Q&A: Doctors on Lasik Surgery

The Food and Drug Administration says patients might not be getting all the information they need before undergoing Lasik eye surgery. NPR's Allison Aubrey talked to two experts to find out what patients should know before they have the procedure.

Kerry Solomon, M.D., co-chair of the Joint Lasik Study Task Force and professor of ophthalmology at the Medical University of South Carolina, Charleston:

What is Lasik?

Lasik stands for laser-assisted in situ keratomileusis. Basically what's happening is a small flap is cut on the cornea, the clear covering of the eye. A blade or a laser is used to make the cut. The flap is lifted and the cornea is reshaped, then the flap is put back into place. This corrects the vision.

Wavefront is often marketed as the latest innovation in laser eye surgery. What is it?

It's a type of Lasik that uses a more precise measurement of the eye. The patient looks into a device that takes thousands of measurements of the eye. The device then converts that into a digitized three-dimensional measurement that's really a fingerprint of the eye. That information is fed into the laser, and then the laser makes its cuts based on the measurement.

Why the difference in pricing for Lasik?

When you look at pricing, it's all about the same. Some people may advertise a very low price to get you in the door, and then increase the price to get you to have the procedure best suited for your eye. So, for example, it's not uncommon for some centers to charge a very low amount and if you have an astigmatism this ends up costing extra. A Wavefront procedure might cost extra, or using a laser rather than a blade to create the flap would cost extra, for example.

What's the alternative to Lasik surgery?

The other option outside of Lasik is photorefractive keratotomy (PRK). It's the same procedure for patients, but no flap is made. Patients who are nervous about having a flap made or who are not candidates for Lasik, may be PRK candidates. PRK has been around longer than Lasik. But Lasik is by far the most common laser vision-correcting procedure. The downside to PRK is that it's a little uncomfortable and it takes a while for vision to come back.

What are the top three indicators that someone isn't a good candidate for Lasik?

One is someone's corneas are too thin or corneal surface is irregular. Another common reason is someone who has dry eyes. Dry eyes are not always a contraindication for Lasik, but may make someone a bad candidate. And the third would be unrealistic expectations. If someone says, "I have to have perfect vision at all times of day and night," that is not realistic. I would tell that patient to stay with their glasses and contacts, because while this procedure is awesome, nothing is perfect.

Scott MacRae, M.D., professor of ophthalmology and visual science at the Center for Visual Science at the University of Rochester School of Medicine, Rochester, N.Y.:

How should someone looking to get Lasik choose a surgeon?

I recommend they go to someone who is a cornea specialist if there are problems with dry eye or irregular corneas. Also, choose a surgeon who has a high reputation and who contributes scientifically by doing research in refractive surgery. People who do research and publish are more invested in new technology, so they're more likely to have a better idea of how to treat complicated problems.

Comments

 

Please keep your community civil. All comments must follow the NPR.org Community rules and terms of use, and will be moderated prior to posting. NPR reserves the right to use the comments we receive, in whole or in part, and to use the commenter's name and location, in any medium. See also the Terms of Use, Privacy Policy and Community FAQ.