The Truth About Laser Eye Surgery (LASIK & LASEK)

in #science3 years ago

This article was motivated by the pitiable experience of a close relative of mine who was misled into undergoing a laser eye surgery with over 99% assurance that the procedure would mark an end to his very manageable eye defect. Unfortunately, the outcome fell far short of expectation as my uncle is, today, a comatose of his former self, and has almost gone blind following the procedure. While this article is not intended to discredit the effectiveness of this technological ingenuity in restoring normal visual acuity, it is meant to enable those those considering the procedure to make an informed decision as all that glitters are not gold.

eyeglasses-2003188_12801.jpg
[Source: Pixabay commons. CC0 licensed]

Eye, without any doubt, is the most cherished of all sense organs. Many people would prefer to live with an amputation or any other manageable health defect than without their natural sightedness. Losing total eyesight is so devastating that victims sometimes would prefer to take their lives than to live under blindness. Having good visual acuity or 20/20 vision means that the natural eye lenses are able to refract light rays to focus on the retina. However, if the eye lenses are not able to do this properly, it could mean the individual has an eye defect. The most common types of eye defects are myopia and hypermetropia in which the light rays brought to a focus in the front and behind retina wall respectively.

Usually, the first treatment option for those with sight defects is wearing eyeglasses or contact lenses for many years, and in some, cases for a lifetime. Wearing eyeglasses or contact lenses day in day out is no pleasant experience.
The discomforts associated with using eyeglasses and contact lenses are integral part of the shortcomings laser eye surgery procedures were developed to get rid of.

Imagine the feeling of being able to see clearly without those awkward optical extras that appear to be blocking your views. However, as children, we were told not to stare at the Sun in order not to harm our eye nerves and possibly going blind or suffering complications. With this in mind, how then will exposing our eyes to laser light improve our vision to the extent that we no longer need eyeglasses or contact lenses? Will laser eye surgery be able to fix all it promises? Is the procedure right for all persons based on viable research statistics? Let's find out in this article...

398px-thumbnail1.jpg
[Laser procedure being performed at US Navy base. Source: Wikimedia commons. Author: US Navy photo. public domain licensed]

What is laser eye surgery (LASIK/LASEK)

It is true that the most common cause of eye defects is the abnormal shape of eye lens and cornea in the case of astigmatism. Theoretically, we could surgically open the eyes, grab the lenses, and reshape them to correct the abnormality in their shapes. But this is too risky and very delicate because lenses are not easily accessible to a surgical surgeon. Protecting the lens is a thin, transparent coating known as cornea that has to be first removed before the lens can be accessed. However, cornea protective covering is curved, transparent, and contains no air, and so plays a part refraction of light rays. Hence, instead of cutting through the eyes to get at lenses which is very risky and delicate, surgeons prefers to work on the cornea coating to correct the eye defect. This is thus the theory behind laser eye surgery.

Having said that, by definition, we can say that:

Laser eye surgery is an umbrella term for several eye surgeries used to correct refractive errors (i.e., how your eye focuses light). The most common types of laser eye surgery include LASIK, and LASEK | Source

LASIK stands for Laser-Aassisted In-Situ Keratomileusis whereas LASEK stands for Laser-Assisted Subepithelial Keratectomy. Medically, kerato is the prefix that is associated with anything that has to do with cornea. From this, we could have so many other medical names. Examples; Keratitis is a medical term used to describe the inflammation of the cornea; Keratectomy is a term used to refer to surgical procedure in which a part of cornea is surgically removed, and Keratomileusis is used when the surgical procedure involves reshaping of the cornea surface as against excising a part of it. With this in mind, it is now obvious where LASIK and LASEK were originally derived from, and we can now differentiate between the two surgical procedures: (LASIK = reshaping cornea; LASEK = removing a part of cornea). What's true for both of these procedures is the fact that they can both be used to correct myopia, hypermetropia, astigmatism and presbyopia. Let's take a closer look, at this point, to each of these procedures...

eye-test-1313976_12801.jpg
[Source: Pixabay commons. CC0 licensed]

