LASIK Prep by Nathan Johnson You know how LASIK works. Here's how you can plan for the best results print article      send to a friend

Maria Sanocki learned the hard way that planning for LASIK is needed, after her first doctor left her with an untreated area known as a central island. She spent three weeks seeing double before a second doctor gently zapped the little island with an excimer laser, giving her optimal vision. "I'm so happy I ended up finding a good doctor," she says in retrospect. "I'm very grateful and I don't want to ever forget and get lackadaisical about my eyesight again." Fortunately, there are preventive steps you can take to ensure that you see straight the first time around. As Sanocki can attest to, doing your homework has never been so important.

LASIK is considered quite safe in the grand scheme of surgical procedures. With a complication rate of around 5%, your chances of having a good result are quite high. Because there are less risks involved and less recovery time needed, ophthalmologists almost always prefer LASIK over other refractive procedures such as PRK and RK. Most patients return to work between a day and a week after the procedure.

An estimated 1.4 million people opted to have LASIK last year. With hordes of LASIK-happy patients clamoring for the services of ophthalmologists, and clinics seemingly sprouting up on every corner to serve them, it's easy to see how people like Maria Sanocki end up in the spotlight. But this does not mean that everyone is having problems. In most cases achieving an optimal result with LASIK is attainable.

Getting results -- the first time!

As with anything else, you have to do your homework to expect a good result with LASIK. First and foremost, the importance of finding a good surgeon should not be taken lightly. According to Dr. Neal Sher, MD, the Minneapolis refractive surgery specialist who cured the eye woes caused by Maria Sanocki's first doctor, this means finding a physician who will see you in advance, and do most of the evaluation personally. "This involves sitting down, looking at your eyes, and talking to you about the procedure, including its risks and benefits, what you can expect, what kinds of problems you may or may not encounter, and how he or she is going to fix them," he explains.

Dr. Sher isn't the only one who considers the surgeon the most important factor in achieving a good LASIK result. Nor is he the only one to emphasize experience. "The best way to avoid problems is to go to someone with a lot of experience," says Dr. David Schneider, MD, a Cincinnati-based ophthalmologist who does LASIK. "I would recommend a surgeon who is committed to refractive surgery as the major part of their practice, as opposed to someone who's just doing a few here and there."

According to Dr. Sher, lack of communication can translate into real problems. "I'm not overwhelmed with botched cases, but I do get people coming in wanting a second opinion," he says. "People come in not even knowing what's wrong with them. No one sat them down as a physician and explained the complication. And that's what I see -- people coming in misinformed about their complication and problem, which compounds their problem even more."

This includes Sanocki's case, in which her first doctor had misdiagnosed the problem. "Central island is not rare with LASIK or PRK," Dr. Sher explains. "It's basically just an undertreated area in the center of the cornea that's a [little bit] more elevated than the rest of the cornea, and comes from fluid shifts in the cornea for certain types of lasers. If you get an area in the middle that's a little wetter than the rest of the eye, a little less tissue gets ablated, because you're ablating water instead of tissue." The problem, in Sanocki's case, was her doctor.

Don't be a LASIK loser

To avoid problems with your LASIK eye surgery, there are a number of precautions you can take:

Find a great surgeon - One thing that all ophthalmologists would agree on is that finding a great surgeon is key to a successful procedure. Although there is some degree of disagreement as to just what this means, many believe the 1,000 procedure mark represents an important step in the experience of a LASIK surgeon. And statistics back this assertion up. "The complication rate drops from 6% to 1% or less after 1,000 cases," says Dr. Schneider.

Here are a few guidelines to bear in mind before selecting that all-important surgeon. CLICK HERE:

Are you a candidate? - While only around five percent of patients are not considered candidates for LASIK, you should make sure you're not one of them. If your eyes dilate to more than seven millimeters in the dark, you are probably at higher risk for glare and halos. Additionally, if you suffer from dry eye or wear Toric or gas permeable contact lenses, there are preoperative measures you must take seriously. Specifically, patients wearing these types of contact lenses will need to refrain from wearing them for two to three weeks prior to surgery. For dry eye, ask you doctor about treatments such as artificial tears and 'punctal plugs.'

Know your lasers - Although this may sound like a precaution reserved for Trekies, certain lasers tend to be better for certain situations, depending on your particular refractive error. Therefore, you should be sure that the laser someone is using is the best laser for your particular refractive error. A good place to start your research may be the FDA's Web site devoted to lasers (fda.gov/cdrh/lasik/lasers.htm).

Be aware of side effects - Although the complication rate for LASIK is relatively low, the most common side effects include:
· Under- and over-correction
· Astigmatism
· Infection
· Night vision difficulties
· Delayed healing
· Corneal haze

In essence, you really just need to use common sense. As Dr. Schneider sums it up, "remember, laser surgery affects your every waking moment once you've had the procedure done, so it's important that you choose someone you can trust and that has your interests at heart."

As for Maria Sanocki, she readily admits she went about things wrong -- and she wasn't the only one. "Looking back on the experience, I now know that the first clinic didn't do the preliminary work that Dr. Sher did. I feel bad because I made an uninformed decision by not looking for a more qualified doctor in the first place."