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Having Lasik, any last minute advice?(10 posts)

Having Lasik, any last minute advice?thdrk1
May 8, 2002 7:32 AM
Monday morning I will be having my eye exam for Lasik eye surgery, Thursday night if all goes well I am schedueld for surgery.
Like most people I am a little apprehensive about what could go wrong, not so much the surgery itself. I would like to hear from anyone who could convince me I am doing the right thing. I have already searched past topics on RBR and of course the web, but now I have taken the first step towards the surgery and want some final thoughts.
My reason for Lasik is mostly sports related. I live in Florida and sunglasses are a requirment and it would be nice to wear normal sunglasses and take them off inside. I have been one of those dorks walking around with sunglasses on inside so I could actually see.

Thanks for any help.

P.S. Vital statistics:

Age- 39

Height- 6'1"

Weight- 175

Profession-Youth Activities Manager (Teacher)

Past surgeries- 5 ACL on right knee

Cycle- 4-5 times a week average 15 miles a day (rehab)

Workout- everyday, alternate knee or upper body on Vitacourse

Bikes- Cannondale Cad5, 8 spd Campy. Colnago C-40, Dura Ace.
Yeti ARC, XT, Zokes. And many others which I am selling.

Other interest- Camping, hiking, rock climbing, travel, cooking, and wrenching.
re: Having Lasik, any last minute advice?gregario
May 8, 2002 7:41 AM
i was thinking about it too but decided against it.

go to www.surgicaleyes.com
Medscape update today with an article related to LASIK (long)brider
May 8, 2002 7:52 AM
here's the Summary:

From
Ophthalmology
April 2002 (Volume 109, Number 4)

Steroid-Induced Glaucoma After Laser in Situ Keratomileusis Associated With Interface Fluid
Hamilton DR, Manche EE, Rich LF, Maloney RK
Ophthalmology. 2002;109(4):659-665

Laser in situ keratomileusis (LASIK) has become an increasingly popular procedure in refractive surgery. As the number of procedures performed has increased, so too has the number of complications. Complications of LASIK have included those related to formation of the flap of epithelium and corneal stroma, as well as free flaps, irregularities in flap structure, epithelial ingrowth within the interface of the flap and ablated corneal bed, and infection. The authors of this study reported a series of patients who developed fluid within the interface in association with a steroid-induced rise in intraocular pressure (IOP) after LASIK.
Four patients, ranging in age from 19-58 years, were reported in this retrospective study. They all underwent LASIK to correct myopia. One patient had a history of chronic open-angle glaucoma. All 4 patients developed diffuse lamellar keratitis (DLK) and were treated with frequent (every 2 hours or more) topical steroids, and 1 patient was treated with oral steroids. All of the affected eyes developed fluid between the flap and the remaining stromal bed. Three of 4 patients developed progressive optic neuropathy and visual field defects despite normal IOP measurements. However, when the IOP was measured outside of the area of the flap, markedly elevated IOP was noted. The fourth patient, who had similar findings on slit lamp examination, required trabeculectomy in each eye for persistently elevated IOP.

The authors suggested that the fluid results from forward migration of aqueous through the stroma, which is driven by elevated IOP. In each patient in this study, Goldmann tonometry yielded falsely low IOP measurements. The authors suggested that the falsely low readings, which were confirmed by measurement of the IOP using the peripheral cornea, resulted from fluid within the interface.

Although there was no definite proof, the authors hypothesized that the interface fluid may be misdiagnosed as inflammation, contributing to a greater likelihood of steroid-induced glaucoma.

In the discussion, the authors highlighted 4 features that may be helpful in the diagnosis of fluid within the interface in patients undergoing LASIK:

Markedly low IOP postoperatively, which should prompt reassessment of the IOP using the peripheral cornea;

Clinical course of DLK, which tends to occur early on, and often responds days after beginning topical corticosteroids;

Steeping on corneal topography, seen in eyes within this series; and

Microcystic edema, a clue of elevated IOP. RF

Abstract:

Steroid-induced glaucoma after laser in situ keratomileusis associated with interface fluid
David Rex Hamilton, MD, MS1, Edward E. Manche, MD2, Larry F. Rich, MD3 and Robert K. Maloney, MD, MA, (Oxon)*4
1 Jules Stein Eye Institute, University of California, Los Angeles, California
2 Department of Ophthalmology, Stanford Hospital and Clinics, Palo Alto, California
3 Casey Eye Institute, Oregon Health Sciences University, Portland, Oregon
4 Maloney-Seibel Vision Institute, Los Angeles, California

* Reprint requests to Robert K. Maloney, MD, MA (Oxon), Maloney-Seibel Vision Institute, 10921 Wilshire Boulevard, Suite 900, Los Angeles, California 90024 USA

PURPOSE: To report the ocular manifestations and clinical course of eyes developing interface fluid after laser in situ keratomileusis (LASIK) surgery from a steroid-induced rise in intraocular pressure.

