LASIK Surgery: Not for Everyone

I guess you’re all familiar with refractive surgery – surgery that corrects visual acuity with the purpose of reducing or eliminating the need for contacts and glasses. Well, in today’s fast-paced technological world, one of the most commonly performed refractive surgery is what the experts call as “LASIK”. You may hear people calling it “LASIX”, but the name actually stands for “Laser-Assisted-In-Situ-Keratomileusis”.

Now, what basically is LASIK?

It is given that LASIK is a surgical procedure intended to reduce or eliminate the person’s dependency on glasses or contact lenses. This procedure is actually “outpatient”, thus you have the chance to go home after the operation. It is performed by a refractive surgeon in order to correct any refractive problems like myopia, hyperopia and astigmatism.

Basically, the LASIK surgery permanently changes the shape of the cornea, the clear covering of the front of the eye, with the use of excimer laser. Also, a knife, medically known as microkeratome, is used to cut a flap in the cornea. Then, a hinge is left at one end of this flap. The flap is folded back revealing the stroma, which is the middle section of the cornea. The procedure further involves vaporization of a portion of the stroma, and that what allows you to smell somewhat like a burning hair during the procedure. After which, the flap is re-placed on its original position.

Is LASIK For You?

One particular truth when it comes to LASIK surgery is that, it is not for everyone. There are a number of medical conditions that some people have that make them poor candidates for this refractive procedure. Well, these conditions are in the first place rare and can only be determined or detected during your pre-procedure examination with what is called a Corneal Topographical Map.

Preoperative Tests

I have here below some of the preoperative tests that you will need to undergo prior to initiating the LASIK procedure for myopia, hyperopia, or astigmatism. These tests are highly required in order to make certain that you obtain the most accurate and proper correction as well as follow up possible. These tests include, but are not limited to:

Complete Eye Examination

A complete eye examination, including pupil dilation, is necessary to determine the refractive power and health of your eye. It is particularly used to determine the refractive error, which is verified with a cycloplegic or dilated technique. Along with this, several tests are made available to determine if you predisposed to Dry Eye Syndrome and related symptoms.

Usually, in this evaluation exam, you will be evaluated for your expectations of what refractive surgery will do for you. It is commonly suggested that if you wear contact lenses, you must stop wearing the lenses for a few weeks prior to the examination. The usual period range from:

• Three weeks for soft daily wear lenses
• Six weeks for gas permeable and extended wear soft contact lenses
• Eight weeks for hard plastic lenses on at least one eye and wear glasses or one contact lens during this period of time.

It is worth noting that the actual time needed for the removal of contact lenses may vary depending upon the recommendation of the doctor for your particular case. Also, the main purpose for the removal of the contact lenses during such period is to attain the most accurate measurements of your natural corneal curvature. To further know this, you may be required to undergo some measurements which are taken every week for a number of weeks prior to the LASIK surgery. This is to make sure that your cornea is stable. Experts say that if your cornea stabilizes sooner than expected after the removal of the contact lens, your LASIK surgery may be done sooner.

Computerized Topographical Analysis

This preoperative test is also known as Computerized Video Keratography and is a mapping of the surface of the eye by height as well as refractive power. In this kind of procedure, the more sophisticated machine is used to measure the thickness of the cornea, as well as the elevation of the front and back surfaces of the cornea. This is usually performed to detect evidences of corneal thinning that are hidden, which might occur in the hidden form of kerataconus.

Tonometry

Before the refractive LASIK surgery, tonometry is taken for a certain purpose – to determine the intraocular pressure. Basically, this measurement is just a normal part of a complete eye examination.

Contrast Sensitivity Analysis

The contract sensitivity analysis may also be done prior to the surgery. This basically measures the ability of your eye to distinguish images under varying degrees of lighting. It was found out that in some people, laser refractive surgery may cause a decrease in the ability to see at low light levels.

Pachymetry

There is only particular purpose for the consideration of this test – to determine the thickness of the cornea. According to some resources, the thickness of your cornea must be measured in order for the surgeon to identify your suitability for the LASIK procedure. As noted, the absolute minimum of residual thickness is 250 microns. So, if the depth of the ablation or the optical zone leaves less than 250 microns of residual corneal tissue, the danger of the cornea shape changing, or blowing out is greatly elevated. Some of the refractive surgeons like to leave 270 to 275 microns of residual cornea in order to give a safety margin to allow for improvement.

If all these preoperative tests are taken, your surgeon and staff will proceed to analyzing the results to determine your chances of success with the LASIK procedure.

Conditions Which May Preclude Your Eligibility for LASIK

As mentioned earlier, the LASIK procedure is not for everyone. If you have any of the conditions below, you are probably not a good candidate for refractive surgery.

Cost is an Issue

Are you one of those who often worry of the cost of LASIK? You should understand in the first place that most medical insurance will not pay for refractive surgery. And, although the cost is coming down, it is still one of the most important factors to consider.

Not a Risk Taker

When it comes to LASIK and other refractive surgeries, certain complications are unavoidable, and this happened in a percentage of patients. Aside from that, there are no long-term data available for current procedure. So, if you are not a risk taker, then LASIK is probably not for you.

It Will Jeopardize Your Career

As you may know, some jobs these days prohibit certain refractive procedures. Therefore, it is important, if you are working, to be sure to check with your employer service before undergoing any LASIK procedure.

Refractive Instability

Refractive instability is a condition in which you required a change in your contact lens or glasses prescription in the past year. The patients who are more likely to have refractive instability are those who are:

• In their early 20s or younger
• Pregnant or breastfeeding
• Taking medications that may cause fluctuations in vision
• Whose hormones are fluctuating due to disease like diabetes

Experts suggest that those people should discuss the possible additional risks wit their surgeon or doctor.

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