When is LASIK not for me?

You are probably NOT a good candidate for refractive surgery if:

• You are not a risk taker. Certain complications are unavoidable in a percentage of patients, and there are no long-term data available for current procedures.

• It will jeopardize your career. Some jobs prohibit certain refractive procedures. Be sure to check with your employer/professional society/military service before undergoing any procedure.

• Cost is an issue. Most medical insurance will not pay for refractive surgery. Although the cost is coming down, it is still significant.

• You required a change in your contact lens or glasses prescription in the past year. This is called refractive instability. Patients who are:

• In their early 20s or younger,
• Whose hormones are fluctuating due to disease such as diabetes,
• Who are pregnant or breastfeeding, or
• Who are taking medications that may cause fluctuations in vision,

are more likely to have refractive instability and should discuss the possible additional risks with their doctor.

• You have a disease or are on medications that may affect wound healing. Certain conditions, such as autoimmune diseases (e.g., lupus, rheumatoid arthritis), immunodeficiency states (e.g., HIV) and diabetes, and some medications (e.g., retinoic acid and steroids) may prevent proper healing after a refractive procedure.

• You actively participate in contact sports. You participate in boxing, wrestling, martial arts or other activities in which blows to the face and eyes are a normal occurrence.

• You are not an adult. Currently, no lasers are approved for LASIK on persons under the age of 18.

Precautions
The safety and effectiveness of refractive procedures has not been determined in patients with some diseases. Discuss with your doctor if you have a history of any of the following:

• Herpes simplex or Herpes zoster (shingles) involving the eye area.

• Glaucoma, glaucoma suspect, or ocular hypertension.

• Eye diseases, such as uveitis/iritis (inflammations of the eye)

• Eye injuries or previous eye surgeries.

• Keratoconus

Other Risk Factors
Your doctor should screen you for the following conditions or indicators of risk:

• Blepharitis. Inflammation of the eyelids with crusting of the eyelashes, that may increase the risk of infection or inflammation of the cornea after LASIK.
  
• Large pupils. Make sure this evaluation is done in a dark room. Although anyone may have large pupils, younger patients and patients on certain medications may be particularly prone to having large pupils under dim lighting conditions. This can cause symptoms such as glare, halos, starbursts, and ghost images (double vision) after surgery. In some patients these symptoms may be debilitating. For example, a patient may no longer be able to drive a car at night or in certain weather conditions, such as fog.

• Thin Corneas. The cornea is the thin clear covering of the eye that is over the iris, the colored part of the eye. Most refractive procedures change the eye’s focusing power by reshaping the cornea (for example, by removing tissue). Performing a refractive procedure on a cornea that is too thin may result in blinding complications.

• Previous refractive surgery (e.g., RK, PRK, LASIK). Additional refractive surgery may not be recommended. The decision to have additional refractive surgery must be made in consultation with your doctor after careful consideration of your unique situation.

• Dry Eyes. LASIK surgery tends to aggravate this condition.
  

Temporary Side Effects Of Laser Eye Surgery

Once you have undergone the surgery, there are certain side effects of laser eye surgery that can be expected and they may be more noticeable on some patients than on other patients.

For example, the eyes will feel mild discomfort or pain for the first two or three days and experience a tearing in the eye. You may also notice pink or red spots on the whites of your eyes. Another side effect of laser eye surgery is that your vision may seem hazy or blurry. Your eyes may feel dry and you may experience glare from lights in the house or outside. You may also see a halo effect around lights and have difficulty with driving at night for the first month.

Most of these side effects of laser eye surgery should be mild and they will disappear in the few days. Lingering side effects of laser eye surgery should be brought to the attention of the surgeon who performed the laser eye surgery.

Long-Term Side Effects Of Laser Eye Surgery

The worst side effect of laser eye surgery is that some patients may lose part or all of their vision as a result of the treatment. The other side effects of laser eye surgery are easier to overcome. For example, some may be under treated or over treated.

For those who have successfully corrected their eyesight, with good vision on the vision chart, some of them may develop permanent debilitating visual symptoms such as glare, halos, and/or double vision that can seriously affect night time vision. They may not be able to see clearly in situations of low contrast, such as at night or in fog.

Another potential long term side effect of laser eye surgery is the development of severe dry eye syndrome. Because of the surgery, your eyes may not be able to produce sufficient tears to keep your eyes moist and comfortable. This side effect of laser eye surgery can be resolved through intensive drop therapy.

Despite of the existence of all the side effects of laser eye surgery, statistics have shown that approximately 92% of patients have been satisfied with the laser eye surgery. However, laser eye surgery is a relatively new procedure. As such, not all side effects of laser eye surgery are fully explored. Some side effects of laser eye surgery may be caused by medications that you are administering for an existing illness while others may be attributed to age.

Now I'm not trying to scare you into not going for lasik. So here's another article

Now, more than a decade later, Lasik is certainly no longer the fledgling it once was. The Straits Times article, Singapore's eye doctors score top Lasik success rates (December 22, 2006), reports that local ophthalmologists have success and safety records that edge out those of international centres, including some in the United States. Having achieved over 99 per cent of operations with zero complications, local Lasik surgery comfortably exceeds the standard set by US regulators which require surgeons to perform "safe" operations in at least 97 per cent of patients.

"At where we are today, I can confidently say that Singapore's level of expertise in Lasik is world-class calibre," says Dr Lee Hung Ming. Dr Lee, who is now Medical Director of Parkway Eye Centre, is also the former head of Tan Tock Seng Hospital's Lasik Centre.

"I believe that the way forward for Lasik is the path of bladeless laser surgery," Dr Lee continues. "The keen precision afforded by the bladeless method and the smoother cuts that result enhance the healing process, and thus reduces the risk of complications."