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Wonderful LASIK, is it?
#1
Hi all, just wonder about the 'benefits' of undergoing LASIK. It is said that LASIK improves the vision of people through changing the refractive power of the cornea itself. Also it is similar to putting on glasses 'permanantly' and the eyesight will get worse just like when one wear glasses. My question is I'm very curious about how vision is like after LASIK. Do anyone have any stories to share? I have heard or seen comments like perfect, Much better than before, perfect sight even after 6 years, and even healthier eyes. And hundreds of people everyday are resorting to this seemingly 'perfect' and instant way of achieving 'perfect' vision.

Cheers,
ROL
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#2
Actually, usually when I hear of LASIK it's a TV special about people's vision getting destroyed, or websites about complications from the surgery. One website that's been around for years is www.surgicaleyes.org

If someone's vision has been very stable for years, who goes to a skilled surgeon, is likely to get the best results. But even so, I wouldn't recommend it to anyone, period. Even ruling out the "failed" surgeries, a "success" is an arbitrary criteria where someone sees at least, say, 20/40 after surgery. A person who after vision experiences double vision, starbursts, bad near vision, constant pain, dry eyes, and whose cut cornea flap gets dislodged is considered a "success." It's too bad that there's so much good marketing for a procedure that is so dangerous.

The most important thing to keep in mind is they aren't shaping a camera lens. It's dynamic human tissue they're cutting and burning away. The eye was not made to cope with that kind of damage. Hell, my finger wouldn't respond well to that, much less something as fragile and sensitive as my eyes.

The second thing to keep in mind is even if someone gets through the surgery with virtually no complications and is 100% happy, it's a relatively new surgery and there's no telling yet what's likely to happen in the future to their eyes, especially considering how much abuse people with vision problems inflict on their eyes already.

And the third thing is LASIK is no substitute for normal vision, any more than glasses are. People who strain their eyes experience so many other problems other than defocus of their eyes, problems which they often wrongly assume people with normal vision also get, including tired eyes, bad morning vision, light sensitivity, and all the other mental and physical consequences of inflicting chronic strain on oneself. These things do not go away with surgery, because they are a matter of how you use your mind and body.

Dave
Site Administrator

"Half of our funny, heathen lives, we are bent double to gather things we have tossed away." - George Meredith
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#3
Hi Dave!  ;D

Well Said friend. What you have stated here is very likely true. I know of a friend whose eyesight deteriorated in 6 months after the surgery, but she claim that she can still afford 'not to wear glasses'. Judging from the amount of money that one has to invest in (currently about 1800 to 2500 SGD for one eye, excluding all those consultations and follow ups, I think), even if it should deteriorate, we will tend to convince ourselves: it's OK, it is still better than last time, as I need glasses.

It's the way people boast about LASIK that somehow makes those who believe in natural improvement sway in their determination, especially if it takes tremendous patience.

But I don't. Because with vision improvement, my shoulder ache is less now, and I feel more alert than before. I have made an interesting observation: people with high myopia, after 'successful' LASIK, still stare. Their eyes are simply stagnant or tend to be stagnant, some even had this squinting look. But yup, they have 6/6 vision!

On the other hand, the eyes of little children and adults with perfect sight are 'alive', scanning the environment at lightning speeds without even one noticing. As a result, their eyes look sparkling and full of vitality.  Wink

Cheers,
ROL
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#4
Hi there,

            This is a topic that I have put a great deal of research into. I'm going to try and show the facts as I believe they are, if you really want to get to the bottom of Lasik you have to go find the scientific journals and scour them as I have. This information is out there, but you won't find it on some slick lasik advertisement.

Lasik:

Lasik is no where near as safe as surgeons will lead you to believe and now that some facts are starting to get out many of these lasik surgeons are starting to leave the practice and move to other laser ablation techniques.

Your eye will never ever ever ever (ad infinum) heal, ever. Your flap will always be suseptible to tearing, especially from a blow sideways to the eye. The best numbers that the limited research can provide is eventually the inside of your eye will regain 2% of its origional strength and the outside layer will recover to 12% (I can't remember this number perfectly, my mind also wants to say 8%).

Surgeons also make creative "lies" about their results. As most eye doctors seem to do, they only measure your refractive error. This is getting better as they look at the surface of your eye with a corneal topography and can see when they've totally screwed up, but you can get 20/20 "perfect" vision and be utterly crushed by blinding sideaffects (common examples are: glare, halos, night time vision, double vision and so on). From what I hear in personal stories, it is more profitible for the surgeon to kick you out the door and take in a new patient than it is to help you with your train-wreck vision. Not all practices are like this though so if you decide to do this pick very very wisely.

