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Carried this over from another thread, "How does LASIK affect HT viewing?" Granted, it's not about digital projectors, but I thought it was important enough to bring to wider attention, as you seldom see balanced information about the procedure. This is not an ad. I don't do LASIK.


Here's what I tell my patients:


LASIK (Laser In Situ Keratomileusis) can be a miraculous procedure for some people, dramatically, nearly instantly changing their entire lives, by allowing them to function without glasses. The great majority of patients are happy with their outcome.


It is, however, not right for everyone.


While it can correct distance vision, it is unable to correct presbyopia, the age related decline in near focusing ability that afflicts us all, usually beginning in our mid forties.


Many myopic (nearsighted) people can continue to read and see up close without glasses for their entire lives, because their eyes are relaxed up close, and do not have to actively focus. When they have LASIK, they become just like the rest of the 'normal' people, and gradually lose their near focusing ability.


As we age, the ability to see clearly up close becomes more and more important, especially as our activities become more limited. The superior near vision of the nearsighted person can offset the effects of eye disease, and allow good near function as old age and more limited activity set in. If you have LASIK, you lose this advantage.


So there's a trade off, diminished near vision for improved distance vision, and it's hard to understand how it feels to be unable to focus up close until it happens to you.


Whether that trade off is right for you depends on a number of factors, among them how nearsighted you are, what kind of activities are most important to you, and how old you are.


If, like Piggy in "Lord of the Flies" you are young and so dependant on your glasses that if they broke you'd starve to death because you couldn't find your food, LASIK could well save your life.


If, at the other extreme, you are old, forgetful, and couldn't see to eat if you misplaced your reading glasses, you might be better off being nearsighted. At least you can see your food.


Most of us fall somewhere between these extremes, and the decision must be individualized.


I, myself, am in my early 50's, mild to moderately nearsighted (-1.50, both eyes).


When I was in my 20's and 30's, I resented wearing glasses or contacts.


When I hit my mid 40's, I became less able to see up close with my glasses on, fine without them.


Today, I still see fine up close, while most of my friends need reading glasses. I've got no glasses on while I'm typing this.


Moreover, my distance vision is not really as bad as I once thought. I can function, if I have to, and get around without my glasses on. As a single guy (again), I can see a woman across the table from me in a restaurant just fine, and don't have to whip out a pair of specs to read the menu. I don't have a pair of "readers" dangling from my neck.


If one of my colleagues said to me "Poof, you're no longer nearsighted", with no surgery, no chance of complications, instant results, I'd say "No, thanks". I'm functioning better than I would be if my distance vision were perfect, both for work, and most of my play. I can get it for free from the best LASIK surgeons around. I haven't. Not because I'm afraid of it, but because I think I'm better off this way.


Personally, I think it might be worth it if you're beyond a -4.00 or so, the point at which you're in trouble without your glasses, and have to hold things really close to read without them, so you're wearing reading glasses anyway. LASIK really can change your life.


Your age enters into it as well. If you're 25, you'll have 20 good years before you need reading glasses. Maybe worth it. If you're 38, you'll have only 6 or 7 good years, maybe you should keep your glasses. Depends on just how thick they are. Get it?


For many people the trade off comes at a lower number, for many, a higher number. Just remember, it's not a panacea, and you have to understand the whole picture when you make the decision whether or not to have LASIK.


All of the above assumes no complications. Generally the procedure is safe and effective, and the vast majority of patients are happy with their result. There are, however, a small percentage of patients who will be forever miserable, even in the hands of the best surgeon. You pays your money and you takes your chances. Good luck.


To sum it all up, yes, LASIK can change your life. Just not right for everyone. Be informed.



Richard E. Charney, M.D.

New York, New York





[This message has been edited by drmyeyes (edited 06-12-2001).]
 

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Doc,


Being 36, I would fall close to your warning line that presbyopia will soon overtake me. On the other hand, I am nearsighted -8.00 in both eyes. I can't function at all without putting on either glasses or contacts.


When I researched Lasik a few years ago, I was seeing numbers like "1 case in 10,000" results in uncorrectably worse vision than they started with.


Many people would consider odds of 10,000 to 1 pretty good. But call me chicken, because those sound like bad odds to me. Everything I enjoy about life, from work to reading, skiing and HT requires good vision. Not perfect, but good. Disposable contacts give me that.


Now somebody might throw out a statistic that disposable contacts have resulted in infections and loss of sight. Maybe so, but it's the old "devil you know" syndrome. Contacts have worked without problems at a moderate cost for the last ten years. They do not provide perfect vision and they are not hassle-free. But they ARE close to risk free for me.


What would the odds have to be for me to bite on Lasik ? I really don't know, but I guess I'll have to follow some of the links that have been posted and research it again and see where the odds are now. They've surely improved since two years ago, haven't they ?


------------------

*********************

Kirk Ellis

G1000 D-ILA, HTPC, Panamorph (soon I hope),

Dish 6000 (HBOHD,SHOHD,CBS,NBC,ABC,WB,FOX,UPN, KCET -- does it get any better ?)
 

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dreamer,


those 1 in 10000 odds are rather incorrect. Right now you can probably see 20/20 with glasses or contacts right? Well after LASIK you might only be correctable to 20/30 or 20/40. That means that is the best you can achieve _with_ glasses or contacts. The odds of that happening is rather higher than 1 in 10000 - especially for the higher myopes. Just check the statistics for some of the lasik surgeons that have been at it for some time.


