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WHAT EXACTLY IS LASIK SURGERY?

LASIK is the acronym for Laser-Assisted in Situ Keratomileusis. LASIK is a cosmetic operation. An ultraviolet excimer laser is used to modify the curve of the cornea in order to change the basic focus of the eye. This will supposedly “cure” refractive errors of the eye – nearsightedness, farsightedness, and astigmatism – and thereby eliminate the need for distance glasses in some people.

LASIK surgeons begin by flattening the eye with a suction ring. This squashes the eye as if it is being squeezed in a vise.  The pressure inside the eye temporarily shoots up to sixty, where normal is between eight and twenty-two. They then slice a flap off the flattened surface of the cornea, just as if they were cutting a slice off a loaf of bread. Then the surgeons use the excimer laser to shave the cornea underneath the flap, thereby changing its curvature. Finally, they place the flap back on the eye, and trust it will seal itself back onto the cornea again.

A similar procedure, photorefractive keratectomy, or PRK, also uses the excimer laser to reshape the cornea, but instead of making a flap the surgeons scrape off the top layer of the cornea. They then often put a toxic chemotherapy agent, Mitomycin C, on the cornea, to prevent haze. This drug is usually not mentioned in the consent form patient sign. PRK is more painful than LASIK short term. PRK was the first procedure approved to re-shape the cornea with the excimer laser.

WHAT ARE SOME OF THE RISKS OF LASIK SURGERY?

If you have LASIK, there is roughly a 50% chance you will develop a painful “dry eye”, which is actually corneal neuropathic pain. This means your eyes will constantly feel as if sand is pasted inside your lids, and they will burn as if you have hot pepper sauce in them. More than a dozen patients have committed suicide because their post-LASIK pain was so bad.

-You have a 2% chance of going blind after LASIK. The causes include corneal erosion and flap loss, retinal detachment, and glaucoma.

-There is a 100% chance you will no longer be able to distinguish between subtle shades of grey.

-There is more than a 20% chance you will no longer be able to function in dim light. You may have to give up driving at night and going to the movies. If your job requires functioning in dim light, you may become permanently disabled.

-LASIK permanently bends, thins and weakens the cornea, which can lead to ectasia. Ectasia is a progressive steeping, or bulging, of the cornea – rather like a tire that has developed a weak spot. As the weakened cornea is pushed further and further out, the eye develops irregular astigmatism that cannot be corrected by glasses or soft contact lenses. Ectasia can develop twenty-five years after apparently successful LASIK.

– There is less than a 50-50 chance you will be able to throw away your glasses, according to a 2009 Consumer Reports survey.

-Even if you see better at distance, you will have other problems you did not have before LASIK. For example, people over forty will almost always have to wear reading glasses.

-To cap it off, your eye is likely to go right back to being nearsighted, or it may even become farsighted. Some eyes continue to fluctuate in vision for as long as twenty-five years.

There is nothing wrong with eyes that need glasses. They see well before the procedure. They ought to see equally well after the procedure, but LASIK does not make eyes see better. All eyes see less well after LASIK if they are carefully tested. Patients are not told this.

WHAT QUESTIONS DO PATIENTS NEED TO ASK THEIR DOCTOR BEFORE CONSIDERING LASIK SURGERY?

Nobody should consider having LASIK surgery!!!!

WHAT OTHER OPTIONS ARE AVAILABLE IF YOU’RE HAVING VISION ISSUES?

Glasses and contact lenses.

WHAT DO YOU THINK IS THE CAUSE OF SUICIDES WITH SOME PATIENTS THAT RECEIVED LASIK SURGERY?

Blindness and severe unremitting constant pain that cannot be treated.

IF PATIENTS ARE HAVING SO MANY DIFFICULTIES AFTER HAVING LASIK SURGERY, WHY IS THIS PROCEDURE STILL AN OPTION?

The consent forms are misleading and inaccurate, and they are not written in words a layman can understand, and the procedure is advertised heavily and deceptively.

 WHY DO YOU FEEL SOME DOCTORS WON’T SAY ANYTHING PUBLICLY AGAINST HAVING THIS PROCEDURE?

I have no idea why ophthalmologists refuse to speak again LASIK publicly. They will readily admit in private that LASIK is a terrible procedure that should be banned.

 HOW CAN I KEEP MY EYES HEALTHY?

See your ophthalmologist once a year if you are over forty, every two years if younger. Use sunglasses in bright light. Protect your eyes with 3 mm polycarbonate glasses if you play sports. Don’t smoke.

 DOES WEARING GLASSES AS YOU AGE MAKE YOUR EYESIGHT WORSE OVER TIME?

Not at all.

WHAT CAUSES PRESSURE IN THE EYES?

Open angle glaucoma is a hereditary disease where the drain of the eye is open, but slowly loses the ability to drain fluid as abnormal debris accumulates, which causes the pressure inside the eye to go up.

Narrow angle glaucoma is a hereditary disease where high pressure builds up inside the eye because the iris – the colored part of the eye – covers the drain and blocks it. Angle closure is cured by cutting a hole in the iris, which unblocks the drain.

SHOULD WE ALWAYS WEAR SUNGLASSES WHEN OUT IN THE SUN?

Absolutely.

 WHAT CAUSES OUR VISION TO FADE OVER TIME?

The lens inside the eye loses its ability to focus over time. In time, everybody will develop a cataract if they live long enough. The retina can suffer aging changes.

Dr MacKay is a graduate (cum laude) of Harvard College. She received her MD degree from SUNY Downstate Medical School which 25 years later, honored her with the Richard Troutman Master Teacher Award in Ophthalmology. She did her Ophthalmology residency at Edward S Harkness Eye Institute, Columbia University, College of Physicians and Surgeons. She did special fellowship training in retinal disease at Bellevue and is Clinical Professor of Ophthalmology at Columbia University Medical School, the first woman to achieve that rank. She has published multiple papers in peer review journals.

 

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