James Salz, MD
James Salz, MD, Clinical Professor of Ophthalmology, University of Southern California Medical School, Los Angeles.
People I know rave about how LASIK eye surgery has solved their vision problems. So it seemed like great news when the FDA approved a new type of LASIK (Laser Assisted In-Situ Keratomileusis) device called CustomVue Monovision LASIK for people who wear bifocals. This new and improved technology reduces the likelihood of some of the most common side effects of traditional LASIK surgery, which are halos around points of light and “night driving glare.” It’s a step forward technologically, but it doesn’t solve another problem inherent to this kind of vision-correcting surgery — which is that people might be unhappy with the results, even when the procedure is successful.
CustomVue Monovision LASIK delivers cutting-edge technology: It customizes eye scanning and measurement programs so the laser can react to imperfections or refractive errors. This ultra-precise monovision LASIK surgery is quite reliable and effective. The problem is, some people who have the surgery are uncomfortable with the results, I was told by James Salz, MD, clinical professor of ophthalmology at the University of Southern California Medical School in Los Angeles. Just as it can be difficult for people to adjust to bifocal glasses or contacts, it is similarly, if not slightly more, difficult to adjust to the monovision produced by this surgery. The net corrective effect of the surgery is that each eye gets relegated to a specific function. One cornea is cut and tissue is removed with a laser to help one eye focus at a distance, while the other is adjusted to focus close at hand. The patient must get used to having one eye working for distance vision, then “handing off” to the other eye to see objects close-up… which is not easy since we’re accustomed to having our eyes work in tandem. Dr. Salz is concerned that the advances in technology might make potential LASIK candidates rush into having this procedure without having properly evaluated whether it’s right for them.
Dr. Salz says it’s best to take this procedure for a “test drive,” so to speak. He suggests wearing contact lenses that adjust your eyesight to what it will likely be post-surgery. “This demonstrates the effect so people can make sure they are comfortable with it,” he says. Some people report feeling dizzy, like they’re on a boat — and afterward they don’t want to have the surgery. “With those who are good candidates, as soon as you put the lenses on, they say, ‘Oh, this is great’ and you can tell right away that they’re going to be happy.”
This brings us to Dr. Salz’s final point: Work with an ophthalmologist who will take the time to make 100% sure you’re comfortable before you proceed with surgery. He suggests first consulting an eye doctor with a good reputation who doesn’t do LASIK to ask about the surgery and for a recommendation to a physician who performs it in your area. “When you ask a doctor who does the surgery, the recommendation is usually surgery — done by that doctor,” he points out. “You can get a bias-free recommendation by asking someone who doesn’t stand to gain.” Then work with that doctor to try out the monovision feeling for at least a week with contacts before going under the laser, just to be sure. LASIK treatment is quick and almost completely painless — but you need to be sure it’s right for you.