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CNN Sunday Morning

Weekend House Call

Aired September 28, 2003 - 08:30   ET

THIS IS A RUSH TRANSCRIPT. THIS COPY MAY NOT BE IN ITS FINAL FORM AND MAY BE UPDATED.

THIS IS A RUSH TRANSCRIPT. THIS COPY MAY NOT BE IN ITS FINAL FORM AND MAY BE UPDATED.


ELIZABETH COHEN, CNN MEDICAL CORRESPONDENT: Good morning and welcome to WEEKEND HOUSE CALL. If you're tired of wearing glasses or contacts, you may be considering LASIK eye surgery, it's one of the newest procedures available to correct vision problems. LASIK has only been around a few years, but it's already helped millions see more clearly. As Dr. Sanjay Gupta reports, now eye doctors are excited about a new generation of LASIK.
(BEGIN VIDEOTAPE)

DR. SANJAY GUPTA, CNN MEDICAL CORRESPONDENT: Britt Bishop has been wearing glasses or contacts for the past 20 years. He's had enough.

BRITT BISHOP, PATIENT: They get in the way, sometimes. If you go in the water, you lose a contact. Playing softball, dirt gets in your eyes or lose a contact, so I'm just ready to be free of glasses.

GUPTA: Britt decided to undergo a new type of laser surgery called, it's called WaveFront LASIK surgery, and it's a cut above the conventional LASIK treatment. The WaveFront system sends a wave of light through the eye, mapping all of the defects, allowing for custom surgery instead of one size fits all approach.

DR. KEITH THOMPSON, OPHTHALMOLOGIST: But, the technology allows us to measure the eye in a more precise way so that we can get them sharper, clearer vision.

GUPTA: Like traditional LASIK, a thin lay of cornea, that's the clear outer covering of the eye, is peeled back. What's new is that the laser is used to perform a custom reshaping of the underlying layer.

UNIDENTIFIED MALE: Keep look straight up for me. Right at those lights.

GUPTA: It takes about 15 minutes per eye with little pain and costs between $1800 $2800 per eye, which is about $500 more than the conventional LASIK. It's rarely covered by insurance.

THOMPSON: So it gives patients a fairly user friendly surgery. That is, they can have the surgery one day and resume their normal lifestyle the next day.

GUPTA: About 4 million patients have had successful LASIK surgery, but there still are risks. Bad night vision, glare, halos occur in 3 percent of patients and the new WaveFront technology reduces flaws to just 1 percent. Other risks include dry eyes, blurred vision, and in rare cases infection, and possible loss of vision. The surgery is irreversible. The best way to reduce risks is to get a thorough eye evaluation and to work with a reputable surgeon. Britt has no complications and now sees with 20/20 vision.

BISHOP: I can just wake up and I have vision. It's perfect.

GUPTA: Like most patients, Britt was able to go back to work the very next day.

Dr. Sanjay Gupta, CNN, reporting.

(END VIDEOTAPE)

COHEN: Before you sign up for surgery, you need to know if you're a good candidate for LASIK. It's not for everyone. You can't have LASIK surgery if you require a change in your contact lens or glasses prescription in the past year. Young people 18 and younger are not good candidates because their vision is still changing in fact they're not candidates at all. Pregnant or nursing mothers have changing vision, as do patients whose hormones are fluctuating due to disease. Don't do LASIK if cost is an issue, most insurance does not pay for it. Although the cost is still coming down, it is still significant. Finally, if you're not a risk taker, you're not a good candidate for LASIK. Certain complications are unavoidable in a certain percentage of patients and the surgery is too new to know if there are long-term ill effects. Weigh the risks and the benefits. If you're happy wearing contacts or glasses, you may want to forgo the surgery.

We want to answer your questions about LASIK surgery and improving your vision. Call us at 1-800-807-2620 or e-mail your questions to housecall@CNN.com.

Dr. Doyle Stulting joins us, here in Atlanta. He's an ophthalmologist and managing direct of Emory Vision.

Thanks for being with us this morning. Quick question regarding WaveFront laser surgery -- who is that best suited for, people who are nearsighted, people who are farsighted, people with an astigmatism? Whose that best suited for?

DR. R. DOYLE STULTING, OPHTHALMOLOGIST: WaveFront surgery has been approved, so far, for people who have low degrees of nearsightedness and astigmatism. But, as time goes on it will become available for others, as well.

COHEN: And so, right now, it's only for people who have trouble seeing far away?

STULTING: Far away, correct.

