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Laser Eye Surgery, Revisited 10 Years Later
gunner_von_diamond (3461783) happened upon Ask Slashdot: Experiences with Laser Eye Surgery from ten years ago, and asks: I was just reading a story on /. from 10 years ago about Lasik Eye Surgery. Personally, I've had Lasik done and loved every single part of the surgery. I went from wearing contacts/glasses every day to having 20/15 vision! In the older post, everyone seemed to be cautious about it, waiting for technical advances before having the surgery. Today, the surgery is fairly inexpensive [even for a programmer :) ], takes about 10-15 minutes, and I recovered from the surgery that same day. So my question is: what is holding everyone else back from freeing themselves from contacts and glasses?
Given that I have a few telescopes and I have been stargazing for ~30 years, I really value my night sight. Knowing that the majority of the laser surgeries have a significant proportion of post-operation aberrations that would directly affect my stargazing abilities is a real hindrance to my taking up the eye surgery.
Halos and diffraction spikes around bright objects, increased glare at night, are all relatively common issues to be dealt with afterwards. Most people aren't bothered by this as they rarely come across the situations where these aberrations would show up (exception being night-time driving).
If the surgeries were able to correct higher-order aberrations and a proper wavefront restoration across a portion of the eye that would be larger than the relaxed iris, then it might be a possibility for me. However, the tech is not yet mature for this, for my use cases.
- This sig deliberately left blank. Nothing to see, move along.
Maybe it's just silly, but I'm really scared of someone shooting a laser into my eye. I don't want to be that 0.01% of cases that has something horrible happen.
I can get glasses that last for 5+ years for a couple hundred dollars, vs. lots more for surgery with its inherent risks. My glasses are generally only annoying when I work outside & get sweaty.
Hail Eris, full of mischief...
E pluribus sanguinem
...my astigmatism is too great for lasik.
It is better to be the hammer than the anvil.
My eyes don't line up in the exact same place when I look at things. I had surgery when I was 15 to correct it, after 20 years, it's coming back a little (although to a much less significant degree). Fortunately, it's small enough that I can use lenses to correct it - I have to wear bifocals now - but that also means that Lasik will never work for me to improve my vision. I could have better than perfect vision in each eye and I'd still need corrective lenses. :|
Give a man a fire and he'll be warm for a day. But light a man on fire and he'll be warm for the rest of his life.
I don't have enough material in my cornea. If they mess it up, there's not much they can do for adjustments.
As long as your eyeball remains parabolic, they can correct your vision more or less indefinetly assuming there's no other issues going on. Once you get lasik, your cornea becomes flattened so they can't really correct stuff with optics so well anymore.
I'd rather be safe and be able to have my vision correctable by contacts and glasses than take a chance at having really terrible vision that is then uncorrectable.
I feel like that's something people need to be made more aware of - lasik flattens your cornea so corrective lenses won't really work as well.
my gf got it about 7-8 years ago and is very annoyed that it has 'worn out' (of course that's just macular degeneration or whatever) and assuming it could be done again it would still cost her another few thousand
I don't know if they didn't know how long the Lasik would last, but they certainly didn't tell her that it could wear off in less than a decade....
So now she has gone back to wearing glasses, which are covered by healthcare
-I'm just sayin'
I'm not a candidate because my eyes never stop changing. So if I had it, in a year or two I'd just need glasses again.
When the figure out a way to "stabilize" the eye itself, or whatever's affecting things, then great. But until then, glasses/contacts for me.
I have keratoconus, which means it can't be done, otherwise I would have jumped on board a long time ago.
There is actually a treatment available for it, which Europe has been doing since 1998 with great results (something like 90% of their patients see improved eyesight with 9% having progression of the disease stopped, and 1% experiencing any negative effects which usually are temporary,) but our glorious FDA overlords still won't approve of the operation in the US. Meanwhile those who do have the disease eventually progress to blindness and require a cornea transplant. There's even a pharma company with big pockets (Avedro) who is trying to push for FDA approval, but even they can't get them to budge.
Yeah, that probably explains the vast majority of the cases.
Plain old fear and nothing more. My contacts are rarely a hassle and I've been told that I look really good in my glasses, so I'm loathe to do anything to my eye that could harm it in any way. I still wonder what the long term (30 years+) consequences are and if a better procedure will eventually be developed. Until I can't wear my contacts anymore, I'm inclined to wait.
