How I answer Queries on Lasik & Refractive Surgery

[Barry Santini]

I wanted to share this with the boarders:
What single thing I found is most often misunderstood about Lasik in the public's mind:

Because the public generally "thinks" (and is often told in advertisements) that Lasik will rid them of glasses & contacts forever, I have found the following presentation quite an enlightening reply when I am asked about Lasik and Refractive surgeries)

Your vision system is "fluid". The physiological factors that change your vision correction do not cease or stop after lasik (refractive surgery). Therefore, this procedure, even if 100% successful and having no apparent side effects for *you*, can only correct your vision completely for a specific slice-in-time. When your vision/refraction subsequently changes, you have the choice of:

1. Tolerating less than the best, most acute vision as you seek to avoid glasses or contacts

2. Begin again to wear glasses/contacts (and for many people, they will say what's the point)

3. Undergo a/the surgery again at twice the risk factor for omplications.




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[Texas Ranger]

I tell them that I have had some clients with great success, I also know some that are far from happy and a couple in litigation. I, personally am about a -5.00 w/ a +2.00 add; if I had a 100% successful lasik procedure to 20/20 distance visual acuity, I'd still need +2.00 lenses for reading. And,likely would have to have some sort of pal for mid range,etc. So, basically, i'd be wearing a no line with a planotop, instead of a -5.00. i'm in a poly panamic crizal lens in a 48 eye, so thickness and weight are minimal now, so why bother. the O.D. next door has done follow up care on 42lasik pts. only a couple are out of glasses, and that's just tempory! Al.

[Pete Hanlin]

I think the benefits and/or drawbacks of LASIK are highly dependent on the lifestyle and "stage of life" of the patient.

I'm 32, and went from -4.75 sph OU to plano after LASIK- however, if I made my living as a truck driver (like my brother does), I'd probably still be unhappy due to the slight increase in halos at night...

In my situation, however, I enjoy reading in bed without worrying about falling asleep in my glasses, I enjoy swimming in the Gulf without messing with glasses, and I like using non-Rx sunwear (tennis is a lot easier without specs, too).

If I would have been able to wear contact lenses, my enthusiasm for LASIK might be diminished, but as it stands I am now free of the eyewear I wore since age 5.

Our office provides pre-op services for an ICON affiliated LASIK provider. Practically all of the patients we've seen have been very satisfied (even the ones still wearing readers). I think it is vitally important that the patient understand the realities of LASIK, but given the right person, LASIK is unquestionably a tremendous procedure.

Pete "and we still sell 'em glasses" Hanlin

[Jeff Trail]

Hi Barry,

How's the biz going with Santinelli?.Good I hope.. well to the question at hand and to "further" the debate. I think it depends on the "who" you are talking to as well as the "how" it is going. As a wholesaler I deal with a wide variety of OD's and MD's as well as being around for a few years have a fairly wide connection of friends in the field and it boils down to how eager they are to slice and zap. Also a lot is based on the type of equipment being used..But from talking to all the OD's and MD's I know I see a fairly distinctive pattern, the people who are least likely to benefit from LASIK are the ones that usually are the ones doing the "bragging" about how great it was :-).. others where the stroma is thinner (the upper mid to high myops) who would be the ones who REALLY want and need the procedure are the ones with the higher degree of problems (wrinkles in the flap, induced astigmatism, halo's and loss of night vision)
The sad part is that with a simple use of steroids BEFORE the procedure they found the problems were greatly reduced.. but not one of my friends are using it in their practice.
Here is the scary part I have an MD located close to me now running commercials that actually say "if you are 20/20 and want BETTER eye sight then we can enhance it with LASIK".. I find this VERY disturbing.
I think it's like most things now a days people tend to forget that it is an INVASIVE procedure and their are always the chances of problems but the "hype" is all most people hear. Same could be said about contacts..people ordering them over the web and every where else with RX's that are years out dated and no follow up , etc., etc. .. and I see plenty of problems from those situations (corneal ulcers , etc.)

Jeff "just one lab rats opinion" Trail

[Barry Santini]

Thank you for the replies to my initial post. However, I think they miss the point I was trying to make. People are happy with lasik, but many are lured because they think their glasses will be gone forever, and they will not. It is not a question of "current"
happiness and satisfaction, but rather of understanding what the future amy hold with respect to both uncorrected acuity, and option to have an improved procedure, when available, later on.
The Forbes article recently pointed out how the legal profession has taken "notice" of the problems people are having with Lasik and the deep pockets they can "feed" on there.
(I like to say that they are the "Tyrannasaurs of the United States" - when they take notice...WATCH OUT! I think the days of "cheaper" refractive surgery are numbered due to future increases in malpractice costs).

What do you 'all think??

Barry Santini
ABOM
NYS Lic. Opt.

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