DESIGN: Retrospective, noncomparative interventional case series.

PARTICIPANTS/INTERVENTION: We examined six eyes of four patients who had diffuse lamellar keratitis develop after uneventful myopic LASIK surgery and were treated with topical corticosteroids.

PRINCIPAL OUTCOME MEASURE
Going to let them shoot me with a laser this Friday.Mike P
May 8, 2002 8:27 AM
I am having LASIK on both eyes this Friday morning. I have seen a couple of vidoes of the actual operation, talked to 10 or so people who have had the procedure (all happy with result, no complications), and have talked to the surgery staff, and I was comfortable with the possible complications until I had to sign the waver. That made me worry. I'm still getting it done. I'm tired of glasses and I'm tired of contacts and all that crap.

Make sure the doctor performing the operation has completed 300 or so procedures on the specific type of laser being used on you.

See ya! (I hope I can see, anyway),
Mike
Don't blink! ;-b (nm)grzy
May 8, 2002 8:28 AM
re: Having Lasik, any last minute advice?feathers mcgraw
May 8, 2002 9:11 AM
I had it done without doing much research. I had a good referral and just went ahead 'cause I really wanted it. The only negative from the operation is that my vision can get cloudy if my eyes dry out, which is only if I ride for 4+ hours, and it doesn't happen every time. If this happens at twilight it can be scary as the streetlights and headlights can make it hard to see, and it's usually the time when I'm worn out and just trying to survive and get home. I also play a lot of tennis, and it's been really great for that. The operation is a cinch even though it can be a bit uncomfortable and of course, a bit scary. Try to relax and enjoy the psychedelic things you'll see when the eyeball gets manipulated.
re: Having Lasik, any last minute advice?turtlemoye
May 8, 2002 9:31 AM
My mother and brother in law both had it and have had no problems. As soon as I can afford it I plan on having it as well. With cycling, surfing, swiming and everything else active I am tired of dealing with glasses and contacts.

Good luck and let us know how you recover.

--Turtle
DO NOT MESS WITH YOUR EYES!!!!!Lazywriter
May 8, 2002 3:00 PM
As the guy stated, he had the surgery and when his eyes dry out his vision gets cloudy. To mw that is not a little side effect. When it comes to your vision, there should be NO COMPROMISES. I work in geriatrics and I speak with my physician friends all the time and very few if any doctors I know actually had the surgery.
Long term studies are obviously not available and they don't know what effect this procedure will have on the aging eye. Even if you go to a reputable doctor, you can get the halos and cloudiness. You don't know how your eye will react.
If you needed work on you eyes to save your vision, go ahead. But for pure vanity or conveinence, IT IS NOT WORTH THE RISK.
re: Having Lasik, any last minute advice?thdrk1
May 8, 2002 6:22 PM
Thank you for the insights.
Mike P if you are able to report on your surgery I would like to hear about it.
I will post an update on whether or not I had the surgery and how well it went. I have given this thought for many years and would generally advise people not to have elective surgery, especially to the eyes. The circumstances change though when you are put in that situation.
My 5th knee operation was necessary to enable me to continue cycling and climbing, however I could still walk without the surgery. If I had a sedentary lifestyle I would have been fine, but I just would like to get the most performance out of my aging body as I can.

thdrk1
Yeah, but these are your EYES.Lazywriter
May 8, 2002 6:49 PM
You can correct your vision via glasses or contacts. Knee surgery is often a more necessary operation. But your vision is moe precious than just about everything else. Think about it. Every aspect of your life would be adversely affected if your surgery goes awry.
I had a sinus operation because I had such a bad infection that it ate the membrane in the back of my sinuses and could have caused a brain infection. That is necessary and worht the risk. LASIK is not necessary and therefore not worth the risk of seeing halos and trailers and sunbursts. Fu(k that. You may not have any complications and that is great, but there are a lot of people that have had problems.