COHEN: OK, great. All right, well we have an e-mail, now. Paul from New Jersey has several good questions regarding LASIK. He wants to know -- he, "Just wanted to know if there have been any studies on the long-term effects of betting laser surgery? Once you've had LASIK surgery, will your eye get progressively worse again? Can the surgery be repeated?"

I think many people want to know that. When you've had the surgery, is there a chance your eyes are just going to gradually get bad again?

STULTING: Actually, LASIK surgery is based on a procedure that has been performed for about 40 years. The new technology is the use of the laser to change the corneal curvature, but the idea of removing some corneal tissue and changing the curvature has been used for about 40 years and patients who had that procedure 40 years ago are now stable. So, we believe that long-term it will remain stable. The eye may change in other ways not affecting the cornea. So that patients who have successful LASIK may eventually become nearsighted or farsighted slightly in the future. The good news about LASIK is that, in general, it can be repeated or other surgical procedures can be offered at a later time that will correct any errors that creep in.

COHEN: It won't always correct it, I think we need to make that clear.

STULTING: It doesn't always correct. There are certain conditions that LASIK cannot correct that you may develop, that's right.

COHEN: OK. We have a phone call from Christine in Ohio.

Christine, welcome to WEEKEND HOUSE CALL. You can go ahead with your question for the Dr. Stulting.

CHRISTINE, OHIO: All right, thank you. I had radial keratotomy surgery approximately 20 years ago. Is LASIK surgery still an option given that type of history?

STULTING: Yes, it is. In fact, many people who have had radial keratotomy in the past, now find that their refractive error has return or they have developed other refractive errors and LASIK would be an option for them. In fact, WaveFront LASIK, which has recently been developed, may give them an opportunity to significantly improve the quality of the vision that they had even immediately after they had radial keratotomy.

COHEN: We have a phone call now, from Bart in Ohio.

Bart, go ahead with your question. Mark -- Mark in Ohio, excuse me.

MARK, OHIO: Yes, could you tell me -- with the advances in LASIK surgery, are there any new advances like, for macular degeneration? One other thing is, if a person has developed drusen, does that automatically mean they're going to get macular degeneration?

STULTING: Macular degeneration is an aging change that affects the retina. And drusen is an early form of macular degeneration. Just because a patient develops drusen does not mean they will progress to full form -- full blown macular degeneration that significantly affects their vision. There are treatments available for certain forms of macular degeneration. And, you should consult your physician to find out whether you would be a candidate for those kinds of treatment or not.

COHEN: We have an e-mail now, from Eric in Illinois. Eric just had LASIK surgery and he's had a problem, he writes, "I had LASIK corrective eye surgery in March 2000 at the age of 22. Since then, I've had a minor problem with dryness, but that is easily resolved with drops. However, I seem to have a bigger problem. My eyesight has regressed a bit. I was at 20/15 after the surgery and stayed that way up to 6 months after the surgery. As of December 2002, my last eye exam, I was at 20/20 in one eye and 20/25 in the other. Is the regression and the dryness normal? At some point, will I need another procedure to correct my vision?"

Dr. Stulting, is it patients commonly find or sometimes find that they need additional procedures to correct their vision after the original procedure?

STULTING: The dryness that was mentioned is very common. Typically patients have dryness for 6 to 12 months after LASIK. But, it's temporary, it's easily treated with artificial tears and it goes away. The change in refraction is less common. In about 10 percent to 15 percent of patients who undergo LASIK, we have to performing additional procedures sometime later to correct the small residual error that they develop.

COHEN: OK, well, thank you Dr. Stulting. And, we'll be back with Dr. Stulting after we take a quick break.

When we come back, we'll talk about finding the right doctor for you. We'll tell you what questions you should ask, and if those low- cost deals you see advertised are really safe. This is your chance to call us with your questions at 1-800-807-2620 or e-mail us at housecall@CNN.com.

We'll be right back.

(COMMERCIAL BREAK)

COHEN: Did you know that reading glasses first appeared in Italy late in the 13th century? They were designed to help the elderly to read. Their popularity was instantaneous and paintings from that time begin to depict wearers in both religious and scholarly settings.

This is WEEKEND HOUSE CALL and we're talking about the newest advances in eye surgeries. We're taking your questions. Call us at 1-800-807-2620 or e-mail us at housecall@CNN.com.

While we get your calls and e-mails lined up, let's check our "Daily Dose Health Quiz." What percentage of American adults wear prescription eyeware?

We'll have that answer in 30 seconds. Stay with us.

