You won't be allowed in any bathrooms, locker rooms, or government buildings.
Posted on 07/08/2004 5:52:31 AM PDT by Max Combined
After almost 40 years of wearing glasses and contact lenses, vision correction was no longer a matter of mere vanity for Phyllis Ward.
"I just wanted to see better. I first got contacts in elementary school, but I never felt as though I could really see," said Ward, 50, who lives in Houston with her husband and three children.
In May 2001, Ward underwent Lasik surgery on both eyes. Lasik is short for Laser-Assisted In Situ Keratomileusis, a treatment for nearsightedness that uses pulses of ultraviolet laser light to sculpt the cornea, the transparent frontal portion of the eyeball. More than 1 million Americans are expected to undergo the procedure this year.
The day after Dr. Douglas Koch, a professor of ophthalmology at the Baylor College of Medicine, performed the surgery, Ward remembers saying, "Oh my gosh! I can see!"
For several months, the results were dramatic and gratifying. But by late 2001, Ward's vision was growing blurry again. She strained to see her son on the soccer field, and night driving proved especially hazardous. She returned to Koch for a fine-tuning procedure on her left eye, and he had another go at her right eye earlier this year.
Ward now has what she calls "full-blown vision." She has no regrets about choosing the Lasik procedure, and Koch, who estimates he has performed the operation almost 8,000 times, suspects he knows why Ward's eyes needed the follow-ups, known among eye surgeons as "enhancements."
As editor of the Journal of Cataract and Refractive Surgery, Koch recently published an article by Dr. Keith Walter, an ophthalmologist at Wake Forest Baptist Medical Center in Winston-Salem, N.C., that blames humidity -- a fact of life in both North Carolina and Houston.
Walter noticed he was performing follow-ups in November and December on patients who had undergone the Lasik procedure during the previous humid summer months. He reviewed the 368 surgeries he had done on 191 patients in 2000, and considered a dozen variables, including patient age and sex, cornea curvature and various environmental factors. About 15 percent of his patients required at least a second Lasik procedure.
His conclusion: Humidity is the culprit. Walter found that during the drier months, he tended to over-correct, which left patients somewhat farsighted. During the most humid part of the year, he tended to under-correct, which left patients still slightly nearsighted. In Houston, the average morning humidity is 89.4 percent, and it reaches an average of 92 percent from June through September. In contrast, Winston-Salem reaches a peak average morning humidity of 90 percent in September.
Walter reported that for each 10 percent increase in operating room humidity, nine out of 100 Lasik patients required a second procedure. He also noticed some correlation between outdoor humidity and temperature in the two weeks before surgery, and the overall effectiveness of the procedure
Walter theorizes that as humidity increases, corneal tissue absorbs more moisture and, thus, less laser energy. As a result, less tissue is removed.
"Humidity has a definite effect on the amount of correction that results for any given programming of the laser," said Koch, who tries to adjust the humidity in the operating rooms he uses to between 40 percent and 42 percent.
Manufacturers of Lasik equipment suggest maintaining the operating room humidity between 35 percent and 65 percent for the most reliable results -- a window of variability Koch called "a very wide leeway." Many doctors have already been using humidifiers or dehumidifiers to adjust moisture levels accordingly, and Koch says he believes doctors must learn through experience to customize their procedures to adapt to local climate conditions.
Koch said his enhancement rate was lower than Walter's, between 5 percent and 10 percent. A possible explanation is that while Houston is always humid, and Koch has always adjusted his Lasik equipment accordingly, temperature and humidity vary more widely across the seasons in North Carolina.
Koch speculates that doctors may have to recalibrate their machinery as the seasons change, but more study is required to substantiate that claim.
Outdoor humidity clearly has an impact on the water content of a patient's corneas, but doctors are uncertain how quickly they adjust to the lower humidity levels in an operating room.
"Your patients are outside in the real world with all of those influences, including temperature and humidity. We don't know the rate of adjustment to indoor conditions. We know the outdoors probably has an influence on the treatment rate," Koch said.
Walter reported that he has devised a new formula for programming his equipment at Wake Forest that takes humidity into account, and that results have improved.
"This is the first study to show that environmental factors can affect Lasik outcomes. For best results, physicians should take these factors into account when calibrating laser equipment," said Walter, who suggested that patients considering the Lasik procedure should inquire about temperature and humidity controls in the operating room.
For her part, Ward said, "I'm perfectly happy with the way I see now. A little tweaking, going in again to see the doctor, was a small price to pay."
Oh man, thank you. Another question to ask about a procedure I have been contemplating having done.
Dang,
Where is John Edwards when you really need him?
I had this procedure done 3 years ago in Feb. I had "complications" and had very bad vision for 6 months (still better than it was with glasses) and then had both eyes done again (enhanced).
I would go through all the hassle and pain again without hesitation because I love my new vision so much.! It was worth it all.
For the record the doc told me that the complication I had was about one in a thousand.
I'm currently maxing out my FSA (300 a month) to save up for one of my eyes. (I'll do the other one next year, all tax-free). This is REALLY good info.
I'm holding out on Lasik until cyber replacement is a reality. That way, if the procedure ruins my eyes, I can sue to get a complete upgrade.
So these guys don't have air conditioning and a dehumidifier?
I guess if I ever need this, I'll have it done in Colorado, no humidity to worry about there.
I had Lasik done in 2001 in Canada. It has been great. I feel like I overcame a handicap.
My husband, my son & daughter-in-law have all had this procedure done in Houston (not by this guy) & none of them have needed "tweaking".
Well, the redo rate is 15% so it makes sense that out of three people no one needed to have it tweaked. If twenty of your family had the procedure, we would expect two of them to need tweaking.
You won't be allowed in any bathrooms, locker rooms, or government buildings.
I hate to sound like a cynic, but let's face it: If everybody had the surgery done, a lot of opticians would be out of business. I suggest you seek the advice of an ophthalmologist before making any concrete decision.
Regards,
PS: I have not had the procedure done, but I wish I could afford to do so.
My sister had this done and regretted it. It caused a problem with dry eyes. Her eyes would make no tears at all. That caused the corneas to ulcerate. She had to put drops in her eyes every few minutes. It really was a nuisance. It interfered with her work and her entire life. She is a doctor and could not do surgery. When driving, she had to put drops in at stop lights. She could not drive on the freeway for any length of time. It took about a year for the problem to improve, but for that year, she was miserable.
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