Believing in seeing

Kelly Richards had worn contact lenses since the eighth grade.

Now in her 30s, the Hayden, Idaho, mother of two was sick of wearing them. Plus, she admits, she wasn’t taking care of her lenses like she should.

“I would constantly get infections in my eyes,” Richards says. “I just decided it was enough.”

But Richards is so nearsighted, she’s not a candidate for LASIK, the popular vision-correction surgery.

So, she became one of the first patients in Spokane to have a contact lens, called the Visian ICL, implanted inside her eye. The device won Food and Drug Administration approval late last year.

She now has nearly perfect vision in both eyes without glasses or contacts, she says, although she does see some halos around lights at night.

“It was a dramatic change for me,” she says.

The market for vision-correction surgery is exploding, driven largely by baby boomers and others wishing to ditch their glasses or contacts for good.

The number of people undergoing LASIK-type procedures has nearly doubled in the past five years, according to a study conducted by Jobson/VCA, a research group. In 2001, 675,000 United States residents had an initial refractive surgery. In 2005, more than 1.1 million people opted for the procedure.

And that doesn’t even count newer procedures, like the one Richards underwent.

“We’re in that kind of explosive growth place now,” says Dr. Mark Kontos, an ophthalmologist with Empire Eye Physicians who performed Richards’ surgery in May.

Kontos estimates that he and the other doctor in his office do 200 surgeries, both laser and lens-based, each month.

So, how do you decide what kind of vision correction you want or need?

First, you need to know what shape your eyes are in. An eye exam will tell you that. Eyes that need too much correction are not good candidates for laser-based surgery because too much of the cornea would need to be scraped away. Plus, if you have vision that continues to change dramatically, surgery is not right for you.

Then you need to decide if you are willing to accept the risks – however small – associated with surgery. Risks include dry eyes, glare or even vision loss.

“As far as LASIK, we tell patients it is a surgical procedure,” says Dr. Jack Schaeffer, an optometrist in Birmingham, Ala., who’s chairman of the contact lens and cornea division of the American Optometric Association. “It’s very safe, but there are risks involved.”

Penny Swanson, who has worn glasses and contacts for nearly 20 years, decided she didn’t want to take a gamble with her eyesight.

“I had contemplated doing the LASIK before but had never liked the idea of doing surgery on my eyes,” says Swanson, 34, who lives on Fairchild Air Force Base.

So, about a year ago, she decided to start doing corneal refractive therapy or CRT. She wears gas-permeable hard contact lenses while sleeping, and the special lenses reshape her corneas overnight.

The process works gradually and reverses as soon as a patient stops wearing the contacts. It has grown in popularity in the past six years, says Spokane optometrist Dr. Nils Ohlsen.

“It’s a great option for people who have difficulty with contact-lens wear or don’t like the idea of having surgery,” Ohlsen says.

Swanson is happy with her choice of CRT and, she says, has recommended it to friends.

“By the end of the first week, I went the entire day without soft contacts or glasses,” Swanson says.

She now wears the contacts to bed every couple of nights and says she sees well, without any nighttime glare.

Since the first LASIK laser was approved by the FDA about 10 years ago, several similar procedures have gained in popularity.

One such surgery is PRK or photorefractive keratectomy. The procedure is similar to LASIK, except that no flap is cut in the patient’s eye. A special device is used to remove and reshape the top cells of the cornea.

PRK is a good choice for people, like those in the military, who could undergo physical trauma that might dislodge the flap, Kontos says. But the procedure is more painful and has a longer recovery time than LASIK, he says.

Kontos expects to see tremendous growth in vision-correction procedures in coming years, especially in lens-based operations.

“We’ve just started this process,” he says. “There’s going to be huge breakthroughs coming.”

As with all health care, it’s wise to do your homework before undergoing any sort of vision-correction procedure.

And beware of low-cost surgery offers, Schaeffer says.

“You get what you pay for,” he says. “That’s so important to understand.

“If a procedure costs a whole lot less, there’s a reason. If a doctor is good, they don’t have to charge low fees.”