Laser Eye Surgery Discussion Thread

point3

tomstickland wrote: »

I did some research on the web last week and they reported that the lasik flap possibly never fully heals in one direction and can break when subject to impact years later.

This is true of any scar. No scar is 100% as strong as virgin tissue.

The corneal flap will "stick down" within 2-3 days, but may take 6 months or more for optimal healing to occur.

General advice is to avoid rubbing the eyes, any swimming or contact sports for 1 week after the surgery. After that, physical activities may be cautiously re-introduced.

Shearing off of the flap can occur after trauma months after the original surgery, but it is true to say that such trauma is likely to produce a significant injury to the eye even if surgery had not been performed.

JennyW_2

tomstickland wrote: »

A friend of mine said to me the other day "how many opticians do you know who have had laser eye surgery?".

this is my feeling too. I've been wearing contacts for years but very wary of having laser surgery. I aired my concerns with my optician last year and she still feels not enough time has been given to see if there are any long-term side effects. All the opticians where I go wear glasses :cool:

My SIL had her eyes done but when driving at night, she has to wear glasses - something to do with headlights and the night - not sure what it is but it's pretty standard. Plus over time and with age, our eyes will continue to degenerate so glasses will probably still be required, even for reading.

I still feel it's a bit of a lottery. I'd be scared of being one of those people where it doesn't work properly :eek:

point3

JennyW wrote: »

this is my feeling too. I've been wearing contacts for years but very wary of having laser surgery. I aired my concerns with my optician last year and she still feels not enough time has been given to see if there are any long-term side effects. All the opticians where I go wear glasses :cool:

My SIL had her eyes done but when driving at night, she has to wear glasses - something to do with headlights and the night - not sure what it is but it's pretty standard. Plus over time and with age, our eyes will continue to degenerate so glasses will probably still be required, even for reading.

I still feel it's a bit of a lottery. I'd be scared of being one of those people where it doesn't work properly :eek:

There's a flaw to that argument.

Optician = one who fits glasses (not medically trained)
Optometrist = doctor who carries out routine eye examinations
Ophthalmologist = doctor (surgeon) specialising in conditions of the eye

The optician doesn't want to lose all his customers by recommending eye surgery, does he?

emmaroids

i thought about having this done, until i saw how its done :eek:

[yt]Y-TUMw1FTmY[/yt]

warning, its nasty

JennyW_2

point3 wrote: »

There's a flaw to that argument.

Optician = one who fits glasses (not medically trained)
Optometrist = doctor who carries out routine eye examinations
Ophthalmologist = doctor (surgeon) specialising in conditions of the eye

The optician doesn't want to lose all his customers by recommending eye surgery, does he?

ok a bit picky but the optometrist (there are 2 where I go) both wear glasses

tomstickland

Some google searching
http://www.usatoday.com/news/health/2001-06-28-lasik.htm#more

http://findarticles.com/p/articles/mi_m0846/is_8_21/ai_83911029

Whether the possibility of multiple surgeries -- and a less-than-perfect outcome -- is a risk worth taking is something prospective LASIK patients must decide for themselves -- preferably, doctors say, well before they have surgery. "Enhancements are part of the procedure," Kornmehl cautions. "I always tell patients if an enhancement sounds unpalatable to you, don't have the procedure to begin with because somebody is going to fall into these numbers. The numbers don't come out of nowhere. They're based on real people."

A forum for those affected by surgery complications
http://visionsurgeryrehab.evecommunity.com/eve/forums/a/frm/f/6541031211

http://www.lasiksucks4u.com/

etc, I've yet to read the detailed info.

Horace

How any one would want to have laser eye surgery is beyond me. They do it at the eye hospital in Birmingham but it is purely for medical reasons not vanity.

Contact lenses can scar the eye too and the eye becomes misshapen - I used to wear contacts but now I have glaucoma and uveitis which means no more contact lens wearing. I wear glasses and because of the glaucoma don't drive at night because the lights really affect my eyes and cause a form of blindness.

