What's Hot Is Not: Laser Eye Surgery

By Grace Halloran, Ph.D

The latest laser technology can slice and dice the cornea, reshaping it through computer driven instruments to correct refractive error. But just how effective is laser eye surgery -- and is it safe? Anyone contemplating this procedure should perform rigorous preliminary research, and ask a lot of serious questions.

Advertising campaigns for laser eye surgery seem to promise that these techniques can practically instantly, painlessly, and perfectly correct sight. Is this the "magic bullet" that everyone has been waiting for, so they can just throw away their glasses?

Recent studies reported in the Food and Drug Administration's Clinical Publication (FDA No. 99-1293) have brought into question the safety and efficacy of laser surgery for improving sight.

Compiling data over the past year from medical journals and lay publications such as Consumer Reports also depicts a less rosy outcome. Most patients do not recover 20/20 sight and may still need to use glasses some of the time. The long-term view is not much better. Even for those who initially attain "perfect" 20/20 sight, the improvement slips for many after six months, necessitating the use of glasses for such tasks as night driving or reading.

With out-of-pocket expenses running $3,000.00 and more, consumers of this practice need to ask many questions. One of the lesser-known side effects in some instances is eye pain: several first-person accounts related to the author described the extent of the pain as "chronic" and "debilitating." Other reported side effects range from corneal infections to under-correction, warranting glasses, contacts, or a repeat of the surgical procedure.

Eliott Kaplan, O.D. of Mill Valley Optometry in Mill Valley, California has observed a variety of negative changes post-laser surgery, and the optometric medical journals are currently reviewing data and procedures. No studies on laser eye surgery exist in this country that are over four years old. It is therefore impossible to know the long-term effects laser surgery has on the eye and corneal health.

Laser Surgery Techniques

There are three types of corneal surgeries for vision improvement utilized by ophthalmologists at this time. The oldest type, now rarely performed, is called RK (Radial Keratotomy), in which a hand-held surgical instrument cuts the cornea. Because RK reshaped the cornea by making four to eight incisions as deep as 90 percent of the cornea, it has been known to structurally weaken the eye itself.

An older type of laser surgery is called PRK. PRK stands for Photorefractive Keratectomy. In this procedure, an area 5 to 9 millimeters in diameter on the surface of the eye -- a laser sculpts the outside layer of the cornea. As much is removed as necessary to correct the refraction error -- from 5 to 10 percent of the thickness of the cornea for mild to moderate myopia, up to 30 percent for extreme myopia.

Possible problems include delayed surface healing, corneal haze and/or scarring, over- or under-correction, and the development of astigmatism. While most complications remain treatable with medications, sometimes further surgery is required.

The latest procedure is called Lasik: Laser in Situ keratomileusis. In this procedure the eye is flattened and a flap of uniform thickness is removed from under the outer surface of the cornea. This procedure is much more dependent upon the surgeon's operating skill than the more computerized PRK procedure, and the complicated equipment has been known to malfunction.

As of February 1995, complications occurred in 10 percent of the procedures, although this number has almost certainly decreased since that time. Complications can result from the failure of the automated instruments to leave a hinge on the corneal flap with the first incision; loss of the corneal flap during or after the operation; or the slipping of the flap and its healing off-center. The first incision can be too deep, causing a perforation of the eye, or too shallow, causing a hole in the flap.

Other results can include invasion of the surface tissue into the central tissue of the cornea; infection; and scarring and loss of visual acuity. Hazing of the cornea and halos seen at night can especially complicate night driving rather than improve visual function.

This elective surgical procedure will certainly improve myopic individuals with improved clarity of sight -- but how much, and for how long, and what its long-term effect is still unknown. The surgery does nothing to improve eye health or keep the retina from suffering the aging process of high myopia. Caution must be the keyword for this type of eye surgery.

Symposium on Natural Vision Improvement

For those wishing to investigate other helpful healing modalities for eye problems, from myopia to macular degeneration, there is an exciting event taking place in Virginia Beach this coming November 20 and 21. This is the First Annual Symposium on Natural Vision Improvement, sponsored by Old Dominion University of Norfolk, Virginia.

This conference is the first of its kind, and boasts an impressive collection of medical doctors, optometrists, PhDs, and lay practitioners, who are all coming together to promote natural vision health and healing. All areas of eye health will be covered, including Bates Method, Homeopathy, Acupuncture, Micro-current stimulation, color therapy, and the latest information on nutrition for the eyes.

For more information and to register, call Old Dominion University at 757-683-4686.

Grace Halloran, Ph.D., Director of Integrated Visual Healing.
655 Lewelling Blvd., #214
San Leandro, CA 94579
Tel: 510-357-0477.
E-mail: ivhgrace@aol.com

Dr. Mercola's Comment:

It seems quite obvious at this time that laser correction of defective vision has a way to grow. I cannot recommend it for anyone.

One of the more exciting developments that Dr. Halloran does not mention is the insertion of several tiny pieces of plastic directly into the cornea to reshape it. The cost is about the same, but the complications seem far less likely and, unlike the laser surgery, the procedure is reversible.

For those of you who need to wear glasses and are anxious to have a solution, hang in there, one is around the corner and I believe in the next five years there will be some much safer and better choices.

Also, don’t forget that one of the major reasons why you have to wear glasses is that you did not sleep in complete darkness as a child. So, if you have children, do them a favor and let them sleep in absolute darkness. That means no clock radio lights and using blackout drapes to stop the streetlights from leaking into their bedroom.

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