(COMMERCIAL BREAK)

COHEN: Checking the "Daily Dose Quiz." We asked: What percentage of American adults wear prescription eyeware?

The answer: 66 percent, according to the Vision Council of America. 136 million adults wear prescription eyewear, and women have worse eyesight. 57 percent of women wear glasses or contacts, 43 percent of men.

Welcome back to WEEKEND HOUSE CALL. We're talking about the newest eye surgeries. Here are some tips for finding the right doctor: Make sure you compare, you want a doctor who has a lot of experience and who's performed the surgery often. Don't base your decision simply on cost and don't settle for the first eye center doctor or procedure that you investigate. Remember that the decision you make about your eyes and surgery will affect you for the rest of your life.

Be wary of deals that advertise 20/20 vision or money back or so- called "package deals." There are never any guarantees in medicine. Make sure you get a good evaluation and ask about after surgery care, it's just as important as the surgery itself.

We're joined, this morning, by ophthalmologist Doyle Stulting and we're getting e-mails from all over the country. This morning, Bethany from California asks, "How can you verify the doctor's credentials and ability to perform eye surgery?"

Doctor, any thoughts on that? How do you know someone is who says he is and what he says he is?

STULTING: I guess finding a doctor is about the same as me finding a mechanic for my car. You have to begin with his education, make sure he was trained at a place that you know, figure out how he stands in the community, and in the profession. Does he belong to professional organizations? Has he performed research? Does he publish papers? Does he teach? Is he well-known by others in the community? Does he have a good reputation? Talk to other patients that he's treated. And most of all, go see him, have an eye exam, be comfortable. Make sure that he can answer your questions. Make sure that he can make you understand about the condition of your eyes and develop a comfort level so that you and the physician, going forward, can make good decisions about your eye care.

COHEN: And, do you want someone -- we talked about numbers before, you don't want to be the first patient. Do you want to ask -- gee doctor, have you performed 20 of these before? 100 of these? Do you do 5 a week, 7 a week? How do you know what to ask?

STULTING: It's a good question to ask to ask. You want to be comfortable that the physician has good experience with the procedure and knows what he's doing. But, it's not necessary that a physician do thousands of cases in order to do them correctly. I think of it as interviewing for the Secret Service. If I were interviewing for the Secret Service, I wouldn't necessarily ask, how many bullets that an applicant had shot. I'd want to know whether he can hit the target or not. So, be sure that you are comfortable with the physician and comfortable that he knows what he's doing.

COHEN: OK, we have another e-mail, this one from Jeff in Pennsylvania. He has a question that a lot of people asked us. He writes, "I've noticed a great disparity between the costs of having LASIK surgery prefared (sic) at different clinics. Why is there such a wide variance in the cost of the procedure?"

STULTING: Well, one of the reasons for the variation is that you may not be getting the same thing for the same price in the different clinics. Be certain that the price that you see covers the same thing. Make sure it include the initial examination, the treatment, the aftercare, and any further surgical procedures that may be required. Make sure you're comparing apples to apples and oranges to oranges, and make sure that the qualifications of the physicians that are charging different prices are similar.

COHEN: We have a phone call now, from Camilla in West Virginia.

Camilla, welcome to WEEKEND HOUSE CALL and you can go ahead with your question.

CAMILLA, WEST VIRGINIA: Yes, thank you. I'm 68. I am wearing progressive lenses and I wondered if there's a maximum age for this surgery.

STULTING: There isn't a maximum age for the surgery, but the strategies for correcting you may be different. One of the possibilities for you today is Monovision, where we correct one eye for distance and one for near, so that people who are beyond the age of about 45 and need reading glasses or bifocals for near vision can use one eye for distance and one for near, without the aid of glasses. So, that would be an option for you today. And in the future, there may be other options that would allow you to see both at distance and at near it the same eye. We're looking forward to those developments.

COHEN: We have a question now, on the phone from Paul in Tennessee.

Paul, go ahead with your question for the Dr. Stulting.

PAUL, TENNESSEE: Thank you, ma'am. Hello doctor. I was recently diagnosed with pigmentary dispersion syndrome, which I was told, is a type of glaucoma. My question is -- would I still be considered a candidate for this type of surgery?

STULTING: Yes, you would, Paul. Pigment dispersion syndrome, as you say, is a condition that can lead to glaucoma, which is optic nerve damage from elevated pressure within the eye. There are some considerations that need to be taken into account when you are considered for LASIK. But, simply having pigment dispersion syndrome does not eliminate you from that procedure. It's something that should be discussed with your ophthalmologist.

