Each year thousands of patients come to Dr. Jason P. Brinton at Brinton Vision in St. Louis, seeking what we call visual freedom, or crisp, clear vision free of refractive errors, glasses, and contact lenses by treating myopia, hyperopia, and astigmatism. We accomplish this through LASIK and its six variations – SMILE, Visian ICL, PRK, Raindrop inlay, Kamra inlay, and Custom Lens Replacement.

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, 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.

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Wear Contacts For Too Long

Eliminate Your Possiblity of Infection

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 in rare cases, 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 St. Louis LASIK 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.

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.

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FAQs

Why do I have to remove my contacts before my exam and before surgery?

Contact lenses can alter the shape of your cornea and can also prohibit oxygen flow to the cornea. For that reason, we ask that you refrain from wearing them both before your Brinton Vision Ocular Analysis (BVOA) and before surgery. Soft lenses should be removed three days before your exam, and seven days prior if you wear toric lenses. If you wear rigid gas-permeable or hybrid lenses, leave them out at least 30 days prior to your exam. This is so that your cornea can be restored to a more natural shape before measurements are taken.

What are my chances of not having to wear glasses or contacts after surgery?

Thanks to the fact that Brinton Vision is able to provide LASIK plus its six modern variations, there are a number of vision problems — some of them pretty severe — that we are able to fully correct. The likelihood that you will have complete freedom from glasses or contacts depends on what procedure is done and on your own body.

For example, even though your refractive error is completely corrected with certain procedures, you may still eventually have over-40 vision problems, or presbyopia, caused by aging lenses. For realistic expectations for your unique vision, please schedule a Brinton Vision Ocular Analysis (BVOA). Statistically, one of every 250 LASIK patients will need to wear a contact to obtain their best vision after laser eye surgery.

Are your lasers and lens implants FDA-approved?

Yes. All of the lasers and implants at Brinton Vision are FDA-approved. Many have also been used years longer in Europe and across the world prior to U.S. FDA approval.

Can anyone get LASIK laser eye surgery?

The best LASIK surgeons in St. Louis and across the country will not try to push you into LASIK or other laser eye surgery because refractive surgeries are elective medical procedures and not everyone is an ideal candidate. Dr. Brinton is a conservative surgeon, meaning he only performs LASIK plus its six modern variations on people whose eye anatomy, vision and health history make it an excellent choice. At Brinton Vision, there is no one-size-fits-all laser vision solution. We take the time to perform the most comprehensive evaluation possible, and our patients are never counted as a “sale.” The best way to find out if you are a candidate for any laser vision correction is to visit us for a Brinton Vision Ocular Analysis (BVOA).

Where are you located? 

The Brinton Vision building is located at 555 N. New Ballas Road, Suite 310 in St. Louis. We are near I-270 and Olive Blvd.