Q & A About LASIK Surgery
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Q : Why do you have four different lasers to do LASIK?
Stephen Slade MD: We have two different lasers that make the ablation, two different lasers that make flaps. And, uh.. there's a very simple answer to why we have four lasers for Lasik. Because we have more than one patient. And by that I mean our patients are so varied. People are different. Some people have a lot of nearsightedness. Some people have a lot of astigmatism. Some people have this requirement or that requirement. So we find that we use the different lasers for different eyes. Different prescriptions. And we find the sweet spot. So we're able to more, uh.. offer, we're able to better offer the patient what might be a solution that suits their eye, their individual eye better. The more tools you have - it just makes sense. And it's helped us with our results.
Q : What is all-laser Lasik and why do you think it is better?
Stephen Slade MD: All-laser Lasik is using two lasers on each eye. Both components. Remember, Lasik is making a very thin flap of corneal tissue, laying the flap back and then reshaping the eye with a laser, replacing the flap. Initially, we used a metal blade to make that flap. And that was back in 1991, when we started Lasik, to-- and did the first ones. And then the laser to reshape. All-laser Lasik is using a laser to make the flap, and then a second laser to reshape the eye. We actually have the nation's longest experience in all-laser Lasik as well as Lasik. We went to it early. Well, we went to it earlier than anybody, because it simply made sense. A laser can make a flap more precisely with unique safety factors that you simply do not have in a metal blade. The metal blade was great. But the laser was an improvement in technology. It gave us so many different options.
Q: There are many practices in Houston that offer LASIK. What kind of homework should a patient do who is considering having LASIK?
Stephen Slade MD: There's lots of Lasik doctors in Houston. Some very good ones. And, it's important for any patient, though, to- to do their homework. To make the choice that's best for them. Luckily the technology is good. The doctors are good. What I would do, if I were a patient, and I think that's the best way to answer it, is I would want, uh.. first to know if I was a candidate. Again, go in, have an exam. Find out if this is something that you really are-- really is an option. Then start investigating it, finding out, you know."Is this something for me?" So what are the questions that-- would I ask? I certainly want to know how long the doctor's been doing the procedure. That would be important to me, that he is experienced. I would want to know does he have different options for me? Does he have different lasers? Might one laser fit my eye better than another? Rather than sort of everybody getting the same tool, you know. I would want to know is he on the forefront? This is rapidly moving stuff. These lasers are developing, the different algorithms, the ways of applying them, the pharmacology. The drops we use. All of this is rapidly evolving stuff. I would want to know, is this a doctor who is engaged? Is he out there nationally, internationally, giving talks, learning from other doctors? I would be impressed if he was teaching other doctors. If he had the latest information that he was sharing with other doctors. Probably one of the most important things I'd want to know is, what do the other doctors, his peers, think of him? Does he do surgery on other doctors? Have other doctors come to him, specifically eye doctors, to have their own surgery done? And then, since I'm probably gonna spend a lot more time with your staff than with you, what's the vibe there? How do I feel about them? What messages are they giving me? Are they proud to be where they are? Are they happy to be where they are? Are they enthusiastic to be working for this doctor? All those things, I think, are important.
Q: Who would you consider a good candidate for LASIK?
Stephen Slade MD: The best thing for anybody who's thinking about this technology, who's looking at our website, is to come in, have a screening evaluation. There's no charge to it. You come in, it doesn't take that long. It doesn't cost anything. I'll talk to you, Dr. Baker will talk to you. You'll have the exam. We'll run you through the machines. And we'll be able to give you a good idea of whether you're a candidate or not. Then, you can go home, research it. Get more information from the website, and kind of start thinking about whether you wanna have it done. Who typically is a candidate? Most people with nearsightedness. Most people with farsightedness. Importantly, we have wonderful ways now to treat astigmatism as well. Up to very wide ranges. Very, very high ranges. Now, there are people who are too nearsighted for Lasik. Luckily, there's little tiny soft contact lenses now, the ICL that can be implanted for those people. So there's options. It's very important to go to a doctor who has other options, than Lasik, so that he's not trying to fit everybody into something that might not be for everybody. In any case, you want to learn what your options might be and if you're a candidate. Most people are indeed candidates.
