Doctors Answers Questions About Eye Surgery

Dr. Soloway: The decision to have laser eye surgery when a patient is already using glasses for reading, on top of their contacts, can be a difficult one and each patient reaches their answer differently depending on their own personal desires and needs. Some patients, when made aware that they will need reading glasses, wonder why anyone would have the surgery. Others using contacts and readers over the contacts view it as a way to at least get rid of one of the two. I like to ask my patients what they are hoping to accomplish with the surgery. I get many different answers, but try to lump them into one of two categories: surgery for vision reasons such as fog, skiing, etc., and surgery for glasses reasons -- the "I hate glasses" sort of patient. The vision group tends to do best with distance correction in each eye and doesn't mind using reading glasses. The glasses group will typically make good monovision patients which will minimize their use of glasses the most. If you would rather wear glasses for reading instead of 24/7, then you have realistic expectations of what the surgery can do and should consider checking to see if your eyes are appropriate for surgery.

Nancy of Raleigh, N.C., asks: I am 54 years old and wear progressive, biofocal glasses. I have extreme dry eyes and tried plugs in my eyes. I also have tried contacts, but they make my eyes feel even drier. I have been told lasik surgery would make my eyes even drier. Would a lensectomy work for me? (I already have the beginning of a cataract in each eye, but it is the slow-growing kind).

Dr. Soloway: Most patients get drier after LASIK surgery and if you already have extreme dry eyes, you "have been told" correctly. Other methods of excimer laser (the laser used in LASIK) surgery such as surface treatments of PRK or EpiK might be considered. Lensectomy shouldn't make the dryness worse, but does have some risk due to the fact that it is intra-ocular surgery, so infections or bleeding, though rare, could cause the vision to end up worse. Depending on the level of your cataract (worse is better) it could however be an excellent choice.

"Kcpin" asks: I have presbyopia otherwise no problems with sight. I'm 52, female and I wear 2+ enlargers. Are they harmful? And would I benefit from lazer surgery?

Dr. Soloway: There is no harm in using the over-the-counter readers or magnifier glasses, and +2.00 is about right for your age. They shouldn't be used as a reason to not visit with an eye doctor from time to time (perhaps every 2 years) to be certain that you don't have any silent eye problems such as glaucoma.

Sherry Davis of Bristow, Va., asks: I am in my early 40's and recently went to the eye doctor. I was told that I wasn't a good candidate for laser eye surgery because my prescription hasn't stopped changing. My eyesight is slowly beginning to revert to far-sightedness instead of near-sightedness which I've been for many years. Is it true that I shouldn't get laser eye surgery? The Dr. instead is recommending a treatment using contacts to mold my eyes while I sleep at night, slowly correcting my vision. I would prefer to go the laser surgery route. What would you advise?

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