Would a surgeon get lasik?

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king kong

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I am going to start school this August and was thinking about getting lasik beforehand. I am also planning on entering a surgical residency after graduating.
Does anyone know if surgical programs frown on the procedure?

Thanks for any advice.

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nobody should get lasik. i am vehemently anti-lasik. go to www.surgicaleyes.com and read about the lasik failures. people who are "perfect candidates" for the surgery still have complications. a 98% success rate means 1 in 50 EYES get screwed up. you have two eyes. the stats are frightening. if you read nothing else on the site, read about the top 10 reasons why you shouldn't get lasik.
 
I had it done 4 years ago after my intern year. It worked perfect & I have had a stable & excellent result. I'm glad I had it done, but looking back it was a bit of a risk. I do know some people who have had some of the minor issues (dry eyes, pronounced halo at night, re-do surgery required. )I would make sure you had some disability insurance prior to having it done. I don't think anyone has placed prohibitions on it as far as your residency. The only people who discriminate against it are the some commercial airlines + the Air Force & Navy who I understand will not take people into pilot training if they've had it done(?).
 
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I work in an orthopedic surgeons office where four of our ten doctors have had lasik. They are very happy with the results and none have had complications. I thought it sounded tremendously risky considering thir careers. My boyfriend had lasik several years ago at a top notch facility with a well-respected surgeon and ended up with double vision in one eye that is not correctable (the other eye is perfect). If he were a surgeon his career would have been over.
 
This is an interesting thread. Three of the four posters on it have less than 6 or less posts each... hmmm... just curious as to why they felt the need to come out of hiding and post on this thread.

I'm also interested to know how someone could get diplopia from LASIK. Could someone explain that to me?

Also, I know for a fact that many commercial airline pilots undergo LASIK and it is not "frowned upon" as was suggested. (I have a family member who is a high-ranking airline executive.)

Lastly, my father just had it done a few weeks ago. His only regret is that he didn't do it sooner. But, LASIK technology has continued to improve over the past few years and I'm sure will only get better and safer. However, as with any medical procedure, one should choose carefully the opthamologist who you're going to let touch your eyes.

-Skip
 
i am a lurker of sorts, but anytime the topic of lasik rears its ugly head in any forum, i come out of hiding. i have never gotten lasik nor do i know anyone who has, but ophthalmology is sort of my... hobby, for lack of a better word. as the stats currently stand for lasik, i don't see why anyone would risk it. it would only take one horror story of a hopeful young professional whose future was wrecked due to lasik to turn me away from the procedure, but there are many of those stories out there. it's a voluntary surgery, a cosmetic procedure, if you will, although it doesn't even always remove the necessity for eyeglasses. there are stories out there of people who were perfect candidates, got an eye messed up, and now have to wear a container of eyedrops around their neck so they can apply it once every fifteen minutes. for the rest of their life. the long term effects of lasik aren't even known; corneas change when you hit 40 or so, but the procedure is so new that few of these people have hit 40 yet. one lasik chain was sued because they reused blades to save on costs and used an average topography instead of a customized one to save on time and money. despite the idea of laser surgery, there is really a blade involved. they cut a flap on your cornea and if it gets an infection or was cut with a dull blade or doesn't go back into place properly or was cut too deep, that causes the "GASH" (glare, arc, starburst, halo) side effects and perhaps lots of pain. i could keep going but as you can see, lasik is far from perfect and i personally wouldn't do a voluntary cosmetic surgery that could go awry in ways far beyond cosmetics.
 