COHEN: We have to take a quick break now. When we come back: What if you can't have LASIK surgery? What are your other options? There are some new surgeries out there, one involves implanting permanent contact lenses and the other uses radio waves. Stay with us to hear more.

(COMMERCIAL BREAK)

(NEWSBREAK)

(COMMERCIAL BREAK)

COHEN: Welcome back to WEEKEND HOUSE CALL. We're talking about the newest eye surgeries. And, we've spent a lot of time this morning on WaveFront and LASIK surgery. But, what if you aren't a good candidate for those, what other options are out there?

There are a couple of new surgeries available, something called CK and also implantable permits contact lenses.

We're joined here, by on ophthalmologist Dr. Doyle Stulting and we actually have a phone call from Tom in Kentucky about CK.

Tom, go ahead with your question.

TOM, KENTUCKY: Yes, good morning. I'm like the first caller who had RK a number of years ago, about eight years ago. I'm 52 now, and I've been apprehensive about the laser surgery to correct -- what I now have is farsighted, a little stigmatism, and definitely Presbyopia. And, I'm curious about the Conductive keratotomy surgery. It sounds like it might be a little gentler and I wonder if you could comment on that as an option and also, you were talking about the correcting the dominant eye for reading without a lens. I wonder if you recommend that, as well. Thank you.

STULTING: CK is a procedure in which radio waves are used to shrink the corneal collagen and steepen it centrally so that farsightedness can be treated. It's also good for creating monovision in patients who have good distance vision to begin with. However, radial keratotomy may complicate the outcomes of CK, so it may not be a good idea if you've already had radial keratotomy.

COHEN: And, implantable contact lenses -- what exactly are those?

STULTING: Implantable contact lenses are lenses that go inside the eye. There are two companies that manufacture contact -- implantable lenses in this country, and they'll be considered for the -- by the FDA for possible approval within the next two months. These, today, are good for patients who have severe degrees of farsightedness and nearsightedness and they can correct things that LASIK cannot correct. In the future, we'll probably find our applications for the treatment of astigmatism and other abnormalities.

COHEN: Now doctor, it seems like every year they're coming out with some new procedure. How do you know when is it time to say -- OK, I'm going to get this year's version, I'm not going to wait to see if there's better one next year or the year after?

STULTING: Well, you never know for sure. There are early adapters and people who want to know for certain before it's right for them, you just have to discuss the risks and the possible benefits with your physician and make your own decision. Learn as much as you can about the procedures and what they may have to offer for you, before deciding.

COHEN: We have an e-mail question now, from Mike in West Virginia, who wants to know, "I've worn hard contacts for 35 years, I was recently evaluated for laser correction, but my doctor told me my corneas were too thin for the surgery. If I had the surgery, I would still have to wear contacts, and I didn't see a benefit in that. What other corrective procedures are available to me to allow me to get rid of my contacts permanently?"

Dr. Stulting, LASIK is not an option for Mike but LASEK -- with an "E" might work. Talk about LASEK with an "E"?

STULTING: LASEK would be one possibility, today. It's treatment on the surface of the cornea that doesn't require as much treat -- of the tissue as LASIK. Another possibility, down the line, would be an implantable contact lens.

COHEN: We're going to take a quick break, now. Grab a pen, when we come back, I'll give you some Web site information to help you find a good eye doctor in your area and I'll run through the average costs of the different operations we've talked about. You're watching WEEKEND HOUSE CALL.

(COMMERCIAL BREAK)

COHEN: To locate an eye surgeon in your area, go to www.aoadrlocator.org. If you put if your zip code and state, you'll find the doctors close to you. We have been talking about the newest eye surgeries available. Here's a quick rundown of the average costs of the operations we've discussed today: WaveFront $2000 per eye; LASIK anywhere from $400 to $2250, but as we mentioned your eyesight is not where you want to save money or get surgery on the cheap; CK radio wave surgery, about $1500 per eye; and the implantable contact lenses, when and if they're approved, this year, will cost about four to $5,000.

We've been talking to ophthalmologist Dr. Stulting.

Any final thoughts on all of these various new eye surgery options that are out there for people?

STULTING: Well, it's an exciting time in my career and it's an exciting time for people who can't see well without glasses or contact lenses. This is real surgery, think of it that way, learn about it, be comfortable with the physician you choose for providing your eye care.

COHEN: And I think, probably also, remember that it doesn't always work out. Most of the time it does, but there could be complications.

STULTING: That's right. COHEN: That could happen. Well, Dr. Stulting, thank you very much for joining us this morning. It's been great. And, I want to thank all of you who called and e-mailed us with your questions. Thanks for watching. I'm Elizabeth Cohen.