LASIK

This is the most common of all, and very simple to understand. The procedure is not painful neither is it comfortable. Here, anesthetic is first used to treat the eye preparatory to the procedure. Then suction frame is used to grip the eyelids as well as pull on the cornea, holding it in position in readiness for the surgery. Within a split of nanoseconds, either laser light or microscopic knife known as microkeratome blade, is used to cut a flap in cornea. With a tiny portion of the flap acting as a hinge, the flap is lifted up and folded back in a way that exposes the corneal tissue underneath, which is then reshaped with the aid of a laser beam under computer control. When through, the flap is placed back and is able to self heal without being aided by stitches or surgical adhesives.

It is wrong to expect an overnight improvement as recovery will occur in phases under the close guidance of your doctor. Click here for a more thorough explanations and precautions following the procedure.

LASEK

LASEK is a less painful or invasive version of an earlier type of laser procedure known as photorefractive keratectomy (PRK). Both procedures are similar in that they interact with epithelial cells of the cornea. However, in PRK procedure, epithelium is entirely removed and discarded whereas LASEK procedure only brushes away the epithelium in order to carry out the surgery and after then places it back for reattachment and healing [ref].

In comparison to LASIK, LASEK is a far less drastic procedure. It is technically referred to as a surface ablation procedure, a process that entails removing some of the epithelial cells of the cornea. Generally, it is thought of as being safer and less susceptible to complications than LASIK. However, there is still an uncertainty over which is a better treatment option. A 2017 Cochrane review of numerous published studies concludes that:

"there is uncertainty in how LASEK compares with LASIK in achieving better refractive and visual results in mildly to moderately myopic participants."

You can go here to read further on LASEK.

800px-The_first_laser_vision_surgery1.jpg
[The first laser vision surgery. Source: Wikimedia commons. Author: Lspeyeclinic. CC BY-SA 3.0 licensed]

Knowing the truth and making an informed decision if the procedure is right or not right for you

More often than not, it is not uncommon to see many newspapers, magazines and internet advertisements paint an attractive picture of the procedure to lure unsuspecting victims of eye defects to undergo the procedure in their choice organizations and make profits off such individuals. They make it look as though the procedure is the elusive magic wand to the victim's eye defects. And most people end up thinking the procedure is as simple as work in and work out with 20/20 vision kind of process. This is by no means the true representation. The truth is, first; laser eye surgery does not guarantee perfect vision, and again, it is not suitable for all persons. That's first. Secondly, it's not as simple as advertisers may want us to believe. All things being equal, a potential candidate has to be put through a long period of preparation before the actual surgery, and recovering after the procedure could take between one month through six months to up to one year.

FDA reports that the safety and effectiveness of laser eye procedure is yet to be determined in persons with some diseases [ref]. This is why it is not for all persons. It is important that prospective individuals undergo a thorough pre-screening procedures to determine where they fall into in order not to complicate their conditions afterwards.

According to the October 2014 publication of the results of FDA's LASIK Quality of Life Study, the below observations are noteworthy...

Based on our initial analyses of our studies:

Up to 46 percent of participants, who had no visual symptoms before surgery, reported at least one visual symptom at three months after surgery.

Participants who developed new visual symptoms after surgery, most often developed halos. Up to 40 percent of participants with no halos before LASIK had halos three months following surgery.

Up to 28 percent of participants with no symptoms of dry eyes before LASIK, reported dry eye symptoms at three months after their surgery.

Less than 1 percent of study participants experienced "a lot of" difficulty with or inability to do usual activities without corrective lenses because of their visual symptoms (halos, glare, et al.) after LASIK surgery.

Participants who were not satisfied with the LASIK surgery reported all types of visual symptoms the questionnaire measured (double vision/ghosting, starbursts, glare, and halos).| Source

FDA would later go on to publish an article to highlight the risks as well as a list of factors and conditions for prospective individuals to consider before choosing a doctor for their surgery [ref]. It is very advisable to review the list before making conclusions.

sign-3278358_12801.jpg
[Source: Pixabay commons. CC0 licensed]

Conclusions

Despite the 95.4% patient satisfaction rate report of a 10-year period data about 3000 peer-reviewed articles from international clinical journals which was published by the American Society of Cataract and Refractive surgery, the key messages of this article should not be ignored.

