for lower order aberrations such as myopia, hyperopia, and astigmatism. By using Wavefront diagnosis, your LASIK surgeon can also correct for higher order aberrations such as:

  • Glare and halos
  • Starbursts
  • Ghosting (a faint second image)

Wavefront technology also increases your chances of achieving 20/20 vision after your LASIK procedure, improves your night vision, and reduces your risk of LASIK complications. In addition, Wavefront diagnosis can also be used to achieve enhanced results with other refractive surgery procedures such as:

  • PRK
  • IntraLase
  • ilasik
  • LASEK
  • Epi-LASIK

Please contact eyes.com today to find an experienced LASIK surgeon in your area.

Femtosecond Laser May Reduce Risk of Myopic Regression after LASIK

A significant fraction of LASIK patients may experience myopic regression after LASIK. When this occurs, the results of LASIK will decline toward increased myopia (nearsightedness) after treatment. It’s not known exactly what is the frequency of this condition, but some studies have suggested it might be as high as 20% during the first six months and as high as 25% after a year. Patients with high myopia (at least 10 diopters) are at the greatest risk for this complication.

A recent study suggests that the use of the microkeratome may be partly to blame for this, and that LASIK patients may be more likely to retain the quality of their LASIK results if the procedure is performed using a femtosecond laser. The study, published in the Journal of Cataract and Refractive Surgery looked at the long-term results of 786 LASIK patients, 377 who had LASIK performed with a microkeratome, 409 performed with a femtosecond laser. Follow-ups were performed for both groups at one week and 12 months after surgery.

Researchers defined myopic regression as a combination of a myopic shift of 0.5 diopters (about 1 line on the Snellen chart) or more with residual myopia of 0.5 diopters or less. Using this definition, the risk for myopic regression after LASIK with a microkeratome was 67%, compared to 44% risk for femtosecond laser LASIK.

This study is part of the growing body of evidence that, although subtle, femtosecond lasers may actually result in significantly better LASIK results than microkeratomes.

To discuss a possible LASIK procedure with a doctor, please contact a local ophthalmologist.

SMILE Eye Surgery Offers an All-in-One Alternative to LASIK

Since LASIK is more than two decades old at this point and has several drawbacks despite its proven results, it should not be a surprise that people are always looking for a new alternative procedure. The new candidate is called SMILE surgery, which is short for Small-Incision Lenticule Extraction surgery, and it uses only a femtosecond laser to reshape the cornea.

This procedure hopes to remove flap complications associated with LASIK as well as the risk of dry eyes after the procedure, and maybe give a treatment alternative to many people who cannot benefit from LASIK.

In SMILE surgery, a small incision is made in the surface of the cornea using a femtosecond laser. The femtosecond laser is then used to cut out a lens-shaped section from the interior of the cornea. This section is then extracted using a small tool.

There have been a number of significant studies performed on this procedure. One of the earliest was performed in Germany and the results published in the Journal of Cataract and Refractive Surgery in 2008, using a slightly different version of the procedure called Femtosecond Lenticule Extraction (FLE, sometimes FLEX or reFLEX). This study treated ten myopic eyes, with 90% of them achieving +/- 1.00 D, approximately equivalent to 20/50 vision. The study showed no evidence of higher-order aberrations.

A more recent study published in the British Journal of Ophthalmology looked at 91 eyes of 48 patients. This multi-center 6-month prospective study showed even more positive results, with 95.6% of patients within 1.00 D, and 83.5% of eyes achieved an uncorrected visual acuity (vision without glasses or contacts) of 20/20 at 6 months, comparable to LASIK results. In the follow-up questionnaire, 93.3% of patients were satisfied and would undergo the procedure again.

The SMILE procedure is already being offered in Britain and India, and researchers are recruiting candidates for clinical trials here in the US. It’s hard to say just how long it will be before the procedure will be available.

To learn more about advanced vision correction alternatives, please contact a local ophthalmologist today.

Am I Too Old for LASIK Eye Surgery?

Although people over the age of 40 are more prone to developing eye disorders and diseases, your age alone does not necessarily disqualify you from LASIK eye surgery. Your ophthalmologist will evaluate several different factors about your medical history and the overall health of your eyes in order to determine whether or not you are a good LASIK candidate. Some older patients who aren’t good candidates for LASIK may be excellent candidates for other types of Laser Vision Correction.

