Lasik Surgery: Go in with Eyes Open

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Ads say that Lasik can "reduce or eliminate dependency on glasses or contact lenses" and "vision improves almost immediately." The downsides are less widely advertised.

More than half of Americans who have Lasik or other laser vision-correction surgery still need to wear glasses at least sometimes. Side effects such as dry eyes, halos, glare and starbursts around lights are common. Those results are from a Consumer Reports National Research Center survey of 793 adults who have had vision-correction surgery since 2001.

Although 80% of respondents said they were highly satisfied with the surgery, our findings point out the need for realistic expectations.

Among the main reasons for having surgery (respondents could cite more than one): 61% said they were tired of wearing glasses; 52% said they wanted to see a bedside clock in the morning; 38% said contact lenses were uncomfortable and hard to care for. But afterward, 55% still needed to wear glasses or contacts at least sometimes. And of those who found it very hard to see that clock, just 36% had little or no trouble seeing it after surgery.

If you're considering laser eye surgery, find basic information at www.fda.gov (search "lasik"). Talk to others who have had the surgery. And ask yourself:

Am I a good candidate?

Your vision should have been stable for the past year. You should be at least 18 and not pregnant or breast-feeding. You shouldn't have a disease that impedes healing (diabetes, say) or take medications that do so. Skip surgery if you have dry eyes. People who were nearsighted before surgery tended to be slightly more satisfied with the results than those who started out farsighted or with astigmatism.

What are my options?

In Lasik (laser-assisted in situ keratomileusis) surgery, a flap is cut into the cornea's surface and lifted, laser energy reshapes the underlying cornea, and the flap is folded back into place. Recovery is generally the fastest. In PRK (photorefractive keratectomy), the surgeon removes layers of tissue from the cornea's outer layer before reshaping the cornea. PRK is often suggested for people with thin corneas. In Lasek (laser epithelial keratomileusis), the outer surface is instead peeled back before lasing, then replaced.

Will insurance pay?

Maybe not, because the surgery is elective, but ask your insurer. Many Lasik centers offer discounts. Costs vary widely. The typical national price for both eyes, after any discounts, is about $3,314.

How do I find a surgeon?

Look for a board-certified ophthalmologist (check at www.abms.org) who has performed your planned procedure many times.

Respondents were happiest if their doctor met with them before and after surgery, took a medical history and eye measurements (cornea thickness, pupil size, tear production) and spelled out risks and benefits. Choose carefully: Satisfaction with the surgeon, even more than the place of surgery, predicted overall satisfaction.

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