CNN SUNDAY MORNING continues right now.

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Aired September 28, 2003 - 08:30   ET
THIS IS A RUSH TRANSCRIPT. THIS COPY MAY NOT BE IN ITS FINAL FORM AND MAY BE UPDATED.
ELIZABETH COHEN, CNN MEDICAL CORRESPONDENT: Good morning and welcome to WEEKEND HOUSE CALL. If you're tired of wearing glasses or contacts, you may be considering LASIK eye surgery, it's one of the newest procedures available to correct vision problems. LASIK has only been around a few years, but it's already helped millions see more clearly. As Dr. Sanjay Gupta reports, now eye doctors are excited about a new generation of LASIK.
(BEGIN VIDEOTAPE)

DR. SANJAY GUPTA, CNN MEDICAL CORRESPONDENT: Britt Bishop has been wearing glasses or contacts for the past 20 years. He's had enough.

BRITT BISHOP, PATIENT: They get in the way, sometimes. If you go in the water, you lose a contact. Playing softball, dirt gets in your eyes or lose a contact, so I'm just ready to be free of glasses.

GUPTA: Britt decided to undergo a new type of laser surgery called, it's called WaveFront LASIK surgery, and it's a cut above the conventional LASIK treatment. The WaveFront system sends a wave of light through the eye, mapping all of the defects, allowing for custom surgery instead of one size fits all approach.

DR. KEITH THOMPSON, OPHTHALMOLOGIST: But, the technology allows us to measure the eye in a more precise way so that we can get them sharper, clearer vision.

GUPTA: Like traditional LASIK, a thin lay of cornea, that's the clear outer covering of the eye, is peeled back. What's new is that the laser is used to perform a custom reshaping of the underlying layer.

UNIDENTIFIED MALE: Keep look straight up for me. Right at those lights.

GUPTA: It takes about 15 minutes per eye with little pain and costs between $1800 $2800 per eye, which is about $500 more than the conventional LASIK. It's rarely covered by insurance.

THOMPSON: So it gives patients a fairly user friendly surgery. That is, they can have the surgery one day and resume their normal lifestyle the next day.

GUPTA: About 4 million patients have had successful LASIK surgery, but there still are risks. Bad night vision, glare, halos occur in 3 percent of patients and the new WaveFront technology reduces flaws to just 1 percent. Other risks include dry eyes, blurred vision, and in rare cases infection, and possible loss of vision. The surgery is irreversible. The best way to reduce risks is to get a thorough eye evaluation and to work with a reputable surgeon. Britt has no complications and now sees with 20/20 vision.

BISHOP: I can just wake up and I have vision. It's perfect.

GUPTA: Like most patients, Britt was able to go back to work the very next day.

Dr. Sanjay Gupta, CNN, reporting.

(END VIDEOTAPE)

COHEN: Before you sign up for surgery, you need to know if you're a good candidate for LASIK. It's not for everyone. You can't have LASIK surgery if you require a change in your contact lens or glasses prescription in the past year. Young people 18 and younger are not good candidates because their vision is still changing in fact they're not candidates at all. Pregnant or nursing mothers have changing vision, as do patients whose hormones are fluctuating due to disease. Don't do LASIK if cost is an issue, most insurance does not pay for it. Although the cost is still coming down, it is still significant. Finally, if you're not a risk taker, you're not a good candidate for LASIK. Certain complications are unavoidable in a certain percentage of patients and the surgery is too new to know if there are long-term ill effects. Weigh the risks and the benefits. If you're happy wearing contacts or glasses, you may want to forgo the surgery.

We want to answer your questions about LASIK surgery and improving your vision. Call us at 1-800-807-2620 or e-mail your questions to housecall@CNN.com.

Dr. Doyle Stulting joins us, here in Atlanta. He's an ophthalmologist and managing direct of Emory Vision.

Thanks for being with us this morning. Quick question regarding WaveFront laser surgery -- who is that best suited for, people who are nearsighted, people who are farsighted, people with an astigmatism? Whose that best suited for?

DR. R. DOYLE STULTING, OPHTHALMOLOGIST: WaveFront surgery has been approved, so far, for people who have low degrees of nearsightedness and astigmatism. But, as time goes on it will become available for others, as well.

COHEN: And so, right now, it's only for people who have trouble seeing far away?

STULTING: Far away, correct.

