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Pros and Cons for Lasik with IntraLase

Those who have had a Lasik technique done, and those who are investigating having a Lasik vision correction procedure, know that the first step of that procedure is to create a small flap in order for the Lasik physician to reshape the cornea.  This flap is created by the surgeon, and can be done using a small blade or using a laser.  Using the laser is generally called a bladeless Lasik procedure, or IntraLasik, or IntraLase.

For those that are considering a Lasik procedure, this review should be helpful in order to determine the pros and cons of the Lasik procedure using IntraLase.  One comment to be made is that the risks and complications possible using the small blade are well known and documented, since that procedure has been done for years and has a database of millions of patients.

Granted, 90% or more of all Lasik patients have no serious side effects or even minor lasting side effects, but it is true that a large part of the complications from Lasik procedures stem from the flap made with the microkeratome blade.  Over the years additional techniques have been developed to further minimize such problems from the standard Lasik procedure.

The introduction of the laser to create the flap is a new frontier in the Lasik procedure.  The laser is used in combination with state of the art software to create a flap of a pre-programmed size at a specific depth and position.  During this process, a soft suction ring holds the eye in place, but this causes no discomfort to the Lasik client.  Generally the only effect noticed by most Lasik patients is a dimming of vision in the eye being worked on for the duration of the treatment of that eye.

The use of the laser creates very small bubbles of water and carbon dioxide that serve as a good buffer between the flap and the cornea itself, and so this Lasik procedure conserves the eye very carefully.  The whole process of creating a flap for one eye takes approximately one minute.

The advantages of using a laser to make the flap for the Lasik vision correction procedure is that there is no way that the cornea can be abraded, nor any chance of the wrong size or depth of flap, since it is all pre-programmed with Lasik software.  The exact vertical edges of the flap produced using this Lasik procedure help healing, and also decrease the possibility that the flap might slip or wrinkle if the eye is accidentally bumped or rubbed during the healing process.

There are very few cons to using a laser to create the flap during a Lasik procedure.  One is that the process takes a bit longer, up to a minute.  A second reason is that the low level suction during this phase of the Lasik operation does result in eye redness for about 5% of the patients, but this goes away within a few days.  The last reason is that there is still a difference in cost between intralase eye surgery and the traditional Lasik eye surgery, but hopefully that will decrease as the years progress.

Questions about Lasik eye surgery

Many people that wear glasses or contact lenses have listened to the claims of how Lasik can give them perfect vision.  They have also heard great Lasik success stories, as well as stories from people that were not sure they had given the decision enough thought.  This guide lists the most common questions asked by people who are considering Lasik vision correction, and answers given by reputable physicians.

The first and most important question asked about Lasik is, not surprisingly, “Is Lasik safe?”  The answer is that it is normally quite a safe procedure, with success rates above 95 percent for good, experienced Lasik surgeons, and 90 percent average over all physicians that perform the Lasik procedure.  This statistic about Lasik success assumes that the patient is a good candidate for Lasik surgery.  The requirements have some specific details and should be gone over with the physician that will perform the Lasik procedure.

It is a very good idea to ask the Lasik physician which patients he has declined to perform the Lasik procedure on, to make sure that the particular physician has and operates with good standards.  Any Lasik practitioner that tries to imply that everyone that comes in to his office is a good candidate for Lasik vision correction should be viewed with some skepticism.  In any case, it is wise to interview several different physicians that perform the Lasik procedure before deciding on one.

A second frequently asked question about Lasik is “What are the possible complications from Lasik surgery?”  Common side effects are starbursts or halos when looking at a light, sensitivity to light and difficulty with glare and night vision, and some sensation that a foreign body is in the eye.  Most of these effects will pass within a few days after the Lasik procedure.  Between 1 and 3 percent of patients will have a lasting side effect such as halos or some vision fluctuation.

It is a very good idea to discuss your particular situation with the Lasik physician to determine if you might be prone to any complications.  There are also variants of the standard Lasik procedure, one of which uses additional waveforms to map out an individual eye, or techniques that only use lasers rather than a scalpel and a laser.

