Contacts vs. LASIK: Science now has the Answer
Contacts vs. LASIK: Science now has the Answer
It’s a question patients ask frequently: Which is better — contacts or LASIK? LASIK provides patients with clear, crisp vision without the (very real) hassle of contacts or glasses, but a new study published in the Journal of Cataract & Refractive Surgery indicates that contact users have even more reason to consider LASIK.
The meta-data study showed that, over five years, contact users are three times more likely to get potentially serious eye infections called microbial keratitis, compared to those who have gotten LASIK. After 10 years, contact wearers are six times more likely to contract microbial keratitis. Those numbers go up for contact wearers who leave contacts in while they sleep.
For those who want to reduce their risk for microbial keratitis, LASIK may be the answer.
What is microbial keratitis?
Microbial keratitis is an infection of the cornea that comes in bacterial, fungal, and viral forms. It is often related to leaving contacts in too long, whether it’s during sleep, in the water, or at other times when it’s best to remove and clean them. The lens can lock harmful germs onto the eye’s surface, and given a chance to multiply, these germs can cause infection.
People with microbial keratitis experience a sudden onset of pain in the eye, discharge, and an increased sensitivity to light, and watery eyes. It can progress quickly, and it can be devastating.
Just last month a young patient who had experienced microbial keratitis in the last year came to see us. Like many people, she had not been very good about taking out her contacts at night or avoiding using them in the shower or pool. Her infection completely destroyed her vision in one eye — to the point where she is now legally blind in that eye — within just a few hours.
The fact that something as simple as forgetting to take out contacts could lead to such horrible repercussions is very disconcerting. This study reiterated to me that laser vision correction is not a cosmetic procedure. It is not even just a lifestyle-enhancing procedure. It is a long-term investment in the health of your eyes.
Vision is one of the most important, if not the most valuable way we experience the world around us. It’s how we connect to those we love. It’s how we perceive beauty. Vision
correction surgery doesn’t just make life more convenient; it makes it more beautiful.
Add to that the benefit of eliminating much of the risk of infection related to contact lens use, and for good candidates, it’s really a no-brainer.
To be fair, microbial keratitis is a rare complication, and can also occur after LASIK surgery — most often if patients rub their eyes, smoke, swim, or otherwise expose their eyes to potential pollutants immediately after surgery. In these cases, as a refractive surgeon, I’ve found that a little bit of education goes a long way.
Taking the time to let patients know what they should avoid and why, both before and after surgery, is usually very effective. In my own practice, I have never had a patient develop microbial keratitis from LASIK, even after the thousands of surgeries I have performed., although I have seen many cases of microbial keratitis caused by contact lenses. I credit the time I spend with them and the diligence of my staff with much of our success.
Study results: What they mean and don’t mean
This new study is significant. Data compiled from 2010 indicates that, among the approximately 38 million contact lens wearers in the U.S., there are an estimated 1 million clinical visits related to microbial keratitis at a cost of about $174.9 million. This is something to think about when comparing contacts versus LASIK.
This peer-reviewed study is believed to be the first meta-analysis (or statistical combining of data compiled from multiple studies) to compare the rates of microbial keratitis in contact lens wearers to those who have had LASIK. Its authors were Jordan Masters, MD; Mehmet Kocak, PhD; and Aaron Waite, MD, all of Hamilton Eye Center at University of Tennessee’s Health Science Center.
In a nutshell, these noted researchers found that the risk for infection was about the same for LASIK patients and contact wearers during the first year after surgery. In the years following though, the risk was all but eliminated for LASIK patients, while it continued at the same rate for contact wearers.
The study does not show causation, meaning there can be a number of factors, such as lens type, lifestyle factors, poor hygiene, and other determinants that would also be helpful to modify in order to lower risk of infection among contact wearers. In addition, Dr. Waite pointed out that more studies are needed to determine if additional contact lens complications, such as dry eye, scarring, droopy eyelids, oil-gland drop-out, and allergies are more likely to lead to vision loss in contact lens wearers.
Still, there is no doubt now that LASIK reduces the chance of infections over time. “Most contact lens wearers use them for decades, which means they have a much higher risk of corneal infection compared to the risk with LASIK,” Dr. Waite said.
If you would like to find out if you are a candidate for LASIK or any other laser vision correction procedure, schedule your comprehensive Brinton Vision Ocular Analysis. We are happy to share in your journey to visual freedom. Click here to schedule your consultation!
St. Louis LASIK surgeon Dr. Jason P. Brinton, MD is an internationally recognized specialist in the
field of refractive surgery. He is a graduate of Harvard College, earned his medical doctorate from the Harvard Medical School, and is board certified by the American Board of Ophthalmology. He has been inducted to America’s Top Ophthalmologists by the Consumer Research Council of America, Leading Physicians of the World by the International Association of Healthcare Professionals, and Top Doctors in America by Castle Connolly. In 2015, he received global recognition as the recipient of the Visian ICL Young Ophthalmologist Award in Barcelona, Spain, and in 2016 was named Ocular Surgery News’ Premier Surgeon 300 Innovators in Refractive Cataract Surgery. He is a dedicated husband, father of four beautiful children, and is passionate about his life, his work, and service to others.