Q: My fifteen-year old son is in a high-level competitive sport and wears thick glasses. Contact lenses haven’t worked well. Is he a candidate for LASIK?

A: No. Reputable LASIK surgeons prefer the patient to be twenty-one years old, though occasionally they will do patients down to eighteen. The risk of high regression (loss of surgical effectiveness) is much higher in these younger patients. However, there is a new FDA-approved alternative to LASIK that does not involve surgery or surgical risks and is reversible. It is called Corneal Refractive Therapy (CRT). Patients sleep in specially-designed contact lenses and the outer layer of cells is reshaped, like orthodontic treatment does for teeth, and the result is good vision during the day without glasses or contacts. CRT, unlike LASIK, is a good procedure for both kids and adults. The procedure has a few limitations but can treat the majority of patients requiring glasses or contacts to see well at distance. Our office provides FREE consultations for patients who wish to determine if CRT is for them. To schedule a FREE consultation, call 317-9747.

Q: Is LASIK surgery effective for “farsighted” patients as well as “nearsighted” patients? I’m tired of wearing reading glasses.

A: To answer this we have to first define the terms. Nearsighted means you can’t see well at distance but close vision (reading) is lots better. Farsighted patients can often see well at distance but see worse at near. As farsighted patients age, their distance vision gets worse, as well as their near vision. There is a third category called presbyopia, which refers to the loss of close vision after the age of forty. Many patients have been told they are farsighted when they lose near (reading) vision, but this is an incorrect use of the term. They are actually presbyopic.

LASIK is effective in nearsightedness and in low degrees of farsightedness. However, if the patient is over forty (presbyopic) and has LASIK which results in good distance vision, he or she will soon need to wear reading glasses. Presbyopia is not corrected by LASIK. There are currently a number of new procedures being tested for presbyopia, but all are still considered investigational and I don’t recommend them at this time.

Q: I’ve been thinking about LASIK for several years but have waited to see if the procedure gets better. Prices don’t seem to change much. Has the surgery improved?

A: In the early days of LASIK I wanted to believe that low-cost, high volume centers could do as good a job as the more expensive centers. I subsequently spent a day in the operating room of such a center in Canada, watching the process. While the equipment and surgeons looked impressive, I learned that it’s the decision-making process that determines to a large extent the success of the surgery. Discount LASIK centers have more pressure to keep the schedule full, and in my experience are more willing to take chances that are not in the patient’s interests. Their lasers, though “approved”, are also not usually the best for the procedure. All of the really bad results I’ve seen have come from discount centers.

LASIK has come a long way. It’s a much better procedure, with many new developments and related techniques that allow successful refractive surgery for patients that were not good candidates a few years ago. Our office works with one of the Northwest's premier laser surgeons, Dr. Stanley Teplick, and provides on-site laser vision correction once a month.  We also serve as pre & post op center for patients that prefer to have the procedure performed at Dr. Teplick's main office in Beaverton, Oregon.  Dr. Teplick is one of the only surgeons in the Northwest currently offering bladeless LASIK, or 'Intralase.'  For more information about Teplick Custom Vision go to www.oregonlaser.com.  

Dr. Ayres provides a FREE e-mail newsletter covering new developments in public health and eye care. To receive this free newsletter, call our office at 317-9747.

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