Boomers go under the laser to stay active

Written by Megan Carney

Photos by John Richard

Jane Gay, 56, just wanted to enjoy her backpacking trip, but all she could think about was how dry and irritated her eyes felt. Gay hated to stop to search for her contact solution, which was buried deep in her pack with several pairs of eyeglasses and prescription sunglasses. But without her contacts or glasses, anything 20 feet away or farther would be a blur.

Gay, who had depended on contacts and glasses to correct severe nearsightedness since she was 7, was tired of needing them to see. She decided to undergo LASIK eye surgery in January.

“It was pretty amazing just to sit up right after the procedure and be able to see better than I can ever remember seeing,” said Gay, who had LASIK at the University of Iowa Department of Ophthalmology. “I was giddy.”

Gay is one of many baby boomers to receive LASIK, which stands for Laser-Assisted In Situ Keratomileusis. LASIK is one of several procedures that correct nearsightedness, farsightedness and astigmatism — eliminating or reducing the need for glasses and contacts.

Dr. Kenneth Goins, a UI LASIK surgeon, said 45 to 55 is one of the two age groups he serves the most. The same is true at Wolfe Eye Clinic in Cedar Rapids, where 45 is the average age of LASIK patients, according to Dr. Todd Gothard.

“A lot of people — they’ve worked hard for many years. They’ve got the income to do it and they want to do more and be more active,” Goins said.

Boomers are more active than previous generations and plan to stay that way, according to a 2003 survey by the Rehabilitation Institute of Chicago. The survey of 1,000 middle-aged adults nationwide indicated they wanted to stay active to live longer.

Gay is one of those people. When not working as director of Iowa Compass and the Iowa Program for Assisted Technology at the UI’s Center for Disabilities and Development, she stays busy hiking, skiing and biking. Her new, near-perfect eyesight makes her feel younger and sharper.

“It makes me feel ready to go and do all the things I want to do,” Gay said.

Adults choose LASIK to enhance their active lifestyles. They also choose it because they consider it safe. Gay was not nervous before surgery because she trusted her doctors. Most of her friends who had it were thrilled with the outcome, she said.

LASIK, which was first performed in 1989 in Greece, debuted in the United States in 1990. Now, about 1.5 million LASIK surgeries are done each year.

During surgery, the eye is numbed before a flap is cut in the cornea, the transparent cover of the eye that helps it focus. With the flap held back, the surgeon uses a computer-controlled excimer laser to reshape the cornea and correct the patient’s vision. The flap is laid back into place and naturally adheres to the eye.

The flap in the cornea can be created either by a hand-held instrument called a microkeratome, or by a laser microkeratome. The all-laser method, often called the IntraLASIK method, is now approved by NASA and the U.S. Navy, two organizations which formerly prohibited LASIK.

“I think that’s evidence our procedure is safe,” said Goins, who in June 2007 became the first ophthalmologist in Iowa to perform LASIK using the IntraLase laser.

Although few long-term LASIK studies exist, some retrospective studies are available. A study published in 2006 in the British Journal of Ophthalmology reported overall positive, stable outcomes for patients tracked for five years after LASIK. Also to LASIK’s credit, all 49 patients received LASIK in 1998 or 1999, when it was not as technologically advanced as it is today. Doctors said the accuracy of LASIK continues to improve.

“I think today, in 2008, patients should not be afraid,” said Goins, who has performed laser refractive surgeries since 1996.

Still, laser eye surgery is not something doctors rush into. Although the actual laser treatment lasts less than a minute, it is preceded by multiple exams and discussions.

Doctors first determine whether a person is a candidate for LASIK, based on their lifestyle, eye anatomy and health.

“The main thing is that the vision has been stable, that their glasses or their prescription hasn’t been changing a lot and also that their eyes are in good health,” Gothard said.

People with a cataract or glaucoma are generally not good candidates for LASIK, Goins said. Doctors need to know about other diseases, viruses, medications, or injuries that could conflict with LASIK. The patient’s lifestyle is also important. People who participate in contact sports like boxing and wrestling may not be candidates for the surgery.

In addition, doctors study pupil size and corneal thickness. This information helps doctors assess who is a good fit for LASIK and who is at high risk for loss of vision, chronic dry eyes, infection or visual symptoms like glare. Patients should consider these risks, carefully.

If a patient is eligible, doctors develop a personalized plan for surgery. With all boomers, that plan includes a special, age-related concern.

Presbyopia, which occurs in most middle-age adults, inhibits the eye’s ability to focus on nearby objects. Presbyopia affects both farsighted and nearsighted people. Nearsighted boomers, then, begin to struggle with close vision in addition to distance vision. Without surgery, presbyopia is often corrected with bifocals. With surgery, a patient has several options.

Many patients choose monovision LASIK, in which one eye is corrected for distance and the other, less dominant eye is corrected for near. Other patients want both eyes corrected for distance, even though they will need reading glasses for close vision. Some patients just want it all.

“Golfers are some of my most difficult patients,” said Goins. “Professors want everything, too.”

Most patients opt to correct the dominant eye for distance and the other eye in the intermediate range, Goins said. Pre-surgery, the patient can determine what range they will adjust to best by testing contacts of varying strengths. Post-surgery, a patient is not out of luck if he or she is unhappy with the results.

“The nice thing with LASIK is that it’s adjustable,” said Gothard. “So if they did do the monovision, and they didn’t like it, they can do more distance.”

Not only is LASIK flexible, it is quick. It takes 10 minutes to treat an eye, Goins said. Patients who choose LASIK can expect a quick recovery with little discomfort.

“It’s really painless,” said Mark Jennings, associate athletics director at the UI Athletic Department. “I had surgery at 3:30 and by 8 o’ clock the next morning, I was driving into work with no glasses.”

Jennings, 57, followed the lead of his wife Vicki, who had LASIK surgery in December 2006.

“The next morning, I could read the news and I did not need my glasses or anything,” she said. “I’m very, very pleased.”

Although popular, not everyone can afford the surgery. LASIK costs range from $1,500 to $3,000 per eye. Goins hopes to develop finance plans in 2008 so more people have access to the surgery, which he believes can improve quality of life.

“With baby boomers, they’ve got a new life to lead and they want to maximize their enjoyment,” he said. “It just gives them more freedom.”