Question about Lasik ?

Discussion:

(too old to reply)

Hans

2003-09-12 21:13:58 UTC

Hi there,

some weeks ago I posted a message about what could be the
contra-indications for people who suffer from Hashimoto (auto-immuun
disease, to find out more click
http://www.4woman.gov/faq/hashimoto.htm ).

I check several doctors, specialists and they all concluded there were
not cases known in whiwh Lasik surgery could cause a risk to a patient
having this disease.

Anyway, I had several pre-op exams and am considered to be a suitable
candidate. I only seem to have rather dry eyes, common for people
having had contact lenses for many years.

Still, it is up to me. The doctor doesn't want me to urge nor force to
decide, telling it's only me who can decide what to do. So I have this
dilemma : try to live with my glasses which I hate or jump into a risk
which eventually I could regret but in an ideal end would give me
'free' vision : freed from contact or glasses. What to do hé ?

Second question : just by curiosity, what is to be considered the
better laser : the Nidek or the Baush and Lomb Technolas ?

Thanks for all usefull info !

Dr. Leukoma

2003-09-12 23:58:26 UTC

Permalink

Post by Hans
Hi there,
some weeks ago I posted a message about what could be the
contra-indications for people who suffer from Hashimoto (auto-immuun
disease, to find out more click
http://www.4woman.gov/faq/hashimoto.htm ).
I check several doctors, specialists and they all concluded there were
not cases known in whiwh Lasik surgery could cause a risk to a patient
having this disease.
Anyway, I had several pre-op exams and am considered to be a suitable
candidate. I only seem to have rather dry eyes, common for people
having had contact lenses for many years.
Still, it is up to me. The doctor doesn't want me to urge nor force to
decide, telling it's only me who can decide what to do. So I have this
dilemma : try to live with my glasses which I hate or jump into a risk
which eventually I could regret but in an ideal end would give me
'free' vision : freed from contact or glasses. What to do hé ?
Second question : just by curiosity, what is to be considered the
better laser : the Nidek or the Baush and Lomb Technolas ?
Thanks for all usefull info !

The answer is that it is well-known that patients with autoimmune disease
can suffer from dry eye. This is because the same process can attack the
major tear-producing gland, the lacrimal gland. In fact, patients who
present with severe dry eye are often referred for blood tests to identify
specific antibodies which might be present. Autoimmune diseases usually
find their way on the list of contraindications for LASIK. Autoimmune
diseases are often progressive, and the combination of the disease, changes
in sex hormones with age, and LASIK could someday prove to a lethal
combination.

Of course, none of the above may occur, but I can tell you that my peri-
menopausal hypothyroid female patients almost always have problems with
their contact lenses.

DrG

Glenn Hagele - Council for Refractive Surgery Quality Assurance

2003-09-13 00:26:17 UTC

Permalink

Only you can decide if the potential benefit is worth the potential
risk. Only you will live with the results - good or bad.

Post by Hans
Second question : just by curiosity, what is to be considered the
better laser : the Nidek or the Baush and Lomb Technolas ?

I believe that it is universally agreed that the true flying spot
gaussian beam technology of the B&L Technolas is considered superior
to the broadbeam technology of the Nidek. Whether or not you require
that higher level of technology I do not know.

One thing that is important is that you would not be able to have
wavefront-guided ablation with a Nidek, but you can with the Technolas
in a few months.

Glenn Hagele
Executive Director
Council for Refractive Surgery Quality Assurance
http://www.USAeyes.org
http://www.ComplicatedEyes.org
glenn dot hagele at usaeyes dot org

I am not a doctor.

lasik advocate with flap melt

2003-09-13 01:33:33 UTC

Permalink

In the U.S. it's a contraindication for LASIK (meaning Do NOT do it
under any circumstances in my opinion).

http://www.fda.gov/cdrh/LASIK/when.htm
You have a disease or are on medications that may affect wound
healing. Certain conditions, such as autoimmune diseases (e.g., lupus,
rheumatoid arthritis), immunodeficiency states (e.g., HIV) and
diabetes, and some medications (e.g., retinoic acid and steroids) may
prevent proper healing after a refractive procedure.

sqrrlbird

2003-09-13 08:28:25 UTC

Permalink

Hi Hans,

I have heard mixed things about thyroid autoimmune diseases. I asked
a few questions because both my parents have Grave's. The answer I
got most often is that thyroid autoinnune diseases are OK as long as
the thyroid hormone levels are under control.

Personally, I would be more concerned about the dry eye. Have you
tried anything to treat this? Some have suggested salmon oil or
linseed oil suppliments that may help. You might give yourself some
time to try to improve your dry eyes before considering surgery.

-sqrrlbird

Dr. Leukoma

2003-09-13 12:45:28 UTC

Permalink

Post by sqrrlbird
Hi Hans,
I have heard mixed things about thyroid autoimmune diseases. I asked
a few questions because both my parents have Grave's. The answer I
got most often is that thyroid autoinnune diseases are OK as long as
the thyroid hormone levels are under control.

Getting and keeping endocrine diseases under control via HRT is often
easier said than done. The same holds true for dry eyes.

DrG

sqrrlbird

2003-09-13 20:16:44 UTC

Permalink

Hi DrG,

Would you agree that it's a bad idea to undergo surgery unless both
are truly under control? Or, based on your experience, would you
maintain that the mere presence of either of these conditions would be
an indication against having surgery?

The thing that worries me about autoimmune diseases, is that they
often come together. Once you have one, it is easy to develop
another, which can go undiagnosed. They run rampant in my family, and
I always knew that if I developed one, I would not have LASIK.

-sqrrlbird

Post by Dr. Leukoma

Getting and keeping endocrine diseases under control via HRT is often
easier said than done. The same holds true for dry eyes.
DrG

Dr. Leukoma

2003-09-13 23:24:53 UTC

Permalink

I think that the mere presence of these diseases should send up a red flag.
Previously I have stated that many of my patients with thyroid disease have
problems with their contact lenses. The fact is that they are already on
HRT for their disease. Also, these diseases do not present a steady state
situation, since the hormone levels frequently need to be adjusted over
time. There is a syndrome involving dry eye, dry mouth, and arthritis
symptoms. The name of the syndrome is Sjogren's Syndrome. So, yes, they
sometimes come together and involve more than one system.

I fully agree with your conclusions.

DrG

Post by sqrrlbird
Hi DrG,
Would you agree that it's a bad idea to undergo surgery unless both
are truly under control? Or, based on your experience, would you
maintain that the mere presence of either of these conditions would be
an indication against having surgery?
The thing that worries me about autoimmune diseases, is that they
often come together. Once you have one, it is easy to develop
another, which can go undiagnosed. They run rampant in my family, and
I always knew that if I developed one, I would not have LASIK.
-sqrrlbird

Post by Dr. Leukoma

Post by sqrrlbird
Hi Hans,
I have heard mixed things about thyroid autoimmune diseases. I
asked a few questions because both my parents have Grave's. The
answer I got most often is that thyroid autoinnune diseases are OK
as long as the thyroid hormone levels are under control.

Getting and keeping endocrine diseases under control via HRT is often
easier said than done. The same holds true for dry eyes.
DrG