What should I do to make sure I'll get good results from LASIK surgery?

(Associated Press/File 2005)

LASIK surgery, in which doctors use small laser cuts to reshape the surface of the cornea to correct vision, is usually a safe and effective procedure. It corrects near- and far-sightedness, and hundreds of thousands of Americans have the operation every year.

But, as recent testimony before an advisory panel to the US Food and Drug Administration made clear, in perhaps 5 percent of cases, it can be ineffective or lead to side effects, including severe dry eye, eye pain, blurred vision, and an inability to drive at night. (Check out fda.gov and search for "LASIK," which stands for laser-assisted in situ keratomileusis)

Prospective LASIK patients should be evaluated ahead of time for dry eye, which affects an estimated 10 million Americans and is a painful condition in which there is a reduction in either the quality or quantity of tears, which are necessary to keep the eye lubricated. Contact lens use can lead to "dry eye," as can birth control pills, antihypertensive medications, and antihistamines.

If you have a tendency toward moderate or severe dry eye before LASIK surgery, you should go into surgery with it well-controlled, because the eye will certainly be drier afterward, said Dr. Ernest Kornmehl, a LASIK surgeon in Wellesley and a spokesman for the American Academy of Ophthalmology.

Kornmehl warns that some surgeons don't see their patients until the day of surgery - leaving initial checks to someone else - and making it more likely that such preexisting conditions will be missed.

Patients should also ask surgeons how many LASIK procedures they've done and look for a doctor who is fellowship-trained in corneal diseases, to maximize the chances of a good outcome.

"You have to choose your physician carefully," said Darlene Dartt, director of scientific affairs at Schepens Eye Research Institute. "And go to a reputable place where you are carefully screened, to make sure your eye is properly evaluated."

JUDY FOREMAN

E-mail health questions to foreman@globe.com.