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A view on the pros and cons of LASIK

Since 1999, the FDA has authorized LASIK for vision correction. Today, around 600,000 LASIK operations are performed annually in the United States. The great majority of persons who have this operation get 20/20 vision, and the vast majority – more than 95% – express satisfaction with the outcomes.

Nonetheless, complications include as glare and halos are prevalent after LASIK. And, in rare occasions, individuals have lost eyesight, had long-term discomfort, or experienced other complications.

Morris Waxler, PhD, a former FDA official who was a member of the panel that authorized the operation, has alleged in recent years that the FDA overstated the hazards. He has requested that the agency withdraw LASIK from the market. The FDA answered that the data did not warrant a recall, but that it would continue to evaluate LASIK safety.

Is LASIK a safe procedure? Yes, according to Edward Manche, MD, an ophthalmology professor at Stanford University School of Medicine and division head of Cornea and Refractive Surgery. “It has been authorized by the FDA and its safety has been verified,” he adds. “While some individuals have had difficulties, the great majority of people fare exceedingly well.”

LASIK Pros

Laser-assisted in situ keratomileusis, or LASIK, is a kind of refractive surgery. The surgeon begins by cutting a tiny tissue flap from the front of the eye. The cornea is then reshaped using a laser to improve light focus on the retina at the rear of the eye. LASIK is a procedure that may be used to address visual abnormalities such as nearsightedness, farsightedness, and astigmatism.

Over the last two decades, physicians in the United States have done more than 19 million LASIK treatments. Although there have been few high-quality, long-term studies on the results, the evidence that exists indicates that the operation is safe and successful.

LASIK is an excellent operation,” says Jennifer Ling, MD, a clinical assistant professor in the University of Iowa Hospitals & Clinics’ Cornea and External Eye Disease Clinic. “It has been able to significantly improve the lives of a large number of individuals by providing them with good vision and liberating them from their glasses or contact lenses.”

Over 90% of patients who get LASIK obtain 20/20 vision, which means they can see well from a distance of 20 feet what a person with normal vision should be able to see without glasses or contact lenses. Over 99 percent of individuals get 20/40 or greater vision, which is sufficient for passing the driver’s license test.

Daniel Sklar, 56, of Smyrna, GA, had the operation in 1999 to treat severe nearsightedness and astigmatism. Following that, he moved from wearing heavy spectacles to having eyesight that was better than 20/20. “It has resulted in a significant increase in my quality of life,” he adds. “To be able to wake up, wash, and see, as well as swim or snorkel without prescription goggles.”

LASIK has been even more successful over the years due to advancements in the treatment. “The outcomes have consistently improved over time as more modern technology has become available,” says Joshua Frenkel, MD, an associate surgeon at Wang Vision Institute in Nashville. The femtosecond laser, launched in 2001, cuts a flap in the cornea using light pulses. The method has been transformed by femtosecond lasers, which provide higher safety and accuracy than a blade.

Other technological advancements enable the production of a personalised map of the cornea, resulting in more accurate vision correction and improved results. “The goal is to eliminate higher-order aberrations, which may result in glare, nighttime halos, and other effects,” Frenkel explains.

Cons of LASIK

The most common adverse effects of LASIK are moderate — including dry eye, burning, and itching, which occur in 20% to 40% of patients. These symptoms often peak about three months following surgery and subside between six to twelve months — although this is not always the case.

Holly Strawbridge, a 68-year-old freelance writer from in Fort Lauderdale, FL, has suffered dry, red eyes since undergoing LASIK eye surgery around 17 years ago. “It’s been an issue,” she admits. “It seems as if I’ve been pulling a lot of all-nighters.” She claims that even if she had been aware of the dryness beforehand, she would have proceeded with the procedure. “To be honest, when compared to the inability to see, dry eye takes a second place.”

Additionally, glare and halos surrounding lights at night, as well as trouble with contrast, are prevalent. Around 20% of those who get LASIK have these complications. They may also improve over six to twelve months, but only a tiny percentage of individuals experience them long-term, Manche explains. If you have one of these problems, you may either return to glasses or contacts or undergo revision surgery.

Additionally, there is a potential that LASIK may not entirely restore your vision, particularly if you were very nearsighted or farsighted to begin with. If this occurs, you will need glasses or contacts in order to see well. “If you are not completely fixed… you may return in three to six months for more surgery,” Manche explains. “The great majority of patients get 20/20 vision in such instances.”

It is very unusual for a vision chart to lose lines of vision. “Even with glasses or contact lenses, eyesight cannot be restored to its pre-LASIK state,” Ling explains. “The likelihood of it occurring is very remote. This is often the result of infection, scarring, or inadequate recovery.”

Even though your eyesight is 20/20 immediately after LASIK, it may not remain thus. Vision may regress. And as you age and the structure of your eye naturally changes, you’re likely to require reading glasses. “As I’ve grown older, the impact of LASIK has waned,” Strawbridge explains. “However, I have had at least ten years of flawless eyesight.”

The majority of LASIK-related complications are transient and provide only little inconvenience, but in some individuals, they are severe enough to be life-changing. John Christian, 44, had the operation in May 2015. He visited a respected hospital and had tests to see if he was a suitable candidate. However, he experienced dry eye shortly thereafter. Treatments such as tear plugs and prescription eyedrops were ineffective, and the dryness became worse.