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FDA Examines 'Quality of Life' for LASIK Patients
Date:4/25/2008

mileusis) surgery involves cutting a small flap in the eye's cornea using a laser. With the flap held out of the way, the surgeon can then reshape the corneal tissue with another laser. The procedure can be used for nearsightedness (as in Tiger Woods' case), farsightedness and, in some cases, astigmatism.

But, the much-touted procedure is not for everyone. Those who should rule it out include individuals who have a misshapen cornea or excessively thin cornea, who have early cataract formation or big pupils, who have dry eyes, or underlying conditions such as lupus or rheumatoid arthritis, said Dr. Norman Saffra, director of ophthalmology at Maimonides Medical Center in New York City.

Negative results can include glare and halos around lights at night. Some patients have actually had to have corneal transplants when LASIK went wrong, Starr said.

Surgeons may also rule out patients with unrealistic expectations. "I had a patient who said, 'I want to be able to see a license plate on a dark country road from a mile away,' so I didn't do it," said Cykiert, who estimated that he declines about 20 percent of patients who come to him.

Cykiert recommends that the surgeon who is going to perform the LASIK surgery also be the one to pre-screen candidates. "One of the things [the FDA] is probably going to find is that some of the people who have complaints that are valid may possibly have not been evaluated pre-operatively as thoroughly as they could have been," he said.

"It's an elective surgery, you're operating on very healthy people, healthy eyes, you don't want to take any chances," said Starr, who turns away 50 percent to 60 percent of prospective patients who come to him.

Starr himself has declined to have the procedure, because he considers himself "borderline." (Refractive surgeons in general, however, are four times more likely than the general population to undergo LASIK, according to a survey from t
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