Over the course of the past two decades, LASIK has become the most well known name in refractive eye surgery in the US. Millions of Americans who suffer from myopia (nearsightedness), hyperopia (farsightedness), and astigmatism (misshapen cornea) have achieved heightened improvement in their eyesight having undergone this simple and highly effective procedure. But for those of you who have yet to experience its transcendent results, you may be questioning how the procedure works.
There are many myths associated with LASIK Laser Eye Surgery. Some of the most common misconceptions are: Vision gets worse with age, so you have to get LASIK again later in life; if you wait a few years, LASIK will be cheaper; Astigmatism can’t be cured with LASIK; and, if you get LASIK you will need to begin using reading glasses.
Dr. Manoj Motwani is a trusted provider of LASIK in San Diego. We sat down with Dr. Motwani to uncover all of these LASIK myths.
Myths Revealed: Discover the truth about LASIK Laser Eye Surgery.
Myth: It’s cheaper to wear glasses or contacts than to get laser eye surgery.
Glasses and/or contacts need to be replaced on a continual basis due to use and wear and tear. There is the added cost of solutions, doctors visits, and the cost of problems that arise. If you spend $50 on contacts and solutions per month , the cost would be $600 per year. Factor in the $75 to see the doctor per year, and within about six years you would exceed the cost for Lasik. If you got nice glasses every year at a cost of $500-$600, you would be in the same ballpark for cost. This doesn’t even include the fact that LASIK is tax deductible, or you can use your Flex Fund or Health Savings Account to pay for it. That would give a discount for the amount of tax you would pay on that money, which could save you a third or more of the cost of the LASIK.
Myth: Vision gets worse with age, so if I get LASIK now, will I need to get it again when I am older?
It is a common misconception that vision keeps changing. Most people have had their prescription stabilize by 18, as the eye lengthens and changes shape as we physically grow and get taller. A few people who intensely read and study may have it change through their very early twenties. After this time your prescription does not change, and you would not need to re-do your LASIK just because you got older. The American Academy of Ophthalmology recommends LASIK for those 18 and older, and I have even done LASIK on those under the age of 18 if they have achieved what is believed to be their maximum height.
Myth: If I wait a few more years, LASIK may become a lot cheaper.
In this technology age we expect everything to eventually become cheaper. That is not true for LASIK, as the technology just hasn’t gotten cheaper, and in many ways it has gotten more expensive. Lasers are not less expensive, especially if the technology is up-to-date. Other equipment has actually gotten more expensive as we have added new types to ensure safety and proper analysis. Medical supplies have only gotten more expensive, and servicing for the equipment is a continuous cost. Staff is no less expensive, advertising is no less expensive, rent is no less expensive, and surgeons are definitely not less expensive! Finally, it is important to remember that you are also paying for the care before and after the surgery, not just the surgery itself. Poor measurements before the surgery are subject to the age old law of garbage-in, garbage-out. In other words, if the measurements aren’t good, and the wrong numbers are fed into the laser, the best laser and the best surgeon in the world can’t give you a good visual result. Poor post-op care can end up with patients not seeing well, having dry eyes, or even with untreated problems such as corneal flap wrinkles, infections, or epithelial ingrowth. Although there are centers that have and will continue to advertise insanely low prices, those prices are bait and switch for procedures that very few people actually qualify for. If you look at the above list of costs just mentioned, you can see what goes into LASIK, and there is no way to magically lower prices. The decreased cost has to come from somewhere, in either inferior equipment, less expensive staff, a “less expensive” surgeon, cheaper supplies, less pre and post surgical care, etc.
Myth: Astigmatism can’t be cured with laser eye surgery, so LASIK isn’t for me.
This is one of the strangest myths I have ever heard. Astigmatism has been treated with lasers for 12 years now, and since most people have some, it is commonly treated part of a LASIK procedure. In fact, I have treated some of the highest astigmatism in the world at 9 diopters of correction, which is 9-18 times what people commonly have.
Myth: Hyperopia (farsightedness) can’t be treated.
Hyperopic treatments have been around for over a decade, and the latest treatments on the Allegretto Wave Eye-Q system are by far and away the best I have ever seen with very rapid, stable results, and the ability to comfortably treat hyperopia even up to 6 diopters.
Myth: You can go blind.
I know of no patient, case study, or case report of a patient ever going blind from a LASIK procedure.
Myth: Intense physical activity can cause me to lose my LASIK flap.
Across 11 years of practice in San Diego I have done LASIK on professional athletes, police officers, firefighters, Marines, Army and Navy personnel, Navy SEALS, pilots, and uncountable numbers of amateur athletes, and I have only seen ONE case of a flap loss. This was from a firefighter during the wildfires of 2007 who walked around a fire truck into a shovel blade that cleaved his flap off. His prior Lasik had been done 4 years before, and after trauma treatment and PRK for refractive error treatment he is 20/15 (better than 20/20) in that eye. LASIK flap loss is an incredibly rare phenomenon, and as my experience has shown, a treatable one.