Stick to wearing glasses - there are some lovely styles around now and in any case if you need to have thick lenses you can always pay for thinner ones.

tomstickland

This one is interesting:
http://users.tns.net/~equity/lasiksos/#Eye Pain

[FONT=Arial,Helvetica]To perform LASIK, the surgeon uses a high power pulsed Laser -- that Vaporizes Corneal Tissue at the Rate of 7.5 Cubic Inches per Second.[/FONT]
[FONT=Arial,Helvetica]Would you stare at the sun ? I hope not.[/FONT]
[FONT=Arial,Helvetica]Would you stare at an Ultraviolet radiation source that is at least 38% -- or 84% -- brighter than the sun, ON AVERAGE ? That's what the LASIK surgeon is asking you to do.[/FONT]
[FONT=Arial,Helvetica]According to the specifications that Bausch & Lomb, and VISX, have given to the FDA, their ophthalmic lasers -- the lasers used during laser eye surgery -- have a "fluence", respectively, of .774 and 1.032 watts per square inch. (References 1, 2, 3)[/FONT]
[FONT=Arial,Helvetica]At sea level, on a very, very bright day, as much as .56 watts per square inch reaches the skin - or eyes - of the person laying in the sun at the beach. (Reference 4)[/FONT]
[FONT=Arial,Helvetica]In other words, it is typical, during laser eye surgery, to stare at a radiation source which is brighter than the sun. The sun emits "broadband radiation" -- in the infra-red, visible, and ultraviolet spectrums. The laser used in laser eye surgery emits mostly 193 "nanometer" radiation. Ultraviolet, C Band, radiation. The kind of radiation which the atmosphere filters out. The kind of radiation we seek protection from when we put "SPF 30" sun-block on our skin, or "UV-protected" sunglasses on our eyes.[/FONT]
[FONT=Arial,Helvetica]Is the human cornea vulnerable to damage from Ultraviolet radiation ? Yes it is, as described below. The first step in collecting this information is a simple web-search using the terms "Ultraviolet Radiation Burn Eye". [/FONT]
[FONT=Arial,Helvetica]http://www.google.com/search?hl=en&ie=UTF-8&oe=UTF-8&q=ultraviolet+radiation+burn+eye[/FONT]
[FONT=Arial,Helvetica]Both the Bausch & Lomb ophthalmic laser and the VISX laser are "pulsed" ultraviolet lasers. The Bausch & Lomb Technolas 217 is "on" for .000000225 seconds, or .000000900 seconds, out of every second. The VISX Star S2 is "on" for .000000100 seconds, out of every second. In engineering terms, this relates to what is what is known as "duty cycle".[/FONT]
[FONT=Arial,Helvetica]During a typical laser eye surgery, a section of corneal tissue 8 millimeters in diameter, 80 microns thick, is removed. First, let's translate that into English units: 8 millimeters = 8 x .03937 inches = .315 inches -- about a third of an inch. 80 microns = .080 x .03937 inches = .00315 inches -- about the thickness of a piece of 20-weight Xerox paper. And the ophthalmic laser is on, at most, .000000900 seconds out of every second. (Reference 2)[/FONT]
[FONT=Arial,Helvetica]To get an idea of the power of this laser -- it's ability to slice through Flesh, Blood, and Bone -- let us ask a simple question: what would happen if the patient was exposed to a radiation source of this intensity, and it was continuous, not pulsed ? To make the calculations easier, and more conservative, let's round the duty cycle off, from .00000090, to .000001. A duty cycle of one-millionth. If this radiation source were left on continuously, for the duration of a typical laser eye surgery performed on just one eye, it would vaporize approximately this much soft tissue: a volume about 10 inches in diameter. 3.15 inches deep. Tapered around the edges. In less than a minute. (Reference 5)[/FONT]
[FONT=Arial,Helvetica]That's a powerful laser. If it were left on continuously, it would photo-ablate a volume of soft tissue (eye tissue and brain tissue, for example) about the size of an adult human's head -- in under a minute. In short, the Bausch & Lomb, VISX, Nidek, and Summit/LADAR-Vision Ophthalmic lasers used to perform laser eye surgery are not just pulsed ultraviolet lasers. They are high-powered, pulsed, ultraviolet lasers.[/FONT]
[FONT=Arial,Helvetica]Many of the laser eye surgery patients with whom I have spoken describe 2 specific symptoms: A foreign-body sensation in the eye, and a painful sensitivity to bright lights. Both of these are treated topically, and temporarily, by applying eye-drops, and by wearing sunglasses. Many laser eye surgery patients -- even patients with "positive outcomes" -- in fact, have these 2 symptoms during the early post-op period, and then the symptoms diminish over time, as the tissue of and around the eye heals from the trauma of the surgery. For some, the symptoms do not attenuate, over time. For some, the symptoms escalate, over time. I find that my own symptoms fall in this latter category. 5 years, and 2 month2, at the time of this writing.[/FONT]
[FONT=Arial,Helvetica]Following are the symptoms described by an occupational safety health organization in Canada - the symptoms associated with the use of an arc-welder which emits significant amounts of Ultraviolet-C band radiation. The symptoms are identical to the symptoms experienced by many LASIK patients, and identical to the symptoms experienced by some LASIK patients. What do these 2 groups of people -- arc welders and LASIK patients -- have in common ? Exposure to extreme amounts of ultraviolet radiation.[/FONT]
[FONT=Arial,Helvetica]* pain - ranging from a mild feeling of pressure in the eyes to intense pain in severe instances[/FONT]
[FONT=Arial,Helvetica]* tearing and reddening of the eye and membranes around the eye[/FONT]
[FONT=Arial,Helvetica]* sensation of "sand in the eye" or abnormal sensitivity to light, and[/FONT]
[FONT=Arial,Helvetica]* inability to look at light sources (photophobia)." (References 6, 7, 8, 9)[/FONT] [FONT=Arial,Helvetica]And, what does the occupational safety health organization in Canada recommend for persons who used insufficient eye protection while operating an arc-welder ? Eye-drops.[/FONT]