Personally, I think Lasik is great - I had it three years ago and it was the best decision I have ever made. my vision was really bad (without glasses/contacts I couldn't see more than 12 inches before my face) and now i have perfect vision. as someone who wore glasses since 1st grade, it was (and still is!) amazing to be able to wake up and actually see the clock next to my bed! but it IS a serious surgery - anyone who is considering it should thoroughly research the surgeon and the clinic. also avoid the heavily "discounted" centers - after all, you get what you pay for. keep in mind too, while laser surgery is relatively new in the US, it's been used throughout the world for many years. In fact, my mom's cousin had it done in Russia in 1985 (she went from a -12 in each eye to a -2!!!) and is still doing great.

i am seriously considering going into surgery (although I haven't even started school yet...) and can't imagine there would be any problem with the fact that I've had lasik. it's true that i may become farsighted sooner now than before i had it, but no one expects a surgeon's eyesight to remain perfect until they retire. personally, i would absolutely recommend lasik. of course the surgery is a risk - nothing is perfect. i guess you have to decide for yourself if the possible negative outcomes outweigh the positive. for me, i was completely dependant on glasses and contacts - i felt that the possibility to live without them was WAY worth the small chance i may have to use eye drops (I don't) or need follow-up surgery (I didn't). but in the end, it's a personal decision that you have to feel comfortable with.

just my $.03
 
I know a lot of people who have gotten lasik, and none have had any side effects. Most of them had it done at Emory, so I guess that have decent opthomologists.

As for the person afraid of the side effects, I know for myself and my peers with really bad eyesight, we are at risk for our retina tearing in old age. My doctor said it would be a sudden darkness if we went blind from it. I think it is correctable, but I highly doubt your vision is as good as before the tearing.

Just my $.02.
 
I thought about lasik about a year ago (1st year of med school) when it was discovered that I have an allergy to the plastic that they use in contacts. After discussing it with the opthomologist who performs this surgery at columbia he recommended that I don't. If I remember correctly he said that about 1% has serious problems (double vision etc.) that is not correctable and about 10% have the halo and minor problems, which for most is not a big deal. However, he told me that if that happened I could kiss surgery as an option good bye. I think the thing that sold me the most was the fact that he himself wore glasses and the 3 fellows in standing with him in the room wore glasses, I have to admit that is what sold me that lasik may not be the best option right now.


He also told me that they have new lens implant technology that is in the works and to wait 3-5 years when this may be an option.
So now I wear glasses most of the time, but since I am leaning more and more to surgery I think it was the best option.
 
Three people in our department had lasik, and all three had some type of complication. One had to undergo a revision. But in the end, all three had good vision and feel that their surgical vision hasn't been impaired.

It's a procedure, so it's a risk.
 
I'm applying to med school this year, and I had the procedure done last year. Unfortunately, the minor complications did occur - halos, starbursts, some inability to pick out discrete objects in very dark settings.

Just some things to keep in mind. If you're genetically deficient in corneal tissue (which isn't all that common, but affects a significant minority), there will be no second operation. Its too dangerous. This happened to me.

My astigmatism was not fully corrected. What's worse, I can no longer wear glasses to correct the astigmatism because I get really bad headaches. Tests show 20/20 vision, but I don't have 20/20 vision. I'll need to find out about disability insurance as I get older. This could cut short a medical career, or keep me out of surgery if I decide I wanted to do that.

My daytime vision is wondeful, and I love the fact that I am no longer dependent on glasses. But old age scares me now, and it never did before.
 
I'm also interested to know how someone could get diplopia from LASIK. Could someone explain that to me?

Corneal surface irregularities and opacities can cause monocular diplopia because the refracted light rays passing through the media are not focused into a single image as they should be.

As you know, lasik alters the corneal curvature through ablation of stromal tissue. If the ablation is off center or irregular, the resulting corneal surface once the flap is replaced will be irregular to some degree as well. Some unlucky patients will also experience scarring and opacification post-op.

Hope that helps.

As far as programs frowning on lasik, they might frown if you had complications resulting in poor visual acuity or diplopia as it could impair your ability to perform Sx. As long as you can see with/without assistance you should be fine. In ophtho we rely on operating microscopes and binocular loupes routinely instead of on the unaided eye when operating. Heck, we rely on magnification for most of the exam too.