Myth: Presbyopia can’t be helped.
That’s the need for reading glasses for people in their 40’s and older: Approximately 70% of my practice historically has been patients in their 40’s, 50’s, 60’s, and 70’s who suffer from presbyopia, or the loss of reading vision. Loss of reading vision is like death and taxes, it happens to everyone. For many years I have done a modified, balanced, monovision for presbyopia patients that works extremely well. The technique requires extreme accuracy with the correction, and careful balancing of the refraction between the two eyes. With that great care, it works very well in the vast majority of patients that I have performed it on. In fact, it is something that I trust enough that my parents, family members, and many of my close friends have it! There is work being done on bifocal corrections on the cornea, but that work has been ongoing for years and some of the issues still have not been solved yet.
Myth: I can get halos at night.
With the aspheric/prolate ablation patterns being done on lasers such as the Allegretto Wave Eye-Q, halos are no longer a significant issue. In fact, that Allegretto has specifically been approved by the FDA to decrease the incidence of halos post-LASIK. The few cases where patients have halo issues usually can be fixed due to refraction or dry issues. Halos have ceased to be a significant concern in my practice.
Myth: Technology is still getting better so I should wait.
The best visual results come from aspheric/prolate corneal ablations, which create a very natural cornea post-LASIK. I was one of the first in the country to do prolate corneal ablations in late 2002, and my results have been excellent for many years. The Allegretto is faster and more accurate, and has even bettered my visual results. Technology for most patients has plateaued, and change now is slow and incremental. For the vast majority of patients the technology and visual results have not changed significantly for a number of years, and I don’t expect things to change in any significant way for years to come.
Myth: LASIK is still really new, the long term outcomes are not known.
LASIK has been around for almost 20 years now, the use of excimer lasers on corneas has been around for over 20 years, the idea of making a flap in a cornea has been around for over 40 years. The long term data has been stable, and exhaustively followed. LASIK is no longer new, and has become a very mature procedure especially with the newest lasers such as the Allegretto.
Myth: I had LASIK, but it didn’t come out right, and now nothing can be done.
I have been repairing prior LASIK procedures and complications for about 9 years now. I am one of the few who chooses to accept these patients, and I firmly believe it is usually a cause of poor surgical technique, poor pre-op measurements, poor post-op care, or poor patient selection. These are all issues that can be addressed, and very commonly fixed. I believe that my work with repairing these procedures has led me to avoid many such issues in my own practice. When I hear LASIK “horror stories,” I now often have a pretty good idea of the diagnosis and the required treatment just by hearing their complaints even before examining them.
Myth: LASIK doesn’t last, I will have to get it every five or ten years.
This is simply not true. In my eleven years of performing refractive surgery in San Diego, less than 1 percent of patients have ever needed any further correction after my normal one year of post-operative follow-up. Often, patients who need their LASIK re-done did not have it done properly in the first place, and their visual difficulties bother them more and more as they get older.
Myth: I’ve been told I am not a candidate.
Many patients who were told they were not candidates are now candidates through the advancement in technology over the past several years, the use of prolate corneal ablations, the use of thin flap LASIK, the use of specialized techniques for extremely high corrections, and the use of advanced procedures such as Epi-LASIK and hybrid Lasik/PRK combinations. I have seen many patients who had previously been told they were not candidates who have done extremely well with laser eye surgery.
Myth: If I get monovision (for those people who need reading glasses), I will have to close one eye or the other to see distance and reading.
With the balanced, modified monovision technique that I perform, patients absolutely do not close one eye or the other. This technique works best with both eyes open, taking advantage of the fact that the brain prefers one eye over the other for distance vision. That is why we all have a dominant eye – we look through a telescope, shoot a gun, aim something consistently with the same eye. Using this system, the brain gets a clear distance image from the dominant, fully corrected eye, peripheral vision from the reading eye, and uses the information from the reading eye when looking at things up close. It’s important to remember that the eyes just gather light, and it’s the brain that actually sees.
Myth: If I get LASIK I am going to need reading glasses.
The need for reading glasses is purely dependent on age, and has nothing to do with getting LASIK. If LASIK is properly done it will not have any impact on either your need/non-need for reading glasses or at what age you will need them. As discussed elsewhere, when reading glasses are needed this can also be compensated for with LASIK.
Myth: My eyes are really dry with contact lenses, and I’m afraid LASIK will make them drier.
Many people who have “dry” eyes with contact lenses actually have constant irritation from the contacts rather than true dry eye. When treated with LASIK, they actually have less dry eye and do better than they did with contacts.
Myth: I will have to use artificial tears for the rest of my life.
Dry eyes are something that can happen temporarily post-LASIK, but as the cornea heals the amount of tears made increases again. If there is any issue, treatment with a course of Restasis is extremely effective. For those patients that have dry eyes ahead of time, treatment with Restasis and punctual plugs is extremely effective. Patients may like the feel of artificial tears and use them long term, but virtually all dry issues post-LASIK can be treated so the use of artificial tears long-term is not a necessity.