Q&A Eye Surgery

"Kcpin" asks: I have presbyopia otherwise no problems with sight. I'm 52, female and I wear 2+ enlargers. Are they harmful? And would I benefit from lazer surgery?

Dr. Soloway: There is no harm in using the over-the-counter readers or magnifier glasses, and +2.00 is about right for your age. They shouldn't be used as a reason to not visit with an eye doctor from time to time (perhaps every 2 years) to be certain that you don't have any silent eye problems such as glaucoma.

Sherry Davis of Bristow, Va., asks: I am in my early 40's and recently went to the eye doctor. I was told that I wasn't a good candidate for laser eye surgery because my prescription hasn't stopped changing. My eyesight is slowly beginning to revert to far-sightedness instead of near-sightedness which I've been for many years. Is it true that I shouldn't get laser eye surgery? The Dr. instead is recommending a treatment using contacts to mold my eyes while I sleep at night, slowly correcting my vision. I would prefer to go the laser surgery route. What would you advise?

Dr. Soloway: One of the first prerequisites of laser eye surgery is that your prescription for distance (not the reading glass prescription) is reasonably stable. Slight changes of a quarter diopter (the measurement for glasses strength) are not typically reasons to not have surgery. The method that your doctor is referring to is called "orthokeratology" and is usually practiced by optometrists (who do not do laser surgery) and not by ophthalmologists (some of whom do perform laser surgery). Orthokeratology can work well depending on the practitioner and the original prescription (weaker prescriptions being easier to treat). Both groups of eye doctors might offer different options based on what is available to them. You might consider getting another local opinion, but be certain to bring as many pairs of old glasses in order to have an assessment of just how much your eyes have been changing.

Brad Dick of Lenexa, Kansas, asks: Are any of the new non-medical eye-focusing programs effective? One program claims a person can, through eye exercise, regain the ability to focus at both distant and close distances. Any truth to these claims?

Dr. Soloway: While there is a good deal of controversy over these non-surgical methods of vision correction, in my practice I have found them to be effective over only a very small range of mild prescriptions.

Frank Kitchen of Folsom, Calif., asks: I have been told that I am not a good candidate for Lasic surgery because I have keloid skin associated with scarring. That was 5 years ago. Have any developments been made that I could now have the surgery? I've told that there are some new procedures that may allow me to have the surgery. I would appreciate your comments on this matter. Thank you for your time and consideration.

Dr. Soloway: Keloid formation is primarily a risk of surface excimer surgery and currently it is not a contraindication for LASIK surgery.

Curt Benefield of San Antonio asks: I have had Lasik surgery about 8 years ago to correct my near-sightedness problem. I am now 56 and have lived with presbyopia for about the past 6 years with a correction of about -1.75. Am I a candidate for corrective surgery?

Dr. Soloway: In the U.S., only a re-treatment to make you nearsighted in one eye with the excimer laser of CK for monovision might help. The other surgical procedures for restoration of reading vision such as SSP (scleral spacing procedure) would not be able to be done as they are investigational and most protocols require no prior eye surgery. One presbyopia investigator's practice is in San Diego and you might contact him for an evaluation: Larry Lothringer, MD.

Carolyn of Brookland, Ark., asks: If you have Amphilophia (lazy eye) in the left eye only and wear bifocals would you be a candidate for laser surgery or would you consider it to dangerous to try? Thank you for your reply in advance.

Dr. Soloway: Monovision may not work well with amblyopia (lazy eye) as the second eye may not see well enough on its own. Depending on the level of weakness, laser surgery, while not more risky, might not be a good option on your only good eye.

Brian Williams of Lenoir City, Tenn., asks: I had RK surgery in 1992 to correct near-sightness. I could read fine without glasses then. Three years ago I had to start wearing glasses again for near-sightness and also for reading. Can surgery correct my near-sightness and allow me to be able to read without glasses?