Summarily put, these key messages are as outlined below:

  • It is important to appreciate the fact that this is a serious surgical process and should not be taken lightly. It is not as simple as deciding to switch from glasses to contact lenses.

  • Ensure you get properly informed on the implications of the procedure, including the possible recovery duration. Don't be caught by the sweet language of the advertisers who are simply doing the bidding of optical clinics. Research and read widely to get trustworthy information from reputable sources.

  • Consider different likely scenarios after the procedure, and have realistic expectations about the outcome. For example; you may not have a perfect vision afterwards, you may have to undergo the process twice in the event of negative outcome, you may even still need to wear glasses. This is to prepare yourself beforehand so that if the outcome falls short of your expectations, you will not entertain suicidal thoughts, go into depression, psychological disorder or hurt yourself in any way.

  • If you, however, decide to go ahead with the surgery, do a thorough investigation on the surgeon. Find out about his credentials and reputation. Please don't go for the cheapest, as your eyesight is not something you would like to sacrifice on the altar of cheapness. Get recommendations from a good number of surgeons.

Goodluck to you.

References for further reading

Yours truly,
@eurogee

Do You Blog About Science, Technology, Engineering, and Mathematics? If Yes, Patiently Read The Below Info

For those writing STEM (Science, Technology, Engineering, and Mathematics) related posts, consider to be part of #steemSTEM community. The link to #steemSTEM community discord room is here. For STEM writers from Nigeria, include #stemng tag in your posts in addition to using normal #steemstem tag. You can check this blog by @stemng for more information. You can visit this post by @steemstem on how to become a member of STEM community. Visit this link for helpful guidelines on writing #steemstem targeted posts. In order not to violate copyright laws in your use of images, consider checking out this post by @steemstem team.

Join Euronation Community on Telegram and whatsapp through the below links to socialize with larger steemit community:

https://t.me/joinchat/HsUnkBJ083m0R6xIp4iA-A

https://chat.whatsapp.com/9VhuK6475477fD7fPIYJ6i

No Witnesses = No Steem Blockchain; If You Truly Love Here, Vote For Witnesses NOW!

Click This Link To Vote Now

follow_eurogee.gif

Sort:  

Your article gives great food for thought. I am a licensed optician and I have to tell you that I’ve seen folks who are extremely pleased and some that ended up worse off than prior to the procedure. Whether you choose to have this done, continue to wear contacts, or do anything without eye protection, consider this- you get one set of eyes in your lifetime. Be sure you are ALWAYS treating them right. You can’t get back what you lose-usually, so please take care in any decisions you make and how you choose to take care of your eyes. Sight is a precious gift.

I appreciate this valuable feedback. And do totally agree with you. Thanks you

Great article on Lasik. I've always heard rave reviews about this procedure and never thought it had such detriments. If my eye sight ever degenerates I think I will be better off wearing glasses than tampering with those lasers. Thank you for sharing :)

Not that bad a procedure but trade carefully. Thanks

I've learnt couple of things here thanks to @eurogee.


I am @teekingtv and I write STEM

Appreciate your visit

Anytime sir.

You talked about 95.4% patient satisfaction, does it mean the procedure achieved the desired result almost 95 times out of 100? If this is the case, I would say it's still a significant success especially if the eye issue is a chronic one.

Even though I would have loved to see more statistical information concerning the procedure, you did a good job with the write-up. Well done.

Hello @gentleshaid

Yes it is a significant record I must confess but at the same time questionable when you consider this FDA observation:

Up to 46 percent of participants, who had no visual symptoms before surgery, reported at least one visual symptom at three months after surgery. Link

But then the essence of this article is for people to ensure that they are adequately pre-screened to determine if they are suitable for the procedure. For instance, it can be very risky for a diabetic (who is liable to delay healing) to undergo the procedure.

Thanks for reading.

@eurogee

Well, the eyes is definitely the most delicate part of the human body. I really wonder why we have to subject ourselves to such risks in the name of making perfect what could be managed.

