New Laser Surgery For Vision

A laser surgery technique called LASIK is gaining popularity as a permanent remedy for myopia. CBS News Saturday Morning Co-Anchor Russ Mitchell followed two patients through the new procedure.

Patients reportedly heal faster and more comfortably after this procedure than with the previous generation of laser eye surgery.

Warren Yeh, a 38-year-old stockbroker who has worn glasses for 20 years, is one who has decided to try it. "I mean I can't even read the newspaper without putting on my glasses or contacts," he said. "I sit about two feet away from a computer screen. I need glasses to see the computer screen."

Yeh and millions like him cannot even see the big "E" on the eye chart from 20 feet away.

In nearsightedness, light rays are focused too far in front of the retina. So the idea is to have the light rays focus on the retina.

Eric Mandel is a corneal microsurgeon who has performed thousands of LASIK procedures. LASIK stands for Laser Assisted in-situ Keratomileusis.

He explained, "LASIK is a procedure where we take the top fifth of the cornea, thinner than a hair...and we peel it open on a hinge painlessly. We then laser or reprofile the cornea, painlessly, so light rays are then correctly placed inside the eye, right onto the retina, so people can see clearly."

The eyes are anesthetized with drops, but the patient is wide awake during the procedure. Dr. Mandel uses a microkeratome to create the flap. He peels back the flap, and lasers the cornea, reshaping it. Then he simply replaces the flap, and smooths it back into place. There are no stitches. The procedure takes five to ten minutes.

Yeh said, "It was an immediate result! I already feel like I'm wearing contacts. That's amazing." Minutes later, Yeh's eyes were watering and his vision was a bit hazy. But the next day, he was back at work.

"I haven't relaxed my eyes at all today, been at work all day, and as time goes by I just keep getting better and better results," he said.

Deejay Diane Prior drove to work the day after surgery. She said, "I can see better now than I did in my contact lenses." Now, she said, "from nine feet away. I can see the numbers on the CDs."

At follow-up exams the following day, both Diane and Warren see with 20/20 vision. There are some common temporary side effects. They may have some glare and halo that could go on sometimes for a few months, and their eyes may develop a little bit of dryness.

The American Academy of Ophthalmology says that major complications like corneal scarring and cutting off the flap occur in one to five percent of all cases.

For nearsighted people, LASIK can defer the day they'll need reading or driving glasses, or eliminate the need for bifocals. But it won't stop the natural aging process.

"This will remain the same, the correction on the cornea. But this inelasticity or this hardening of the lens will progress and that's why people lose their ability to focus up close," said Mandel.

"But for now, with his vision still clearing one day after surgery and more improvement expected, this patient is satisfied," he added. "Let me put it this way," said Yeh, "if my eyes do not get any better than this, I'm still happy."

LASIK is not covered by most insurers. It costs around $2,500 per eye and most people have both eyes done at once.

Mandel told us that some people are not good candidates for LASIK, including:

• people under 18,
  
• people with bad cases of diabetes
  
• patients who have only one "good" eye, such as people with a "lazy" eye, and
  
• women who are pregnant or nursing, since the post-operative care involves antibiotics and steroids.

For more information on the procedure go to eyenet.org the Web site of the American Academy of Opthalmology or ascrs.org the Web site of the American Society of Cataract & Refractive Surgery and the American Society of Opthalmic Administrators.

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