You must weigh the risks and benefits in your case. I plan to remain a -5.75 myope until something better comes along. Having cared for miserable post lasik patients while on cornea service really reconfirmed for me that the possible benefit is not worthwhile for me even though I know great refractive surgeons who would do my procedure with a professional courtesy discount. No thanks, I love ophtho too much to risk it.
 
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I plan to have LASIK in the next 24 months. Also, the army is now providing it for their soldiers. It has its risks and I have my disability insurance.
 
Why would you risk it?

Just get those extended-wear contact lenses that you only have to take out to replace once a month.
 
Originally posted by ArrogantSurgeon
Why would you risk it?

Just get those extended-wear contact lenses that you only have to take out to replace once a month.

Noooo! Please don't sleep in your contacts!
 
Originally posted by Skylizard
I plan to have LASIK in the next 24 months. Also, the army is now providing it for their soldiers. It has its risks and I have my disability insurance.

... so disability insurance makes everything okay if you have a loss of best corrected vision?
 
Noooo! Please don't sleep in your contacts!

OpthoBean,
What about those contacts that your wear overnight, when they reshape your cornea? And then you can go all day with perfect vision and no glasses or contacts.
 
Isn't it uncomfortable to wear glasses while operating, especially when using microscopes?
 
It is uncomfortable to wear a lot of things during surgery...

face mask
bonnet
ponytail holder
underwire bra
thong

My glasses are the least of my concerns when I have to contend with the above items. Thank goodness we don't wear corsets too often anymore!

As for the contacts, I am not talking about therapeutic CL, bandage CL, aphakic CL, scleral shells, prostheses, etc....

When someone mentioned "extended wear" CL, I interpreted that as what the public considers (incorrectly) to be "extended wear"CL. This group includes all of the disposable CL, even though the FDA has only approved the focus day/night CL as suitable for overnight wear based on their pre-market studies. No K ulcers resulted in the studies, but there were other complications. These complications occurred less frequently than with existing brands of CLs, so the day/night CL are considered "safe." I am sure many people are happy with these lenses unless they are the unlucky ones to end up with the few complications that prompt them to visit their friendly neighborhood K specialist. At least in the Detroit Metro area, the K guys don't recommend 24/7 wear of non-therapeutic CLs because even a low risk is still a risk.

If you want to sleep in your Acuvues, knock yourself out. A doc interested in staying out of the courtroom would not recommend the overnight use of CL, even if the FDA says its safe. It just takes one unfortunate patient who suffered complications to show up at your door with Joe's Discount Lawyers and ruin your day. If you tell the patient to wear them for 30 days, what is to stop them from "saving money" and extending the wear to say 60 days, or 90 days. Of course they would not admit wrongdoing, they will claim they were following YOUR instructions when they were innocently injured. Joe will have no problem filling the stand with "expert" K guys who say that one should NEVER sleep in CLs, and the story ends badly.

This is why I say no to overnight CL to anyone who asks. If they choose to do it anyways, it is their bad.
 
Just wondering.... (I'm not a surgeon) but...

My vision is extremely poor. I'm nearly blind as a bat. Something like -8 with pretty bad astigmatism. I've had glasses since the 2nd grade and I converted to CL at 19 (toric lenses). I was deathly afraid to put something in my eye and was a non-believer that you can actually put something in our eye to see better. Having overcome this step, I am now wondering my options with surgery. Is Lasiks able to treat astigmatism now? And is 98% success rate (I read somewhere above that it's 1 in every 50!) something you can depend on? Having extremely poor vision for most of my life has made me keenly aware of its importance and necessity.
 
I'm not an ophthalmologist but I think another issue to consider, especially for those just begining medical school, is that your myopia is likely to continue to progress when you are doing alot of near-work such as reading.

I had an excellent opportunity to get the procedure before medical school while working for an ophthalmologist but I declined for this reason.