There is no practical difference which way the flap is hinged, new lasers that track your eyeball movement don't work 10% as well as they claim and many surgeons turn off those features as they interupt the surgery a disconcerting number of times because of movement in your eye. Machines are often poorly calibrated and poorly maintained. Surgeons do not sterilize their surgery rooms. If any debris is trapped under the flap things can go bad fast. This surgery is not suitable for high refractive errors, as you would need to sacrifice too much tissue in the eye and jepordize its safety.

Surgeons exagerate the quality of their lasers. Go to the FDA website, you can get some no bs studies there on the success rates of various lasers.

Now there is emerging a new type of 'microkeratome" on the market. Instead of cutting the cornea with a microkeratome, which is not as accurate as surgeons will tell you it lasers the flap into your eye. This technology has not shown promise and it does increase the risk or haze formation. Another thing I should mention to you is that the device used to hold the eye still during this part of the procedure compresses your eye flat. Pressures are known to increase many fold causing increased incidence of floaters (big ones, not little ones) as well as other things, including overall structural weakness of the eye.

Now, as most people seem to speak of lasik surgery, but use it to refer to all types of refractive surgery I will cover some more types for you.

Radial Keratotomy/Diamond Microsurgery:

If your surgeon tells you that you are not a canditate for any surgery, save for this one, this is god telling you that you can not have refractive surgery.

RK features unpredictable results, changing refractive errors and a ridiculously high level of side effects. You will never be able to withstand high or low pressures either.

Now that being said this surgery did start out extremely positive. It started in Russia with a very good success rate because the doctors were not fixated on profit. They were willing to split the pie and stick to their one task, doing it to perfection instead of our current jack of all trades doctors.

Long story short: this is an extremely old, unreliable techniqiue that no self respecting surgeon would perform.

LASEK/PKR/EPI LASEK/Surface ablation techniques:

The close cousin to LASIK and the flap surgeries, surface ablation works in an almost identical manner, except the laser is applied to the surface of the cornea without a flap being made. This is making a big comeback in recent years as people are realizing the dangers of lasik. These techniques are documented to have a greater risk of the refractive error returning, greater discomfort and a greater probability of haze forming.

These techniques are not suitable for patients with high refractive errors, the higher your refractive error the greater the risk for haze development. Some surgeons use Mitomycin C on your eye to keep haze from forming. This practice is not fully researched yet. It does appear that it stops haze from forming in some patients, however it also kills alot of the stuff it touches in your eye.

Now this surgery spares your eye the looming threat of the lasik flap, but it comes at a high price. In the process of ablating your eye the Bowman's membrane is irreversibly destroyed. It will never grow back. The Bowman's membrane it thought to contain a fair potion of your eye's ability to filter out high energy radiation. the side-effects of sacrificing this membrane are not fully researched.

There are other surgerys out there like inacts, or phyiscally placing a lens infront or behind your iris, but I believe these techniques are far too new to even be considered.

Believe me, I wanted this surgery to be the miracle solution it is touted to be and it can be, but the risk factors are simply too large for me to ignore. I would say that if you needed this to pursue a dream job or something of that nature then the choice is up to you. If you are only looking to get rid if your glasses, this is a serious gamble considering the limited benefit you can derive from it.
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#5
A close friend of mine seemed excited in the few months to a year after the surgery, but does not openly talk about it anymore.  His brother has worse eyesight than he did, but has not yet signed up for the surgery.  I think this speaks volumes. 
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#6
Hi bkowalski, I have this similar situation with this friend of mine, she said right after the surgery, she experiences halos. But can already 'see'. Then I attended an evening function with her and I realised that she 'strained' to see some details on a door indoors about 15 m away from her when i can see it just right (with glasses at that time). That time I began to wonder about what kind of vision is she having.

5 months later she went overseas for tour, when she came back she told me ' she can't read the signboards along the roads'. I told her that she's just merely tired. She said no, even after a week she's back she still can't really see that well...

About a year later, when she realised that I was practicing the Bates method and benefiting from it, she was so excited about it. I then took the opportunity to ask her again how's her vision after LASIK, she said it's 'not as sharp as before' but 'still don't need glasses'. And she is not so open about it anymore. So I guess it's just one's luck if their vision really stays as it is. Cos as Dave mentioned, it's dynamic human tissue that is being burned off and who knows what happens after that.
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