30-Day Contact Lenses:
A Smart Alternative to LASIK?

If you're interested in LASIK, but either don't want surgery or aren't a candidate, you may want to consider continuous wear contact lenses, which are U.S. Food and Drug Administration-approved for up to 30 consecutive days of wear without removal.

Like LASIK, 30-day contact lenses offer hassle-free good vision. Let's consider the relative merits of both in terms of safety, effectiveness, and cost.

Both contact lenses and laser eye surgery are safe for the overwhelming majority of patients, but each carries some risk. Sleeping in contact lenses increases the chance of infection. For laser eye surgery, the risk is mostly dry eyes and visual abnormalities.

Continuous wear contacts. The 1980s first brought us 30-day contact lens wear, but that changed when people wearing their lenses for up to 30 days in a row began having more eye infections. Shortly thereafter, the FDA reduced wear time to a maximum of one week.

So what's different now? A new contact lens material — silicone hydrogel — that allows six to seven times more oxygen to permeate the lens and thereby keep the cornea healthy. Even so, overnight wear of contacts isn't for everyone, and people who have had previous problems with contacts may not be good candidates for 30-day wear.

Laser vision correction. The vast majority of LASIK patients enjoy good uncorrected vision after surgery with minimal (if any) complications. Nighttime glare and dryness remain a problem for some patients, at least in the near term. But newer lasers with eye trackers and larger treatment zones allow surgeons to minimize the risk of these glare complications. Eye trackers reposition the laser if your eye moves. Doctors sometimes treat a larger area of the cornea in patients whose pupils are larger than average, to ensure good vision after surgery. In addition, years of laser vision correction experience have taught surgeons to be better at screening out poor candidates for surgery, who are more likely to experience post-surgical problems.

Both 30-day contacts and LASIK can produce excellent vision quality for the right candidates. But in addition to your immediate visual outcome, each has implications for your vision later in life that many people don't consider.

Continuous wear lenses. With 30-day contact lenses, most people can be immediately assured of good, sharp vision. If you'd rather have no doubt whatsoever about the visual outcome, then 30-day contact lenses may be a better option for you than laser vision correction.

With contact lenses, you also have the flexibility to change the prescription down the road, should the need arise. And wearers entering their presbyopic years can switch to bifocal contact lenses, or they can use reading glasses in combination with their distance contacts.

Laser vision correction. Today surgeons are more experienced, and laser technology has improved. Consequently, the visual acuity experienced by LASIK patients is statistically better than ever.

These visual results are also partly due to custom LASIK, first approved by the FDA in 2002, which uses sophisticated mapping technology to correct subtle visual abnormalities. Laser manufacturers tout the fact that many custom LASIK patients are actually able to see better than 20/20 — but for many people, the same is true of contact lenses.

Bear in mind that LASIK can't completely fix presbyopia, though a monovision procedure can help. So if you've had LASIK, at some point you will still need reading glasses, or bifocal contact lenses with no correction for distance.
 

Continuous wear contacts. Expect to pay about a dollar a day for continuous wear contacts. With 30-day lens wear, you almost eliminate the cost of lens care solutions — but you'll want to keep some on hand in case you need to remove the lenses. That means 30-day lenses will cost about the same annually as other soft lenses.

Laser vision correction. The average cost of LASIK was about $1,965 per eye in the spring of 2005. Although the up-front cost is higher, you largely eliminate your cost for vision care products for many years to come. Most surgeons also offer financing with monthly payments to soften the one-time blow.

It's important to note that you don't entirely eliminate your vision costs with laser vision correction. It doesn't negate the need for regular eye exams to check for vision changes or symptoms of eye disease, and in most cases it doesn't eliminate the eventual need to correct presbyopia.

Before you make your final decision, get the unbiased advice of an eye doctor who is open to both 30-day contacts and laser vision correction. If the doctor says you're a good candidate for both, the choice comes down to personal preference. Your answers to the following questions can point you in the right direction.

• What is your tolerance for risk? Contact lenses carry a lesser degree of risk than LASIK. Any kind of surgery has inherent risks to consider.
   
• How much convenience are you looking for? If even a once-a-month contact lens routine is too much trouble, you might prefer LASIK.
   
• How important is flexibility? Contact lenses can be changed again and again to adapt to your changing needs.
   
• How will you eventually deal with presbyopia?
   
• Is up-front money a factor? Thirty-day contact lenses are less expensive in the short term, but LASIK may be less expensive in the long term.

If you're hesitant about either option, there is a third choice: orthokeratology (or "ortho-k"). Like LASIK and continuous wear, ortho-k frees you from daytime contact lens use, though you must sleep in specially designed contact lenses each night.

For more in-depth information, read our articles on extended wear contact lenses and laser eye surgery. Whichever you choose, you will likely join the ranks of many satisfied customers. Each is an exciting option for convenient and hassle-free vision correction.