|
|
 |
|
|
|
|
|
|
|
BEYOND GLASSES:THE LATEST LASER EYE SURGERY
 Don't Even Think About Blinking: Metal forcepts hold open Blau's eye so the laser can work its magic.
Beware of slick advertising or places where surgery is the only "product" sold. "It felt like a meat market," recalls Debra Ervolino, 32-a minus six in one eye, minus seven in the other-who works in sales on Seventh Avenue. She had been following PRK since she read about its being done in Russia and Germany. When the FDA finally approved the procedure here, she went to Crystal Vision's free seminar: "It was rush, rush, rush-We can do it for you right now. I had questions, and they just weren't very sympathetic." The supermarket approach is not uncommon. When I called one Park Avenue ophthalmologist and inquired about "laser surgery," the receptionist asked, "For vision correction or wrinkle removal?"
Based on your prescription and your goals, the surgeon will propose either PRK (just the zap) or LASIK (the flap and zap). According to Dr. Robert Maloney of UCLA, one of the principal investigators in an ongoing national study, the two procedures have comparable results-although the vision of LASIK patients improves more quickly, and they have less or no post-op pain. LASIK, however, requires a higher degree of surgical skill. In unsure hands, or with a poorly functioning microkeratome, the flap can be sliced off or get caught in the machine and end up wrinkled; it can be relaid off-center; particles can get caught underneath. With PRK, which is technically less demanding but far from foolproof, the epithelial layer is zapped directly. It can result in corneal haze, scarring, a halo effect at night, or a central island (a bump on the cornea).
If you're extremely nearsighted, you may not have a choice. Given the currently approved excimers, LASIK is the only procedure done on patients whose vision is worse than minus seven. If you have a greater-than-minus 1.5 astigmatism, you'll have to wait for the Visx "Star" laser, already approved for nearsightedness, soon to be approved for astigmatism up to minus four diopters. And if you're farsighted, hyperopic excimers and the even newer holmium lasers are a few years away from approval.
No surgeon can, or should, guarantee 20/20 vision. In fact, one of the risks of both surgeries is under- or overcorrection. The more correction one needs, the harder it is to hit the target. Five to 10 percent of undercorrected PRK patients go back for an "enhancement," as do 10 to 25 percent of LASIK patients-admittedly, higher myopes who have more to correct. Overcorrection, which makes you far sighted, is more difficult to remedy. At worst, either surgery could cause "irregular astigmatism"-a wrinkled cornea-which only rigid contact lenses can correct.
The most honest surgeons admit that it's impossible to predict the idiosyncrasies of healing. After my first operation, I could see across the room. The bad news was that I couldn't read anything-a problem Paul Fichtenbaum also experienced. Although Speaker and Cooper assured that "the reading vision takes longer to come in," I, who make a living with words, was not convinced. By the next morning, though, I glanced at my sister's copy of the New York Times and, like an excited first-grader, exclaimed, "I can read!"
I had virtually no discomfort with the left (first) eye. But the morning after the second operation, I woke up in pain. My right eye was tearing profusely, as if something was in it. At Dr. Speaker's office, his associate confirmed that my cornea had been slightly abraded by the suction ring. Within three hours-and after several doses of anti-inflammatory drops-the pain was a distant memory.
Still, no one warned me about the dryness. There I was, in the lens wearer's version of No Exit-feeling as if I had left my contacts in too long and was unable to take them out! The discomfort was instantly relieved by wetting drops, but for the first week to ten days, I had to hose down my eyes every fifteen minutes.
There was some psychological adjustment as well: I became totally obsessed with my new eyesight, its nuances, its deficiencies at night, my lack of depth perception. I tired easily and wasn't "back at my desk in a day or two," as some claimed they were. But gradually, my vision improved, and I got used to it. Today, I don't have a moment's regret.
Most trailblazers in the brave new world of laser refractive surgery are equally delighted with the results. But the first tier of customers have been mostly the rare Mister Magoo types, like me, for whom the surgery was hardly cosmetic. The question is, will the average Jane or Joe buy into this technology, take the risk of having an operation, and shell out five grand in the bargain-just for the privilege of not wearing glasses? Laser-stock speculators predict a future of storefront clinics where one can simply drop in for a quick vision fix. The technology itself, already earning high marks for safety, is bound to get even better and doctors more proficient. And as more and more people cast aside those Matsuda frames and queue up for the Zap, thick, cumbersome glasses may become a twentieth-century relic.
|
|
| Previous < 1 2 3 4 > Next |
|
|
|
|
|
|
|
|
|
|
|
