lasik vs implantable contacts?

December 17, 2007 9:34 AM

What are your thoughts on Lasik versus implantable contact lenses?

I've read a little about PRK and it sounds like it might be too painful for me, so I'm ruling it out. I'd like to go with the surgery with the lowest risk of major complications. And the one that lasts the longest.

posted by pipti to health (17 comments total)

I've read alot about implantable contacts due to my eye condition (keratoconus). From what I read, the implants have significant issues with infection and pain.

My wife had the laser surgery ~4 years ago. They gave her a Valium and she said there was no pain, just a little nervous. She walked out of the office being able to see. Afterward, she didn't mention any real pain or discomfort. She still has 20/15 vision in both eyes.
posted by Argyle at 9:39 AM on December 17, 2007

Oh. Well, I'm certainly not keen on infections or pain. Maybe Lasik is a better option. (Of course, I'm discussing this with my doctor, too.)
posted by pipti at 9:41 AM on December 17, 2007

I've never even head of contact implants. A friend had laser surgery around 8 months ago - her vision is great now but she has really dry eyes (something to do with the tear ducts being damaged?) and has to put drops/cream in them frequently. Apparently this will get better with time.
posted by corvine at 9:46 AM on December 17, 2007

I also had Lasik - in 2002. Walked out a little grossed out at what had just happened, but otherwise able to see. I'll never forget the doctor asking me to look over my shoulder at the clock on the wall and tell him what time it was. I was told that as I got older, I'd still be at risk for normal, age-related vision stuff. My near-sightedness is gone - 20/20 since then, and I was -4.5 in one eye and -5.5 in the other.

Now, I've noticed some slight haloing at night, usually of blue-colored lights, but it's otherwise fine. The procedure was done like clockwork. It was pretty amazing - everyone on the team tightly synchronized and coordinated. The surgeon and I talked throughout the whole thing.
posted by jquinby at 9:48 AM on December 17, 2007

As I understand it, Lasik is generally the preferred option. If you are a suitable candidate for Lasik, you should get it. If you're not, it's worth exploring the pros and cons of another option, but while IANAD (IANAOpthamolagist/IANAOptometrist), I have always understood that if you can get Lasik, there are very few reasons why you should choose something else instead.
posted by cklennon at 9:56 AM on December 17, 2007

I've spoken to my doctor several times about exactly this. He's a proponent of doing the least-invasive and least-destructive method for fixing eye problems (Glasses -> Contacts -> Surgery).

For this reason, a couple of years ago we started talking about implanted lenses, because they theoretically could be removed/replaced later with little to no side-effects. Unfortunately the costs of this surgery haven't gone down as much as he expected in the first year or so since approval in the United States. I'm still undecided, but my contacts are fairly hassle-free and that greatly outweighs the cost and risk of either surgery. My doctor did recommend that implanted lenses might be better because I have already thin corneas that are not ideal for Lasik.

I also have a job that greatly relies on my eyesight, particularly my eyesight in the dark (video production during a live music performance). The risk of haloing would be a potential detriment to my work.
posted by shinynewnick at 10:37 AM on December 17, 2007

My 65-year-old mother had implants during cataract surgery about seven years ago, and her eyesight remains stellar, though she also has problems with tear production -- she has to use drops a couple times daily.
posted by changeling at 10:40 AM on December 17, 2007

I've had lasik, and pain wasn't an issue—and I'm very squeamish about stuff touching my eyes.

You are given numbing drops before they go to work on you. You do have some physical sensations in your eyes during the procedure, and it's certainly freaky to contemplate what's being done to them, but it's not painful.

Many people get scratchy feelings in their eyes for a week or so after lasik. My wife, for one. I had very little of that.

My correction is somewhat less than 20/20 now (20/30 or 20/40), which is a letdown. But I've had no halos, and my near vision is still excellent (I'm 42, so this is noteworthy).
posted by adamrice at 10:47 AM on December 17, 2007 [1 favorite]

Lens implants are what you have when your sight is so far gone, Lasik can't help.
posted by gatchaman at 10:57 AM on December 17, 2007

I am not familiar with implantable contacts but can discuss Lasik. You need to understand the vast difference between Lasik done completely with lasers and PRK. The outcome is the same but getting there is very different.

When people talk about little or no pain, being out of work for a day or two and it being a piece of cake are most likely talking about all laser surgery. The flap is cut on your cornea with a laser, then lifted and the eye is corrected with a laser. I went in for this type of surgery after being determined as a good candidate.

BUT, I ended up getting PRK because they could not get a good position for my eye to cut the flap. For PRK, they actually "scrape" away the layer and then corrected with a laser. The tissue is eventually regenerated.

Let me tell you that PRK is significantly more painful and is more like a week recovery, missed work, and the vision enhancement seemed much slower. I did get my 20/20 vision, it was just a different process. It is my understanding that the military uses PRK and some doctors still prefer it.

Any good doctor/facility will give you a free consult to discuss all of the pros/cons and is well worth exploring.
posted by maxg94 at 11:07 AM on December 17, 2007

I had Lasik ~2 years ago and, other than the minor discomfort during the procedure, never had any complications. I wish I had done it sooner!
posted by grateful at 11:14 AM on December 17, 2007

Lasik FTW. I had it less than a year ago and it's probablydefinitely the best $3500 I ever spent. I was very nearsighted (and astigmatic) before the surgery and now I've been glasses-free for 10 months (and loving it).

A caveat, though -- avoid PRK unless you're some sort of extreme athlete who regularly gets direct pokes in the eye, or your doctor tells you it's absolutely necessary due to eye shape or whatnot. A friend of mine had PRK and he tells me it was quite debilitating for a few weeks. To compare, I was able to correctly read the number plate of the car in front of mine as I was driven back home after my procedure, and I drove myself back to the clinic for my follow-up the next day.
posted by clevershark at 11:27 AM on December 17, 2007

I have the verisyse lenses. I love them-- I was not a good candidate for lasik because my myopia was so extreme. My vision is 20/15 in the daytime. I do have a little haloing at night.

I had to do each eye separately, it's a much more serious surgery. However, I was only out of work for one day with each eye.

If money is no object, maybe go for the lenses. I'm not aware that infection is actually that big of a problem-- but that you'd have to go over with your doctor.
posted by miss tea at 12:21 PM on December 17, 2007

My father opted to get lenses when he had cataract surgery. While his distance and mid-range vision is now awesome, he needs a pair of reading glasses for books &c, and a different pair for monitor distance. And yes, he gets halos at night. He doesn't judge it to be an unqualified success.
posted by mumkin at 12:46 PM on December 17, 2007

Yes, the lenses, like LASIK, will not prevent you from having presbyopia, which is what causes you to need reading glasses. Sounds like your dad might need bifocals or graduated lenses for his reading/monitor work.

The halos are definitely irritating, but generally they only bother me when I am driving, which I don't do frequently anyway. If you were a big commuter it might be a larger issue.
posted by miss tea at 1:25 PM on December 17, 2007

My dad also had the lenses put in after cataract surgery. About a year later, he had an almost complete retinal detachment in one eye. The doctor said that the lens surgery was a small factor in this happening. My father is a bit old, and he might have had the detachment anyway; you might be young and spry. But anyway, the more you know. Oh, he also gets that halo thing.
posted by bluefly at 2:13 PM on December 17, 2007

FWIW, someone I know had PRK done within the past year, and he said that one of his eyes is for far vision and one is for near vision--maybe not a problem for you, but I think that would bother me.
posted by phaded at 4:36 PM on December 17, 2007