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Q: Contacts and Laser Eye Surgery? ( Answered 5 out of 5 stars,   2 Comments )
Subject: Contacts and Laser Eye Surgery?
Category: Health
Asked by: 88star4-ga
List Price: $50.00
Posted: 18 Apr 2006 03:05 PDT
Expires: 18 May 2006 03:05 PDT
Question ID: 720109
I asked a question earlier, about how to get along without glasses
when near-sighted, and now have two very specific areas of interest.

1. Contact lenses - I'd like to find ones that work, but have really
dry eyes. Last time I tried (4 years ago) lenses were too
uncomfortable (unwearable). Are there any new lenses now available
that feel good, regardless of eye dryness? (Or any being developed)?

2. Laser-eye Surgery. I never even considered this. The idea of
physically altering your eye seemed like ill-advised, too good to be
true, and would rather just put up with wearing glasses then risk it.
(You don't want to mess up your eyes). But something made me think it
could work for the first time -- that thing is Peter Jackson (King
Kong). I'd love to know what he has done. He used to wear glasses, but
now has no problem without them. If there was ever proof of eyes
working from an operation like that, it is his amazing artistic
accomplishment. Just look at a thing like King Kong: there can be no
doubt that his eye works as amazingly effectively as you could ever

Any ideas?
Subject: Re: Contacts and Laser Eye Surgery?
Answered By: alanna-ga on 18 Apr 2006 13:27 PDT
Rated:5 out of 5 stars
Hi 88star4-ga, 

Great questions. Much progress has been made in eye correction, so I'm
sure there's an answer for you--just like there was for Peter Jackson
(see below).

I thought it might be a good idea to first point you to some diagrams
of the eye, so you can envision what we're talking about.

There is a cool interactive diagram of the eye at the site below. Just
place your cursor over the part of the eye you want to see, and it
lights up.  You are most interested in the cornea on which the contact
lens rests and which is reshaped in laser surgery.

There is a plainer diagram with definitions, again clearly showing the cornea at:

Now to your first question on CONTACT LENSES.

Contact lenses are small discs that rest on the fluid which covers the
cornea.  Contact lenses are more comfortable than ever thanks to
refinements in the materials used to make them.

Let's take a look at all the options:

There are two basic types of contact lenses, SOFT and RIGID. Both
allow oxygen to pass through them, an important factor for eye health.
The down side of contact lenses is that they permit the build-up of
proteins, calcium and fats (from the tears that bathe the cornea)
causing discomfort.  However, removal and cleaning of the lenses fixes
this problem.

Before we completely rule out the rigid lenses, we might look at their
plus side for a moment.

RIGID lenses (gas permeable) are made of harder plastic and tend to be
less comfortable, especially during the first days of wearing them . 
However they do offer the best correction, especially for astigmatism
or a distorted corneal shape.  They also allow more oxygen to pass
through and are less likely to cause infection.  They are the most
durable of all the types of lenses, sometimes lasting several years
before needing to be replaced.

I know you tried rigid lenses and found them uncomfortable. There are
options for making them more comfortable if you choose rigid (see

SOFT lenses (for daily wear) are the choice of most contact lens
wearers.  They are soft because they contain water.  Water allows
oxygen to pass through the lens and also gives the lens its wet feel. 
They are considered to be very comfortable and "easy to adapt to." 
They need to be discarded and replaced more frequently than rigid

Some soft lenses are designed to be last  about a year before needing
another pair.  They are taken out every night. Other soft lenses need
to be discarded after a specific period of time.

"Disposable lenses. ..are soft lenses designed to be worn for a
specific period of time, then thrown away and replaced with a fresh
pair of lenses....They can be worn for one day or up to three months ?
during waking hours ? before being discarded."

" Extended-wear lenses ... are soft lenses that are approved for more
than 24 hours of continuous wear. ...They can be worn continuously for
up to seven days before they need to be removed for cleaning."

The newest kind of extended-wear lens is the SILICONE HYDROGEL which
can be safely worn for up to 30 days--night and day.  This material
lets oxygen pass through promoting eye health.

DRY EYES are the result of not enough tears forming to bathe the
cornea. This causes discomfort as you well know.  The silicone
hydrogel may be the answer because the lens itself doesn't dehydrate
during wear as do the other soft lenses.

Yet at the end of the day, dry eyes and contact lenses don't do well
together without extra and possibly bothersome care and precautions. 
Changing the lenses frequently is one solution: therefore a daily
disposable lens might be well tolerated. And since you can buy just a
few disposables at one time, they might be worth a try.  If they don't
work, you can look into ...

The technical name for laser surgery is "refractive surgery."  This
type of surgery reshapes your cornea.  Depending upon your vision
problem, the cornea can be flattened or mounded or steepened.