The thing that's holding me back is what are the long term effects? The technology really hasn't been around for a long time. I'm in my early 30s; I could maybe live for another 50 years! What will be the effects when I'm in my 80s?
I've heard that people who get the surgery may need to have it redone in 10-15 years. What happens after the 3rd or 4th redo? Can one even see? Are there other potential sideeffects?
That's really the only thing holding me back. My vision, present and future, is too important to risk. Glasses get the job done just fine.
-"Those who fought today will die tommorow."-
I'm missing part of a finger, but I can manage.
I could live with a limp.
But eyesight is a pretty big gamble. Yeah its small. But still higher than lottery.
That's why I opted for orthokeratology. I put my lens for one night, once every 7-ish days, and have 30/20 vision for the first 24h and then 20/20 for the rest of the week.
In Britain the DVLA are looking at their policies.
Drivers who have had eye surgery are generally marked as never requiring corrective lenses. But the DVLA have found numerous instances of drivers eyesight falling below minimum standards after laser eye surgery.
This laser eye surgery is not, in all people at least, permanent.
Obviously, in the DVLA's case, their answer is "We don't care... if you're below minimum standard - whatever the reason - you need to report it to us and wear some kind of corrective lens until you can prove otherwise". Which is sensible.
As a glasses wearer all my life, my eyes have stabilised. But laser-eye surgery is not only vastly oversold by marketers posing as doctors, but also not permanent. I could spend several thousand pounds and risk my eyesight (no surgery is without risk) in order to get out of a habit I've been in for the last 20 years that doesn't actually affect my life often at all (my prescription is unchanged for 10+ years, I've had the same three sets of glasses - including sunglasses - for 10+ years, I rarely break things like that, and the microsecond it takes to put them on in the morning and take them off at night is negligible).
That's why.
He had Lasik and they messed up, but it was partly due to a pre-existing issue he had with his eyes. Now he has to take some medicine & eye drops every day.
Taking guns away from the 99% gives the 1% 100% of the power.
Mostly because as a general technical rule I don't trust my balls with private institutions unless they're highly regulated
If you go in for Lasik but they end up operating on your balls, I think there's a real problem there.
That's how a friend's father, an eye surgeon, put it.
It doesn't always go right, and (yes, rarely) it goes very wrong. There are no take-backs with the laser surgeries.
If you must, do the surgery that is reversible - they insert a small piece of plastic that corrects the lens shape.
Please help metamoderate.
Yes, the older cheaper version of lasik did result in halos and star bursts at night, however for many years now the newer version of lasik does correct for higher order aberrations. I believe it is called 3d wavefront technology. They perform a 3d scan of the eye prior to the surgery and thus can correct for higher order aberrations. The older and significantly cheaper lasik was only a 2d scan. I had lasik done with the newer technology 8 years ago and still have 20/10 vision with no degradation thus far and no post operation issues. I'm fairly certain the percentage of people who have post operation problems is at most a few percent.
I Lasik on both my eyes 7 years ago, and it was the best $4000 I ever spent. Went from 20/50 and 20/200 to 20/15 and it hasn't changed since. My big concern was dry eyes. Mine were dry frequently at first but after about 6 months it went away and now it's like I had good vision from the start, I don't have to take any extra care than average. I don't have any haloes or night vision problems either. Sometimes at night I still marvel at how crisp all the neon lights look from a distance.
My advice on the whole thing:
1 - Don't cheap out, you only have 2 eyes. Go to the best place in town. They offered a "custom wavefront" option for a few hundred more, basically it was a better/more automated scanning technique that helped customize the procedure for my eyes and I went for it. The procedure I had used a laser to cut the corneal flap and I think the entire thing was automated, the doctor just verified everything and then hit "go".
2 - Follow all their instructions to the letter and beyond. I wore the night goggle things twice as long as they said to and was religious about taking the different eyedrops, not swimming, not touching my eyes, etc etc. I didn't rub my eyes for 18 months but now I do whenever I feel like it. I wear safety glasses when I'm doing woodworking but the occasional chip still sneaks in there and it doesn't cause any more problems than normal. Anyway I didn't have a single hint of a complication and I think following the directions went a long ways towards achieving those results.
3 - Wait until your prescription doesn't change for a few years before getting lasik. I had to wait until my mid 20's.
My contacts cost me $70 for a one year supply. That's about thirty years in comparison. If my contacts become micro-scratched, I throw them away. If lasik gives me halos, I'm screwed. No contest.
