If laser eye surgery is a safe and good thing, why do some people not go for it? They prefer glasses over it. Why? Even rich people like Bill Gates.

With all respect, the premise of your question is incorrect. Far more people wear glasses than contact lenses, but that does not mean contacts are not a "safe and good thing." Many millions of people have refractive surgery on their eyes every year. Most of that surgery is LASIK. And with some exceptions (that should not be ignored) there is well over a 96% satisfaction rate according to an American Academy of Ophthalmology survey. But LASIK is not for everyone for many reasons.

Perhaps you think LASIK doctors tell all their prospective patients: "LASIK=Perfect Vision, forever, regardless of what your vision problem is." But this is not at all true and has never been promoted as such by any responsible clinic and doctor.

LASIK is most highly successful in treating myopia and astigmatism in people before they reach middle age and the development of presbyopia. Even if you have "perfect" distance vision after LASIK, you will become presbyopic and lose your near vision during your early to mid-forties. This does not mean the LASIK failed. LASIK does not cure Presbyopia.

This is a major reason why LASIK is not done as often in older people: The natural lens is already hardening by age 50 and beginning to discolor (cataract development) . So LASIK is probably not going to be as successful as in younger people.

LASIK is not so good for hyperopia (another type of farsightedness) because it tends to wear off with time, unlike in nearsighted patients where it lasts much longer. There are other types of refractive surgery that is often better than LASIK in these patients.

However, the biggest reason more people (who are young and good candidates) do not get LASIK is the out-of-pocket expense: it is almost never paid for by insurance!

_Written by J. Trevor Woodhams, M.D. - Chief of Surgery, Woodhams Eye Clinic