There are probably 100 million people who went through the procedure of Lasik, but a few of them could name a doctor or place, not to mention the measurements before and after the operation. However, it is this kind of information that is fundamental in the successfull treatment of patients with cataract with "Lasik anamnesis".
Over the past 20 years, the words LASIK, Amazon, Uber, Facebook, and Twitter have entered our lexicon. The word LASIK, though, has become a fixture.
And it’s no wonder. Over the years, tens of millions of procedures have been done in the US. It’s probably 100 million worldwide.
It’s quick, effective, and doctors even perform it on themselves and their own families. I had the honor of going through this procedure 11 years ago. So did my brother, my 24-year-old daughter, my mother, and mother-in-law. Everyone was pleased with the results.
But now ophthalmologists are increasingly seeing patients coming back with cataracts after the operation.
Lasik itself does not affect the development of cataracts. The process of the clouding of the lens, if you live long enough, develops in everyone sooner or later.
When a patient goes to the ophthalmologist or optometrist with post-operative cataracts, though, it turns out that glasses aren’t helpful anymore and having an operation is the only solution.
Technically, it’s the same operation that you get if you’ve never had Lasik before. The yellowed lens is removed and replaced with an artificial one. In this case, however, the measurements that calculate which lens should be used are complicated.
Artificial lenses are of various kinds. There are monofocal, multifocal, toric multifocal, those that correct myopia, farsightedness, astigmatism, and others. In some cases, the person doesn’t even have to wear glasses or contacts post-operatively. I suppose you already know all of this.
But if the patient had Lasik 20 years ago, he or she may have become so accustomed to not wearing glasses that having to wear them again is unacceptable.
Lasik veterans have special requirements. The cornea is unique, and that makes the task of calculating the lens very difficult.
It’s often the case that patients who go to an ophthalmologist that doesn’t have modern diagnostic tools and the latest programs for calculating lenses are in for a “refractive” surprise.
They think that glasses won’t be needed, but it turns out they are and with thick lenses. This is because they have extreme farsightedness or conversely myopia with high diopters. Let’s say you suddenly hit -6.
Such a surprise is unpleasant for the patient and doctor. How do we prevent this?
The best thing to do is get all the information you can from the doctor who performed the Lasik previously. Measurements before and after the operation. This data is fed into a program that calculates a nomogram and prompts the correct solution. Often, though, this information doesn’t exist anymore. The operation was performed a long time ago, in another city. Sometimes patients don’t remember the name of their doctor or they’ve retired. By law, doctors must keep records for 7 years, but those 7 years are long gone. At that point you ask, rhetorically, “What’s to be done?”
Arthur Benjamin
(to be continued)
You may put your vision in the best hands by asking the proper questions of a potential LASIK physician using this No-Regrets Guide. We've included our own responses to these inquiries to prevent you from having to conduct an interview. But if you need more explanation or have other worries, let us know! We are at your service.
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Author: Arthur Benjamin, MD
