On my last visit to my ophthalmologist, I inquired about the benefit of having laser surgery. He said that once a person passes 40, it's not worthwhile. As his wall is covered with diplomas, I accepted his professional opinion. However, it seems to me that people a lot older than 40 are getting it. Any comment?

J.

I must disagree with your doctor. Laser eye surgery to correct nearsightedness (myopia), farsightedness (hyperopia) and astigmatism is a highly successful surgery with low risks. There are currently two methods of laser eye surgery, PRK and LASIK. PRK is a procedure in which doctors use a laser to reshape the surface of the cornea. In LASIK, doctors first lift up a flap of cornea and the laser is used to reshape lower layers of the cornea. Both PRK and LASIK have similar long-term results, although LASIK has become more popular because patients tend to heal faster and experience less discomfort.

The age range for LASIK is generally from 18 to 80, although there are probably people even younger and older who have had LASIK. In my practice. the average age of patients undergoing LASIK surgery is 43. In addition, I have found the results of LASIK in people over the age of 40 to be as good as in those who are younger than 40.

However, one thing to keep in mind is that once people pass age 40, their eyes lose the ability to focus on small print and other nearby items. This is called presbyopia. Therefore, if people over 40 undergo LASIK with the goal of obtaining excellent distance vision in both eyes, they will generally require reading glasses. Still, many such people are happy to have LASIK so that they do not need glasses or contacts for activities such as sports and driving.

One popular option for people over 40 is called monovision. In this situation, one eye is corrected for good distance vision, while the other eye is corrected for good close vision. Before undergoing LASIK to create this set-up, it is important for patients to try monovision using contact lenses to make sure that they can adjust to this arrangement. The disadvantage of monovision is that there is a mild loss of depth perception. However, using LASIK to create monovision can enable many people over 40 to eliminate the need for glasses entirely.