tomstickland

The more I read then the more I'd advise anyone to do their homework rather than assuming it's just a "shopping mall" procedure.
Many of the risks/side effects are well known:
http://www.operationauge.com/lasik-safety-knowledge.html

Images:
http://www.operationauge.com/images-lasik-lasek-prk.html

tomstickland

http://www.scq.ubc.ca/?p=144

Fortunately, complications occur in less than one percent of operations and minor complications such as dry eye and halos usually resolve themselves in a few months as the cornea fully heals.[11] Over- or under-correction is the number one complaint among patients; however, when interviewing patients, these complaints were usually the result of expecting too much from the surgery.

Very few patients experience infection-related difficulties which are usually due to improper sterilizing techniques in the clinic; overall, infections make up less than 1 percent of complications. Even though both techniques are very similar, patients are usually more satisfied with LASIK than PRK at 90 and 52 percent respectively

All three laser refractive surgery techniques appear to obtain satisfactory results with a very low number of complications. However, this does not mean that the operation is to be taken lightly. It is important to note that the FDA only approves the use of a laser for a particular application; they do not monitor the techniques used. Many of the complaints can be attributed to errors within individual clinics. Concern has been expressed over the “bargain basement” clinics that guarantee 20/20 vision for low, low prices. To make up the cost these clinics may cut corners which could involve using older equipment and sterilization techniques.

There is a lack of long-term studies focused on the performance and potential risks of refractive surgery. One study reported stability in PRK-treated eyes 12 years after treatment. [10] A more recent study however, has shown that the age degeneration of eyesight over 5 years was greater than normally expected in LASIK treated patients

Thus far, there are no studies that have investigated the relationship between laser refractive surgery and cataract formation. It is possible that insufficient time has passed since the first surgeries for an accurate study correlating cataract formation after laser refractive surgery.

A UK forum
http://www.lasik-eyes.co.uk/forum/forum_topics.asp?FID=9