COHEN: OK, great. All right, well we have an e-mail, now. Paul from New Jersey has several good questions regarding LASIK. He wants to know -- he, "Just wanted to know if there have been any studies on the long-term effects of betting laser surgery? Once you've had LASIK surgery, will your eye get progressively worse again? Can the surgery be repeated?"

I think many people want to know that. When you've had the surgery, is there a chance your eyes are just going to gradually get bad again?

STULTING: Actually, LASIK surgery is based on a procedure that has been performed for about 40 years. The new technology is the use of the laser to change the corneal curvature, but the idea of removing some corneal tissue and changing the curvature has been used for about 40 years and patients who had that procedure 40 years ago are now stable. So, we believe that long-term it will remain stable. The eye may change in other ways not affecting the cornea. So that patients who have successful LASIK may eventually become nearsighted or farsighted slightly in the future. The good news about LASIK is that, in general, it can be repeated or other surgical procedures can be offered at a later time that will correct any errors that creep in.

COHEN: It won't always correct it, I think we need to make that clear.

STULTING: It doesn't always correct. There are certain conditions that LASIK cannot correct that you may develop, that's right.

COHEN: OK. We have a phone call from Christine in Ohio.

Christine, welcome to WEEKEND HOUSE CALL. You can go ahead with your question for the Dr. Stulting.

CHRISTINE, OHIO: All right, thank you. I had radial keratotomy surgery approximately 20 years ago. Is LASIK surgery still an option given that type of history?

STULTING: Yes, it is. In fact, many people who have had radial keratotomy in the past, now find that their refractive error has return or they have developed other refractive errors and LASIK would be an option for them. In fact, WaveFront LASIK, which has recently been developed, may give them an opportunity to significantly improve the quality of the vision that they had even immediately after they had radial keratotomy.

COHEN: We have a phone call now, from Bart in Ohio.

Bart, go ahead with your question. Mark -- Mark in Ohio, excuse me.

MARK, OHIO: Yes, could you tell me -- with the advances in LASIK surgery, are there any new advances like, for macular degeneration? One other thing is, if a person has developed drusen, does that automatically mean they're going to get macular degeneration?

STULTING: Macular degeneration is an aging change that affects the retina. And drusen is an early form of macular degeneration. Just because a patient develops drusen does not mean they will progress to full form -- full blown macular degeneration that significantly affects their vision. There are treatments available for certain forms of macular degeneration. And, you should consult your physician to find out whether you would be a candidate for those kinds of treatment or not.

COHEN: We have an e-mail now, from Eric in Illinois. Eric just had LASIK surgery and he's had a problem, he writes, "I had LASIK corrective eye surgery in March 2000 at the age of 22. Since then, I've had a minor problem with dryness, but that is easily resolved with drops. However, I seem to have a bigger problem. My eyesight has regressed a bit. I was at 20/15 after the surgery and stayed that way up to 6 months after the surgery. As of December 2002, my last eye exam, I was at 20/20 in one eye and 20/25 in the other. Is the regression and the dryness normal? At some point, will I need another procedure to correct my vision?"

Dr. Stulting, is it patients commonly find or sometimes find that they need additional procedures to correct their vision after the original procedure?

STULTING: The dryness that was mentioned is very common. Typically patients have dryness for 6 to 12 months after LASIK. But, it's temporary, it's easily treated with artificial tears and it goes away. The change in refraction is less common. In about 10 percent to 15 percent of patients who undergo LASIK, we have to performing additional procedures sometime later to correct the small residual error that they develop.

COHEN: OK, well, thank you Dr. Stulting. And, we'll be back with Dr. Stulting after we take a quick break.

When we come back, we'll talk about finding the right doctor for you. We'll tell you what questions you should ask, and if those low- cost deals you see advertised are really safe. This is your chance to call us with your questions at 1-800-807-2620 or e-mail us at housecall@CNN.com.

We'll be right back.

(COMMERCIAL BREAK)

COHEN: Did you know that reading glasses first appeared in Italy late in the 13th century? They were designed to help the elderly to read. Their popularity was instantaneous and paintings from that time begin to depict wearers in both religious and scholarly settings.

This is WEEKEND HOUSE CALL and we're talking about the newest advances in eye surgeries. We're taking your questions. Call us at 1-800-807-2620 or e-mail us at housecall@CNN.com.

While we get your calls and e-mails lined up, let's check our "Daily Dose Health Quiz." What percentage of American adults wear prescription eyeware?

We'll have that answer in 30 seconds. Stay with us.

(COMMERCIAL BREAK)

COHEN: Checking the "Daily Dose Quiz." We asked: What percentage of American adults wear prescription eyeware?