If you go in for Lasik but they end up operating on your balls, I think there's a real problem there.
That's why not Zoidberg. That right there.
the preceding comment is my own and in no way reflects the opinion of the Joint Chiefs of Staff
I had it done about 11 years ago. The day after I had it done, one of the flaps came loose (left eye) and I had to go back to have it re-seated. Then the day after that it came loose again, so I had to have it reseated (again). The day after that it came loose AGAIN, so they put a contact on it and left it there over the weekend, and even after all that, one of the edges of the flap became wrinkled, which makes that eye see more blurry in low-light conditions.
About a month later, my right eye had a sharp pain, so I went to the doc who said nothing was wrong. For the next 6-8 months, I had vision in my right eye that was torqued and weird looking, giving me massive headaches. I went back for a checkup at that point, where they said the edge of the flap on my right eye had come loose, and cells from the surface of that eye had grown under the flap. So we scheduled another appointment, where they lifted that flap, cleaned it out, and put it back. It has stayed in place since then, but there have been other effects:
I can't get less than about 7 hours of sleep per night for longer than a few nights in a row, otherwise my right eye dries out and gets blurry and the headaches come back, I can't sleep on my front because my eyes dry out and I can't see, I can't rub my eyes hard, night vision is significantly worse than day. For about 4 years after the re-seat on the right eye, I had to carry lubricating eye drops around with me all the time.
Even as I type this, my right eye is slightly dry and blurry, giving me a headache. I realize I'm in the 0.1% of people who have issues, but I wish I had just stayed with glasses/contacts. At least you can take those off or out and they don't permanently damage your eyes.
7. Every opthamalogist that I know hasn't had Lasik done on themselves, they still wear glasses.
Have a Day!
I have a condition called Keratoconus, a weakening of the structure of the cornea. I cannot have LASIK done. Unfortunately this condition is often asymptomatic until you are in your 20's, for some it will stay asymptomatic (correctable with glasses) but they still risk serious damage to already weakened corneas if they undergo LASIK. So have it done, sure, but please get your eyes examined by a professional beforehand.
If all else fails, immortality can always be assured by spectacular error.
Yep. My dad's an ophthalmologist, and he doesn't recommend LASIK for anyone over 30 because of this (except in a handful of unusual circumstances). You're trading off future reading vision for distance vision now, and the older you get the closer "now" becomes.
I'll gladly keep my ability to read without holding things at arm's length or putting on reading glasses for as long as possible, though admittedly my distance vision isn't that bad (I wear my contacts if I'm going to a movie or something, but I don't need to wear them for normal daily life) and I was already pushing 30 by the time LASIK really matured (about 10 years ago)
If you're, say, 26 now (so you'll get a good 14-20 years of fully corrected vision) and have terrible distance vision, LASIK may make a lot more sense.
rage, rage against the dying of the light
As many who have replied to you have already noted, they do full remapping and correct for 2nd and 3rd order abberations. It's amazing tech now. If you can, go in for the free scan where they do a 3d surface map of your eyes, the detail and resolution of the mapping machine is just pure nerd-porn, especially if you're an optics guy. I've done both eyes, and would like to share my story: I've been extremely near-sighted with astigmatism my whole life. I'm now in my late 30s, and my eyes stopped changing in any real fashion about 5 years ago -- they stabilized around -8.75 diopters of correction needed. I'd always worn disposable contacts, but hated being blind at night when they were out. When I was 5 or so, I walked into a branch that left a scar on my left cornea that previously excluded me from lasik -- UNTIL the new 3d wave mapping came out. They did have to use the blade to cut the flap on my left eye (as opposed to the ilasik cutter on the right eye), but I can now see at 20/25 out of my left eye for the first time since I was 5. Previously it was correctable to a best of 20/40. They actually almost totally removed the scar tissue automagically while at the same time corrected for the extreme nearsightedness. I'm a believer. If you are worried about the night vision effects, those are truly present in the first couple of months. Those that say they're not are the same people that don't notice the low bitrate on satellite radio.. ;)
After about a year, however, I personally have zero effects, starbursts, rings, hazing, or lack of contrast anymore. It takes a while for the lens to heal up, but it did for me.
Negatives:
I now need UV protection in the sun. I didn't realize that my contacts previously provided UV blocking, and the sun is annoying now without sunglasses.. :)
Maybe it's just silly, but I'm really scared of someone shooting a laser into my eye. I don't want to be that 0.01% of cases that has something horrible happen.
