Musings of LASIK-damaged physician on how LASIK is perpetuated

I'm not religious by any means, but if there is a Hell, there is a special place in it for Refractive surgeons.

I've been trying to understand the phenomenon of LASIK surgery's tenacity despite all the clear indications that it should be abolished. I believe that there are several key elements that refractive surgeons consciously or inadvertently exploit. First, we all hated our glasses and contact lenses. The promise of "perfect", unaided vision is so very seductive. The lure took away much of my objectiveness so I was hearing and reading only the propaganda and little of the real science. The dense marketing overwhelms the objective information on RS. Next, vision is poorly quantitated. Visual acuity is a subjective report by the patient..."yeah, one looks clearer than two...wait, let me see two again". No one really assesses how light is refracted by the anterior eye then interpreted by the retina and brain. The optics of the human eye are not static either. So the patient, ecstatic to be free of lenses, believes he or she is now seeing great just because the 20/20 line can be resolved without glasses. Never mind the loss of contrast sensitivity, loss of night acuity, loss of accommodation, corneal derangement, dry eye..etc. Now you have a population of LASIK patients who WANT to believe their vision has been improved. They go on to be poster children for LASIK and tell their friends and the vicious cycle perpetuates. Those of us that get the worst complications are written off as unlucky bastards.

Getting physicians to organize a campaign might be a start. Let's get the PhD's involved too.

We'll see the day that this tragic surgery is banned. You said you enjoyed Shiraz. Well, I have a bottle of 1998 Penfold's Grange Hermitage in my cellar that I hope to share with you when the plug is pulled on LASIK.

MD Regrets Custom Wavefront

I had "Custom Wavefront" LASIK on both eyes last January which puts me at about eight months. I have severe dry eye and had to have both my lower puncta cauterized three months ago. I've also developed erratic visual acuity and loss of contrast sensitivity; glasses and contacts can't help since refraction for me is a moving target. I also now have terrible accommodative dysfunction which no one seems to be able to explain. I guess this generates a lot of the eye pain that I experience.

I am in a procedure-intensive specialty and I have some knowledge of the informed consent. The consent form offered up by most refractive surgeons is a sorry document which is guided by legal standards and doesn't give the patient realistic information by which to make their decision. I fully believe that that constitutes malpractice in the setting of an elective procedure. There is also too much reliance on patient satisfaction surveys and not enough emphasis on real science. Sure, if you were trying to market an expensive surgical procedure, glowing patient testimonials are better for the bottom line than evidence-based medicine. Not even a marketing 101 flunkie would submit a brochure which lists these real, possible outcomes...

  • likely decrease in low light and night vision
  • definite decrease in tear quantity and/or quality...no real way to estimate if you will be symptomatic or not
  • eye fatigue and/or eye pain
  • unpredictable quantities of metallic debris left behind
  • permanent denervation or paresthesias of the cornea
  • retinal detachment or ischemia during surgery

If I would have suspected that any of the above outcomes were possible, I'd be sitting here right now CLEARLY viewing my computer screen with my old trustworthy glasses on.

I genuinely believe that RS [refractive surgery] is a crime in its present form. LASIK may be the worst of the offenders. It "cheapens" the field of medicine and is perpetuated by greed. I don't consider refractive surgeons colleagues...these people aren't healers. I've also given lots of thought on how to reach potential victims of the RS industry. At least patients deserve accurate information before making such a potentially life-altering decision.