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July 9, 2010 | Comments: 1

LASIK: Reading the Fine Print

LASIK surgery for presbyopia—that is, age-related farsightedness—has been approved by the FDA for people who are also nearsighted. But it’s not without risk. 

Presbyopia makes it hard to focus on near objects, such as a book or computer screen. It develops after age 40, and until recently could be managed only with reading glasses or, in some cases, contact lenses. 

If you already wear glasses or contacts for other vision problems, the onset of presbyopia may mean bifocals, which are sometimes hard to get used to. So LASIK for presbyopia has a ready market.

LASIK surgery to correct refractive errors (the inability of the eye to correctly focus light so that the retina can transmit a clear image to the brain) has been around for a while now as a treatment for nearsightedness (myopia) and astigmatism (irregular curvature of the cornea). It is also a treatment for presbyopia, but it’s too early to know about its long-term effects.

As a treatment for presbyopia in nearsighted people, the surgery results in one eye that sees close up, while the other eye sees at a distance—this is called monovision. Your brain adjusts to the different input from both eyes. Monovision contact lenses have been in use for years.

Many people do fine with monovision and are pleased with the results of their surgery. But others cannot get used to it. Before committing to surgery for presbyopia, you should try monovision contact lenses for a week or two while pursuing your full range of activities—reading, working, playing a sport, seeing a movie, driving. If you don’t like monovision contacts, don’t have the surgery.

No guarantees

Possible side effects of LASIK surgery for presbyopia include seeing glare or haloes around lights at night, blurry vision or double vision, and headaches. You may need glasses for certain tasks even after surgery. Your depth perception and thus your driving ability 
may be adversely affected. Chronic dry eye syndrome is another possible complication. Also, good results may diminish with age.

To be a candidate for LASIK surgery for presbyopia, you must be healthy and have healthy eyes. People with diabetes, glaucoma, or weakened immunity may not be good candidates. The cost varies widely across the country—anywhere from $500 to $2,000 per eye. Insurance does not cover the surgery. 
Be cautious about slick ads and cheap prices. Don’t believe promises of “20/20 vision” or “Satisfaction guaranteed.” If you want more information, this FDA website is a good place to start.

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