Q: Are there people who are not candidates for LASIK?
Stephen Slade MD: There are people who are not candidates. Perhaps, you know, the first person that I would think of as not a candidate is somebody who has an unrealistic expectation of what the surgery can do. The surgery is a wonderful surgery. But it is not perfect. It is not going to make every single person see 20/20. If a person is over 40, they might still need reading glasses. If a person has a very large correction, or if a person has any other problem in their eye. If their retinas are weak, they might not be a perfect candidate. Might not have a perfect result. And of course nobody can be guaranteed to have any particular result. So that would be one person. Somebody who's just hoping, or expecting more out of it. Somebody who simply would come up and say,"I'm not gonna be happy unless I'm absolutely perfect and never have to wear glasses again for the rest of my life." Maybe not a good candidate. Uhm.. there are people with retinal diseases that are not good, uh.. candidates for Lasik. There are people with corneal diseases of the front part of the eye. The part that we're operating on. Inherited diseases, such as keratoconus that are not necessarily good candidates for Lasik. They may have other options now. We're doing a wonderful trial with cross linking. It's a vitamin trial with ultraviolet light that's specifically for people with keratoconus. But those people may not be candidates for Lasik, certainly. There are people that have other different conditions of the eye or diseases of the eye that do- that would rule them out. But in general, most people are candidates for Lasik or PRK. And there are patients that are, uh.. well, with the majority of the patients we do, we do Lasik with. On the other hand there are patients who really do better with PRK. So that's why we do both.
Q: Which is safer, Lasik or contact lenses?
Stephen Slade MD: That's a great question. Which is safer, Lasik or contact lenses? Interestingly, there was a study by the University of Oregon that was presented, uhm.. which confirmed what many of us cornea specialists have always believed. In terms of several f- conditions, Lasik is safer. Now, I'm thinking specifically of infections. We see more eyes that have infections from patients wearing contact lenses than we do from Lasik. And this is borne out by this recent study from the University of Oregon. Certainly, if you want the absolute safest choice, then you would wear glasses and stay inside, and never leave your house, so that nothing could ever hit you in the eye and break the glasses and shatter them. If you really wanted the very safest option you wouldn't buy a car. You'd walk. If you really wanted the very safest option you wouldn't go out at night. You'd stay inside. If you really wanted the very safest option, you probably wouldn't live in Houston. You'd probably live somewhere out in the country. So, uh.. you know. What we do with our lives is we take, uh.. risks and benefits, and we balance them. And we decide, will the benefit of anything, you know, living in Houston, driving a car, going outside, wearing contacts, having Lasik, will the risks of that outweigh, or will they be balanced, by the benefits? And the benefits of Lasik are just tremendous. The potential benefits of Lasik are just tremendous. While there are risks, the risks tend to be one-time risks, clustered around the surgery itself. And with all-laser Lasik, they're low. Now, consider the benefits. The benefits are the wonderful vision without glasses or contacts that you enjoy every waking moment of the day. Typically for the rest of your life. I don't know of a procedure other than eye surgeries, such as cataract surgery, Lasik or PRK, where you get the benefits, you get to enjoy the benefits of these surgeries, as a group, cataract surgery, Lasik surgery, PRK surgery. You get to enjoy the benefits of these procedures every waking moment of your day. And, you know, there's a lot of things that I enjoy. You know, whether it's golf, riding bikes, sports, a nice dinner. But certainly, it's not every waking moment of my day. So the potential benefits of eye surgery is phenomenal. Yes, there are risks. But for many people, in many different situations, the benefits far outweigh the risks.