Lasik seems to be the cause of MANY people's dry eyes

[magalvin]

From all the reading I've done on this site, I don't think I'd EVER get Lasik. I have dry eyes from computer work (job) and long term contact use and couldn't ever think how bad it must be with Lasik with them fully cutting and never having tears again. I thought my eyes were bad until I read some of these HORROR stories about goggles and not being able to go outside. Mine is just annoying and I haven't been able to wear contacts (hoping to now I'm on Restasis) but not as bad that I can't go outside! My fiance wanted Lasik but I refuse to let him get it incase he would have the horrible side effect of dry eyes!

[PotatoCakes]

My husband wanted Lasik too and I've been trying to dissuade him for years. When my eyes got really bad and I discovered this site, I told my husband how many people on here have dry eye due to Lasik. He's not thrilled about glasses & contacts but at least he's no longer considering Lasik. Lots of people seem to come out of Lasik just fine but the risks seem way too high, IMO, knowing what I know.

I've directed a fair number of people considering Lasik to this site so they can read about others' experiences. They may still opt for the surgery but at least they have a greater idea of some of the risks since it seems a lot of doctors never mention them or downplay the severity.

[Rebecca Petris]

I want to share a couple of thoughts for those of you concerned about loved ones who want to get LASIK. In my experience a lot of people are unpersuadable once they've been hooked on the idea and are unmoved by horror stories or even experiences of family members because they don't feel it's relevant to them. In those cases if I'm talking with them and I sense they are determined to get LASIK, I try to share information that can help them either do surgery more safely or at least better understand what they're doing. Here's some key points you might want to share with a LO who is determined.

1) PRK as an alternative: If they have a low to moderate prescription, tell them to research wavefront ("custom") PRK as an alternative. While all laser refractive surgeries have risks and we have our share of PRK dry eye folks here, PRK eliminates a lot of other LASIK (flap-related) risks AND it substantially reduces the risk of post-operative dry eye. There is no compelling reason from a VISION PERFORMANCE standpoint to prefer LASIK over PRK - the reason people with low to moderate prescriptions do LASIK is largely convenience (note, it's especially convenient for the drs too!) - faster visual recovery and less pain. Think about it. PRK has been done since the early 90's, and here we are 2 decades later and many top surgeons have circled BACK to PRK after many years of doing mostly LASIK. There's a lot of good reasons why, and dry eye is high on the list.

On the other hand if they have a high prescription, and you think they're open to it, make sure they find out how much higher almost all LASIK risks are for people with high prescriptions.

Now, If they are aged say 45-50+, it is VERY important that they understand #s 2 and 3 below:

2) Presbyopia - Most people start experiencing presbyopia (need for reading glasses) in their 40's. If you get LASIK when you have presbyopia, you have two options: a) fully correct distance vision in both eyes - in which case - talking here about people who are nearsighted to begin with - you will NO LONGER be able to read without glasses. Or, b) get monovision, where one eye is corrected for distance and one for near vision, in which case it is ESSENTIAL that you try out this concept with contact lenses before surgery because many people cannot tolerate this type of vision imbalance in practice, or can tolerate it but don't like it. You do not want to find out after surgery that you don't like it as the only way out is more surgery or more glasses. Also, people getting monovision really need to think in advance about what they'll do if one eye isn't corrected to where it needs to be. Decide in advance if you are going to be willing to get a re-op on that eye. Laser correction accuracy tolerances aren't what you think they are.

3) Cataract surgery implications: The average age at which people in this country get cataract surgery is 63. During cataract surgery your lens is removed and replaced with an implant, so your distance vision is corrected. Furthermore, prior refractive surgery makes it more difficult for doctors to accurately calculate the correction you will need with your new lens implant. (Note - those who get refractive surgery MUST keep their own copy of their records on file for this reason - you never know if you'll be able to get those records when you need them, as the facilities are not required to hang onto them forever.) So, suppose you're 55 years old and want to get LASIK, and suppose you're a statistical average. IF all goes well and you are corrected to exactly the prescription they target, you're basically buying 8 years of less dependence on glasses for distance vision. See #2 above as you may also be buying more years of dependence on reading glasses, depending on your preop prescription.

These things are important to know in order to make an educated decision, IMHO, but you won't find anyone advertising them.

/lecture