Paleo Diet and Paleolithic Diet Questions & Answers

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Before you tell me that there will always be something better around the corner, and if I keep waiting I'll just be blind forever, hear me out...

I've been doing a lot of research on LASIK and there are actually quite a few different forms (LASEK, EPI-LASIK,All Laser LASIK, Wavefront LASIK, etc...), each with different positives and negatives. The original procedure wasn't that accurate, it was based on a traditional optometrist lens prescription. Today, the state-of-the-art seems to be Wavefront LASIK, where instead of using an average correction factor the whole eye, your eye is scanned (mapped) and the ablation of your cornea is customized to your particular optical aberrations.

So, here are my thoughts... it seems to me that the laser ablation process has become accurate enough that we don't have to worry about the laser damaging surrounding tissue or not having enough resolution to optimize the corneal reshaping process. There will always be exceptions, but I feel with the eye tracking technology they have now it's pretty good. My real issue is with the flap creation, where about 70% of the nerves are cut to remove the flap from over the cornea! This just seems like an archaic method of doing things, and although they have laser flap creation now, you're still getting your eye cut up and the damage resulting from creating the flap can cause halos and other sight issues (especially under low light conditions, larger pupil). Not to mention the fact that "dry eyes" occurs in about 30% of LASIK patients, and is related to the nerve damage due to the flap creation. So my only real hesitation is regarding the flap, and whether a healthy Paleo diet (possibly with some supplementation, Vit-A, Vit-D, Vit-K2, etc.) would be enough to mitigate most of the post-op complications...

Would you do Wavefront LASIK? Have you had Waverfront LASIK done? Do you think on a Paleo diet the nerves would regenerate better and not be an issue? Is it really worth waiting to see if a non-flap option becomes available (FLIVC)?

edited Feb 16 2012 at 16:06

asked Feb 15 2012 at 17:29

jjtitus
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I kind of really don't see why you're asking this on Paleohacks unless you think this community is somehow uniquely dialed in to cutting edge eye surgery information... – gydle Feb 15 2012 at 18:14

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I just figured this is a community of smart analytical people, and I wanted to get a Paleo perspective on "hacking" my eyes... I'm sure I'm not the only one with contacts/glasses that's contemplated this, gone crazy on researching it for a few days, and still had some lingering questions afterwards. – jjtitus Feb 15 2012 at 18:34

And who knows, we might even have a few Paleo Optometrists and/or Refractive Surgeons in our midst with a more "cutting edge" view on things! – jjtitus Feb 15 2012 at 20:06

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You probably read already this but in case you didn't... lasikcomplications.com/TopTenReasons.htm – Lady_Arwen Feb 15 2012 at 21:12

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I see this as one of those things where we improve on paleo. In the past, Grok would have died with bad vision. Critters would have eaten him. These days, we can use glasses to correct, but the optimal solution is to not need glasses at all. – James Feb 17 2012 at 6:25

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Lady_Arwen · Accepted Answer · 2012-02-15 21:17:36Z UTC

You have to decide benefit risk ratio. LASIK is a cosmetic procedure but has real medical risks - infections, blindness, etc.

Most Opthalmologists (eye surgeons) and optometrists themselves do not get the procedure done on themselves including those I know. One friend told me the best LASIK surgeon she knows at Baylor in Houston rejects 90% of his patients, and only does it on the top 10% that he thinks will have the best success - and that's the quality control she would want.

The FDA is investigating LASIK claims because marketing suggests they are ignoring patients who are upset and only focusing on the best cases.

I think if your career depends on LASIK - swimmer, diver, etc. and you need that vision 24-7 and you are a good candidate then it may be risk worth taking.

LASIK increases the lifelong risks of retinal detachment especially in trauma such as contact sports, explosions, air bags in car accident, etc. - lesson was learned the hard way in the Iraq/Afghanistan war.

You will never get the vision with LASIK that you have with glasses or contact lenses. You may get to 20/20 or 20/15 but the clarity is not the same since the cornea is being cut the light is refracted so higher order aberrations (HOA) are artificially induced. Some patients are fine with this and others are not.

It cuts corneal nerves, some of which will never heal to normal.

Some patients will have dry eye for the rest of their lives and will NOT be able to wear contact lenses because it is so uncomfortable. Dry eye worsens with age for even normal people without LASIK. Some patients will be on lifelong artificial tears ranging from once a day to once every hour depending on the severity of dry eye. Sometimes this develops later in age 40's/50's.

