LASIK Realistic Expectations, part 2
Laser vision surgery improves the uncorrected vision (how a patient sees without corrective lenses) in great majority of patients, but it does not guarantee perfect vision.
Individual considerations according to refraction:
(Click on any topic or scroll down.)
· Myopia and myopic astigmatism
· High Myopia
· Hyperopia and hyperopic astigmatism
· Presbyopia
Myopia (nearsightedness) & myopic astigmatism
According to recent figures provided by ASCRS, which considered 1,736 eyes with myopia and myopic astigmatism (up to -14 diopter of myopic error and 6 diopter of astigmatism), approximately 87% of the eyes that had LASIK achieved 20/40 or better one month post-operatively.
By six months, 93% of eyes achieved 20/40 or better. In most regions, this is qualifies you to drive without having to wear contacts or glasses.
The same study found that 45% of eyes achieved 20/20 or better at one month post-operatively. This number climbed to 50% at six months post-operatively.
According to the original LASIK studies submitted to the US FDA, an average of 56% achieved 20/20. The results with the VISX CustomVue FDA study were even more impressive, with 98% of patients achieving 20/20 or better vision. As with all refractive surgeries, patients may still need to occasionally wear corrective lenses to achieve sharpest possible vision.
High myopia (very nearsighted)
Several United States and international studies demonstrate that LASIK for higher degrees of myopia can be effective if patients whose eyes are characterized by higher degrees of myopia have a different set of expectations regarding possible outcomes.
The incidence of regression with the highly myopic patients after LASIK is slightly higher. The aim then is for 20/40, rather than 20/20, to make allowance for this, with the goal of the surgery being within one diopter of emmetropia when vision stabilizes. Additionally, studies have noted a slightly higher risk of complications in highly myopic patients.
Hyperopia (farsighted) & hyperopic astigmatism
Eyes that are characterized by hyperopia carry a different set of expectations regarding outcomes than myopes.
Typically, the visual recovery of hyperopic patients is not as quick as that experienced by myopic patients. Consequently, Dr. Cutarelli may discuss a surgical plan that calls for operating on the one eye then wait a few days to several weeks before operating on the second eye.
Overall, studies have shown that the six month post-operative results are similar to those achieved for myopia. However, there may be a slightly higher incidence of regression associated with the procedure.
As with myopia, those with lower levels of hyperopia experienced slightly better overall results than those with high hyperopia.
In the United States, LASIK for hyperopia is an off-label procedure on many of the older excimer lasers, and treating hyperopia in conjunction with more than 1 diopter of astigmatism is not permissible outside of clinical trial settings on some of the machines. At Cutarelli Vision, all of our machines exceed the necessary requirements to treat hyperopia.
If you are over 40 years old and are corrected for excellent distance vision, you might have to give up some of your close vision.
This happens because presbyopia , the natural hardening of the lens, affects people as they enter their forties. Presbyopia is caused by the changes within the eye's crystalline lens as one ages, and affects everyone. These changes prevent the lens from changing focus from the distance to up close. Eventually everyone, if they live long enough, will need to wear reading glasses. LASIK does not prevent the onset of this condition, nor does it treat it. Monovision is a possibility that has met with substantial success in allowing patients some independence from separate distance and reading glasses, and something you may discuss with Dr. Cutarelli.
