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  • LASIK vs PRK

    First year in practice as a surgical subspecialist. I’ve been wearing corrective lenses since age 12 or so. I’d like input from ophthalmologists here who perform this surgery and from ophthalmologists who would have this surgery done to their own eyes. Also interested in other physician’s experiences with the procedure.

    I have my own occupation disability insurance as well as $225K left in student loans. My biggest concern is that I will not be able to see after the procedure, which won’t allow me to operate, which won’t be covered by my disability insurance, and that my student loans won’t be discharged....?

  • #2
    I had Lasik about 17 years ago at the age of 35. At that time, many Ophthalmologists were transitioning from PRK to Lasik.
    I was a surgeon at a large academic center. Other surgeons in my department received PRK at the recommendation of the Optho Dept Head, who felt it was better. These other surgeons had short-term (few weeks) side effects with PRK, to include edema, ecchymosis, and severe photophobia, to the point of not being able to operate for a few weeks.
    Instead, I went to a private Optho and received Lasik for myopia. I had 24 hours of postop “floaters” but was otherwise asymptomatic afterwards and was very pleased. I didn’t miss more than a day for work.
    At about 15 years postop, my age-related myopia started to return, presbyopia has started to show up, and my astigmatism has slightly worsened, so I now wear Rx glasses for night driving, and at theaters or lecture halls.
    I was hesitant to get surgery at first, even cancelling the first time I scheduled it. However overall, I remain pleased and realistic about the decision and results.

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    • #3
      I'm a retina surgeon, and not a refractive surgeon, so take this for what you will. PRK is definitely a lot more traumatic to recover from because of the cornea having to recover more. LASIK is much much quicker. I'm lucky to not have to wear glasses (except for helping my old man presbyopia) so I've never had it done. My dad had it and was very very happy with the result. During my training, we'd see pts have LASIK, sit up and be told to read the clock across the room. They would read it and then start crying because it was the first time, in their lives, they could see far off without their glasses. It looks like a small miracle to them (and us).

      The most common concerns with LASIK (that I can recall) are flap slippage, epithelial ingrowth, and halos around images. The first two are very uncommon, and treatable with an experienced surgeon. The last one takes time to clear. More experienced surgeons can speak better to these issues. Even with these concerns, if I needed LASIK, I'd definitely have it done for myself

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      • #4
        I had LASIK done by a nationally known surgeon and it is definitely up there on the best things I've done. I had gotten to the point where contacts would irritate my eyes so bad that I had gone strictly to glasses. I was not one of the ones that sat up and could read the clock across the room. I was actually somewhat p*ssed because everything was still blurry AND foggy and I made sure they didn't throw my glasses away. They assured me it would clear up over the next several hours and it did. I had some halos for a month or so after but they completely subsided. I had drier than normal eyes for a few months as well but it went back to normal. I would recommend finding the most highly respected surgeon in your area and getting a consultation. Hint: the most highly respected surgeon isn't the one doing Group-Ons for $399/eye.

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        • #5
          I had LASIK done around 15 or 16 years ago now. I had to start wearing glasses again for driving/operating 2 years ago. Being able to see at the beach or the pool when swimming was well worth it for me.

          Eye3md I think you're the first ophthalmologist I've ever seen say they would get LASIK on themselves. I've always seen people recommend against it.

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          • #6
            My wife had Lasik 8 years ago. She has needed glasses since age 6-7. Mostly wore contacts as an adult but wanted to get it done before having kids so that she would not need to fumble in the night for glasses. The optho was a jerk and yelled at her for her head not fitting in his apparatus correctly. But it has been years without trouble so I guess we can let that one go. She was very happy with the results. It cost around 4K if I remember correctly. It was a big expense when I was a resident but it seems totally worth is now.

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            • #7
              Had lasik done in 1997 in my first year of residency. Best $400 for 20 minutes of service ever spent. Residency insurance covered 2/3 of the cost(which I remember surprised the the ophthalmologist's biller).

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              • #8
                Thanks all! My vision is between -4.25 and -5.00. I’ve grown tired of glasses and contacts. It feels like I’m walking around with a serious case of beer goggles without my lenses. Ha. I would like to swim, etc and still be able to see. I agree I haven’t met any ophthalmologists who would have the procedure which is why I have been hesitant! I originally wanted to wait until I had paid off my student loans, but the interest rate is so low (0.41%) that I’m taking my time (5 years...)!

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                • #9
                  CordMcNally, good point about the dry eyes. You will need to be aggressive using artificial tears after the surgery. Also, another good point about the "special deal" LASIK centers. Find a good experienced LASIK surgeon in your area. If you have straight forward myopia (near sighted) without astigmatism or keratoconus, then LASIK should be very straight forward (ie, hard to screw up). If you have astigmatism, or other corneal issues, those certainly need to be discovered before surgery or it can lead to screw ups. An experienced LASIK surgeon will know how to deal with the good/bad of any of these with ease.

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                  • #10
                    Originally posted by Nysoz View Post
                    Eye3md I think you're the first ophthalmologist I've ever seen say they would get LASIK on themselves. I've always seen people recommend against it.

                    I have had several ophthalmology friends who had it performed as well......but, they are also heavily involved in cataract/refractive surgery. Their reasoning was "how can I justify LASIK to my pts if I am still wearing glasses myself?".

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                    • #11
                      I've thought about it for years. My vision is also in the -4 to -5 range with astigmatism. I've had glasses since about age 5, so they're almost a part of me, but anything involving water (pool, beach) is annoying and switching back and forth with prescription sunglasses is a pain also.

                      Still, I'm a pathologist so if there's even minor side effects from LASIK with light sensitivity or anything else it would suddenly become a very big deal. Maybe I'll see what's available when I retire...

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                      • #12
                        Originally posted by ScubaV View Post
                        I've thought about it for years. My vision is also in the -4 to -5 range with astigmatism. I've had glasses since about age 5, so they're almost a part of me, but anything involving water (pool, beach) is annoying and switching back and forth with prescription sunglasses is a pain also.

                        Still, I'm a pathologist so if there's even minor side effects from LASIK with light sensitivity or anything else it would suddenly become a very big deal. Maybe I'll see what's available when I retire...

                        Not that it occurs with everyone but I've heard numerous LASIK pts comment their vision is better after LASIK than what they could ever achieve with contacts or glasses.

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                        • #13
                          I was warned off by a corneal surgeon who said, in effect "Your eyes arf perfectly healthy and your corrected vision is fine. Why would you even consider surgery?"

                          I am a radiologist so developing any new vision problems, even temporarily, would be a major reason not to consider it. Since I spend all day staring at computer screens, apparently terrible for dry eye, that is the last thing I would want to risk.

                          Having worn glasses all my life, I am never comfortable without something in front of my eyes.

                          But glad to hear that many people are happy.

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                          • #14
                            I feel the same way afan (except I wear contacts). I have been tempted but I worry about that small but not trivial risk of complications. I was also told my pupil size was large and increased the risk of halos (or some other issue I can't recall).

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                            • #15
                              There is more data now then when this was made...
                               

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