FRIDAY, March 22, 2002 (HealthDayNews) -- Millions of Americans have thrown away their glasses and contact lenses because of LASIK surgery.
With more than 3 million procedures to date -- and counting -- the laser eye surgery has quickly become one of the most popular elective surgeries available.
Yet all but a tiny fraction of those three million patients have been adults. LASIK for people under 18 is virtually unheard of.
That may be changing. Several studies are under way, both in the United States and overseas, to determine whether LASIK is an effective treatment for eye disorders in children and adolescents.
Until those studies are complete, there is very little data for doctors to go on. So, not surprisingly, they are divided in their view of whether the surgery should be used for younger patients.
"I'm very comfortable recommending LASIK for adolescents who can't wear glasses or contacts for whatever reason and need good vision," says Dr. Robert Maloney, director of the Maloney Vision Institute in Los Angeles.
Maloney cites several success stories among his younger patients. One 16-year-old, the captain of his high-school football team, couldn't tolerate contacts and wouldn't wear glasses under his helmet. LASIK surgery took care of his problem.
Another of Maloney's patients, an 8-year-old boy, had normal vision in one eye and severe nearsightedness in the other. He couldn't wear eyeglasses, so doctors had him wearing a single contact lens.
"Unfortunately, he has severe attention deficit disorder, and the contact kept falling out," Maloney says. "His parents were losing thousands of dollars a year on contact lenses."
Maloney performed LASIK on the boy's bad eye, and "it worked spectacularly," he says. "He did better in school. He was able to participate in sports."
In LASIK surgery, a doctor uses a laser beam to reshape the patient's cornea. The concern with using LASIK on young patients stems from the fact that eyes continue to grow and change shape until at least age 18 or older.
A 12-year-old child who undergoes LASIK surgery to correct nearsightedness, for example, may need additional surgery by age 18 as the eye continues to change shape.
That's why many doctors continue to call for caution in considering young patients for LASIK. They say it should be reserved only for cases of serious medical necessity -- not merely for kids who don't want to wear glasses.
"On a routine basis, we would strongly advise against this," says Dr. Walter Stark, director of cornea and cataract services at the Wilmer Eye Institute and a professor at Johns Hopkins University School of Medicine in Baltimore. "Nobody knows what's going to happen to the child's eye.
"The data are not in for younger people, so the safety has not been documented," Stark adds. "This is not something to be promoted."
And he notes that the Food and Drug Administration has not approved the use of LASIK for patients under age 18, although doctors are allowed to make what are called "compassionate" decisions on a case-by-case basis.
"The LASIK procedure has been promoted so much," Stark says. "People come in and they don't know what it is. Some doctors promote it so much, and they really don't want people to realize it is surgery.
"This is actually a fairly big surgical procedure on the eyes," he adds. "It is a major commitment. So you just have to be careful when you're dealing with minors."
Stark describes himself as a conservative surgeon who turns away 60 percent of the adult patients who come to him for LASIK surgery.
The American Academy of Ophthalmology takes no official position on LASIK for kids. But it seems safe to say that LASIK won't soon become an everyday thing for adolescents who can't wear contacts and don't want to wear glasses.
Even Maloney, who takes a less-conservative view, has only performed a handful of procedures on children out of the 20,000 LASIK surgeries he's done overall.
"Is there a tidal wave of adolescents demanding LASIK for purely cosmetic reasons? No, that's just not happening," Maloney says.
What to Do: Find out more about LASIK surgery and how it's done by visiting the Medem Medical Library. And check your child's vision with this simple test from the American Association for Pediatric Ophthalmology and Strabismus.
