August 25, 2010

LASIK Surgery—A Good Alternative?

I use contact lenses, but my eyes get red at times. I’m considering LASIK surgery. Do you recommend it?

Being a cardiologist/internist and pediatrician/ob-gyn team, we are not experts at everything, and would probably not have answered this question were it not for a recent announcement by the U.S. Food and Drug Administration (FDA).
It seems there is a special interest lobby concerned about adverse outcomes of the LASIK procedure, and the FDA has agreed to launch a project to study outcomes. Its report is likely to be delivered by the end of 2012.
Complaints center on visual problems such as poor distance vision, dry eye, redness and pain, glare, and haloes. Most people undergoing the surgery (95.4 percent worldwide) report satisfaction with the results. It’s because more than 750,000 surgeries are being performed annually in the United States that the 4.6 percent dissatisfaction is being looked into. In total, this represents more than 30,000 dissatisfied patients a year.
2010 1529 page28Of course, satisfaction reflects expectations, selection of patients, other conditions that might affect the outcome, and even the emotional status of the patient. It’s these factors that will be evaluated, and a more rigorous reporting of postoperative status will be required. In the military the experience with LASIK has been excellent, but it’s dealing with healthy younger people whose performance may well be enhanced by a procedure that makes it possible to dispense with glasses.
We suggest that you consult a reputable ophthalmologist who is experienced in the procedure, and ask them all your questions so you know exactly what to expect. Neither of us has had the procedure done ourselves, though the results of this new project may convince us.
My parents lived into their 90s, but both developed Alzheimer’s. I worry that a healthful lifestyle might increase the chances of getting Alzheimer’s disease because of living longer. Is there much evidence of this?
It’s difficult to perform studies on lifestyle and risk, because there are many potential traps.
People who are health conscious may be a different subset from those who seem to care less. Self-reporting of diet and exercise is subject to considerable hazard for the researcher, because recall isn’t accurate. It’s possible for factors of note to become hidden in the multiple potential contributors to a given outcome.
In the situation of Alzheimer’s, there have been several observational studies suggesting that diet and exercise reduce the risk of contracting the disease. The observational study, though, is often subject to incorrect conclusions. A study reported in The Journal of the American Medical Association (JAMA 302 [2009]: 627-637) suggested less Alzheimer’s risk in people consuming the Mediter-ranean-type diet and utilizing high levels of exercise. Should such a study be confirmed, it suggests high levels of activity coupled with a largely plant-based diet would permit a longer and healthier life. There is still a lot we need to learn about Alzheimer’s, and though many factors that seem to influence the disease have been identified, none prevents the disease absolutely. Until we find the cause and mechanism, we do well to live in a way that promotes all-round health. 
Send your questions to Ask the Doctors, Adventist Review, 12501 Old Columbia Pike, Silver Spring, Maryland 20904. Or e-mail them to [email protected]. While this column is provided as a service to our readers, Drs. Landless and Handysides unfortunately cannot enter into personal and private communication with our readers. We recommend you consult with your personal physician on all matters of your health.
Allan R. Handysides, M.B., CH.B., FRCPC, FRCSC, FACOG, is director of the General Conference Health Ministries Department. Peter N. Landless, M.B., B.CH., M.MED., F.C.P.(SA), F.A.C.C., is ICPA executive director and associate director of the General Conference Health Ministries Department.