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LASIK still a valuable investment 20 years after surgery

Manuel J. Chaknis, MD, was one of the first ophthalmologists in the US to undergo LASIK.

Issue: April 25, 2015

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We refractive surgeons often encounter patients who, in consultation, bring up concerns that LASIK “wears off.” Manuel J. Chaknis had his LASIK procedure almost 20 years ago and speaks to his long-term results, which are outstanding. Most patients do not quite understand that the presbyopia phenomenon should not be equated with LASIK wearing off. Others are not aware that monovision LASIK works quite well for many patients and can be added even after prior LASIK.

The second major point is that those of us who perform LASIK routinely hear phrasing similar to Manuel’s: “This is the best thing I’ve ever done” and “This is the best money I’ve ever spent.”

Any other refractive surgeons out there who would like to tell their own personal story of refractive surgery, please contact OSN Editorial Director David W. Mullin at dmullin@slackinc.com.

Richard A. Norden, MD
OSN Refractive Surgery Stories Editor

Manuel J. Chaknis

I am a 51-year-old ophthalmologist who had LASIK in November 1996. I was one of the first ophthalmologists in the country to have refractive surgery. At the time, I was a 33-year-old cornea/refractive fellow with Drs. Frank Price and Bill Whitson in Indianapolis. The surgery was performed with the Bausch + Lomb Technolas 116 and ACS microkeratome. My prescription was approximately –2.50 –1.00 × axis in each eye, with corrected vision of 20/20 and uncorrected vision of 20/400.

At the time I had surgery, I was wearing hard contacts. I had to take them out mid-afternoon due to discomfort and wear eyeglasses the rest of the day. I had considered PRK, but near the end of my residency, LASIK was emerging. I decided to wait and see the LASIK results during my fellowship before proceeding with surgery. Overall, I had been contemplating laser refractive surgery for 1.5 years before proceeding with it.

My LASIK result was great. Refractions have varied from +0.25 D to –0.25 D over time. At the time of my surgery, preop oral sedative medications were not given to patients, and I would have liked and benefited from something such as Valium to help relax during surgery. The two parts of surgery that were not easy were the lid speculum (mild discomfort) and the microkeratome cutting the flap (moderate discomfort). I had the usual tearing, light sensitivity and discomfort about 45 minutes after surgery, but I took oral pain pills, slept for 3 hours and woke up 4 hours after surgery, able to easily watch the news while having dinner.

My postop course was smooth except for one portion, about a month after surgery. I had stopped using the artificial tear drops after the first week or two, and by a month postop, I had become dry and vision had blurred. Restarting the artificial tears quickly restored my good vision status, and it has never been an issue since, even though I stopped using tears again about 2 months later. Two years ago, at age 49, 16 years after my surgery, I developed the usual age-appropriate presbyopia and wear +1.00 “dollar store glasses” for reading books, charts, the computer and other near vision tasks. I love clear distance vision, so I am content with this situation. I do not want monovision surgery, and I do not want to wear contacts or glasses all the time.

LASIK was the best thing I ever spent money on. I believe it was also the best value, the best “bang for my buck,” of anything as well. I have performed more than 25,000 primary LASIK and PRK surgeries over the past 18 years and thus strongly believe in it when done on appropriate surgical candidates with excellent equipment and by an experienced, careful surgeon. If I had it to do over, I would still choose LASIK as the best procedure for me, then and now.