Daily Press (Sunday)

Folks considerin­g Lasik should be aware of procedure’s risks

- By Joe Graedon, M.S., and Teresa Graedon, Ph.D. In their column, Joe and Teresa Graedon answer letters from readers. Send questions to them via www. peoplespha­rmacy.com.

Q: Anyone who has had Lasik eye surgery will need to stock up on a good eye lubricant. The procedure made my eyes really dry, and I’m not the only person to experience this.

My favorite lubricant is Refresh Tears because it comes in a thicker variety for nighttime. There are other good ones out there; just don’t buy the ones that say, “Help get the red out.”They will wear off and leave your eyes drier than ever.

A: The Food and Drug Administra­tion approved Lasik surgery on the front of the eye (the cornea) in 1999. It has been promoted as a way for people to enjoy excellent eyesight without eyeglasses. Every year, about half a million people undergo the procedure.

However, the FDA has become aware that patients sometimes have undesirabl­e outcomes.

The agency is concerned that people contemplat­ing Lasik surgery receive relevant informatio­n so they can evaluate the benefits and risks. It has issued a “Draft Guidance” that warns about dry eyes, double vision, difficulty driving at night and, in rare cases, persistent eye pain.

As for drops to alleviate dry eyes, the ophthalmol­ogists we consulted suggest a product free of preservati­ves. Examples include NanoTears TF, Refresh Optive Advanced, Systane Ultra and TheraTears.

Q: Many years ago, my mother developed painful cracks at the sides of her mouth. Eventually, she was diagnosed with pernicious anemia, a fatal disease if not treated.

As I understand it, people with the disease cannot get enough B12 from food because they lack an intrinsic factor necessary to metabolize B12.

The treatment for pernicious anemia was B12 injections, which healed the mouth sores and improved her strength and energy. Nowadays, research has found that B12 supplement­s in pill form are just as effective, but one must take a high dose and be monitored by a physician. In my mother’s case, cracks at the corners of her mouth saved her life from this potentiall­y deadly deficiency.

A: Pernicious anemia is, as you described, a serious condition in which a lack of intrinsic factor means vitamin B12 is not absorbed. If a person does not get this crucial nutrient over time, the nervous system may be damaged. Symptoms may include fatigue, dizziness, palpitatio­ns, shortness of breath, sore tongue, weakness and numbness or tingling in the hands and/or feet.

You are correct that pernicious anemia was once treated almost exclusivel­y by monthly

B12 injections. However, clinical trials show that high-dose vitamin B12 pills (1,000 micrograms/day) are also effective (Frontiers in Medicine, Aug. 23, 2016).

Q: I’ve been on Prilosec daily for over 20 years. If I’m late taking this pill, I get terrible heartburn. My doctor says that I am doing well. As far as I can tell, I don’t have any side effects and, in the meantime, I do not have heartburn!

A: The label on over-thecounter Prilosec (omeprazole) states: “Do not use for more than 14 days unless directed by your doctor. You may repeat a 14-day course every 4 months.”

Long-term use may result in weaker bones, cardiovasc­ular problems, infections and kidney damage, among other complicati­ons. Painful rebound heartburn symptoms often occur shortly after stopping this acid-suppressin­g drug, which can make it hard to discontinu­e.

 ?? DREAMSTIME ?? Some patients find that persistent dry eyes become an issue after undergoing Lasik eye surgery.
DREAMSTIME Some patients find that persistent dry eyes become an issue after undergoing Lasik eye surgery.

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