As laser vision correction improves and lasers become more precise, ODs are able to better identify great candidates for LASIK. And if, during that process, ODs remember old beliefs and conventional wisdoms regarding refractive surgery, it can allow for happy patients with even better vision outcomes.
For single-vision myopic contact lens wearers, the discussion about reading glasses should have already occurred, leaving the successful multifocal contact lens wearers and glasses wearers to address.
While telling these patients they are “too old” for LASIK shortens the conversation, it won’t stop them from seeking it, particularly if they are fed up with glasses.
It is better to spend the extra time explaining the pros and cons rather than letting the patient decide which method of correction is best.
There are many types of age-related, ocular pathologies that should affect decisions to forego or undergo LASIK. One common challenge are cataracts, and more specifically, determining when a cataract is a cataract.
Certainly, a decrease in best corrected visual acuity is a valid reason to move from a cornea-based surgery to a lens-based procedure. Also, patients who glare test to a level where insurance will consider covering cataract surgery may be best suited for a lens-based procedure. A grayer area is when a patient experiences a myopic shift,but visual acuity remains 20/20. That is not a refractive error I would want to chase with laser vision correction.
As laser vision correction improves and lasers become more precise, ODs are able to better identify great candidates. And if, during that process, ODs remain open minded about old beliefs and conventional wisdom regarding refractive surgery, it will allow for happier patients.
1. Joe Rogan Experience podcast #1411. Available at: http://podcasts.joerogan.net/podcasts/robertdowney-jr. Accessed 1/31/20.
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5. Friehmann A, Mimouni M, Nemet AY, Sela T, Munzer G, Kaiserman I. Risk Factors or Epithelial Ingrowth Following Microkeratome-Assisted LASIK. J Refract Surg. 2018 Feb 1;34(2):100-105.