I don't mind my glasses really and it seems I can only tolerate contacts for 8-10 hours a day. But I would tolerate diplopia and halos even worse.
 
not exactly sure why wearing a bra and a thong would be distracting you during surgery??? don't you normally wear these items anyways...thanks for the visual picture that it conjured up in my mind's eye though😉 😀
 
I'm glad a genuine opthalmologist submitted her informed opinion. My opinion is that it isn't even close to being worth the risk. As hawaiigirl mentioned, it's a cosmetic procedure that has risks--albeit relatively low--for a condition that has a virtually risk-free treatment (glasses). The odds ratio of complication when you compare the two would just about peg infinity. If I could find an insurer willing to take a multimillion dollar risk, I might consider it (but still probably wouldn't), but I challenge any of you to find such a policy for a trainee-level person.

98% of the time, things will turn out fine, but that 2% when compared to 0% is too horrible to contemplate if you really care about being in the OR.

A female opthalmologist who wears a thong in the OR sounds like proposal material.
 
Originally posted by OphthoBean
It is uncomfortable to wear a lot of things during surgery...

face mask
bonnet
ponytail holder
underwire bra
thong

My glasses are the least of my concerns when I have to contend with the above items. Thank goodness we don't wear corsets too often anymore!

You got me beat- even Foxxy Cleopatra doesn't dare to wear a thong in the OR 😱

I do, however, tend to be thrifty with my contacts and wear them much longer than they are intended. Why throw them out if they are perfectly good? Though I do agree, I wouldn't recommend it to a patient.
 
zinjanthropus said:
Have there been any major changes in LASIK surgery that makes it safer/better/less risky today then it was 3 years ago?
That is what I was wondering. I have an uncle and aunt who just got lasik surgery and my uncle is fine. My aunt has blurry vision and dry eyes. I don't know if it will correct itself or not b/c she just had it done a week ago. I am interested in getting it too, but if it is still risky I will stick to contacts.
 
hawaiigirl, you appear to bring a strong bias to your argument. Let me first say that I have no expert knowledge of this process. You are training in allopathic, evidence based medicine. Anecdote and opinion has less value than evidence. When you mix anecdote and opinion without providing your credentials, they have even less value. I appreciate your passion but find your opinion hard to place a value on without knowing your knowledge level. You give me the impression that you are an Optomitrest or married to one.

For example, as a general surgeon, I can speak well of intestinal surgery but not of neurosurgery. Again, not a personal attack, just looked like a drive by on lasik.
 
Wow, talk about exhuming the dead. Almost 3 years. Anyway, my mom had lasik, and it worked perfectly. But, a friend of mine had it done and her retina detached. I don't know if they are related, but it's quite a coincidence. Personally, I'm glad I decided against it; the risk of my surgery career ending is too great.
 
mysophobe said:
Wow, talk about exhuming the dead. Almost 3 years.
:laugh: Everyone always says to do a search!
 
anyone have suggestions to limit glasses fogging durring surgery?

The only fool-proof way (perfect for me on 4hrs sleep) is to use those masks with the sticky tape on one side.

anyone have any suggestions?
 
Thong issue is interesting... might just renew my interest in the surgical fields. 😉

However, I, too, am highly interested in the Lasik topic. I am considering two fields in which eyes are of paramount importance... surg and rads. So, considering I've got a -5 or -6 myopia bilaterally, and I absolutely DESPISE glasses, I've been considering Lasik for many years. My wife also is dead-set that she wants it, but being that she is going into Pediatrics, the potential complications probably wouldn't be as catastrophic for her as they would for me, in terms of future career choices.

Also, the CL debate was interesting to me. I have worn contacts almost exclusively for about 15-17 years now, and I have never thrown them away after a month, and I never take them out to sleep. I generally wear a pair (I think Acuvue and Newvue are the ones I've worn most) for anywhere from 2 to 4 months at a time, sometimes taking them out for a cleaning once or twice during that time. I simply couldn't convince myself to spend the extra money to throw them out that often, when they worked just fine. Of course, towards the end, the scratches, calcium buildup, etc., let me know when it was time to move on to another pair. In fact, I just put in a new pair this morning, and since it's my last pair, I will need to go have a new exam done (first in 18 months I believe, so that's how long my 6 pairs lasted me this time).

