OPHTHALMOLOGY

Q: I had LASIK surgery 15 years ago when I was 35. Now my vision feels like it is changing especially at near. How long do the benefits of LASIK surgery last? Do I need an enhancement? What hap- pens when I get older and need cataract surgery?

A: The effects of LASIK eye surgery are considered to be a permanent way to reshape your cornea and thus correct your vision. While LASIK patients may enjoy many years free from or with minimal use of glasses or contacts, the fact is that everyone’s eyes change as they get older. It is important to understand that LASIK does not change the normal aging process of the eyes nor prevent other things that may happen in the eye such as presbyopia, the age-related loss of focusing power for seeing near objects. This means that even if you have had LASIK to correct your distance vision, you may likely need reading glasses in your mid-40s.

There are many other reasons why your eyes might be changing over the years since your LASIK surgery. Whether or not you should have an enhancement depends on why your vision has changed and the overall state and health of your eyes. If you are experiencing changes, visit an eye doctor who specializes in refractive surgery for a complete eye exam to determine what may be affecting your vision change. Before proceeding with an enhancement, your doctor will want to make sure that the best-corrected vision is good and there isn’t another problem limiting your vision such as dry eyes, a visually significant cataract, retinal disease, or other factor.

Cataracts are also a natural part of the aging process and at some point cataract surgery may be necessary. For those who have had LASIK, calculating the power of the intraocular lens (IOL) used in surgery poses a particular challenge.

Ordinarily, IOL power calculations are straight forward and rely on two main measurements, the length of the eye and the curvature of the cornea. In those who have had LASIK, the corneal alterations make it more difficult to calculate the corneal power because the corneal shape has been altered.

The good news is that cataract surgery has advanced remarkably. Today, patients can choose from a wide variety of lenses along with additional high precision laser technology that together can provide customized options for enhanced and optimized visual outcomes. One such high precision technology available to help verify the choice of lens power for the LASIK patient is the Optiwave Refractive Analysis System or ORA. This intra-operative, realtime analysis by the ORA system measures all the unique optical characteristics of your eye’s focusing ability and the lens implant power needed to achieve the best vision. In cases where LASIK has preceded cataract surgery, it is important to have a surgeon who understands all the issues involved.

As you follow-up with your eye doctor for continuing eye care, it will be important to provide the history of your laser vision correction, along with any testing and the results, to facilitate the appropriate care of your vision.

Gregory Eippert, MD 9485 Mentor Ave., #110, Mentor 44060 440-255-1115 www.opivision.com

Gregory Eippert, MD