Some patients once they hit 40's/50's have problems driving at night due to glare, pupil dilation, and aberration.

I have seen perfectly healthy normal 24 year old patients with no medical or ocular history have best-corrected LASIK 20/60 after the surgery because of complications from the healing and the flap. They will never be able to even drive again. The surgeon was good - their eye did not respond well to it. There was nothing in the evaluation that could have predicted this.

You will need reading glasses once you hit 40, so you are back to glasses - or bifocal contact lenses (and there are some good ones my patients love).

In the 1980's they used to do refractive surgery with a scalpel, and now done with laser. It is viewed as barbaric nowadays. I think LASIK will be viewed the same way in 10 years. There is some research trying to reshape the cornea with drugs - drops. I don't know if it will be better or safer but it may happen.

I have seen the good, the bad, and the ugly - so I hope you are a good result if you do it! If you do it, do the custom wavefront with the best surgeon you can find - DON'T be cheap!

baseball109 · Answer 2 · 2012-02-15 19:43:54Z UTC

I asked my Opthamologist about LASIK just the other day. He wears glasses. He commented that its fine, but that he wouldn't have it done and amongst many of his colleagues that perform the surgery, the vast majority will be wearing glasses when they turn up to work that morning. If my specialist wouldn't do it to himself, I won't be doing to myself either.

Susan · Answer 3 · 2012-02-15 17:59:31Z UTC

I had my surgery done about a year and a half ago and I couldn't be happier. Although this isn't completely in line with your question, I had PRK specifically because it was a non-flap option. Even the smallest risk of that flap dislodging due to my lifestyle (contact sports, skydiving, etc.) was too much for me. Healing time and pain were significantly longer/worse than the LASIK options out there, but I'm completely satisfied with my 20/15 vision and not having to struggle with contacts or glasses anymore.

PaleoGirl · Answer 4 · 2012-02-15 18:05:03Z UTC

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I had wavelength lasik last year. The next day I was completely fine, the first day was painful irritated eyes, but I think you should be fine. The cornea regenerates pretty quickly.

answered Feb 15 2012 at 18:05

PaleoGirl
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Dan · Answer 5 · 2012-02-16 00:41:55Z UTC

I join those who have had the procedure (six years ago in my case) and are completely happy with the results. I also agree about taking the risks and surgeon track record into account.

I had what's called "monovision" done, which means that one of my eyes is optimized for distance, and the other for close work -- the brain's amazing in figuring this out! -- so I need neither driving nor reading glasses. Before, I needed both. The surgeon also placed tiny "dams" in the tear ducts to help prevent dry eyes, and I've never had a problem with that.

Knarf · Answer 6 · 2012-02-15 19:06:55Z UTC

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Do you really need it? The idea of LASIK is like any other surgery. You're hacking some part of your body off, and you're NOT getting it back.

answered Feb 15 2012 at 19:06

Knarf
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No, you do regenerate your cornea. The human body's an amazing thing, huh? Lasers are also amazing. – citrusfire Feb 15 2012 at 19:14

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I hear you, LASIK is considered an irreversible procedure, and does come with risks... which is why I'm researching it so heavily, and coming here to discuss it further with all of you. There are risks to wearing contacts/glasses too, it's all about finding what's best for you. In my case, glasses don't work (break, fall off, hate "looking through" the lens) and contacts irritate my eyes (increased risk of infection, needing solution/case everywhere, etc.), so something like LASIK seems like a decent option. – jjtitus Feb 15 2012 at 19:47

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I understand. As long as you're careful in the research, and safe about the risks, and finding the right doc, I'm sure it'll turn out okay. No one in paleoland likes seeing fellow paleos get screwed... – Knarf Feb 15 2012 at 20:02

@ citrusfire, I did not know this. Will go take a look at this... – Knarf Feb 15 2012 at 20:03

Canhawk · Answer 7 · 2012-02-15 19:16:07Z UTC

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I'm 6 years post LASIK and all is well. It's awesome actually. Only side effect - if you can even call it that - is teeny tiny halos around lights and stuff at night (I'm talking ultra small, but noticable nonetheless). Really, no different than if you were wearing glasses. that and I find my eyes are a little drier in the morning than before. Other than that, I have better than 20/20 vision now.

