Eyes Laser Surgery

[Dr. Dan]

John,

It sounds like you have done a lot of good research and probably will be quite happy with your upcoming procedure. For the sake of accuracy I would like to refine a few of your comments.

You are correct in noting that pupil size is important, but not quite for the reason you stated. A slight increase in spherical aberration occurs after almost every Lasik procedure regardless of pupil size. Glare, halos and decreased contrast sensitivity are noted by a few patients, even those with small pupils. The problem with large pupils is that the optically-poor transition zone at the edge of the treated area is included within the pupillary aperture, analogous to non-aligned optics in a camera or enlarger (Trying to keep this thread somewhat photographic). Small pupils are better for many of the same reasons that smaller apertures make better photographic images.

The ability to focus at near after the procedure is very age- dependent. If you are older than say, 45 years, and if you have a perfect distance postop result, say 20/20 or better in both eyes, you will not, repeat not, be able to focus at 10 inches, or even 20 inches. If you are younger - yes, near vision can also be good, but even then you will lose it after a certain age.

[mark lindsey]

I hear that many people are developing a severe dry eye problem due to this procedure. I would look into this before I did anything....

[Sandy Sorlien]

Dan Depending on your view camera, maybe you could try a binocular viewer. I have an Arca-Swiss 6x9 and due to my aging eyes (47) I could not see to focus on the small ground glass without being almost outside of the dark cloth. When I got Arca's bino viewer, however, thanks to the magnification I can see great!

[Harry L. Martin]

Dan, I must admit that I have only scanned the answers because everytime I mention having had Lasik work done I hear the same general negative comments. Speaking only for myself, I am very happy with the results. I chose mono-vision and again I am very happy with the results. Now, after 50 years, I don't have to wear glasses anymore. No more trouble with fogged and dirty glasses. I don't have to hunt for my glasses any more. I can't think of any downside in my photography or day to day living. I had the work done last year at age 64. Because of my age it took about six months to heal completly. Although, I never had to wear glasses since the surgery. My vision improved as each month passed. Good Luck if your decide on Lasik, Harry

[Kevin Crisp]

Dan or Anybody Else Considering this: Don't be too shy to ask about risk. There will come a point in time when the MD delivers to you a talk about the risks. This could happen, that could happen, another complication is X, etc. This is basically a description of everything that could go wrong and when you have that list explained to you, only then do you give what lawyers call "informed consent." But "risk" as it relates to informed consent is not (or should not be) merely a recitation of possibilities. A listing of possible bad outcomes means nothing without the additional information (which MD's often overlook or avoid talking about) concerning the frequency at which those untoward events (called in medical-legal circles "a bad result") occur. And the only number that matters to you is how many times YOUR DOCTOR has had that "bad result" with one of his/her patients. (Isn't that better to know than the rate of X complication in the general population of people who've had the procedure you are going to have?) So when a certain unfortunate complication is described to you, before the MD gets to the next one, you should ask how often he/she has had that occur to a patient. This should not offend the doctor and you have a right to know. You can then intelligently size up the risk you are taking and make a decision. Also, it should not go without saying that you should be assured that the doctor who tells you his/her track record is the one that will be doing the procedure. If you show up for the appointment and somebody else is going to do it (yes, this does happen) the information you were told (or requested and received) about the doctor who isn't working on you doesn't mean much.