Is
Lasik for me?
According to the FDA, you
are probably NOT a good candidate for refractive surgery if:
- You are not a risk taker.
Certain complications are unavoidable in a percentage of patients,
and there are no long-term data available for current procedures.
- It will jeopardize your
career. Some jobs prohibit certain refractive procedures. Be sure
to check with your employer/professional society/military service
before undergoing any procedure.
- Cost is an issue. Most
medical insurance will not pay for refractive surgery. Although the
cost is coming down, it is still significant.
- You required a change
in your contact lens or glasses prescription in the past year. This
is called refractive instability.
- Patients who are:
- In their early 20s
or younger,
- Whose hormones are
fluctuating due to disease such as diabetes,
- Who are pregnant
or breastfeeding, or
- Who are taking medications
that may cause fluctuations in vision, are more likely to have
refractive instability and should discuss the possible additional
risks with their doctor.
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- You have a disease or are
on medications that may affect wound healing. Certain conditions, such
as autoimmune diseases (e.g., lupus, rheumatoid arthritis), immunodeficiency
states (e.g., HIV) and diabetes, and some medications (e.g., retinoic
acid and steroids) may prevent proper healing after a refractive procedure.
- You actively participate
in contact sports. You participate in boxing, wrestling, martial
arts or other activities in which blows to the face and eyes are
a normal occurrence.
- You are not an adult.
Currently, no lasers are approved for LASIK on persons under the
age of 18.
The safety and effectiveness of refractive procedures has not been determined
in patients with some diseases. Discuss with your doctor if you have a
history of any of the following:
- Herpes simplex or Herpes
zoster (shingles) involving the eye area.
- Glaucoma, glaucoma suspect,
or ocular hypertension.
- Eye diseases, such as
uveitis/iritis (inflammations of the eye)
- Eye injuries or previous
eye surgeries.
Keratoconus
- Other Risk Factors
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Your
doctor should screen you for the following conditions or indicators
of risk:
- Blepharitis. Inflammation
of the eyelids with crusting of the eyelashes, that may increase
the risk of infection or inflammation of the cornea after LASIK.
- Large pupils. Make sure
this evaluation is done in a dark room. Younger patients and patients
on certain medications may be prone to having large pupils under
dim lighting conditions. This can cause symptoms such as glare, halos,
starbursts, and ghost images (double vision) after surgery. In some
patients these symptoms may be debilitating. For example, a patient
may no longer be able to drive a car at night or in certain weather
conditions, such as fog.
- Thin Corneas. The cornea
is the thin clear covering of the eye that is over the iris, the
colored part of the eye. Most refractive procedures change the eye’s
focusing power by reshaping the cornea (for example, by removing
tissue). Performing a refractive procedure on a cornea that is too
thin may result in blinding complications.
- Previous refractive surgery
(e.g., RK, PRK, LASIK). Additional refractive surgery may not be
recommended. The decision to have additional refractive surgery must
be made in consultation with your doctor after careful consideration
of your unique situation.
- Dry Eyes. LASIK surgery
tends to aggravate this condition.
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