Should You Consider refractive surgery?

By the mere fact that you’ve chosen to read this website, you’ve obviously given some thought to the possibility that you might benefit from some sort of refractive procedure. For those not familiar with the term “refractive procedure”, this term indicates any type of procedure that is designed to reduce dependence on corrective eyewear, that is, glasses and contact lenses.

Statistically speaking, the majority of readers are considering LASIK. However, there’s now a myriad of options when it comes to refractive surgery and the astute will consider these options before embarking on a procedure. This is no longer the era of a “one size fits all” type of refractive procedure. Nevertheless, even ophthalmologists that provide refractive surgical procedures have a difficult time staying abreast of the array of devices, procedures, and nuances that are inherent in refractive surgery as well as the refractive surgical indications (surgical intent) and potential adverse effects of such devices and procedures. But don’t let that statement bring your reading to an abrupt halt! After all, that is the purpose of this website - to provide you, the reader, with a fairly solid foundation of knowledge that will allow you to make a more informed decision about which procedure (if any) and surgeon you choose for your eyes.

At this point you may be wondering which procedure is right for you. Should you choose LASIK? Maybe you’ve heard about LASEK or IntraLASIK…. UH, OH! There’s something more than LASIK available? Then again, perhaps you’ve heard about Epi-LASIK. Maybe your friend or family member told you about PRK and said it was safer than LASIK, or maybe they said it was dangerous? Either way, could you trust what a friend had to say? You may well have heard about CK (conductive keratoplasty) for the “farsighted” or for those with presbyopia (need for reading glasses). Is this for you? Are you farsighted or nearsighted? How would you know? Are you over forty and need reading glasses? Does it matter? Maybe, just maybe, you’ve heard about the first implantable contact lens (lens implant) called the Verisyse phakic (pronounced “fa'-kik”) intraocular lens. Could this lens be for you? Is it better than LASIK? Is it better than CK or a replacement for CK? Perhaps you’re the type that doesn’t want to even consider anything other than LASIK just because it’s not familiar to you and you don’t or won’t trust anything else. OK, so you’ve decided you don’t want to consider any other procedure besides LASIK. Did you know that there are different types of lasers, different methods to make the LASIK flap, and surgeons that run the gamut from performing their first case to those that perform over 200 procedures a day?

Please, above all, I implore each of you to thoroughly understand your unique situation and the procedure and surgeon that you choose. It horrifies me that patients sometimes want to come in and “get their eyes done”. Sometimes they want to have “that laser procedure…. You know, that one so you’ll never need glasses again”. I’m often amazed at how much research some people will do before buying a car, a television, camcorder, etc., yet when it comes to their “eye surgery”, they’ll proceed with plans for surgery because their friend “had it and loves it”. Even worse, there are surgeons who advertise “20/20 Or It’s Free!” Yes, these procedures are good, very good, even excellent, but advertising of this sort might make you think that it’s risk free. It isn’t. Don’t be fooled and don’t start price shopping for the lowest “deal” because this is surgery you’re considering! Did you ever hear of anyone looking for a “deal” when they were considering a coronary artery bypass surgery? Of course not! Yet, patients sometimes think that eye surgery is just “a laser procedure”, as if the laser does all the work. Nothing, and I mean nothing, could be further from the truth. The decision making process as well as the procedures themselves can be rigorously demanding of even the most dedicated eye surgeons. refractive procedures should only be performed by highly trained, skilled, and experienced EyeMD’s (ophthalmologists).

I’ve outlined this website to make it easily readable. I don’t expect most people to read this entire website. In fact, I’ve organized the website in an attempt to simplify the decision-making process and to minimize any readings that aren’t applicable to your eyes. This website is purposely succinct, at least for a topic this broad. I’ve deliberately kept the website brief enough that it will be useful. I’m certain that virtually no one (eyecare professionals aside) wants to know everything about refractive surgery! I’m also certain that you don’t want an anthology that provides detail you’ll never use or need to help you make the right decision. As such, I’ve organized the website for brevity and provided an algorithmic approach to help you determine which procedure might best suit you and your unique eyes.

If you are nearsighted, I’ll help to guide you through the decision maze to help you understand your options. The same holds true for those who are farsighted, those who have presbyopia (need for “reading glasses”), and those who don’t know what they have but just want to see better without glasses or contact lenses! The first six chapters of this website will provide a fairly solid foundation of knowledge that will make everything else much easier to understand. So, take heed of that bit of advice.

As a suggestion, if you don’t know what type of refractive error (nearsighted, farsighted, astigmatism, presbyopia) you have, and you just want to get to the “meat” of the issue, review chapter five, “Understanding Your Glasses or Contact Lens Prescription” and move forward. If you already know what type and degree of refractive error you have and you want to begin reading about your options, “Contemplating refractive surgery - What Are the Options for Your Eyes?” But, be prepared for some difficulties in understanding the details because you may not have the foundation of knowledge set forth in the first few chapters.

If you happen to be the more erudite, just keep reading and I’ll walk you through some history of refractive surgery, a condensed version of how the eye works, then we’ll progress to understanding your glasses/contact lens prescription and, finally, begin a review of the refractive procedures that are presently available. This is certainly the approach that will make the remainder of this website much, much more easily understood as well!

At times, as you read, you may believe that I am pontificating a bit. If so, I apologize in advance. There are times in the website, however, that I believe it is appropriate for me to express my opinion to you in a rather dogmatic way. It is only for your benefit! However, very little of the website is based on my opinion. Rather, you will notice that the website is fully referenced and I’ve relied almost exclusively on the most respected, peer-reviewed ophthalmic journals and experts in their fields to bring you the most trusted refractive surgery studies and data available.

Finally, be prepared to learn some of the lexicon of the ophthalmologist. It is impossible to present this material without such terminology and still present truly useful content. I’ll try to explain ophthalmic terms as we encounter them and I’ve provided a glossary as well. With that said, I submit this website to you for your edification. I hope you enjoy it and that it meets and even exceeds your expectations!