Anna DinndorfMost people do not take kindly to a six-millimeter laser beam focusing on their eyeball. But as students near their early 20s, more and more are considering LASIK eye surgery. Senior Niko Agbayani said he would consider LASIK surgery for convenience.
“There are times throughout the day that contacts bug you. Sometimes a small piece of dust can irritate your eye if it gets on or underneath your contacts,” he said.
LASIK eye surgery offers visual correction for the nearsighted, farsighted and astigmatism-bound.
“The laser is just a light beam that focuses on the cornea. The laser itself, you can’t see it, you can’t feel it,” said Linda Tsai, assistant professor in ophthalmology and visual science and corneal specialist.
Laser-Assisted In Situ Keratomileusis (LASIK) is a refractive eye surgery. The laser reshapes the cornea, the outer layer of the eye, so that light entering the eye will directly hit the rods and cones in the retina in the back.
“The laser is very accurate, so you can actually use the laser on small spots to get a very good correction on the cornea,” said Tsai.
The surgery can correct vision for nearsighted people who cannot see far away, or farsighted people who have to squint when trying to read the big E on the eye chart. LASIK can also fix astigmatism, which is when the normally round cornea resembles a football.
“Astigmatism actually focuses to a line,” explained Tsai. “I always like to think of it as when you look at the sun with rays coming out. If you have astigmatism, things are going to be in focus in a certain direction more than another direction. You don’t get the image clear all the way around, you need extra power in a particular area to make the image sharp.”
Junior Mitch Cooper was nearsighted until this past August when he opted for LASIK surgery. Generally, LASIK patients range from age 21, when eyesight becomes more stable, to age 55, when people start needing reading glasses and developing cataracts. The eye continues to grow lengthwise until the early twenties, but patients can be good LASIK candidates if their prescription has been stable for 12 months. Cooper’s prescription had been stable for a year and, he added jokingly, his “check didn’t bounce,” prior to surgery.
Tsai and other cornea specialists run several tests on patients interested in the surgery. Those with thin corneas, diabetes, autoimmune diseases or disorders causing extra inflammation or decreased healing are dissuaded from getting LASIK surgery.
“I usually do a full eye exam in the office,” said Tsai. “If I have an old pair of glasses or any notes I can see how stable they are. I explain that Lasik is 95 to 99 percent successful. It’s a great procedure, but they have to accept that there’s a little bit of risk to it.”
Little prep is needed for LASIK surgery, said Cooper. Patients arrive about half an hour before surgery and are given steroids to control inflammation, antibiotics to minimize infection, and valium, if needed, to help with relaxation.
Eye drops are used to administer topical anesthesia. A special blade called a microkeratome – kera meaning cornea – cuts a superficial flap on the top of the cornea. The surgeon then fixes an eye tracking devise on the patient’s eye so “if people aren’t looking at the right thing, the eye tracker turns the laser off. You don’t shave something that you don’t want to shave,” said Tsai.
The laser then quickly pulsates and removes the computer-controlled correct amount of tissue from the cornea to reshape it for improved vision.
“The minute they were done with the surgery I could already see farther, more clearly,” said Cooper. “I guess my eyesight was a little blurry. It took about a week or two for the corneal flaps to heal. It took about a month before I could see perfectly at night.”
Patients may at first see halos at night when looking at light. When the pupil dilates, it may dilate beyond the lasered area, thus blurring vision. Now, doctors taper the edge of the lasered area to prevent long term halos from forming.
“The only thing that patients notice after the laser is that your eyes are usually dry because the eye has been opened during the procedure. Within a few hours usually you’re seeing better. Almost all my patients are 20/20 or 20/25 the next day,” said Tsai.
LASIK costs anywhere from $1,000 to $2,500 per eye. Patients should be wary of low-cost clinics, however. Often, optometrists or other employees will screen patients and perform follow-up care with the patient. The patient only meets the ophthalmologist on the day of surgery. These clinics also have hidden costs, such as extra fees for fixing astigmatism.
“Some just buy the laser; they want the volume. The surgeon comes in, leaves, and doesn’t really do any personal follow-up on the patient at all,” said Tsai.
Tsai typically charges $1,750 an eye and offers discounts for University employees. Most insurance plans do not cover LASIK.
Before choosing a doctor, patients should ask if the surgeon has performed at least 1,000 LASIK surgeries, uses the latest LASIK software, provides pre and post-operation care and what percentages of patients see 20/20 or have complications after surgery.
“Some people, it really changes their life. It doesn’t sound like much to have to put contacts in, but you’ll talk to people who are now more active and functional,” said Tsai.
Cooper agrees.
“I feel more free that I don’t have to remember to bring my contacts and glasses with me everywhere I go. My favorite thing is waking up and being able to see the alarm clock.”