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10 Key Facts to Know About LASIK

Eye Surgeon Helps You Wade Through the Hype
By Barbara Russi Sarnataro
WebMD Feature
Reviewed by Louise Chang, MD

You can hardly turn on the TV or the radio without hearing ads about a new, low-cost eye surgery to rid you of those bothersome glasses or contacts. But how can you be sure you're not playing Russian roulette with your eyes?

WebMD Health professional Bill Lloyd, MD, is a board-certified ophthalmologist qualified to perform laser refractive surgery. LASIK is one of the most frequently performed operations in America. In order to shed some light on this very popular surgery, Lloyd outlines ten important things to know before undergoing laser refractive surgery.

1. Know Yourself -- Why do you really want to have this surgery? You will live with its results forever, so don't be caught up in a fad. There are no guarantees. Many LASIK patients are still wearing glasses!

2. Know Your Surgeon -- Look for an experienced, board-certified ophthalmologist. Ask direct questions regarding your surgeon's experience and complication rate. Will your surgeon continue to take care of you after the surgery, after surgery, or will you be redirected to a non-physician?

3. Know Your Refractive Error -- The more nearsighted (myopic) you are, the more likely you may need a repeat procedure (euphemistically called "refinements"). Ask your doctor what the chances are that you'll need a refinement.

4. Know if You Are Eligible -- LASIK is not for everyone. People with severe dry eyes, certain corneal diseases, and other select eye conditions should not undergo LASIK.

5. Know What Happens -- Be sure you fully understand the entire procedure. Since you will be awake for the surgery, you don't want any surprises.

6. Know the Odds -- After laser refractive surgery, most patients enjoy improved (not necessarily perfect) vision without their old glasses. Nobody guarantees 20/20, 20/25, or 20/30 vision. If you hear such claims, consider looking elsewhere.

7. Know the Risks -- Laser refractive surgery is surgery. There is no such thing as "minor eye surgery." Complications such as overcorrection, undercorrection, making the pupil off center, damaging the cornea, inflammation, and infection can leave you miserable. You may hear statistics about 2% or 5% complications, but if it happens to you, it's 100%!

8. Know the Limitations -- LASIK is used to help correct nearsightedness and astigmatism. Laser refractive surgery will not prevent you from needing reading glasses as you approach middle age. There may be future advancement but, as of this writing, LASIK patients will need help to read later in life just like their parents did.

The majority of people with mild or moderate nearsightedness can expect to have uncorrected vision (without glasses or contacts) of 20/40 or better after LASIK surgery. Some may have 20/20 vision or better. Good results are less certain with more severe nearsightedness.

9. Know Your Postsurgical Care -- Be sure both you and your partner understand the postoperative eye-drop routine. Since these medications influence corneal healing, your final visual outcome will depend heavily on the correct use of your eye drops. Make sure you find out what kind of care you will receive after the surgery and how often your doctor will want to see you. Be sure to ask about any limitations you may have after surgery, such as sports or makeup.

10. Know About Alternative -- Alphabet soup! LASIK, LASEK, PRK, INTACS, and many more. Don't hesitate to ask your surgeon, "Is this the very best way to treat my situation? Are there other methods?" Experienced eye surgeons typically know three or four ways to manage the same patient. Carefully weigh any decision to participate in any innovative research trials. It's hard to beat solid experience!

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Reviewed on June 30, 2006

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