The waves associated with lights used for medical therapies of such high level are often treated to become mild. But even at that, the eyes is too delicate to be subjected to them.

Anyways, the fact that the procedure has recorded about 95% success is one reason why there's no going back. The number is pretty commendable.

Interesting read @eurogee

Yes. Thanks for being here

This procedure is carried out by professionals who I believe will tell the patient the attendant risk and follow due process. I don't think there is surgery where someone is guaranteed a 100% chance of success. There is no ideal situation, but I still think laser surgery is safer than most other surgical methods.

All surgery carries some risk of
complications (a complication is defined
as an unexpected occurrence). In laser
eye surgery, complications are very
rare, and advances in technology and
surgical expertise mean that almost all
complications can now be corrected. In
fact, the chance of an expert being faced
with a situation of marked permanently
reduced vision or quality of vision that he
or she could not correct satisfactorily is
about 1 in 30,000 London Vision Clinic Pg. 31.

I think I can take a 1 in 30,000 or 99.9966% chance of success.

Good article :)

That's for such an objective view sir.

This procedure is carried out by professionals who I believe will tell the patient the attendant risk and follow due process

Not all of them do this these days. People seem to be interested in money than they are in other people well being. The story of my relative is a case study. I myself have been sick before to such a extent that I had to travel to India to seek a more advanced treatment. I know my experience. And I can tell it's not all that palatable.

Appreciate your visit.

Regards

Thanks for sharing some useful info about LASIK and LASER treatment.

Your posts are always informative and I always appreciate your time in writing such detailed blogs.

Thank you for using eSteem and you have been chosen by eSteem curators for Encouragement Program .

I visited the blog page but could not figure out what you meant. Can you explain more please.?

As you can see in the Encouragement Program page, it's a set of rules set by @good-karma and team to evaluate the posts posted thru eSteem mobile or Surfer desktop apps and encourage the authors by rewarding their posts.

Recently we had a discussion with @good-karma and decided to use that message to appreciate authors and invite authors to visit that blog to understand the rules.

Couldn't see encouragement page. All I saw was @good-karma. Thanks for your reply anyways.

yes true that human can survive without any organ i.e arms,legs but can't leave without eye . without eye he or she does not imagine how world is and how his or her family is ..

microscopic knife known as microkeratome blade, is used to cut a flap in cornea

Wow! Sometimes I try to imagine the mind of the surgeons. They should be appreciated. Thinking about using a microscopic knife to operate on another humans eyes gives me a funny feeling. I hail surgeons

When through, the flap is placed back and is able to self heal without being aided by stitches or surgical adhesives.

Hmm. That's something I never knew. I always thought that the flap must be stitched back.

Thanks for this nice write up. It's really amazing!!

Well, in as much as we hail football players, sure surgeons deserve some Kudos too but THAT IS WHEN THEY DO A GOOD JOB.

Nigerian medical practitioners suck big time. Sometimes you visit a hospital with headache problem and come hack having that deadly HIV. Seriously, it ain't funny. The day Nigeria Super Eagles played Croatia, I was in complete village, Ikeja to get some gadgets and came across this woman who just arrived from UK. Situation made us share some life experiences and that was how she talked about her mother that lost her life recently. The deceased was said to be having cancer but luckily, she was treated in UK with organic means and was fortunate to survive it. She came back to Nigeria and visited a hospital with toothache complaint but end up dead. On top wetin!? Toothache! 😢

So while I admire the good surgeons who are professionals, I can beat the hell outta the idiotic ones. There was a situation where a Nigerian surgeon forgot a needle inside a woman's belly after surgery. RIP to the innocent woman 😢.

So, I am already furious as it is. Do not get me more angry.


I am @teekingtv and I write STEM.

I totally agree with you 100%!

I have finally made it in life! 😂

I agree with you on the basis of @teekingtv's opinion. Not in all cases but only when they do a nice job! Thanks for visiting.

@eurogee

Congratulations! Your post has been selected as a daily Steemit truffle! It is listed on rank 3 of all contributions awarded today. You can find the TOP DAILY TRUFFLE PICKS HERE.