As for advances - there have been some advances in technology yes, but you'll have to make sure that the surgeon you choose has not only access to that technology but also is familiar with its use. It usually takes a while for new tech to filter down to everyone out there. Just as not everyone has the latest/greatest dvd player not all clinics have the latest/greatest laser surgery equipment.


That said - your degree of refractive error is absolutely on a scale where it would improve your life quality greatly if you had successful laser surgery. Just make sure you check the other thread and be aware of the risks and drawbacks.



------------------

/frode
 

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I think i have to agree with Dr. Charney, i have been

thinking about this quite a while. I'm 47, my left

eye is -2.0 my right eye is -1.5. About a year ago

i switched from glasses to contacts. Absolutely great

for far vision, sucks for reading. On the weekends

i do not use the contacts at all. Much better overall.

I find myself driving without contacts or glasses more

and more. Was thinking about lasik, but a friend in

the business who owns one of the largest perlevisions

in the country will not let me get lasik. 100 inch

diagonal picture without glasses is just fine http://www.avsforum.com/ubb/smile.gif


[This message has been edited by kevin gilmore (edited 06-13-2001).]
 

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There was an article in Fortune about 1 year ago about LASIK.

Bottom line was that at Emory University Eye Clinic in Atlanta they are in the trial stages of a new kind of LASIK. From what I remember, a computer scan maps your eye and give the surgeon (and I guess the machine) a custom LASIK surgical plan. The results were said to be much better than standard LASIK, with most people resulting in having 20/10 vision. It was said to correct a lot of the problems that standard LASIK cannot correct. This is what I am waiting for. I think (again from memory) that it will go public around 2003 - 2005 depending on how the clinicals go.

If anyone has an online Fortune subscription maybe they can dig up the article and post the info.

I have no affiliation with Emory nor am I a Dr. or involved in the healthcare industry in any way nor have an interest other than having horrible vision that I want corrected.

MASE
 

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How can it be off topic with two threads with this many posts? If this keeps up we'll have to start a LASIK forum http://www.avsforum.com/ubb/biggrin.gif Anyway, I can't say how glad that I am that this topic came up because I've been thinking about it too - I have a coke bottle over my left eye and it still doesn't participate much.


Thanks to all!



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And if you have *severe* astigmatism, you wouldn't need an anamorphic lens on your 4:3 projector! You've got "built-in" anamorphic lenses, without glasses! http://www.avsforum.com/ubb/wink.gif


(I wear glasses for slight astigmatism, and noticed that my glasses do horizontal compression-or vertical stretching- to correct it ).
 

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i would not even dream of doing something like this at present, as it is an ELECTIVE procedure with unacceptable risk.


compare the inconvenience of wearing glasses/contacts to (the small but NOT negligible chance)of suffering permanent non-correctable vision.


as a photographer / HT nut, any problem with my vision is totally unacceptable / unthinkable. the risks are still WAY too high. the odds may look good, BUT if YOU are the one in 10,000 that end up w/ uncorrectable vision/ blindness, etc., statistics mean nothing.

lots of food for thought:

http://www.surgicaleyes.org/


this comprehensive site contains 1,000+ horror stories of doctors, pilots, etc. that had to quit their jobs due to lost vision after LASIK should give one some pause... it also have SCARY images showing visually the kins of negative effects suffered by some patients (and why 20/20 by itself is not a measure of success)




another account:
http://www.hugsandhope.com/lasik.htm


Also, from a paper this week (Arizona Daily Star 6/10/2001):


"While more than 95 percent of LASIK surgeries produce good results, delighting many patients, both the FDA and the Federal Trade Commission are alerting the public that up to 5 percent emerge with temporary or permanent complications, including worse vision than before surgery."


"And up to 15 percent of all LASIK patients require what the surgeons call "enhancements" - follow-up procedures to correct problems and complications, usually at the patient's cost."


"The biggest complication we have is not hitting the mark - the patient does not get perfect 20/20 vision or needs a correction," said Dr. Ajay Sanan, a Tucson eye surgeon who underwent yearlong specialty training in LASIK and other corneal surgeries.


"But that happens in such a small minority of patients. The very worst that can happen - losing vision that is not recoverable - occurs only 0.3 percent of the time. "


the link for the above story: http://www.azstarnet.com/star/sun/10...kmistakes.html


the above number of 0.3 is much worse than i thought, and he says "only"?!!


"only" 1 in 333 people have unrecoverable vision problems according to Sanan - this will have people running from his office if expressed this way...


PS: yes, i DO take risks everyday. i drive on the freeway, fly, etc. http://www.avsforum.com/ubb/wink.gif


[This message has been edited by bossmonkey (edited 06-13-2001).]
 

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Wait a minute Rob. You just might have stumbled upon an inexpensive edition of the Panamorph. Of course, everyone in the room would have to have a pair...



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BizzaroTerl,


Here's a couple of links. Some of them are not exactly neutral, but the statistics should be fairly accurate:
http://www.sptimes.com/News/100100/W...s_risks_.shtml

http://www.lasikprk.com is extremely messy, is on three different domains, but contains the most neutral/factual information I've been able to find. Browse as much as you can. There are statistics in there somewhere.. along with indications whether you would be a good candidate for LASIK, and calculators for what your night vision will look like based on pupil size and degree of myopia.
http://www.chicagolasercenter.com/cgi-bin/lasik.pl same site as above, but with a link to a night vision simulator. If you're going to be watching HT then make sure you take this test first.

http://www.fda.gov/cdrh/lasik/ official FDA site.

http://www.surgicaleyes.org very good site with lots of information about the negative consequences of LASIK and other eye surgery.


------------------

/frode


[This message has been edited by Frode (edited 06-14-2001).]
 
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