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Another Nod for Eye Surgery

Study confirms LASIK surgery works well, but causes dry eyes

TUESDAY, Jan. 29, 2002 (HealthDayNews) -- The people who make eyeglasses probably aren't thrilled about the eye surgery known as LASIK, but a new report suggests there is plenty to like about the procedure.

After examining dozens of studies, a team of ophthalmologists confirmed the laser surgery significantly improves eyesight in many patients, and rarely causes serious complications. However, the eye doctors also found the treatment caused more cases of dry eyes than some had expected.

"People frequently noticed side effects after surgery, but generally those got better," says study co-author Dr. Christopher Rapuano, an eye surgeon and professor of ophthalmology at Thomas Jefferson University in Philadelphia.

During LASIK surgery, doctors make small cuts in the cornea to change its shape and improve vision. The surgery treats astigmatism, which causes blurred vision, and nearsightedness (myopia), which is the inability to see clearly at a distance.

Hundreds of LASIK clinics have opened in the United States over the past five years, and numerous radio personalities have lauded the surgery.

LASIK is short for laser-assisted in situ keratomileusis. It restores vision to 20/20 in seven of 10 people, but it doesn't prevent patients from needing reading glasses as they age.

Rapuano and his colleagues pored over 160 LASIK studies published over the past 33 years.

"We looked at each article, and determined how good the science was," Rapuano says. "The science is good in many articles, but not nearly as good in many more."

The researchers then reviewed the conclusions of the best studies. Their findings appear in the current issue of Ophthalmology, the journal of the American Academy of Ophthalmology.

This study of studies confirms what many ophthalmologists already know: LASIK is best for people with low-to-moderate myopia and astigmatism, and not as effective for those with severe forms of those disorders.

The good news is most people with myopia have mild cases. People with extreme myopia are fairly rare, making up perhaps 5 percent of cases, Rapuano says.

Although LASIK may not work in severe cases, patients should be allowed to choose the surgery as long as they're made aware of the chances of failure and the risks of more side effects, Rapuano says.

Dry eyes are perhaps the most common complaint, affecting three of four LASIK patients for several weeks or months after surgery, Rapuano says.

"It was probably more common than some people had suspected," he says.

The study confirms the importance of letting patients know about side effects beforehand, Rapuano adds: "If you don't tell them and then they find it, they're more likely to think of it as a problem."

Other common side effects include "nighttime starbursts" -- halos around lights -- and a reduced ability to discern contrasts between objects. "In a dim room, everything will look a little grayish," Rapuano explains.

However, advances in LASIK technology should reduce the number of cases of "contrast sensitivity," says Dr. Richard A. Yee, professor of ophthalmology at the University of Texas Health Science Center.

What To Do

For more about LASIK, read a special FTC brochure on the basics of LASIK.

The U.S. Food and Drug Administration also has this information on LASIK surgery.

Take this quick quiz to see how much you know about LASIK.

SOURCES: Interviews with Christopher Rapuano, M.D., attending surgeon, cornea service, Wills Eye Hospital, and professor of ophthalmology, Thomas Jefferson University, Philadelphia; Richard A. Yee, M.D., professor, ophthalmology, University of Texas Health Science Center, Houston; January 2002 Ophthalmology
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