The nine criteria for LASIK surgery

— Staff Writer

LASIK can correct many visual impairments and provide improvement to sight, but its effectiveness can be more or less depending on the eyes of the patient.

LASIK and PRK generally are successful and provide satisfying results, but certain people may not be right for surgery.

Read on to see if you meet the requirements of a successful LASIK procedure:

1. Healthy eyes

Many conditions affect the eyes, and potentially complicate LASIK surgery. Some are temporary, such as dryness from seasonal allergies, or are more permanent, such as cataracts. Others include pink eye, or conjunctivitis, and any eye injury or infection. These conditions will have to be taken care of first, and in the case of cataracts, may require their own surgeries.

In the case of dry eyes, LASIK may complicate the condition, causing discomfort or difficulty. Most people suffering from dry eyes are undiagnosed, so be sure to pay attention to the common symptoms. Do you suffer from burning or stinging, a gritty sensation in the eye, reduced tolerance to wind, intermittent blurry vision, or even excessive tears in some cases? If you do, discuss these issues with your doctor during a free consultation.

Your surgeon can evaluate your eyes and determine if you are at risk, and may even be able to treat your condition. Dry eyes have many treatments, including artificial tears, punctal plugs, medicated eye drops, flaxseed or fish oil supplements, or a combination of these approaches.

Uncontrolled glaucoma will also prevent you from being a candidate for LASIK or PRK procedures, but may be treatable.

2. Cornea thickness

During LASIK procedures, refractive error is compensated for by reshaping the cornea through ablation, which improves visual acuity. To produce the new and proper curve requires a minimum amount of tissue to shape, and may be impossible if the cornea is too thin, or the surface is irregular. Certain conditions like keratoconus may make the eye unsuitable for LASIK procedures, compromising the results of surgery.

Those who have consulted with LASIK specialists in the past and been told their corneas were too thin for LASIK should seek an additional consultation. Improvements in the available technology now allow for LSIK procedures on much thinner corneal tissue. Using a femtosecond laser over an older microkeratome allows for a thinner flap to be created, preserving the underlying tissue.

Refractive surgery and implantable lenses, or phakic intraocular lenses (IOLs), may be other potential options if LASIK is still not recommended by your doctor.

3. Pupil diameter

Those with large pupils, or an increased risk of dilation, are at increased risk of certain side effects. Common issues of halos, glare and starbursts in low light, and especially when driving at night, are more likely for those with larger pupils.

It is important to discuss the risks and benefits of the LASIK procedure with your doctor to make an informed decision.

4. Acceptable prescription range

LASIK cannot cure all prescriptions. Though it can treat nearsightedness, farsightedness, and astigmatism, extreme ranges may not be suitable for LASIK

Correcting for very high refractive errors do not have predictable results when corrected through LASIK, and the benefits may not outweigh the risks.

Certain procedures, such as for extreme myopia, may require too much tissue to be removed. In these cases, the potential for complications increase, and again, the benefits may not outweigh the risks.

For such extreme refractive errors or impairments, there are other procedures which your doctor may be able to discuss with you. Phakic IOL implantable lenses or refractive lens exchange have both had good results, and may be more appropriate.

5. Age

Most LASIK procedures are not performed on those under the age of 18, and some are not performed on those under 21. Though younger patients may be treated in certain extreme cases, it is at the discretion of their doctor, and the approval of parents and guardians. Many risk are involved, and it should not be considered lightly, or as a first course of action.

There is no upper age limit, though it is common for those entering middle age to begin developing presbyopia, an age-related visual impairment. LASIK is able to make corrections for refractive errors, but patients may still require reading glasses to compensate for a loss of flexibility in the lenses of their eyes.

Monovision LASIK may be recommended by your doctor in cases of extreme presbyopia. This procedure corrects one eye for farsightedness, and one for nearsightedness, improving the range of focus a patient can enjoy without the aid of corrective lenses.

Dry eyes are also an issue for aging patients, and may complicate the procedure. Both men and women have the potential to develop dry eyes as they age, but may be able to seek treatment for their condition.

6. Stable prescription

The eye changes and develops as we age. This is one reason why children and young adults require changes to their prescriptions regularly. However, this means LASIK should not be performed until the eyes have reached a level of stability. Correcting for a current prescription is useless if the eyes continue to change and cause further impairments. Most doctors recommend a period of two years of a single prescription, but some will accept only one year.

Often, nearsightedness is the least stable visual impairment, and is then the most likely to cause further changes to vision.

Ultimately, your doctor will be able to discuss matters and determine if your situation is right for LASIK.

7. General health

Though LASIK is non-invasive, it is still surgery, and should be considered carefully. Contraindications to LASIK procedures include various degenerative conditions or uncontrolled autoimmune diseases such as Sjogren’s syndrome, rheumatoid arthritis, type 1 diabetes and AIDS. LASIK may still be an option for those with HIV if their white blood cell count is high.

Any condition which compromises the immune system or healing of a patient may complicate LASIK procedures, and should be considered carefully.

Only your doctor will be able to make the final determination.

Additionally, various medications may complicate LASIK, either during the procedure, or post-operative. Anything which compromises the healing ability of the body may be an issue during eye recovery. And, any medications which increase the likelihood of dry eyes may also pose their own issues.

8. Pregnancy

Due to hormonal shifts, a woman’s cornea may change shape during pregnancy. Like with an unstable prescription, this change makes one an unsuitable candidate for LASIK.

After pregnancy, the eyes should return to normal in a matter of months. LASIK can be performed then, without issue.

It should also be noted that pregnancy can cause dry eyes in certain cases. This condition may last for months following birth.

Also, it is possible that the medication given in post-recover for LASIK may not be suitable for mothers who are breastfeeding. It is recommended to discuss this with your doctor before surgery.

9. Realistic expectations

Though LASIK enjoys a high degree of success and satisfaction, it is a form of surgery and carries with it a certain amount of risk. One should understand that no result can be guaranteed.

A doctor may only be able to determine if you are a good candidate or not, and discuss the potential risks and benefits as they relate to your situation and personal medical history.

It is important to be honest and forthright with your doctor. It is also important to realize that LASIK is not a cure, but a corrective measure. It may even be that LASIK lessens your best vision, but allows for improvements to your general vision, which can free you from reliance on corrective lenses.

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Staff Writer

Hi! I'm a staff writer for Way to Vegas.