Lasik surgery and diving

[bcfrench]

I have 20/550 vision in both eyes and wear prescription masks. I have had bad luck with contacts because of a combination of severe astigmatism and the chemical makeup of my tears that seems to infuse my lenses with instant, severe protein buildups.

I am content to wear glasses and the scuba optics work just fine. However, I am sometimes concerned that I am visually helpless without them. I have considered getting laser surgery to improve my without-glasses vision.

My concern, however, comes from my knowledge that a different eye surgery, radial keratonomy, basically fails at high altitude. I am concerned about the effect of pressure changes at depth and whether that might ruin my underwater vision.

Have there been any studies on eye laser surgery and scuba diving?

...Barb

 

[kcDiver]

Barb,

I am not a doctor but I am somewhat "blind". I have been considering Lasik and have spoken with a number of divers who have had the procedure done. They all highly recommend it. None of them have had any complications or problems diving because of the procedure.

I have also heard, but cannot confirm, that it is sometimes cheaper to fly to Phoenix for the weekend and have it done there. Apparently, they do it really cheaply out there and the cost of the procedure, tickets, and hotel room is less then having the surgery done at home. Of course, you're going to want to find a reputable doctor to do it no matter where you go.

I've also heard about another procedure "corneal shaping" that I want to look into. I'm not sure what's involved but I've heard it's non-surgical.

Good luck,

kcDiver

 

[Mario S Caner]

Hello Barb, let me first start by saying that I'm not a doctor. But I am an instructor whom has trained many students whom have had lasik type surgery... my roommate included. Since the pressure inside your mask is in constant equilibrium with the surrounding water column, through equalizing techniques, you shouldn't feel any discomfort.

On descent you should be exhaling through your nose every once in a while to equalize the air-space. And the expanding air will take care of itself on ascent.


Sea you in the Deep Blue!

 

[scubadoc]

Hello Barb:

Here is what Frank Butler, MD our diving ophthalmologist at 'Diving Medicine Online' has to say:

"1. There are no case reports that I am aware of which document diving-related complications after LASIK.

2. There are at least three potential complications that might occur in post-op LASIK patients as a result of diving:
- Globe rupture from facemask barotrauma (unlikely)
- Interface keratitis (infection of the flap interface)
- Flap displacement from interface bubbles

3. I would recommend waiting a minimum of one month before resuming diving after LASIK.
As always, I would discuss this with your ophthalmologist, so that he or she will be able to add any special knowledge about your specific situation that would be relevant."

It is doubtful that any studies have been completed on the strength of the partial corneal incision that is done with the LASIK procedure, but should be somewhat similar to the partial incisions of radial keratotomy. Full thickness corneal incisions require 3-6 months before full strength has returned.

The corneal flap of the LASIK procedure sticks back down quickly without sutures due to a vacuum effect. The last return appointment is usually 3 months PO. I have had one ophthalmologist to recommend 2 weeks before return to diving; this seems too early to me. As noted above, Dr. Frank Butler recommends one month wait.

The danger, of course, is the possibility of a mask squeeze with chemosis (bruised swelling) and disruption of the flap. Negative pressure in the air space of a face mask caused by a mask squeeze may result in subconjunctival hemorrhage, lid ecchymosis (bruising) and edema, and could theoretically cause the rupture of incompletely healed corneal or scleral wounds.

Caveats include the facts that the operation is not for everyone, does not work well for everyone and success is related to the experience and care of the surgeon. For something as precious as your vision - price should not be a factor.

 

[Donna]

To bcfrench I had 20/400 plus a 2.75 astigmatism in both eyes. I had LASIK in one eye and had to get PRK in the other eye. (Due to my bone structure the spectrum would not set right on the one side) LASIK side healed quickest. Took around 4-6 months for complete stability on the PRK eye. Am happy with both. I had prescription lenses also but nothing for the astigmatism. I thought the blurryness underwater was what everyone saw. It's so great to not have to worry about losing your mask underwater. I feel so much more confident and my husband is amazed at the fish I find. It's worth it.