Laser surgery in your 50s
TECHNOLOGICAL advances in laser eye surgery have brought continuous improvement in safety and efficacy.
Through the years, LASIK ( laser eye surgery) has become a mainstream procedure for the correction of refractive errors.
Most people experience a decline in the quality of their vision when they hit their 40s. With a very large population of baby boomers now in their 40s and above, the demand for corrective eye surgery has been on the rise.
In fact, there are increasing numbers of patients above the age of 50 enquiring about LASIK.
Many may wonder whether there is an age limit for LASIK. A study carried out by Dr Dimitri Azar and colleagues at University of Illinois, Chicago, that involved performing eye surgery on patients aged 40 to 69 concluded that there were no significant statistical differences in final visual acuity between the different age groups of those aged 40 to 69.
Hence, I believe that there is not necessarily an age limit for one to perform LASIK. Rather, it depends on the state of the eyes of the patient rather than his age.
However, each candidate seeking refractive surgery must undergo a thorough eye examination and be considered on a case- by- case basis.
Those in this age group should take these precautions into consideration before undergoing LASIK:
The natural lens inside the eye has to be clear and the patient must understand that LASIK will not prevent a cataract from developing in the future.
Changes in vision or prescription may indicate an early onset of a cataract. Patients who are already developing a cataract and undergo LASIK may find their vision deteriorating in a few years. The main cause of this is not that the laser eye surgery is not permanent; rather, it is caused by the cataract.
Be aware of any signs of agerelated eye diseases or a family history of diabetes, glaucoma or corneal disorders.
Another thing to consider is dry eyes. This is more common in those aged above 50 due to changes in their body as well as side effects of certain medications.
Dry eyes are a common side effect of LASIK, especially during the recovery period. During the LASIK procedure, a significant amount of corneal nerves, which help reduce dry eyes, is cut.
However, with a technology called SMILE ( small incision lenticule extraction) the corneal nerves are preserved and the chance of developing dry eyes is significantly lessened.
LASIK is contraindicated if a patient is on Amiodarone ( a drug that helps keep the heart beating, normally used by patients with heart disorders).
Using Amiodarone after undergoing LASIK may cause coloured haloes around lights, photosensitivity, blurred vision, dry eyes and lens opacities.
So prior to undergoing any laser eye surgery, ensure that your doctor knows of your medical history and prescription drugs.
Presbyopia is a loss of elasticity in the lens resulting in the eye losing its flexibility to adjust its focus, which affects a person’s ability to see fine details up close. It normally develops at age 40 and above.
In LASIK, the laser treats the cornea to correct myopia, hyperopia and astigmatism but it cannot stop the natural lens inside the eye from ageing.
Hence, undergoing LASIK in your 20s will mean that you will eventually need to wear reading glasses at age 40 and above to see close- up details.
In LASIK, presbyopia is commonly addressed through a method called monovision, where one eye is corrected for distance vision and the other eye for near vision. So, when both eyes are open, the brain will adapt accordingly and the patient can see clearly both far and near.
Monovision may only work effectively in some patients so they should discuss their occupation, hobbies and other lifestyle issues with their doctor to determine if the procedure is right for them.
It is not suited to people who require sharp distance vision, precise depth perception or precise near vision in their day- to- day activities.
Some patients can adapt well and fast, but some may take longer. There is also the option of a full eye correction to restore a balanced distance vision.
Most people can expect a good outcome if they maintain realistic expectations. If you seek laser eye surgery to correct your vision problems, talk to your surgeon about the benefits and risks of surgery involved at your age.
Make sure that you are fully informed of the advantages and disadvantages of the procedure as well as understand the aftercare tips. –
Dr Yen Siew Siang is a senior ophthalmologist & laser refractive surgeon at Optimax Eye Specialist.