If you are an older patient who is considering Laser Vision Correction, it is important to understand that full correction may not be possible. Eventually, most people over 40 years old will run into presbyopia – a problem where the lenses of the eyes harden and cannot focus on near objects anymore. This makes it necessary for you to use of bifocals, trifocals, or reading glasses. Since presbyopia is not a corneal condition, LASIK cannot correct it.

Because of this, older patients usually have two options with LASIK eye surgery:

  • Correcting one eye for distance, and one eye for near vision (monovision)
  • Correcting both eyes for distance (patient will still need reading glasses for near vision)

If you have further questions about LASIK eye surgery for older patients, contact an experienced ophthalmologist in your area today.

Presbyopia

Having 20/20 vision is nice. It’s the way your vision should be. Millions of people need corrective lenses to see 20/20 because of myopia. However, these individuals, as well as those who have natural 20/20 vision may find when they hit their early 40s that things that were once so crystal clear up close have begun to get fuzzy. This blurred vision may be more than a passing thing, it may be presbyopia.

Presbyopia is part of aging, and unavoidable for nearly everyone after they’ve reached 40. It’s the reason your grandparents all wear reading glasses, and it’s the reason your parents hold their books and magazines as far away from them as they can.  Presbyopia is, for all intents and purposes, age-related farsightedness.

Why people develop presbyopia is not fully understood, and there are a couple theories. One is that the lens begins to become hard due to proteins. This makes the lens less flexible to focal changes. Another theory is that the ciliary muscle begins to weaken. This makes it harder for the lens curvature to steepen to see things near. A third, and newest, theory is that the lens continues to grow, and by age 40 it has grown so much that the ciliary muscle does not have enough space to contract and steepen the lens. However, this last theory is not held by many eye doctors right now.

Whatever causes presbyopia can only be fixed by the old standbys: corrective lenses, LASIK, and conductive keratoplasty (CK).

If you are 40 or older and have noticed your near vision beginning to blur, find an experienced eye doctor in your area to test you for presbyopia today.

Does LASIK Make Your Pupils Dilate More?

LASIK eye surgery will not increase your pupil size. However, since your vision improves a great deal after LASIK, you might be more attentive to the size of your pupils than you were before. Near vision and bright light can cause your pupils to contract, while far distance and low light will make them dilate.

Each patient’s pupil size tends to be unique. Several different factors can affect the dilation of your pupils, including:

  • Caffeine
  • Lighting
  • Alertness
  • Medicines
  • Alcohol

If you already have large pupils and undergo LASIK eye surgery, it is possible that your eyes will dilate beyond than the LASIK treatment zone in darkness. This can cause issues with night vision, such as glare, halos, and starbursts. Having large pupils will not disqualify you from LASIK surgery, but it will be weighed against other factors when an ophthalmologist is determining your LASIK candidacy.

Fortunately, modern LASIK technology has lessened the odds of patients experiencing night vision problems and other LASIK side effects. In fact, studies show that 85% patients who have received treatment from the VISX CustomVue laser have experienced a significant decrease in their amount of night-time glare after surgery when compared to before.

If you have further questions about LASIK surgery and pupil size, please contact an experienced ophthalmologist in your area today to schedule an initial consultation.

Is LASIK Safer Than Contacts?

Many people are drawn to the benefits of LASIK eye surgery, but fearful of its potential complications. However, when the risks of LASIK are compared to the risks of contact lenses, LASIK actually comes out on top as the safer option.

Oxygen is essential in order for your eyes to function properly. Unfortunately, daily contact wear prevents your eyes from naturally receiving oxygen from the air around you. This can lead to problems like irritation, redness, and “ghost vessels” – blood vessels that appear in your eyes in order to re-route oxygen from other areas of your body.

Additionally, the risk of infection from wearing contact lenses is far greater than the risk of infection after LASIK surgery. Even a careful cleaning routine might not wholly prevent infection from contact lenses. In the past few years, many different contact lens solutions have been recalled for providing a higher risk of infection, or else for simply being ineffective.

If you are considering LASIK eye surgery, schedule a consultation with an experienced ophthalmologist in your area today to find out if you are a candidate.