The procedure itself is a trip though. Not at all painful, but not for the faint of heart either. Don't get the "no-touch" though. From what I hear, rehab is a bitch. The one where they cut the flap in the lens you're driving again in a day or two.

answered Feb 15 2012 at 19:16

Canhawk
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Really...? A lot of what I've read suggests that all-laser (Bladeless, no-touch, etc.) had possibly better end results due to uniform flap thickness and less prone to "human error". The theory is that the microkeratome (tool used to physically cut the flap) doesn't cut an even thickness, so there's some non-uniform distortion to the laser as it's ablating the cornea. With the all-laser option, a low intensity laser beam is scanned over the flap area and creates bubbles at a set level, creating flap with uniform distortion over the cornea. May be worth a little longer recovery period? – jjtitus Feb 15 2012 at 19:34

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Well as I understood it at the time, the lens itself doesn't regenerate, which is why it can be re-shaped with the laser to correct your vision, but the cornea does. That's why the "no touch" is able to burn straight through the cornea to get to the lens; it'll just regenerate anyway same as if you cut a flap and let it heal. The downside of "no touch" is quite an extended recovery period because the whole cornea needs to regenerate, but the end product is the same. Or so I was told anyway. – Canhawk Feb 15 2012 at 23:41

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I see, I thought you were talking about the Intralase (bladeless) removal option of the flap during LASIK, I think you're actually talking about PRK where they don't create a flap at all, and like you said, they actually burn through the outer layer of the eye to reshape the lens. The benifit of this is that your eye isn't cut (impacts to the head can dislocate the healed flap, since it is significantly weaker) but the recovery period is longer (like you mentioned). To my knowledge wavefront-guided PRK doesn't exist yet, so theoretically wavefront LASIK would produce a better end product... – jjtitus Feb 16 2012 at 12:29

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Well JJ, FWIW I was a competitive full contact muay thai kickboxer (in the heavyweight division) and had my first fight after LASIK maybe about 6 months post surgery. I've been punched in the face, kicked in the head, elbowed in the jaw and kneed in the eye since having LASIK and my vision is still like that of a marine corps sniper. YMMV but my experience with it has been excellent. :) I believe a lot of NFL players have had it as well and they seem to be doing alright (though I have no clue as to what specific kind of surgery they had...) – Canhawk Feb 16 2012 at 16:58

Nivanthe · Answer 8 · 2012-02-15 20:00:46Z UTC

I had the Intralase procedure in December and drove myself to work the next day. The glare for me was minimal, and went away within the month. I saw 20/20 the next day, and it's settled to better than 20/15 now.

The flap isn't a big deal, and the nerves do regenerate of course. After about a month I mostly forgot to put my drops in unless it was completely needed, because my natural tears were back to doing their thing.

I still carry drops around for drier environments, like in my office.

Overall, I don't regret it, and neither has anyone I've talked to who has had LASIK. I was only STRONGLY encouraged to go to the 'best' surgeon (luckily fairly close by) instead of saving money at a 'cheaper' place and still needing glasses to drive at night, etc.

Marie · Answer 9 · 2012-02-15 22:01:04Z UTC

Had it in 1996...The BEST THING I'VE EVER DONE FOR MY LIFE "HEALTH".

I was blind. Really, legally blind. Yes, the big "E"..not readable.

While I'm now not 20/20, I'm very happy by the fact that I am not a detriment to others in the event that I loose my glasses. And, whoooo hoooo, I enjoy going to the beach soooooo much more. I mean there is sooo much more to see...you can read between the lines on that one.

However, I did (do) research the HELL out of anyone who takes a knife to my perfect bod. I went to one of the three Docs in the original LASIK clinical trials and could not be happier. (Dr Manger) I've also sent friends and family to him and they have better than 20/20 vision and are really happy.

Aughra · Answer 10 · 2012-02-15 22:52:56Z UTC

My mother has done it and 3 other people in my extended family have done it; all with spectacular results. Find an Excellent doctor... don't go to one of those cheapy places. Usually the worst that can happen is dry eyes but even my one family member who ended up getting that said they'd rather use some eye drops once or twice a day then every have to put another contact lens in their eye again.

Where do you live, by the way? My mother knows all the best opthamologists in the country and could probably recommend someone for you. (she knows some in Canada too.) She does business consulting for elective surgery centers (lasik, plastic, etc.)

David Csonka · Answer 11 · 2012-02-17 06:05:41Z UTC

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Elective. Unnecessary. Irreversible. They're your freaking eye balls.

answered Feb 17 2012 at 6:05

David Csonka
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And purely a personal choice. Some of us prefer not to have to wear coke bottle thick glasses if we don't have to. – James Feb 17 2012 at 6:16

Why so defensive? – David Csonka Feb 21 2012 at 4:55

James · Answer 12 · 2012-02-17 06:23:33Z UTC

There's nothing really evolutionary coming down the pike that will change things substantially in the marketplace. So if you want to go for it, there's not any major reason to wait. I had my eyes done last year.