It's not silly, just very unlikely. I've had the surgery and I won't kid you that the idea of someone cutting my eye still makes me a bit squeamish even today. That said I still consider my lasik procedure to be the best money I've ever spent. One of the partners in our company had it too and feels similarly.
As with any surgery it is 100% appropriate to be cautious and ask a lot of questions. If you still are uncomfortable with the idea it's ok not to get the surgery. I'm fairly active and it helps with sports I play but if you aren't bothered by glasses and they don't cause you problems then there is no need to get the procedure.
iLASIK is done with all lasers, one to make the flap that was previously done by blade, and the usual LASIK after that. Fewer reported complications than with the older blade style. At my six month checkup I was seeing 20/10 from my left eye and 20/15 from my right. I'm 48 and previously wore progressive lenses. They adjusted my right for a closer focal distance.
It all just works, I love it.
Trolling is a art,
I had mine done around 2000, and at -10.25/-9.75 was on the limits of what could be achieved back then. The cost did mean I didn't have to wear glasses, so represented good value for money. My eyes do have a faint ghost image in low light conditions, which means whilst I can drive at night, I do have to make sure I'm alert. As I'm now 50, I'm investigating whether I can have a second minor correction.
Donte Alistair Anderson Roberts - hi son!
Karma: Chameleon
That's what you'll have to do if you have LASIK. If you don't have LASIK, you'll avoid the need for reading glasses or push it back by many years. That's kind of the point.
rage, rage against the dying of the light
Somewhere around 10-15 years back, I was in the Robonaut lab at Johnson Space Center (a friend of mine was being promoted to full colonel, and because she helped oversee the Robonaut lab, they were having Robonaut pin her insignia on her; side note: having to pin it was absolutely terrifying the operator, since Robonaut had no sense of touch, and he was petrified that he'd stab his boss with her own insignia pin). From what I could see, Robonaut's head at the time was a seamless, translucent, amber-colored, resin material that was visibly hollow on the inside. I asked one of the engineers how they managed to do that, since I wasn't aware of any manufacturing techniques to make a solid object that was both seamless and hollow. As I recall it, he basically explained something along the lines of a liquid resin bath with multiple lasers shining into it, and where they intersected, the resin hardened. Basically, a form of 3D printing using lasers.
Why do I bring that up? I bring it up to illustrate the fact that what we're doing with lasers is advancing all the time. Likewise, the hardware, software, and techniques for laser eye surgery are constantly getting better. Yet despite that, they have yet to address the fundamental source of most complications: the creation of the flap so that the laser has a surface onto which to do its work.
But Robonaut's resin head tells me that the technology should be possible to not need that flap at all. I figure it's just a matter of a few more years before we have better imaging of the cornea or new techniques for using the lasers, meaning we can make the necessary adjustments to skip the flap. And if we did that, it'd mean that the halos from shallow flaps, dry eyes from cut nerves, or flaps getting detached years later after traumatic impact will all be things of the past. Moreover, it also means that if in a few more years something even better comes around, I won't have a giant incision that never fully heals that might exclude me from being a candidate for that procedure.
If I was confident that the current state of LASIK was as good as it'd ever get, I'd go for it immediately, since it's already "good enough"...the rate of serious complications is remarkably low with modern techniques. But with better stuff almost certainly around the corner (just look at where laser eye surgery was in the '90s compared to today and the trajectory will be apparent), why risk missing out on it by permanently damaging my eye now?
Especially for those of us who aren't blind without them, what's wrong with putting a pair of glasses on for certain tasks?
I want to delete my account but Slashdot doesn't allow it.
And lose the superpower of seeing into the ultraviolet?
Hell no!
There are two types of people in the world: Those who crave closure
" I would have paid double or more of what I did especially in hindsight. :)
so you're saying LASIK also improved your hind sight? Impressive.
The Kruger Dunning explains most post on
I'm waiting for the 4D revision so I'll be able to see through time.
Thats' not my understanding at all. my understanding is that when you get old your vision doesn't so much "change" as become less "elastic", you loose the ability to easily re-focus.
That much is true, but myopic individuals are naturally focused at nearer range. It's not uncommon for presybobia--or at least significant enough to need reading glasses--to be delayed past age 50 in people with myopia (especially those with little or no astigmatism), or even avoided altogether. Well, that's not entirely correct: if you're wearing your contacts or glasses, you'll need to take them off to see at close range during that interim period.
http://www.aoa.org/documents/o...
