At Long Last, LASIK (Part 2)

In con­tin­u­a­tion of yesterday’s post…

Besides the tests to make sure that you can safely have the laser surgery, there are some con­sid­er­a­tions you should have in mind. They basi­cally break down into med­ical and lifestyle, but these are pretty broad categories.

For med­ical, you want to think about any med­ical you have or you have a fam­ily his­tory of that might cause prob­lems for you:

Like Mei S men­tioned on Face­book yes­ter­day, you should have a sta­bi­lized pre­scrip­tion. No point in get­ting surgery if you’re just going to need it again in a cou­ple months, right? Most sur­geons look for pre­scrip­tions that haven’t changed in two or three years. Luck­ily, mine hasn’t changed in about four years. A rule of thumb I learned is that by about 25, your eyes should have fin­ished all the growth (and there­fore size/​shape changes) that they will go through.

My whole fam­ily has really bad aller­gies, so brought that con­cern up to the doc­tor. I was given gen­er­ally the same answer by all the sur­geons — it would be smart to avoid avoid get­ting the surgery dur­ing the height of allergy sea­son, but they give you steroidal anti-​inflammatory drops to use whiel the eyes are heal­ing, and they should basi­cally elim­i­nate any poten­tial prob­lems. I just had to be care­ful about using the drops reg­u­larly and not rub­bing my eyes.

My mom’s dry eyes were aggra­vated by her LASIK pro­ce­dure, so I brought that up, too. The doc­tors per­formed tear tests and told me I shouldn’t have a prob­lem based on those results.

Then there is the other cat­e­gory, lifestyle, which is pos­si­bly even more generic. Basi­cally, you want to think about any work or hobby activ­i­ties or envi­ron­ments that might cause prob­lems with your eyes. Any­thing involv­ing hot, dry, dusty envi­ron­ments or activ­i­ties involv­ing poten­tial injury tot he eye or eye strain.

I told my doc­tors that I wanted to get back into mar­tial arts and was wor­ried about an injury to the eye. I got three basic answers.

The first answer was that yes, there is a very slight chance of injury to the eye, and you will find hor­ror sto­ries if you go look­ing for them. But basi­cally, you have to suf­fer a sig­nif­i­cant hit directly to the flap they cut into the cornea to dis­place it and have a seri­ous prob­lem. If that hap­pens, they can redo the surgery (after allow­ing time for the cornea to heal up first.)

The sec­ond answer was that if I get LASIK with IntraLASE, mean­ing the flap is cut with a laser instead of with a blade, it will heal bet­ter than nor­mal LASIK and injury will not be a prob­lem. Appar­ently, NASA recently approved LASIK only with IntraLASE for their astro­nauts. How­ever, this claim was dis­puted by a cou­ple other doc­tors I saw, who said there are no defin­i­tive stud­ies show­ing bet­ter heal­ing after LASIK with IntraLASE, so take that as you will.

The third answer I got was that instead of LASIK, I could con­sider sim­i­lar laser eye surg­eries such as PRK. In PRK, instead of cut­ting a flap in the cornea, the top layer of the cornea is actu­ally removed and it has to heal back after surgery. Since there is no flap to poten­tially dis­place, it is a safer operation.

Oh, and of course, there is always the con­sid­er­a­tion of cost!

From the places I vis­ited, I found that tra­di­tional LASIK should run about a thou­sand dol­lars. (There are cheaper places, but they are gen­er­ally sur­geons with less expe­ri­ence and/​or less than state-​of-​the-​art equip­ment.) Wave­front pro­ce­dures run four to five thou­sand. (Remem­ber, Wave­front is cus­tomized to your eyes’ spe­cific shapes, not just your pre­scrip­tion, and gen­er­ally has bet­ter results and fewer side-​effects like impaired night vision.)

LASIK and PRK, if both are offered, should be the same price. (Both come in tra­di­tional and Wave­front forms.) LASIK with IntraLASE gen­er­ally costs a lit­tle more than LASIK with a micro­ker­atome, but it shouldn’t be more than a cou­ple of hun­dred dol­lars, which you should be able to nego­ti­ate down to no difference.

If you have a very high pre­scrip­tion and need the Alle­gretto laser, expect to pay up to a thou­sand dol­lars more.

When com­par­ing prices, be sure to ask about the costs of follow-​up vis­its after the surgery, med­ica­tions you will need while heal­ing, and enhance­ment pro­ce­dures. (Enhance­ments are when you go in for another round of laser surgery because you did not reach opti­mal results the first time.)

I think that’s enough to chew on for now. Next, I’ll com­pare the doc­tors I went to.

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