So, yeah, anecdotally, I have done this for 15+ years with seldom a problem. Once in a while, a slight irritation/infection in my conjunctiva that goes away after a couple of days of 'resting' from contacts and perhaps some Tobrex or something (if I snagged a tube from the ER).

But I really am interested in both of these areas... has Lasik gotten any better/safer over the last few years, and what other options do I have for contacts? Wearing glasses will NOT work for me.

Updated opinions?
 
I'm just starting my PGY1 as a Gen Surg categorical. I had been wearing contacts/glasses for about 18 years when I had Lasik this past March...two weeks before the match. For me I was tired of glasses and contacts. It was fine in the OR if I was wearing my contacts, but that wasn't an option for me if I was on call...I would have to take out my contacts eventually. I always felt like my field of vision just wasn't what it could be wearing glasses. I also fancy myself a bit of an outdoorsman and if I was going to be out for any extended period of time it was always such a hassle with my corrective lenses. The prospect of ever losing my glasses or contacts while I was out in the field was enough to scare me to death. I would have been essentially blind...helpless...in the wilderness. Anyways that probably sounds pretty silly, but nonetheless, those are the reasons that I sought out Lasik.

My doc was a bit of big wig down in Houston and he told me that he himself had a very low complication rate (less than one percent) for complications such as dryness, halos, night vision difficulties, etc. His serious complication rate was next to nothing (hundredths of a percent) that included astigmatism, altered vision that is uncorrectable and blindness.

For the laser that he used on me 98% of folks ended up with 20/20 vision or better!! I went in the day after surgery for a check-up and my vision was already 20/20. It continued to get even sharper for about 6 weeks or so, and it's been awesome...no halos, no problems at night, just great vision without having to screw around with glasses and contacts.

It wasn't all great though...evidently the opening to my eyes is pretty small. Small eyes plus Cro-Magnon brow I suppose. Anyhow, my doc used a laser called intralase to cut the flaps instead of free-handing them like some do. That particular laser has to mount onto your eye and for me it was a pretty tight fit. I recall several techs holding me down and the doctor pulling my eye open as he forced the mounting cup onto my eye while I writhed in pain. I also recall the surgeon yelling at me, "I know it hurts but you're gonna have to suck it up!" LOL :laugh: I can laugh now, but I didn't think it was very funny at the time. The soft tissues around my eyes were pretty swollen for several days, but luckily that was the worst of it and my vision is great. So unless you have smaller eyes than 90% of the population this shouldn't be a concern for you.

That's my story on Lasik, and generally I would recommend it to other people. My surgeon says he does the procedure on other surgeons "all the time", though I did not ask him to quantify that statement. I would caution people to shop around for their surgeon though and make sure he/she has a good reputation and see what his/her success and complication rates are. Mine had all of those statistics published. All eye surgeons are NOT created equal. The lasers are great, cutting edge technology but they are just a tool...like a scalpel...you want the guy holding it to be as skilled as possible. My surgeon was good, his bedside manner wasn't perfect...."SUCK IT UP!!!"...but at least my vision is good. I paid a lot more than most people do, but shopping for cut rate eye surgery just didn't make sense to me.
 
Hmm... was hoping for some more info on this thread. Although it is a holiday weekend, so maybe later...
 
Joel Fleischman said:
anyone have suggestions to limit glasses fogging durring surgery?

The only fool-proof way (perfect for me on 4hrs sleep) is to use those masks with the sticky tape on one side.

anyone have any suggestions?

You have to control your breathing. Do not exhale too fast, and inhale relatively quickly (works for me, but I am not a surgeon, rather a lowly pre med). Also if you are nearsighted, you will probably not need your glasses during surgery, and if you do need them, why not use contacts?