I upvoted your contribution because to my mind your post is at least 21 SBD worth and should receive 147 votes. It's now up to the lovely Steemit community to make this come true.

I am TrufflePig, an Artificial Intelligence Bot that helps minnows and content curators using Machine Learning. If you are curious how I select content, you can find an explanation here!

Have a nice day and sincerely yours,
trufflepig
TrufflePig

I've been always thinking about Lasik for a long time now. Never would get it, but it's been on my mind. Just the mere thought that someone will slice into my eye and shoot me with lazers in my eye and i can't blink just scares the crap out of me.

It still have a high success rate and generally considered to be a safe procedure but ensure you are thoroughly pre-screened. And your surgeon is reputably capable. You can. Thanks

Many people would prefer to live with an amputation or any other manageable health defect than without their natural sightedness

This is true, living without sight can be extremely difficult, I believe slightness is the most important sense we have.

I am really sorry about what happened to your relative, and there is always the small possibility of something going wrong, but in my family there is a person who went through this type of surgery because she wanted to fix her myopia and stop using glasses, everything went perfect with zero problems.

So even though this is not a perfect procedure, it is very good to have this option for the people who want to fix their eyes.

Do you know what went wrong with the procedure applied to your relative?

you will not entertain suicidal thoughts

This sounds extreme don't you think?

Thanks for visiting.

Do you know what went wrong with the procedure applied to your relative?

Perhaps he was just unlucky but the way he talks about it, it looks like he was made to under the process under duress in order to part away with his money. Currently, he rarely sees, and cannot drive.

you will not entertain suicidal thoughts

Some folks who had had to take their lives over amputation, how much more total blindness? I don't thinks so sir. It's a possibility.

@eurogee

At the age of 25 I started wearing eyeglasses, and it is really hard without it, and with all the ads about LASIK i was thinking it is a good idea to undergo surgery, but now I have to think twice really, i don't want to risk the window of my soul.... Nice reading sir eurogee as always 😍😘

It's still a go-to in chronic extreme cases as Success rate is high but ensure the surgeon is a seasoned specialist. Thank you

Thank you so much sir... 😍❤️

Excellent article.
I had LASIK surgery myself and while the procedure was a succes overall, I do 'suffer' from halo's, increased sensitivity to sunlight and reduced night vision. I was informed about the risks beforehand. Despite these side-effects I have no regrets at all and if I could go back in time I would do it again. For me personally the upside of not being visually handicapped anymore outweigh the relatively minor discomforts of the side-effects.

I am however very glad that I only had these side-effects. Some of the horror stories out there are terrifying.

What a great testimony. Happy for you. And thanks for sharing your experience with us.

I started to wear glasses since I was 25 and it is part of who I am. I don't see them as an inconvenience, but a necessity and it's like wearing a hat. I tried contact lenses at that age too, but I found it was too much a burden to clean and uncomfortable when working very long hours. I am scared of this kind of surgery and had never considered it. Glasses are fine. Thank you for the post that explains everything about the risks.

Thanks. Nice to have you here.

Hi @eurogee!

Your post was upvoted by utopian.io in cooperation with steemstem - supporting knowledge, innovation and technological advancement on the Steem Blockchain.

Contribute to Open Source with utopian.io

Learn how to contribute on our website and join the new open source economy.

Want to chat? Join the Utopian Community on Discord https://discord.gg/h52nFrV

Thanku for share the great information on steem community

I am glad you covered this!

You should cover more on PRK. From my research PRK surgery is a better choice but takes a longer time to heal. The problem with both LASEK and LASIK is that they both require a thin cut of a flap that is later put back in place.

Having this FLAP is very dangerous especially athletic individuals who commonly get their eyes exposed to some kind of trauma to it. The FLAP at times can come off during eye contact even with the eyes closed.

I've been wearing glasses or contacts for decades. And I can't tell you how much I hate having to wear either for driving.
I was told by several lasik practitioners that I am a perfect patient for correction of my astigmatism.
If I can do it financially, I will.