Question:
My wife is in her 50s and she wears glasses due to short-sightedness. One day, she told me that she hoped to go for LASIK surgery so that she would not have to wear specs anymore, but she is worried that her age will pose a risk to the eyes if she undergoes the surgery. Will there be risks if an elderly person decides to go for LASIK surgery?
Answer:
LASIK surgery is a type of refractive eye surgery where a special laser is used to reshape the cornea in order to enable light entering the eye to be properly focused onto the retina for clearer vision. Like any other surgical procedure, LASIK is associated with
certain risks. Fortunately these risks are not very frequent. LASIK is an effective treatment option for individuals keen to get rid of their glasses for short-sightedness.
However as your wife is in her fifth decade now, she is also likely to have lost some ability to focus on near objects, a condition which is called long-sightedness or presbyopia. Her long-sightedness will continue to progress at least over the next couple of years. This is one of the major concerns for individuals considering LASIK after the age of 40. As LASIK is usually a one-of procedure, it may be able to correct her current degree and give her good vision without glasses. However after the LASIK her ability to see objects close up is likely to be hampered to some extent. In order to try and maintain the ability to see near
objects, there may be options such as Monovision LASIK (where one eye is corrected for distance vision and the other eye is corrected for near vision) or Multifocal LASIK (where LASIK changes the shape of the cornea to create more than one power on the front surface of the eye).
Normally, both eyes work together equally when one looks at an object to produce what is alled as binocular vision. This ability allows us to perceive depth during common visual tasks in our daily life. Monovision may be associated with varying degrees of loss of inocular vision and resultant loss of depth perception. Hence not everyone is able to adjust to or tolerate monovision. Generally a LASIK procedure is not considered eversible hence it might be worthwhile to try simulated monovision using contact lenses to see if she adapts well to monovision before considering monovision LASIK.
Multifocal LASIK may be associated with a reduced ability to appreciate contrast and/ or tendency to see haloes around lights at night.
Finally, it is also important to understand that LASIK will not halt the progression of long-sightedness. Your wife may have to be prepared to undergo further surgical procedures or to use glasses for near tasks even after undergoing the LASIK procedure as the long-sightedness progresses.
As there are alternative treatment options for short-sightedness
associated with presbyopia, your wife should have a detailed discussion with an eye specialist to understand the LASIK procedure, the alternatives and the risks involved before considering the procedure.
Dr Ajeet Madhav Wagle
Medical Director and
Senior Consultant
Singapore International Eye Cataract
Retina Centre, Mount Elizabeth
Medical Centre
