Recent encouraging news about the long term results of lasik surgery will no doubt please the 1.4 million Americans who elected to have Lasik vision correction surgery last year.
The Food & Drug Administration (FDA) is still cautious; it believes that laser companies have not yet presented enough evidence to enable final conclusions about the effectiveness or the safety of enhancement surgery.
However, the recent news is encouraging. The American Academy of Ophthalmology was told at its annual meeting in November 2006 a follow-up study of people who had undergone lasik and PRK (photorefractive keratotomy)10 years earlier was very positive.
The researchers found that while there had been some regression, on average patients had maintained 20/25 vision.
A 2005 Irish study of patients who had had lasik surgery in 1998 and 1999 was also positive. There had been some regression, but surgeons had been able to correct eye defects with a great deal of accuracy, and there was a high level of patient satisfaction.
The popularity of the lasik option for people who depend on eyeglasses or contacts therefore appears to be well-founded, and the results can often be dramatic.
Some 95 % of all patients report improved vision almost immediately. Quite often eyesight improves to 20/40 or better.
The first modern Lasik surgery was performed in America in 1991, so many surgeons now have nearly 20 years experience, and equipment and techniques are continuously improving.
Still, the FDA is cautious. Its website notes that "Long-term data is not available. Lasik is a relatively new technology. The first laser was approved for Lasik eye surgery in 1998. Therefore, the long-term safety and effectiveness of Lasik surgery is not known."
Lasik surgeons agree, and caution that lasik is surgery, and therefore some risk.
The FDA list of potential problems is sobering:
Some patients lose lines of vision (on the eye chart) that cannot be corrected with glasses, contact lenses or further surgery;
Some patients have troubling side effects that can include glare, halos or double-vision. Situations of low contrast, such as driving in fog or at night, can become a real problem for those who lose some visual acuity ("sharpness"), even if they have 20/20 vision;
Patients may be over- or under-treated, which may require further surgery, called enhancements, to correct;
Patients may develop severe "dry eye" problems;
Results are generally not as good in patients with very large refractive errors - although this is an issue that most surgeons will highlight at the very first examination, and will probably recommend against lasik in such circumstances.
The FDA is worried that the benefits of improved vision may not be permanent. While the recent studies support the view that there may be a gradual regression, but it does appear to be just that - gradual.
There is always the possibility that even with the surgery, a patient may still need to wear glasses; this will be particularly true of older patients.
On balance, therefore, the new findings suggest that as long as you have investigated the issues properly, you have chosen your surgeon carefully, you understand the potential side effects, and you are a good candidate, you can count on achieving good lasik long term results.
By: Darrell Van Zyl -