I had the PRK done vs LASIK. The flap with LASIK never heals 100%, it'll be weak for the rest of your life. It's not a big deal for the majority of people with a sedentary life, or even semi active. But I didn't want to take the chance with the activities I wanted to do. PRK was the best alternative for me.

Recovery time is faster for LASIK than PRK, but that's because they're cutting a flap open and zapping, vs. taking a layer of cells off and going through the lens. You're looking at several months for PRK. The other thing with PRK is you see fairly well right after surgery, then it drops substantially in quality as it heals, and then comes back again. They explain it, but it's still a bit disconcerting, you have to have patience.

Astigmatisms can be corrected, but in my experience, had a longer recovery time, more pain. One eye had an astigmatism, the other didn't.

I hated contact lenses, and never got into them. Had to buy expensive high density glasses, otherwise I'd have pretty thick coke bottle type glasses.

In my case, after correction, I could read the eye chart down to 20/20 vision and better straining. However, it was fuzzy. Not as sharp as with glasses. So functional 20/20, not really 100% sharp 20/20. While I'm happy that I can see 20/20 without glasses (since I couldn't see before), it was a bit disappointing it wasn't as sharp. But I'd still do it anyways.

I am doing a lot more outdoors activities stuff now than I did before, simply because it's so much easier without glasses (since I would be pretty much blind if something happened to my glasses). I had made a lot of excuses not to do something because of the hassle before. So lot more opportunities now. Scuba diving, mountain biking, surfing, etc.

Jen · Answer 13 · 2012-02-15 18:00:19Z UTC

I had LASIK done back in 1998. Went to Canada because it was cheaper. It was the best thing ever. I was initially interested in radial keratotomy, (I'm showing my age here) but waited for the LASIK- which sounded better than the diamond tipped scalpel. I say, why wait? Especially if the technology is that much better now.

Lola · Answer 14 · 2012-02-15 18:49:03Z UTC

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try paragon crt - I use the lenses and have never been happier! They reshape your cornea during the night, take em off during the day, 20 20 all day and all you have to do is sleep with them in every night

answered Feb 15 2012 at 18:49

Lola
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	Hmmm... I think one of the biggest things I'm trying to get away from is sticking things in my eyes on a daily basis (I wear 30 day continuous wear contacts currently, occasionally sleep in them but mostly take them out at night). So, I'm not sure trading one lens for another is optimal (still at risk for infection, have to remember to always have your case, solution and lenses with you, etc...). – jjtitus Feb 15 2012 at 19:11
	Plus, and this is just speculation, I would imagine that a lens hard enough to change the shape of your cornea overnight probably isn't very oxygen permeable during a time when oxygen to the eye's surface is limited by the closed eyelid already... – jjtitus Feb 15 2012 at 19:21
	Some people love Paragon CRT, but some nasty fungal infections that can cause blindness happen if the hygiene isn't immaculate. – Lady_Arwen Feb 15 2012 at 21:18

holly · Answer 15 · 2012-02-15 19:40:39Z UTC

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does anyone know which of these is better suited for dry eyes (if any)

answered Feb 15 2012 at 19:40

holly
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I believe all of these surgeries have the possibility of complications with dry eyes... they can plug your lower tear duct to help, but this doesn't always work either... – jjtitus Feb 15 2012 at 20:18

Thanks! Gah. I hate my contacts – holly Feb 16 2012 at 2:41

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Holly, I hate them too... but to be honest, they've been a huge improvement over glasses, and the new 30 day continuous wear lenses feel even better. It seems like advancements in laser based refractive surgery have been really slow... PRK has been around since the 1980's!!! – jjtitus Feb 16 2012 at 13:06

i haven't heard of the continuous wear lenses. i will have to look into that. i have a connective tissue disorder and we are plagued by dry eyes – holly Feb 16 2012 at 17:27

PRK's better for dry eyes than LASIK, but you can have problems with both. – James Feb 17 2012 at 12:04

Daniel Kirsner · Answer 16 · 2012-02-17 05:25:03Z UTC

I had conventional LASIK on July 5, 2001. No complications and excellent results. If I were to do it today I suspect I would opt for Wavefront, but am not up on the current technology. If you care to tell me what the pros and cons are of each choice you're considering, perhaps I can help...

LASIK, Should I Wait or do it Now?

16 Answers