Oh yes, I had PRK done about two and a half years ago. My daytime vision was great for about a year and then turned to crap. My night vision sucked due to halos and starbursts (now that my eyes suck again, these are gone). I am back to wearing glasses. For me it was money not well spent (just my experience).
 
an interesting question to have answered would be, do ophthalmologists themselves have LASIK or other vision corrective surgery done on themselves? if so, by whom? if not, WHY NOT?!

my feeling is that most do not have it done themselves.
 
Hehehe...an "every 3 year" bump.

Well, I had LASIK 3 years ago, at Duke, with Alan Carlson - there was a fellow in the room, but he didn't touch me. What turned the corner for me was that it was computer-controlled - not "free handed" like before.

My night vision is a bit worse, but no halos, no diplopia, and no other side effects or difficulties. Contact lenses were not an option since a course of Accutane when I was younger, which left my eyes too sensitive for CL.
 
I am thinking of laser vision correction in the next year or so.
I knew plenty of residents and attending surgeons that have had it done over the past 3-4 years. I think the army has been providing it for GIs under some sort of program over the last couple of years.
WebMarketing said:
...NASA and the United States Navy both endorse iLASIK as the preferred method of vision correction. It was not until LASIK was developed into an ALL-LASER method using a femtosecond laser for the cutting of the corneal flap that NASA considered approving LASIK for the eyes of United States Astronauts and space program candidates. The military and NASA together conducted extensive research and thus confirmed the excellent safety record of the Intralase Femtosecond laser.

As for contacts.... It's unfortunate, very common in the ORs. IMHO, contacts in the OR should be treated the same as they were in Organic Chem lab.... should not be allowed. I have seen too many folks not wear eye protection (or even with eye protection). Numerous eye spray events in folks with contacts. When it happens, there is always that panic of... "oh my god, it's behind my contacts, i need to get my contacts out...."

0.05

JAD
 
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I had LASIK done many years ago, when it was still pretty new. I understood it was a risk, but I weighed those risks against my situation (could only count fingers at 4 feet and 6 feet with my right and left eye without contacts, the anisometropia made it very difficult to tolerate glasses, had already had one corneal infection that made life very difficult until it healed, and my life was adversely affected by the limitations in my sight-even walking down a hallway without correction was a challenge and if anybody approached me I would be a little on edge until they were right in front of me since I couldn't tell who they were). I went through 8 wks of Army basic training having to wear glasses (and threw up repeatedly for the first week or so while trying to adjust). I missed out on being an expert sharpshooter because I couldn't see the 300 meter targets. At night if we would get woken up abruptly for some "extra training" and I couldn't get to my glasses fast enough, I was screwed. We did our field training exercise and had to wear our protective masks for most of the night (I didn't have corrective inserts yet). I had to have a buddy hold my hand and walk me to the latrine every time I needed to pee, because I absolutely could not make it on my own.

In the end I decided on LASIK since that was the best option at the time. In the 12 or so years since I have never regretted my decision.
 
I am certain I can find an experienced surgeon. I could go to Canada for the famous MD there or go to Long Island for DrMcDonald, etc..... I know experience of the surgeon is crucial. I can find hundreds of surgeons declaring great experience, etc... all over the country.
For me right now, the toughest issue is trying to figure out if the "type of laser" is critical to deciding who does my eyes.... It seems like that question is not as easy as saying ethicon & covidian staplers are the same.... No longer is the hand held microtome an issue.... it's "all laser"..... I just can not sort out is there objective evidence for what kind of LASIK I should go for????

No, I am not asking for medical advice, just pointing out a common dilemma in this issue....

JAD
 
A few of my colleagues underwent Lasik with excellent results. For me, it's reading glasses because of old age. I eliminated the thong issue by only operating "commando" without knickers or bra.I wear scrubs and Birkie Bostons or Danskos only. Everything stays cool and comfortable. Of course, my problem in medicine has been being too cold most of the time. It's only in the OR under the lights that I start to warm up and feel comfortable.
 
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