One question we all hesitate to ask is “Will the Lasik procedure be painful?”  Since our eyes are one of the most sensitive parts of our bodies, it is comforting to know that having Lasik vision correction is usually nearly painless.  There is often some mild discomfort after the procedure, but this is effectively controlled with medication.

“Will I have 20/20 vision once the Lasik correction is done?”  Though many patients do get nearly perfect vision, not all patients have their vision totally corrected.  You can definitely expect to have improved vision and minimized dependency on any glasses or contacts.

“What is the cost and how do I pay?”  A typical Lasik surgeon charges between $500 and $2500 per eye, depending on the patient and the surgeon.  However, a Lasik physician should be selected on experience level and track record, not on the lowest price.  Insurance rarely covers the cost of Lasik, but many Lasik centers have a type of financing program offered to their clients.

Consider Lasik eye surgery as one way to significantly improve the quality of your life.

Lasik Eye Surgery or ICL?

A number of people who are considering the Lasik procedure to correct their nearsightedness or farsightedness have of some potential problems of Lasik, and are wondering if there are other options.  Though more than 95 percent of the Lasik patients have a very successful procedure without any major side effects, there are choices for people who wish to improve their vision.  Let’s compare two, and discuss these choices with a reputable ophthalmologist.

Traditional Lasik surgery uses a scalpel to create a small flap in the eye, and then a laser reshapes the eye in order to focus accurately.  There are two more recent forms of Lasik, one that entirely uses a laser and does away with the scalpel.  Another variation uses a three dimension waveform for people with unusual eye shapes, and both of these are worth discussing with your ophthalmologist.

Those people with very thin corneas or other issues that make Lasik not a good candidate for their particular case can consider implantable contact lens surgery.  This is known as ICL in the eye surgeon’s lingo, and is a good alternative to Lasik to permanently correct vision.  These lenses function in exactly the same way as removable lenses, except that they remain permanently in the eye.  Like Lasik, they reshape the eye in order for it to focus accurately.  The patient will not feel the lens once the operation has been performed.

Lasik and ICL are similar in several ways.  Lasik can improve vision affected by nearsightedness and astigmatism, and ICL can improve these vision deficiencies also.  Both Lasik and ICL also have some of the same risks, one of these being that the correction is not accurate after the first operation is done.  Lasik is a much more frequently performed procedure, and less than 3 percent (according to the FDA) of these patients need to undergo additional surgery to further correct vision after the first Lasik procedure is done.

Like any operation, there is a chance of infection in either a Lasik procedure or an ICL operation.  Good post-operative care by the patient will minimize this and regular checkups at the Lasik or eye care center will nearly always clear this up without further complication.  In a small percentage of the cases, either Lasik or ICL patients may not achieve perfect vision and may need to continue to wear corrective eyewear, though usually not at the same strength as the original eyewear.

One advantage of ICL over Lasik is that ICL is a reversible procedure, where the implanted lens can be removed later if that becomes necessary.  Lasik involves the reshaping of the cornea to bring objects accurately into focus, and is permanent.  However, for a typical, healthy patient either Lasik eye surgery or ICL will generally bring about the desired improvement in vision.

Lasik is generally a less invasive procedure, and this is reflected in the current cost of the operation.  The current price for a Lasik procedure is between $500 and $2500 per eye, depending on the type of procedure and the presiding physician.  A typical price for ICL is between $1500 and $3000 per eye.  Do some investigation into the options offered, and select the eye care procedure that is best for your personal case.

Solving a Lasik Post Op Problem

I had Lasik vision correction surgery two years ago, and am quite glad I did.  I think that my Lasik story might be helpful to some that consider that they might not be a perfect Lasik client, and are concerned about side effects after the Lasik procedure.  I did have a significant side effect after my Lasik operation, but have weathered it well, and still recommend the operation highly.

My operation went exactly as described, with no pain or real discomfort at all.  My Lasik physician was clear, stating each step that he completed so that I would know the Lasik procedure was proceeding as expected, and more quickly than I had imagined.  I know that all of the discussion I had earlier with the Lasik professionals stated the operation generally took less than twenty minutes, but I was still surprised.  