The answer: 66 percent, according to the Vision Council of America. 136 million adults wear prescription eyewear, and women have worse eyesight. 57 percent of women wear glasses or contacts, 43 percent of men.

Welcome back to WEEKEND HOUSE CALL. We're talking about the newest eye surgeries. Here are some tips for finding the right doctor: Make sure you compare, you want a doctor who has a lot of experience and who's performed the surgery often. Don't base your decision simply on cost and don't settle for the first eye center doctor or procedure that you investigate. Remember that the decision you make about your eyes and surgery will affect you for the rest of your life.

Be wary of deals that advertise 20/20 vision or money back or so- called "package deals." There are never any guarantees in medicine. Make sure you get a good evaluation and ask about after surgery care, it's just as important as the surgery itself.

We're joined, this morning, by ophthalmologist Doyle Stulting and we're getting e-mails from all over the country. This morning, Bethany from California asks, "How can you verify the doctor's credentials and ability to perform eye surgery?"

Doctor, any thoughts on that? How do you know someone is who says he is and what he says he is?

STULTING: I guess finding a doctor is about the same as me finding a mechanic for my car. You have to begin with his education, make sure he was trained at a place that you know, figure out how he stands in the community, and in the profession. Does he belong to professional organizations? Has he performed research? Does he publish papers? Does he teach? Is he well-known by others in the community? Does he have a good reputation? Talk to other patients that he's treated. And most of all, go see him, have an eye exam, be comfortable. Make sure that he can answer your questions. Make sure that he can make you understand about the condition of your eyes and develop a comfort level so that you and the physician, going forward, can make good decisions about your eye care.

COHEN: And, do you want someone -- we talked about numbers before, you don't want to be the first patient. Do you want to ask -- gee doctor, have you performed 20 of these before? 100 of these? Do you do 5 a week, 7 a week? How do you know what to ask?

STULTING: It's a good question to ask to ask. You want to be comfortable that the physician has good experience with the procedure and knows what he's doing. But, it's not necessary that a physician do thousands of cases in order to do them correctly. I think of it as interviewing for the Secret Service. If I were interviewing for the Secret Service, I wouldn't necessarily ask, how many bullets that an applicant had shot. I'd want to know whether he can hit the target or not. So, be sure that you are comfortable with the physician and comfortable that he knows what he's doing.

COHEN: OK, we have another e-mail, this one from Jeff in Pennsylvania. He has a question that a lot of people asked us. He writes, "I've noticed a great disparity between the costs of having LASIK surgery prefared (sic) at different clinics. Why is there such a wide variance in the cost of the procedure?"

STULTING: Well, one of the reasons for the variation is that you may not be getting the same thing for the same price in the different clinics. Be certain that the price that you see covers the same thing. Make sure it include the initial examination, the treatment, the aftercare, and any further surgical procedures that may be required. Make sure you're comparing apples to apples and oranges to oranges, and make sure that the qualifications of the physicians that are charging different prices are similar.

COHEN: We have a phone call now, from Camilla in West Virginia.

Camilla, welcome to WEEKEND HOUSE CALL and you can go ahead with your question.

CAMILLA, WEST VIRGINIA: Yes, thank you. I'm 68. I am wearing progressive lenses and I wondered if there's a maximum age for this surgery.

STULTING: There isn't a maximum age for the surgery, but the strategies for correcting you may be different. One of the possibilities for you today is Monovision, where we correct one eye for distance and one for near, so that people who are beyond the age of about 45 and need reading glasses or bifocals for near vision can use one eye for distance and one for near, without the aid of glasses. So, that would be an option for you today. And in the future, there may be other options that would allow you to see both at distance and at near it the same eye. We're looking forward to those developments.

COHEN: We have a question now, on the phone from Paul in Tennessee.

Paul, go ahead with your question for the Dr. Stulting.

PAUL, TENNESSEE: Thank you, ma'am. Hello doctor. I was recently diagnosed with pigmentary dispersion syndrome, which I was told, is a type of glaucoma. My question is -- would I still be considered a candidate for this type of surgery?

STULTING: Yes, you would, Paul. Pigment dispersion syndrome, as you say, is a condition that can lead to glaucoma, which is optic nerve damage from elevated pressure within the eye. There are some considerations that need to be taken into account when you are considered for LASIK. But, simply having pigment dispersion syndrome does not eliminate you from that procedure. It's something that should be discussed with your ophthalmologist.

