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An eye to the futureJury still out on long-term effects of popular laser surgery
(CNNfyi) -- There was a time when the procedure sounded more like something from a cheesy science-fiction movie -- beaming rays from a laser into someone's eyes to improve their vision. But now, it's commonplace. Since the Food and Drug Administration approved laser eye surgery in the United States five years ago, the number of nearsighted people seeking that type of vision correction has increased drastically. The number of patients having the surgery has grown from 108,000 in 1996 to 1.6 million this year, and an eye-care industry group has projected 2.6 million will put their eyes under the laser next year.
However, while the popularity of the 15-minute surgery is growing, doctors readily say the surgery is not for everyone, and they concede that because the procedure is a new one, there are no long-term studies to indicate how it affects the eye. Opponents of the surgery insist that if people would practice good eye health measures, they can preserve their vision. In the beginningThere are three types of corneal surgery that ophthalmologists use. Radial keratectomy, or RK, is the oldest and is rarely used. That procedure involves a physician using a handheld instrument to cut into and reshape the cornea. (Cornea shape is a critical element in determining how well a person sees.) Photorefractive keratectomy, or PRK, involves using a computerized laser to sculpt the cornea. It removes part of the cornea depending on the severity of the myopia, or nearsightedness. Lasik, laser in-situ keratomileusis, is the newest form of vision correction surgery. It can be used to correct myopia, hyperopia and astigmatism. In this procedure, the physician cuts a flap in the cornea, removes a uniform thickness of the cornea, then flips the flap back onto the cornea. To picture it, imagine raising the top portion of a hamburger bun, taking the pickles off, then flipping the bun back onto the burger. Doctors perform the surgery under local anesthetic. Although the procedure is outpatient and lasts less than 30 minutes, it does carry risks. Risks and limitationsThere is no evidence that the surgery will improve the health of the eye. And the surgery will not prevent the gradual loss of vision that often accompanies aging. According to the Lasik Institute's literature, risks from the surgery include decreased night vision and corneal haze, or a superficial healing the cornea begins after contact with the laser. The amount of haze varies from patient to patient. Sometimes it diminishes over time and sometimes the person's vision is worse than before surgery.
Other possible complications include infection, severely dry eyes, glare or the appearance of halos around objects. Sometimes the surgery undercorrects a vision problem or overcorrects it, and the patient still needs glasses after surgery. However, few people experience those complications, according to data collected by the American Academy of Ophthalmology. Although surgery has improved the vision of scores of people, not everyone is eligible for laser eye surgery, said Arthur Stone of the American Academy of Ophthalmology. People younger than 18 should not have the surgery because their vision is still changing. Other factors that would make someone ineligible for the surgery include cornea shape, medical history such as diabetes or vascular disease, the severity of nearsightedness or extremely dry eyes. Vision problems can be preventedGrace Halloran has been legally blind twice and is in the process of recovering her vision again. She is the director of Integrated Visual Healing in San Leandro, California. Halloran said that many of the vision problems people experience can be prevented. "Everyone know how to floss and brush, but few people know how to take care of their eyes," Halloran said. "No one teaches that." The human eye is constructed to see things in a distance, Halloran said. It comes from the human predilection to be hunters and gatherers, she said.
The muscles of the eye naturally focus that organ up and outward. But the evolution of society has most people spending time indoors and looking at objects -- books, computer screens, control panels -- that are close to their faces. Those actions force the eye to turn inward and downward, causing eye strain and possibly nearsightedness or vision loss and the need for glasses. Halloran suggests that people practice good vision preservation measures when working with objects close at hand or when reading. She recommends placing a book mark every few pages when reading. And when reaching the marked page, look off into the distance to relax the eye. A sticky on a computer screen will serve as a similar reminder. She also recommends frequent palming. That technique involves closing the eyes and covering them with your palms to block out light. She said everyone should do that for a few minutes throughout the day. "Even when the eye is closed, it can detect light through the lids," she said. "And the eye is straining to figure out the light. Palming blocks that light and gives the eyes a chance to relax." Staring into the distance, blinking, palming and inhaling and exhaling deeply can help to sustain vision, Halloran said. The secret to good eye health is simple, she insists. "Look. Blink. Breathe," she said. "That's all it takes." RELATED STORY: Bye-bye bifocals: New approaches to aging eyes RELATED SITES: Lasik Institute | |||||||||||||||||||||||||||||||
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