Eye Surgery - Am I Qualified To Have It?
That's one of the first questions most people ask
about refractive surgery. What they really want to know is: Will I
be happy with my eyesight after my operation? Unfortunately, there
is no simple formula to determine answers to these questions.
Although general guidelines help eye doctors decide who might
benefit from refractive surgery, each candidate must be carefully
reviewed on a case-by-case basis. That is why you go to your eye
doctor for individualized care and advice. Every operation must be
considered in terms of a benefit-to-risk ratio for that specific
patient. With elective surgery, it always pays to be conservative.
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Figuring out if you might be a good candidate
for refractive surgery is as much an art as a science. How
will your doctor decide if you will be happy with your
outcome?
The process is inexact. Looking for people with
reasonable expectations, eye doctors try to screen out
patients who expect perfect results. Of course, what the
laser does is science. With excimer laser surgery, your
doctor enters a specific set of numbers into the laser's
computer, and the software executes the instructions that
control the laser pulses. But how does your doctor decide
what numbers should be put in the computer? He must consider
how your age will affect your wound-healing response and
also must enter data in the computer that will produce a
result that will work for your individual eyes and
lifestyle. It takes long experience talking with many
patients before and after each type of procedure to do this
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Your doctor will want to know if you are happy with your
eyesight with contact lenses. If you are, then the physician
can attempt to duplicate your prescription with laser
surgery. If you are thrilled with your vision with contact
lenses that undercorrect your nearsightedness, your doctor
can be more conservative in programming your surgical
refraction.
In other words, by targeting your correction at
slightly under 20/20 in the distance, the risk of making you
farsighted or overcorrecting you can be diminished. After
discussing your personal expectations, your job, and your
hobbies - and studying your eye examination and history - your
surgeon must pick the exact numbers to put in the computer that,
along with your healing response, will determine your future
vision. This is the art of vision correction surgery.
Successful eye surgeons want to match your expectations to what
they can deliver. Doctors look for indications that patients are
highly motivated to improve their vision. Striving to operate on
people who will be pleased with their outcomes, ophthalmologists
should avoid performing surgery on anyone who expresses major
doubts about a procedure. After years of observing patients'
reactions to refractive surgery, physicians who specialize in
this field start to develop a "sixth sense" about who will be
happy with the results. But no matter how long surgeons have
performed laser surgery, they continue to learn more from their
patients. Such invaluable experience helps doctors identify
people who should avoid having these elective procedures.
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The range or degree of your refractive error
is a key consideration in determining whether you are a good
surgery candidate. Your physician will measure your
corrected and uncorrected visual acuity. If you are
nearsighted, can you read the 20/30 line on the eye chart?
Or do you strain to see the big E (about 20/400 on some
charts)? Generally, the higher the correction, the greater
the motivation to have a laser operation.
LASIK surgery, unlike radial keratotomy (the older,
non-laser operation), can improve a wide range of refractive
errors, including farsightedness. Nearsighted persons
currently can be treated if their refraction is between -1
and -12 diopters - sometimes, depending on the individual
case, up to -14 diopters. Although extremely myopic people
need help the most, LASIK can leave some of these patients
with an unacceptable amount of residual error, meaning that
they still will need glasses for distance. |
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So if your correction is greater than -14 diopters, you may want to
wait until medical technology has more to offer you. LASIK
could improve your vision, but you probably still would have
to wear corrective lenses after surgery.
Years ago, in doing refractive surgery before the modern LASIK
technique was available, doctors often had to tell extremely
near-sighted patients, "We're sorry. You're not a candidate. We can
only make your vision about 50 percent better." Some people would
respond, "I'll take it! I would like to have thinner glasses. I want
to be less helpless without correction." They had reasons for
seeking even a partial improvement in their eyesight. For them,
better was better, whether better was perfect or not. Other patients
would say, "Well. if you only can make my eyesight 50 percent
better, why bother having surgery? I would still have to wear
glasses even though they would be thinner." For these patients, not
having a refractive operation would be the correct choice. |
