Baby boomers who want to rid themselves of their contact lenses should consider laser in-situ kertomileusis (LASIK) surgery as a viable option. Although LASIK traditionally has been considered less effective in individuals >40 years of age, a study shows new techniques offer better outcomes for middle aged and older patients.
In this retrospective consecutive cases series, Ghanem et al from Harvard Medical School, Massachusetts, studied outcomes in 710 eyes of 424 patients aged 40-69 years who underwent LASIK between 1999 and 2005.
The study group had refractive spherical errors ranging from -10.5 diopters (D) to +6 D and cylinder of up to 2.50 D. Patients were divided by age into 3 groups: 40-49 years, 50-59 years and 60-69 years. All LASIK procedures were performed by the same surgeon. Outcomes were analyzed for nearsightedness with or without astigmatism (511 eyes) and farsightedness with or without astigmatism (199 eyes). Outcomes were based on postoperative follow-up visits of at least 6 months.
The study indicated postoperative safety, efficacy and predictability were comparable among all age groups. At the final follow-up, 80-100% of eyes in all groups had 20/30 or better uncorrected visual acuity and 81-90% were within ±1 D. In all 3 groups, 91-100% of patients achieved 20/40 or better visual acuity following LASIK.
Many LASIK patients in the study opted for monovision, a strategy that offers distinct advantages in addressing presbyopia, a condition often present in an older population. In monovision, one eye is corrected for distance vision, while the other eye is corrected for near vision, often eliminating the need for reading glasses. Researchers indicated that monovision can effectively compensate for the loss of accommodation that often occurs in older patients. The study concluded that despite challenges unique in the 40- to 69-year age group, LASIK correction for nearsightedness and farsightedness has reasonable safety, efficacy and predictability.
Ghanem RC, de la Cruz J, Tobaigy FM, et al. LASIK in the presbyopic age group: safety, efficacy, and predictability in 40- to 69-year-old patients. Ophthalmology 2007; 114:1303-1310.