Problems after Lasik Surgery

The FDA has received persistent complaints about outcomes and “quality of life” following LASIK (laser-assisted in situ keratomileusis) eye surgery. Even though the total number of patients reporting problems is relatively low, about 5% one has to keep in mind that reporting rates of complications resulting from a variety of medical causes such as drug reactions, etc. is less than 10%. Even without taking this into account, with 750,000 procedures annually in the U.S. (13.5 million procedures total  performed in the U.S., and only 16.3 million worldwide!) the total number reporting problems amounts to 675,000 patients.

Complaints reported include poor distance vision, dry eye, redness and pain, glare, and halos.  According to the JAMA, Dec. 9, 2009, advocacy groups opposing LASIK surgery have added other complications, including depression and suicide ideation.

See LASIK Surgery watch for discussion of other potential problems with LASIK surgery that are becoming the source of controversy among ophthalmologists. Among these are problems with accuracy of intraocular pressure (IOP) measurements used routinely to screen for glaucoma. “Permanent changes in corneal thickness and biomechanical properties following LASIK result in inaccurate IOP measurement, exposing patients to risk of undiagnosed glaucoma and associated vision loss.” Also mentioned is the problem of measuring the corneal surface in cataract surgery to calculate the power of in intraocular lens implantation.(IOL). Changes to the cornea after LASIK can  cause inaccurate measurement of IOL power, which may result in a poor visual outcome after cataract surgery.

In May of this year the FDA and CDC began reviewing reports of fungal keratitis-a serious infection which can cause destruction of the cornea-  in over 90 patients wearing contact lenses using cleaning/disinfecting solutions, ReNu and MoistreLoc by Bausch and Lomb.

The FDA plans three studies, culminating in a survey of quality of life following LASIK surgery in about 2500 patients from the general population.This may not take place for 1-3 years.  According to this site, LASIK eye Surgery is the procedure of choice and can be elected to be done for a person who is dependent on glasses or contact lens for a prolonged period.”  It seems to me that one should consider carefully whether his desire not to wear glasses or contacts supercedes the possible immediate and long-term risks of undergoing surgery on his cornea.

I wonder, in other words, the true percentage of 750,000 patients a year who really Need or benefit from LASIK surgery. See this American Academy of Ophthalmology site.for more information.

2 Responses to “Problems after Lasik Surgery”

  1. Emma says:

    I know this is an old entry but I wanted to say that I have never understood why people with only minor vision problems would undergo something so drastic as LASIK.

    I’ve asked some people who wanted this surgery, especially when it first became mainstream, and many told me that they thought glasses to be unfashionable and that they either couldn’t wear contacts (fair enough neither my dad or I can) or that they didn’t want the bother of dealing with contacts. This seems like a poor excuse to have something this drastic done and it does not surprise me, now or then, that there are poor outcomes and that there is controversy in the medical community over this procedure.

    Granted there are people out there that could and can benefit from this procedure. In fact I know two people who would, one who went ahead and got the surgery and said it was life changing and the other who is seriously considering it but cautious and weighing the pros and cons. Both of these people have/had severe astigmatism.

    Thank you for this thoughtful entry and the link to the LASIK watch group. I know some people considering getting this because they don’t want glasses anymore and while this seems like a drastic step to me, I do want them to have all the information. It also makes me wonder how many more patients had adverse side effects that weren’t reported.

    • Thanks for your comments which I appreciate -especially since they are coming from the LASIK watch group. s for reporting adverse effects, whether due to drugs,medical devices, or procedures, recall that less than 10% of patients-and doctors-report problems to the Governmenet, FDA, medical groups, etc.

      Much appreciated.

      Martin F. Sturman, MD, FACP

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