Wearing glasses never really bothered Peter Courture. The
51-year-old attorney from Palo Alto had worn them since college,
but when he moved to Brittany, France 18 months ago, he had more
trouble.
Wearing glasses never really bothered Peter Courture. The 51-year-old attorney from Palo Alto had worn them since college, but when he moved to Brittany, France 18 months ago, he had more trouble.
“When I’m surfing or when I’m swimming in the river, especially downstream with rocks, I can’t see without my glasses,” Courture said. “But if I wear them they get water or steam.”
Courture decided that the time was right for a popular procedure: LASIK surgery. First introduced in 1991, the laser-based corrective surgery is now performed on more than a million people each year and the numbers are growing. With more advanced lasers available, it’s safer than ever (fewer than one percent of Lasik patients to date have experienced serious problems leading to vision loss) and effective to boot. Many patients see vision corrected to the legal driving limit of 20/40 or to the standard 20/20.
“Laser is now more accurate than contacts, safer than contacts, and healthier than contact lenses,” said Dr. Robert Crowe. The Morgan Hill ophthalmologist spent much of his career as a contact lens specialist, but has shifted focus recently. “Right now about one out of 100 people who have contacts get the surgery. I’d like to see all of my contact lens patients getting it if possible.”
The surgery, said Crowe, will cut down on irritation, dryness, infection, and cases of conjunctivitis, or “pink eye.” It could also prevent serious contact-related problems such as corneal ulceration.
Lasik is actually short for laser in-situ keratomileusis, which means “correction of the eye through the use of a laser.”
When the eye works normally, the round cornea focuses light onto the retina creating a clear image. If the focal point falls short it creates nearsigtedness. This is caused when the length of the eye is too great in relation to the curvature of the cornea.
This eye to corneal-curve ratio is too short in people who have farsightedness, causing the image to come into focus behind the retina. And if the cornea is football-shaped, it creates astigmatism, or a bending of the rays of light entering the eye. The shape creates two focal points within the eye, distorting the picture.
All of these issues can be corrected with laser treatment. What happens is this: A small incision is made around the cornea, and a flap of the eye is peeled back to expose a deeper level of the corneal structure. A cool-beam laser is then shot into the eye, chipping away at select spots to reshape the cornea. Nearsighted people have theirs flattened to project over a longer distance, while the outer margin of the cornea is sloped to form a greater curvature for someone with farsightedness.
After the laser has done its work, the flap is replaced and smoothed down like wallpaper. It heals on its own without stitches, but patients must wear goggles to bed to avoid inadvertently rubbing their eyes. Resting as much as possible is recommended during the first 24 hours.
Temporary effects that may last for a few days or even a few weeks include light sensitivity and glare or halos. These effects are permanent in three to five percent of cases, according to the National Eye Surgical Education Council. Vision is not guaranteed to be perfect after the surgery, either.
“We’re up front with patients, in letting them know that we can’t guarantee the result, though their chances for achieving 20/20 are very, very good,” said Ryan Berroya, chief technician and researcher for Turner Eye Institute, which has locations in San Jose and around the Bay Area. “You don’t want to get caught with your pants down and, besides, it’s not ethical to promise something even if you’re sure it will happen. Some conditions are very rare, but they still occur.”
Poor candidates for lasik surgery include women who are pregnant or nursing as well as people with eye allergies, recent herpes infections in their cornea, auto-immune disorders, and insulin-dependent diabetics with poor control.
Another major problem, according to Staci Paul, marketing manager for Turner Eye Institute, is a thinning of the cornea called keratoconus. When making a decision about LASIK, it is important to do research on the subject yourself. A doctor should always test your corneal thickness and discuss your medical history prior to recommending surgery. Other tests that may be performed include mapping of the eye with either a corneal typographer or new WaveScan technology, which essentially takes a thumbprint of the eye.
Some doctors in the area do pre- and post-LASIK treatment, but the surgery is not offered in the South Valley.