"Refractive surgery is usually considered an elective surgery ? which
means it isn't vital to your health and well-being. For this reason,
Medicare and most insurance companies won't cover the cost of the

The most frequently used procedures  are LASIK and LASEK.  I will also
briefly discuss the PRK method.

LASIK (laser-assisted in-situ keratomileusis). In a LASIK procedure "a
knife, called a microkeratome, is used to cut a flap in the cornea. A
hinge is left at one end of this flap. The flap is folded back
revealing the stroma or middle section of the cornea. Pulses from a
computer-controlled laser vaporize a portion of the stroma and the
flap is replaced." When the laser is on the patient stares at a fixed
point for about a minute.  There is a ticking sound, and some people
have reported a smell like burning hair when the corneal tissue is
being removed.

The procedure takes about 30 minutes with the patient lying back in a
reclining chair.  There will be a feeling pressure on the eye, but not
pain.  After the surgery patients experience blurred vision for a
short time.

It is considered better to have just one eye done at a time. This
allows you to see how you've responded to the surgery and also avoids
having both eyes blurred at the same time.

LASEK (laser epithelial keratomileusis) surgery is almost the same as
LASIK except only the top layer of the cornea is cut; then the cornea
bathed in alcohol and loosened before it is turned back.  Whether
LASEK is used or not depends on how much the cornea needs to be
reshaped. If the cornea is very thin, LASEK might be the preferred

Recovery time from LASEK is longer and a protective lens must be worn
for about 4 days over the treated eye.

Just to be as thorough as possible, I'll add that there is a third
type of laser refractive surgery in use today.  It is PRK
(photorefractive keratectomy), which involves "the removal of the
surface layer of the cornea (epithelium) by gentle scraping and use of
a computer-controlled excimer laser to reshape the stroma."

"Generally, PRK surgery has a high success rate. However, side effects
do occur. Because the corneal surface is cut, it takes several weeks
to heal. In addition, there is some eye discomfort following the
surgery that may last for several weeks. The following are the most
common side effects and complications. Each individual may experience
side effects differently. Side effects may include:

    * mild corneal haze (following surgery)
    * glare or halos around light (this side effect may be present for
months following the procedure)"

"Most patients are very pleased with the results of their refractive
surgery. However, like any other medical procedure, there are risks
involved. That's why it is important [to] understand the limitations
and possible complications of refractive surgery."

I suggest you study the above website as it does a thorough job of
listing every possible risk.  The one you would be most interested in

"Some patients may develop severe dry eye syndrome. As a result of
surgery, your eye may not be able to produce enough tears to keep the
eye moist and comfortable. Dry eye not only causes discomfort, but can
reduce visual quality due to intermittent blurring and other visual
symptoms. This condition may be permanent. Intensive drop therapy and
use of [tear duct] plugs or other procedures may be required."

You should ask your doctor about this risk, especially since you now
experience dry eyes.  This warning does not mean you can't get the
surgery, because dry eye syndrome can often be remedied, sometimes by
plugging the tear ducts.

Now to the fun part of your question: PETER JACKSON!

It appears that he did indeed have eye surgery.  He was quoted as
having grown "tired of being outside with rain and dust on the
glasses" while he is directing.  He also lost a lot of weight.
(third paragraph)

You might like to see some pictures of the "new" Jackson.  Here they are: (see sidebar)

Google search strategy

Search terms: human eye anatomy diagram OR OR

Search terms: laser surgery OR OR

Search terms: "contact lenses" dry eyes comfort

Search terms: "peter jackson" laser eye surgery

Good luck (but I hope you don't get into any fights with your "new" eyes).

88star4-ga rated this answer:5 out of 5 stars
That was fantastic. Thank you

Subject: Re: Contacts and Laser Eye Surgery?
From: stanmartin1952-ga on 21 Apr 2006 13:09 PDT
I would check things out carefully before getting surgery. When they
cut the flap on the cornea, they cut the nerves. It takes 6 months or
so for the nerves to grow back, and in the meantime, some people,
especially those with dry eyes, have to endure a lot of pain. There is
a site called (costs $25 for membership) that helps
people with bad surgical outcomes.
Subject: Re: Contacts and Laser Eye Surgery?
From: onenonblonde-ga on 23 Apr 2006 03:12 PDT
If you haven't already, see an optholomologist (not an optomotrist)
about your dry eye issue.  It may be correctable, making contact
lenses perfectly acceptable.

If you don't have a correctable issue, most reputible Lasik/Lasek
surgeons offer a free evaluation.  Get evaluated and discuss the dry
eye issue. If you are in a big city, get evaluated at 2 or 3... see
what they say.

alanna has given you great information, but at the end of the day,
every patient is different.  Get your own eyes evaluated.

Good luck!

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