"Due to lens effectivity, patients who wear spectacle corrections for myopia experience presbyopia later than those with emmetropia or hyperopia. Patients with myopia typically require less powerful bifocal additions than same-age patients who wear spectacle corrections for hyperopia."
rage, rage against the dying of the light
Halos are caused by the correction area being smaller that the dilated pupil size, has nothing to do with the type of LASIK.
More info: http://www.usaeyes.org/lasik/f...
The most common post LASIK problem is actually dry eyes, 50% of patients.
It is certainly not a perfected surgery IMHO.
PRK was what resulted in halos and starbursts. Early LASIK didn't have a large enough flap cut so in extreme darkness a pupil could dilate out past the corrected area. I don't think they cut as often now and instead use ablative procedures that remove material from the surface after first mapping the eye's surface. After the surgery you could have some dryness that can take some time to go away, use drops.
If you're prescription is stable I HIGHLY recommend the procedure. I went from 20:70 20:90 to 20:20 20:30 - I was legally blind without correction and my Dr laughed when I asked that. I got the surgery the January following the initial FDA approval in the United States. I was no longer able to wear contacts as my eyes had begun to starve for oxygen and the blind spots that glasses have nearly got me killed in traffic - literally. I went from losing my towel on the beach and not being able to read the alarm in the morning to being able to read an alarm across the bedroom - I could read that distant alarm 2 hours after surgery. I was terrified prior to the surgery, a near miss driving with glasses solved that damn quick.
When my surgery was done procedures were cruder, the FDA limited what they could do (to my detriment), and they didn't know about the pupil dilation yet. I wouldn't trade it back for the world! The difference this made in my life has been incredible. I've suffered no side effects other than some dryness which can cause Chelazians in my eye lids if I'm not careful. My vision remains pretty good, I'll need reading glasses before too long I suspect. I could have a tune up done to sharpen things but considering what I lived with before I'm not sweating it. My night vision remains good but age has taken its toll in that dept, I don't mind as it beats being blind.
I should admit, I've run into one or two people with horror stories and I'd never do mono vision unless I never had stereo vision to begin with (I know someone like that). The number of success stories I've encountered is far far higher. It's still surgery, not to be taken lightly, but its a damned miracle for some of us...
Build it, Drive it, Improve it! Hybridz.org
Sounds like my case. Increasing couldn't get wear contacts any more without problems, hated all of the problems of glasses, was scared of the surgery... and it was just nothing. Seriously, how can instantly improved vision not be at the top of your to-do list?
People said I was dumb, but I proved them.
Actually you're right, that was a typo. Try 20:700 20:900!
Without correction I could literally not see any part of the eye chart on the wall. First car at a red light? Without correction I couldn't see the stoplight much less what color it was!
One day my dr told me it would be a week or two before my contacts would be in because they had to manufacture them. Puzzled I asked why and was told that there was little enough demand that they didn't keep any in the shelf. I then asked how much stronger I could go before they didn't make anything stronger. My dr told me they made a few stronger but not to worry because we could switch manufacturers and find some even stronger! That day scared the crap out of me because I realized I might really be getting to a point where correction became very difficult. It was probably an additional 4+ years before LASIK came along, thankfully I never needed a stronger prescription. I'm still supposed to get dilated yearly so they can check inside, a detached retina is apparently a very real possibility since my eye is so "long". They dilate me because otherwise it's like trying to look into a room thru a peephole - their words not mine.
The prospect of losing ones vision is damned scary to say the least :-(
Build it, Drive it, Improve it! Hybridz.org
As you get older, the focus range of your eyes decreases such that they more or less become "stuck" at a certain focal length from your face. Laser surgery will generally make the "stuck" range or point be further out, which could harm reading even if it improves distance vision.
The ideal "stuck" point probably depends on what you do the most. If you are at a computer screen often, then about 14 to 24 inches seems like it would be the ideal, although you couldn't see small things up close well.
My eyesight's focus is settling to around 10 inches away, which is shy of the ideal monitor range. Is surgery worth that extra 8 inches?
The bottom line is that age is a bitch and laser surgery forces you to make tradeoffs as old eyes will only have one ideal focus with or without. Choose the red distance or the blue distance, but not both.
Table-ized A.I.