How to Get Laser Eye Surgery You Won’t Regret Later
No glasses. No contacts. And no complications.
Originally written for and published in Men’s Health October 2022 Edition:
https://www.menshealth.com/lasik-laser-eye-surgery-what-to-know/
This year, 1+ million Americans are expected to receive laser eye surgery – including LASIK, PRK, SMILE, and Advanced Surface Ablation (ASA) – in pursuit of these life-changing benefits.
Most will choose LASIK without thinking twice. Such is the value of a household name, the power of advertising, and the allure of a fast recovery.
Despite this, I think consensus is growing that LASIK’s lead in laser vision correction is a bad thing. As a current ASA surgeon and former LASIK surgeon, I think (hope!) we are finally approaching “Peak LASIK.” The rate of regret with LASIK has certainly never been higher.
Here’s why: LASIK complications, especially dry eyes, appear to be soaring in unison with daily screen time and media consumption. In a FDA study from 2009 (before Instagram, Zoom, Netflix), 46% of LASIK recipients reported one or more visual issue (dry eyes, halos, haze, starbursts) after surgery. Based on what I am seeing first-hand from patients who have received LASIK recently, this percentage is much higher today due to compounding dryness from Digital Eye Strain.
An abbreviated version of this article ran in Men’s Health. You can read it by clicking here.
These side effects are unique to LASIK and other incision-based procedures like SMILE and “Bladeless LASIK.” These procedures hinge on surgeons cutting the cornea to allow for the laser correction, which creates a permanent “flap” of tissue. While this approach enables a fast recovery, it opens a pandora’s box of challenges that are simply not present with ASA and PRK, which shape the cornea without a cut, resulting in far less nerve damage.
That’s not to say LASIK is wrong for everyone, but it’s important to do your research. Homework is the “secret” to every A+ Laser Vision Correction outcome. Before you rush into LASIK, be sure you are extremely confident that the surgery is right for you.
Here are four tips to help ensure that your laser eye surgery is safe and effective:
The more personalized the procedure, the better.
Your eyes, your lifestyle, and your career.
The procedure you choose has to be the right fit for all three of these factors.
Regarding your eyesight, there are two types of lasers you can get with any laser vision correction procedure – a conventional ablation laser and a custom “wavefront” laser. Lower-order aberrations are mild cases of myopia and astigmatism. These are corrected with a normal laser. High-order aberrations like spherical aberrations require a custom or wavefront treatment. Don’t worry, your surgeon will determine what you need after your initial examination.
Regarding your lifestyle and career, procedures like LASIK are strongly discouraged for individuals who participate in contact sports, those who work blue collar jobs (i.e. factory workers), and those in professions where acuity – including night vision – is paramount (first responders, aviation, aerospace and defense, transportation, etc.).
This is because the flap (usually about 20% of your cornea) never completely fuses with the rest of the cornea after the surgery. A poke in your eye on the basketball court or by your toddler can dislodge the flap, creating a whole host of problems.
Likewise, white-collar workers who spend most of their day on the computer are not good candidates for LASIK. When you combine the propensity for dry eyes from LASIK with 8 to 14 hours of screen time per day, you could be dealing with chronic dry eyes for decades.
When it comes to choosing a surgeon, there’s no substitute for experience and communication.
Not all surgeons or clinics are equally invested in your long-term vision and wellbeing.
The first quality to look for in a surgeon is prudence. You’re best off going to someone with a conservative threshold who won’t hesitate to tell you that you’re not a good candidate for their procedure.
Secondly, the ability of your surgeon to be highly accessible to answer questions and concerns before and after your operation is paramount. Many large surgery centers (“mills”) rely on revolving-door surgeons who perform your operation and then are never heard from again, leaving you to communicate with trainees.
Finally, how many times has the surgeon operated on similar prescriptions? Experience is indispensable; look for someone who has performed hundreds of procedures.
Think ahead.
Recovery time can vary widely on a case-by-case basis. But be wary of “instant gratification.”
Whereas PRK and ASA require a longer recovery period (because the corneal surface needs to heal), LASIK’s is almost immediate. The cost of that, however, is that you live with the risks of the flap cut.
Base your decision on your vision and wellbeing 3 months or 3 years post-op instead of 3 hours or 3 days.
Looking for a detailed comparison between ASA, LASIK, and PRK? Click here to read mine.
It’s your vision – don’t outsource the decision.
It bears repeating: your individual eyesight, occupation, and lifestyle must dictate which surgery you choose.
It’s critical that you contemplate these factors in detail and that your surgeon fully understands your visual demands. Don’t compromise or allow yourself to be wooed by a great promotion or even a referral from a friend. Everyone is different and saving a few hundred dollars does not justify the risk.
Researching and discussing these demands will help ensure that your laser eye surgery will transform your life for the better.