Thursday, January 3, 2013

Can your vision become worse after you have laser eye surgery?

Q. After you have laser eye surgery, can your vision still become worse?

A. In a one word answer 'Yes '

Laser eye surgery reshapes the front of your cornea to correct vision.

However as you age your eye structure changes,this alters how the light entering your eye is bent and hence alters the sharpness of your vision.

If you have laser eye surgery it will (hopefully) correct your vision at that time,but it cannot correct future changes in your eyes which will occur.

Also if you have laser eye surgery to correct your distance vision now, then in the future (age mid 40s plus ) you will definitely need reading glasses (or a further procedure such as CK)


What are the long terms side effects of laser eye surgery?
Q. I am interested in having laser eye surgery to correct short sight but I am concerned about the longer term side effects as I get older. I can't find much information about this subject on the web so I would be really interested to find out.

A. The risks outlined below apply to both PRK and LASIK procedures. The chances of having a serious vision-threatening complication are minimal, and there have been no reported cases of blindness following either PRK or LASIK, says James Salz, M.D., clinical professor of ophthalmology. However, FDA is aware of a few instances of severe eye injury requiring corneal transplant.
Infection and delayed healing: There is about a 0.1 percent chance of the cornea becoming infected after PRK, and a somewhat smaller chance after LASIK. Generally, this means added discomfort and a delay in healing, with no long-term effects within a period of four years.

Undercorrection/Overcorrection: It is not possible to predict perfectly how your eye will respond to laser surgery. As a result, you may still need corrective lenses after the procedure to obtain good vision. In some cases, a second procedure can be done to improve the result.

Decrease in Best-Corrected Vision: After refractive surgery, some patients find that their best obtainable vision with corrective lenses is worse than it was before the surgery. This can occur as a result of irregular tissue removal or the development of corneal haze.

Excessive Corneal Haze: Corneal haze occurs as part of the normal healing process after PRK. In most cases, it has little or no effect on the final vision and can only be seen by an eye doctor with a microscope. However, there are some cases of excessive haze that interferes with vision. As with undercorrections, this can often be dealt with by means of an additional laser treatment. The risk of significant haze is much less with LASIK than with PRK.

Regression: In some patients the effect of refractive surgery is gradually lost over several months. This is like an undercorrection, and a re-treatment is often feasible.

Halo Effect: The halo effect is an optical effect that is noticed in dim light. As the pupil enlarges, a second faded image is produced by the untreated peripheral cornea. For some patients who have undergone PRK or LASIK, this effect can interfere with night driving.

Flap Damage or Loss (LASIK only): Instead of creating a hinged flap of tissue on the central cornea, the entire flap could come off. If this were to occur it could be replaced after the laser treatment. However, there is a risk that the flap could be damaged or lost.

Distorted Flap (LASIK only): Irregular healing of the corneal flap could create a distorted corneal shape, resulting in a decrease of best-corrected vision.

Incomplete Procedure: Equipment malfunction may require the procedure to be stopped before completion. This is a more significant factor in LASIK, with its higher degree of complexity, than in PRK.

Problems with a Perfect Procedure: Even when everything goes perfectly, there are effects that might cause some dissatisfaction. Older patients should be aware that they can't have both good distance vision and good near vision in the same eye without corrective lenses. Some myopic patients rely on their myopia (by taking off their glasses, or by wearing a weaker prescription) to allow them to read. Such a patient may need reading glasses after the myopia is surgically corrected. Another consideration is the delay between eye treatments. If one eye is being done at a time, then the eyes may not work well together during the time between treatments. If a contact lens is not tolerated on the unoperated eye, work and driving may be awkward or impossible until the second eye has been treated.


When you have laser eye surgery, can you see all of their instruments touching your eye?
Q. When you have laser eye surgery, can you see all of their instruments touching your eye?
What do you see during the procedure?
Do you feel anything?
Can you see anything?


As, you can see, there are a lot of questions going through my head about this. I am not having it done, but I am very curious about the subject :) Thank you!

A. I just had eye surgery but it was for cataract removal. The prep you for surgery and then put you in what is called, "twighlight", and you can't really feel anything except a little water on your eye. It went pretty fast and I didn't have any pain at all during the surgery. I had mine in the hospital and I could see some lights over head that looked colored. I was out of it but awake. They also cover your other eye and put a covering over. Later I was wheeled out and I felt fine. There was no patch involved.


How bad do your eyes have to be to not be able to get laser eye surgery?
Q. I really want laser eye surgery and I have a few questions.

My eyes are really bad, one is -7 and the other is -9 and those are the numbers for my contact lenses. What's the worst prescription you can have and still get laser eye surgery?

Also, I have floaters on my eyes, is it still possible to get the surgery with floaters on your eyes? (Floaters are little dots that you see in your normal vision for those who don't know)

For those who live in Canada and have gotten it done, how much did you pay for your surgery?

A. You would have to have a consultation. It is not just as simple as just measuring your prescription. During laser surgery the surgeon slices a layer off the front of your cornea (in very simple terms) so, the thickness of your cornea is a huge factor.

ie. you could have a very thin cornea but only have a small prescription and be unsuitable for surgery or you could have a higher prescription and be suitable because your cornea is thick.

I feel the answer will be no because your true prescription will be stronger than your contact lens prescription and over a -9 is really pushing it but you'll never know unless you see some surgeons. It is cosmetic surgery so treat it like that, See several surgeons and get several opinions, don't opt for the cheapest, opt for the one with best results and recommendations. There are other types of refractive surgery for example cataract surgery (without actually having a cataract!) so there may be an option for you :)





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