LASIK Surgery: What are the Risks vs. the Benefits?
© 2013 Health Realizations, Inc.
Every year, 1.3 million Americans undergo LASIK surgery to correct their vision, and most have good results. In fact, only 2 percent to 3 percent of LASIK (which stands for Laser-Assisted In-Situ Keratomileusis) patients have complications, according to the American Society of Cataract and Refractive Surgery.
The allure of never wearing glasses or contacts again draws over 1 million Americans to LASIK surgery every year. Most leave happy, but a small percentage suffer dry eyes, eye pain, and even permanently impaired vision.
But while the opportunity to see clearly without glasses or contacts is a tempting one, is it worth the potential risks that do exist? This is the question that everyone considering LASIK surgery must face.
How Does LASIK Work?
LASIK surgery permanently changes the shape of your cornea, which is the clear covering in front of your eye. The surgery works like this:
A special knife is used to cut a flap in your cornea, which is folded back to reveal the middlesection, or stroma, of the cornea.
Pulses from a laser are used to vaporize a portion of the stroma.
The flap is replaced.
The idea is that once the shape of your cornea is changed, it will be able to bend, or refract, light rays to focus on your retina, rather than at a point beyond, or short of, it, helping you to see better. Generally speaking, LASIK may help someone who has nearsightedness (myopia), farsightedness (hyperopia) or astigmatism.
More than 90 percent of people who have LASIK no longer have to wear glasses or contact lenses most of the time, and most can expect to achieve 20/25 vision or better, according to the Mayo Clinic.
What are the Risks of LASIK Surgery?
All surgery comes with risks, but LASIK presents a unique position in that it is not a life-or-death surgery, yet it does carry risks that could threaten your ability to see.
Some people still have to wear glasses or contact lenses after having LASIK surgery.
Meanwhile, the first laser for LASIK eye surgery was approved just 10 years ago in 1998, so the long-term safety of this procedure is completely unknown.
According to the U.S. Food and Drug Administration (FDA), LASIK can involve the following risks:
Vision loss: Some people have lost lines of vision on the vision chart, and this vision loss cannot be corrected with glasses, contact lenses or surgery.
Debilitating visual symptoms: Some people have developed glare, halos, and/or double vision that seriously impacts nighttime vision.
Trouble seeing in certain situations: Even when the results turn out favorably, some people do not see as well in situations of low contrast, such as at night or in fog, after the treatment as they did before.
Being under-treated or over-treated. Not every patient achieves 20/20 vision without glasses or contacts. Some people require additional treatment, and some may still need glasses or contacts after the surgery.
Severe dry eye syndrome: LASIK may lessen your eye's ability to produce enough tears to keep it moist. Dry eye syndrome is not only uncomfortable, it can reduce the quality of your vision.
The results may diminish with age. This is particularly true if you are farsighted.
Does LASIK Surgery Cause Depression?
Another unforeseen side effect of LASIK surgery may be depression. In response to patient complaints, the FDA is planning a large, national study to examine the link between LASIK complications and quality of life, including psychological problems like depression.
There have been recent reports, for instance, of people who have experienced serious side effects from LASIK, such as impaired vision and constant eye pain, who have fallen into depression and even committed suicide.
"Depression is a problem for any patient with a chronic vision problem," said Christine Sindt, an optometrist and associate professor of clinical ophthalmology at the University of Iowa in Iowa City, in the Chicago Tribune.
"But in the case of post-LASIK patients," she continued, "the depression is compounded by remorse. It's not just that they lose vision. They paid somebody [who] took their vision away."
Who Should NOT Have LASIK?
Even if you have decided to have LASIK, you should know that there are certain groups of people that are not good candidates for LASIK surgery, and these include people who:
Have had a change in their contact lens or glasses prescription in the past year. This indicates that you have "refractive instability," and is common among people in their early 20s or younger, pregnant or breastfeeding women, people whose hormones are fluctuating, people with diabetes, and people taking certain medications that cause vision changes.
Have a disease (or are taking a medication) that impacts wound healing. This includes autoimmune diseases (rheumatoid arthritis, etc.), HIV, diabetes and medications such as retinoic acid and steroids.
Participate in contact sports. Boxers, wrestlers, martial artists and others who take part in sports that involve blows to the face are not good candidates.
Are not over 18. LASIK is not approved for children under 18.
Have a job that prohibits it. Certain professions prohibit LASIK surgery, so be sure your job would not be in jeopardy before moving forward.
Ultimately, the decision of whether or not to have LASIK is a very personal one. Be sure that you take the time, and do the research necessary, to make the right decision for you.
U.S. FDA: LASIK Eye Surgery
ChicagoTribune.com February 25, 2008