COHEN: We have to take a quick break now. When we come back: What if you can't have LASIK surgery? What are your other options? There are some new surgeries out there, one involves implanting permanent contact lenses and the other uses radio waves. Stay with us to hear more.

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COHEN: Welcome back to WEEKEND HOUSE CALL. We're talking about the newest eye surgeries. And, we've spent a lot of time this morning on WaveFront and LASIK surgery. But, what if you aren't a good candidate for those, what other options are out there?

There are a couple of new surgeries available, something called CK and also implantable permits contact lenses.

We're joined here, by on ophthalmologist Dr. Doyle Stulting and we actually have a phone call from Tom in Kentucky about CK.

Tom, go ahead with your question.

TOM, KENTUCKY: Yes, good morning. I'm like the first caller who had RK a number of years ago, about eight years ago. I'm 52 now, and I've been apprehensive about the laser surgery to correct -- what I now have is farsighted, a little stigmatism, and definitely Presbyopia. And, I'm curious about the Conductive keratotomy surgery. It sounds like it might be a little gentler and I wonder if you could comment on that as an option and also, you were talking about the correcting the dominant eye for reading without a lens. I wonder if you recommend that, as well. Thank you.

STULTING: CK is a procedure in which radio waves are used to shrink the corneal collagen and steepen it centrally so that farsightedness can be treated. It's also good for creating monovision in patients who have good distance vision to begin with. However, radial keratotomy may complicate the outcomes of CK, so it may not be a good idea if you've already had radial keratotomy.

COHEN: And, implantable contact lenses -- what exactly are those?

STULTING: Implantable contact lenses are lenses that go inside the eye. There are two companies that manufacture contact -- implantable lenses in this country, and they'll be considered for the -- by the FDA for possible approval within the next two months. These, today, are good for patients who have severe degrees of farsightedness and nearsightedness and they can correct things that LASIK cannot correct. In the future, we'll probably find our applications for the treatment of astigmatism and other abnormalities.

COHEN: Now doctor, it seems like every year they're coming out with some new procedure. How do you know when is it time to say -- OK, I'm going to get this year's version, I'm not going to wait to see if there's better one next year or the year after?

STULTING: Well, you never know for sure. There are early adapters and people who want to know for certain before it's right for them, you just have to discuss the risks and the possible benefits with your physician and make your own decision. Learn as much as you can about the procedures and what they may have to offer for you, before deciding.

COHEN: We have an e-mail question now, from Mike in West Virginia, who wants to know, "I've worn hard contacts for 35 years, I was recently evaluated for laser correction, but my doctor told me my corneas were too thin for the surgery. If I had the surgery, I would still have to wear contacts, and I didn't see a benefit in that. What other corrective procedures are available to me to allow me to get rid of my contacts permanently?"

Dr. Stulting, LASIK is not an option for Mike but LASEK -- with an "E" might work. Talk about LASEK with an "E"?

STULTING: LASEK would be one possibility, today. It's treatment on the surface of the cornea that doesn't require as much treat -- of the tissue as LASIK. Another possibility, down the line, would be an implantable contact lens.

COHEN: We're going to take a quick break, now. Grab a pen, when we come back, I'll give you some Web site information to help you find a good eye doctor in your area and I'll run through the average costs of the different operations we've talked about. You're watching WEEKEND HOUSE CALL.

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COHEN: To locate an eye surgeon in your area, go to www.aoadrlocator.org. If you put if your zip code and state, you'll find the doctors close to you. We have been talking about the newest eye surgeries available. Here's a quick rundown of the average costs of the operations we've discussed today: WaveFront $2000 per eye; LASIK anywhere from $400 to $2250, but as we mentioned your eyesight is not where you want to save money or get surgery on the cheap; CK radio wave surgery, about $1500 per eye; and the implantable contact lenses, when and if they're approved, this year, will cost about four to $5,000.

We've been talking to ophthalmologist Dr. Stulting.

Any final thoughts on all of these various new eye surgery options that are out there for people?

STULTING: Well, it's an exciting time in my career and it's an exciting time for people who can't see well without glasses or contact lenses. This is real surgery, think of it that way, learn about it, be comfortable with the physician you choose for providing your eye care.

COHEN: And I think, probably also, remember that it doesn't always work out. Most of the time it does, but there could be complications.

STULTING: That's right. COHEN: That could happen. Well, Dr. Stulting, thank you very much for joining us this morning. It's been great. And, I want to thank all of you who called and e-mailed us with your questions. Thanks for watching. I'm Elizabeth Cohen.

CNN SUNDAY MORNING continues right now.

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