Tuesday, May 12, 2009

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Dealing With Dry Eye After Lasik Surgery
May 11, 2009 at 4:03 pm

Dry eye has been long recognized as a postoperative side effect of Lasik surgery. Studies have concluded that clinically detectable dry eye is present nearly universally following Lasik surgery, even when patients do not normally experience dry eye symptoms. There are a couple of causes of dry eye problems. First, when the corneal flap is created during the Lasik procedure, either a steel blade or a laser must cut through the corneal tissue and corneal nerves are disrupted in the process. The deeper this cut, the more likely the disruption to nerve tissue. The laser reshaping of the cornea further disrupts the nerve tissue. During the time while the nerve tissue heals and regenerates, the reflex to tear and blink is significantly diminished; thus creating the dry eye problem.

The quality and smoothness of the corneal surface and tear layer is important for quick recovery of good visual acuity. The tear layer is actually the first optical surface that light hits when it enters the eye during the Lasik procedure. If that tear layer is irregular or deficient, it can create a poorer visual image, with heightened "ghosting" or "fuzziness."

To maximize my patients' vision postoperatively, I suggest approaching the problem of dry eye with a basic regimen that includes the following:

1) A good preoperative evaluation for preexisting dry eye problems and maximizing the surface condition prior to performing Lasik
2) The usage of the Intralase FS lasers for making the initial Lasik flap rather than the steel razor blade microkeratome
3) The good use of artificial tears and gel lubricants postoperatively, even if the patient does not complain of dry eye symptoms

I also suggest that patients use cyclosporine 0.05% eye drops (Restasis) twice per day for one month postoperatively. Studies have shown that this regimen can improve visual outcomes and reduce the need for enhancements after Lasik surgery. It appears that the improved quality of the tear layer can actually improve a patients vision, so that they are less likely to feel the need for additional or touch up surgery. This not only improves the patients overall experience but decreases the possibility of any secondary side effects or complications that could occur with a second procedure, however rare that would be.

Ultimately, attention to detail with every aspect of surgery enhances the outcomes as well as patient satisfaction in the long run. That's why surgeons need to pay so much attention to new and innovative technologies and medications on every level as they are developed.

Dr. John Suson MD is an ophthalmologist and a clinical instructor at the Medical College of Wisconsin. Currently, Dr. Suson is in private practice with his sister at their Suson Eye Specialists clinic. Eye health and care are both a family tradition and lifelong passion for Dr. Suson.

Article Source: ArticleSpan


Avoiding The Five Hundred Dollar Lasik Gimmicks
May 11, 2009 at 4:03 pm

People will sometimes see ads for $500 Lasik and they'll think, "Wow, is that really possible?" Generally, Lasik surgery goes for around $2000 per eye, so people are shocked to see the difference. Obviously, the last pair of glasses you bought may have cost around that much, so it doesn't seem to make sense. How can a precise surgery like Lasik cost almost as little as a pair of glasses?

The obvious answer is that it can't. The ads are designed to get you in the door but are deceptive in many ways. Certain chain centers have even received warnings or disciplinary action from the Federal Trade Commission for deceptive advertising. To avoid an FTC warning, the advertised price is often a starting point to which thousands of dollars will be added before surgery can actually proceed.

One common tactic is to offer an older, very limited technology for cheap. In fact, many people that might qualify for this cheap surgery should be discouraged from having surgery because their vision is already fine. Alternatively, people with normal prescriptions are then told that they do not qualify for the prices advertised.

They also use the sales tactic of up-selling the patient with "optional benefits" that are not truly optional. The surgery itself is billed as one component, but the various parts of the preoperative evaluation and postoperative care are then added onto the price. It is impossible to perform the surgery without doing a complete examination beforehand and follow-up afterward, so the price skyrockets when everything is added up. Anesthesiologists used to have a joke: "The cost to put you to sleep for surgery is only $1, but if you want to wake up, that price rises." It's the same with these Lasik surgery chains, but the joke is really on the patient.

It is crucial to understand that the technology available for the extremely cheap $500 eye surgery is usually very old and doesn't apply to most people that truly need Lasik. These cheap centers continue to use the old razor blade flap cutting technology that all of the highest quality reputable Lasik surgeons abandoned years ago. Why would you want a high speed vibrating razor blade cutting your eye if you could have a high precision, high safety laser do the same thing?

Unfortunately, by the time all of this is revealed to the patient, they have been charged a significant, nonrefundable consult fee for an evaluation. To avoid these traps, only work with reputable surgeons who use the newer laser technologies and who don't try to lure you in with gimmicks. Remember, when it comes to your health, you should never try to cut corners.

Dr. John Suson MD is an ophthalmologist and a clinical instructor at the Medical College of Wisconsin. Currently, Dr. Suson is in private practice with his sister at their Suson Eye Specialists clinic. Eye health and care are both a family tradition and lifelong passion for Dr. Suson.

Article Source: ArticleSpan

 

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1 comment:

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    Regards,
    5th Avenue eye center
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    ReplyDelete