At the end of the operation, my Lasik doctor replaced the flap to its correct position in my eye and covered it with some kind of clear goop.  Even at that time I could notice a distinct improvement in my vision.  I was instructed to wear goggles over my eyes for five nights in order to prevent me rubbing my eyes while I was sleeping.  I guess they assumed that any good Lasik patient would not do that when awake.  

In addition, I followed all post-op Lasik procedure instruction to the letter.  I slept immediately after the Lasik procedure was done (after I made it home, of course), used the eye drops religiously, and did not try to strain my eyes by reading everything that I could.  I was amazed the immediate improvement in vision that Lasik makes, just as if there was a set of weightless contact lenses.  Very impressive.

My biggest problem in Lasik procedure recovery was a result of epithelial erosion.  The flap that is made in the eye during the Lasik procedure is made from epithelial cells.  Once the flap is replaced at the end of the Lasik procedure, these cells start to regenerate in order to fill in the line where the flap has been cut.  All of this is normal post-op Lasik healing.  However, in my case the cells would grow fine, but at night my eyes tended to dry out when I was asleep.  So, when I woke up, my eyelid would pull up some of the new cells from their place where they belonged, where if my eye was sufficiently moist they would have stayed in place.

I told this to my Lasik eye surgeon, who said this side effect just makes healing a little longer and it was not a serious side effect.  When I went for a checkup to the Lasik center (which I highly recommend any time a Lasik client has any post-op worries or questions) they decided that I needed a thicker, more jelly like version of the eye drops to use at night.  This worked well, and the rest of my post-Lasik recovery went well.  
I am a strong advocate of the Lasik vision correction procedure.  I also strongly suggest interviewing a number of positions, and do not put low cost as the highest priority.  Your eyes are very important, and a highly competent Lasik physician is the most important factor.

Talk to Your Lasik Surgeon!

For anyone considering a Lasik procedure to correct vision, it is crucial to find a physician that is reputable and caring.  It is also very important that they are experienced and knowledgeable in the Lasik procedure, and that they have a track record of patients that are happy with the treatment they received and the results that they got.

This guide gives a number of basic questions that you should ask when deciding on which Lasik center and which doctor to select for your Lasik procedure.  The comfort you have during the process, and even the results that you receive, may depend on getting good answers to these questions.  It is important to realize that the answers to these questions will vary from physician to physician.

The first question to ask is “How many years have you been performing this type of Lasik surgery?”  There are several variations of the Lasik procedure, and the doctor should have a track record of at least three years in doing Lasik procedures.  This amount of time also allows the doctor to watch his patients and the long term success of their Lasik procedures.

Next, ask the physician for the number of Lasik procedures they have performed in the last two years.  The physician should do the operation frequently enough that he is well versed in current procedures.  Also, he should be successful enough that prospective Lasik patients feel comfortable in coming to the Lasik center.  The physician should perform at least 500 Lasik surgeries in the last two years.

At this point, ask what percent of his clients that underwent Lasik surgery ended up with 20/40 vision or better.  Notice that not all patients will achieve 20/20 vision, and that is acceptable.  However, it is important that 90 percent of the patients get at least a 20/40 correction after the first Lasik procedure.  Claims of much more than 90 percent might make him seem much better, but in this case ask for evidence that that number is true.  There are some exceptional physicians out there, but also a few Lasik doctors that make unfounded claims.  Asking the doctor what percentage of Lasik patients achieve 20/20 should run about 50 percent.  Again, if the number is greatly higher, ask for evidence.

Finally, ask about post-Lasik complications.  The percentage of patients that experience complications after 6 months is complete should be 3 percent or less.  If the physician claims that complications are so rare that he doesn’t keep records, you should be very suspicious and ask for evidence, if any.  No doctor is perfect.  Similarly, when asked the percentage of patients that require an additional operation to achieve clear vision, the number should be less than 10 percent.

To wrap up the interview, ask the physician what types of Lasik procedures he recommends and practices, and under what circumstances he denied a Lasik procedure to a patient.  Not all vision challenged people are good candidates for a Lasik operation, and the doctor should at least have a few examples of people he dissuaded from the operation.

Finally, ask about the cost of the operation and if financing plans are available through the Lasik center.  A physician that is willing to sit down and discuss these questions is often a physician that will address any other medical issues that come up, and is a good prospect to perform your Lasik procedure.