Based on my situation, should I get LASIK?

[kanon]

Gosh, based on your history and based on the stories I hear from people on this forum who really suffer a lot with severe dry eye from Lasik, I wouldn't do it. I have severe dry eye (not from Lasik) and it really affects your entire life and is really painful. I just wouldn't risk it...you never know if you are going to get it and there is no cure. But I understand the allure of Lasik! Good luck.

[Rebecca Petris]

Hi Apham,

Question 1:

Reputable or not, they all make their living from LASIK. If you want an unbiased opinion, go to a dry eye specialist who doesn't do LASIK, or who does very little of it.

By the way... a little math on those 60,000 procedures: LASIK has been FDA approved since 2000 (that is, that's when the earliest FDA approval for a laser for LASIK occurred). 60,000 procedures means a surgeon doing 24 surgeries per day (that is, every 20 minutes for 8 hours), 42 weeks of the year, for the last 12 years, that is, since approval. (210 days times 8 hours times 3 per hour = 5,040 surgeries annually; divide those 60,000 by 5,040 and you get 11.9 years. I've allowed 10 weeks vacation or days when they're not operating.) Of course, they may have started doing LASIK on an off-label basis much earlier but we needn't go there.

A surgeon who does that much surgery is doing NONE of the aftercare. How the heck does s/he even know whether their patients got dry eye or how bad it was? Some poor miserable optometrist is dealing with the aftermath until the patients get fed up and move on.

Question 2.
There is no simple answer to that question. Sometimes we know, sometimes we don't. There are certain risk factors, but if I had a nickel for everyone I know with no obvious risk factors who got it bad, well...

Question 3.
Lots of people. My favorite approach is physical barrier over the eyes at night. That may be anything from a sleep mask to plastic wrap to specialty goggles designed for the purpose. There are some examples in the dry eye shop (link above) but you can also find things locally.

[apham]

Hi everyone,

I have a couple of questions regarding lasik... but first, here's my story:
I never felt like I had dry eyes until 4 months ago. Before that, I've been wearing contact lenses since I was 14 (I'm now 25). I started noticing out of nowhere that my contacts were gradually bothering my eyes more and more, until I decided I could not wear them anymore. I went to the ophthalmologist who said that I have dry eyes due to improper closing of the eyelids when I'm sleeping AND being a contact lens wearer. It's funny how I was able to wear contact lens for so long without ever having to use eye drops.. until it hit me out of nowhere!
I started using regular preservative free eyedrops + the restasis. I felt like my eyes were getting better (but I do feel like they are dry here and there, and I can only wear contacts once a week for about 5-6 hours before they start feeling dry - but not painful). Since they felt better, I went to 3 different lasik consultations w/ 3 different doctors. They each told me I'd be a good candidate because my eyes aren't that dry. schirmer's test was a 10. They also mentioned that if my eyes were dry, it would show up on the cornea topography and i'd have blurred vision.

Here are the questions:

1. Since I've been doing a lot of research, I'm wondering if I should trust these doctors. A lot of people say that someone with pre-existing dry eye would be a terrible candidate. On the other hand, I read a lot of articles online from doctors who say that dry eye wouldn't eliminate the patient as a candidate, but it's important to get it under control. I had consultations with pretty reputable doctors, one having done over 60,000 surgeries. What do you think?

2. I've heard of people with normal eyes that get severe permanent dry eye after lasik. And then I've heard of people with dry eyes who still get lasik and are perfectly fine afterwards. What causes one patient to get permanent severe dry eye while another doesn't have any symptoms? Is this something based on a good/bad surgeon, or does it solely depend on the patient's body and how it heals?

3. Does anyone here have the same problem, where we can't close our eyelids all the way when sleeping? If so, how do you cope with it? I have genteal gel but it seems to evaporate before morning, leaving my eyes kind of dry in the morning.

Thanks in advance!