Thanks for your help in advance. I've read several of your responses to questions on this board and you seem to be a person of integrity and conscience. Could you please speak to the The 10 Reasons Why You Should Not Have Lasik which are found on the www.surgicaleyes.org website? I found this list quite interesting and very convincing. I had Lasik two years ago and have suffered from severly dry eyes and compromised night vision. How could any doctor of integrity be positive about a procedure that has so many devastating side effects and so much risk?

Susan - every surgery and everything we do has some level of risk. All cosmetic surgeries have some level of risk: From the removal of a wart, to liposuction, breast implants, eyelid surgery for baggy eyelids, bariatric surgery to combat obesity, or laser eye surgery.
One of the main issues is that while many surgeons carefully explain the risks of surgery, others are so excited about the surgery that they gloss over the risks. Patients as well are so excited that they sometimes do not listen to all of the risks - especially when their friends or family members may have already had successful surgery.
The top 10 reasons article is saying exactly that - that there is risk with surgery and that there are many lasers that treat the cornea, and none have proven to be "better" than the other. As well, the article mentions loss of contrast sensitivity and the creation of optical aberrations. For most individuals, the change in contrast sensitivity levels is not functionally significant - and even the top contrast sensitivity expert (Dr. Arthur Ginsburg, Ph.D - at www.contrastsensitivity.net ) has not compared the difference of patients before and after LASIK to determine the exact change in contrast sensitivity.
To give a real life-example - one of my good friends had LASIK for 9 diopters of myopia 3 years ago with me, and he was 7 for 8 in our softball double-header last night. So he is functioning at a very high level after surgery.
Of course - if a patient experiences any of a number of complications that can occur with LASIK, or they started off before surgery as a bad candidate due to large pupils or other problems - then they may be more likely to end up with functionally decreased vision.

Lets look at a few more of the Top 10 reasons - which are way off base:

Photophobia (sensitivity to light) often occurs with LASIK - this is absolutely not true. It can rarely occur if a person has significant dry eyes, but otherwise people do not complain of photophobia commonly after LASIK

Cataracts - the article you are supporting claims that since people after LASIK will no longer be wearing UV-coated lenses - that they are at higher risk for cataracts. I think people can choose to wear sunglasses after surgery if they so desire.

"Myopia will eventually be your friend" - true for people with mild prescriptions, but false for people with moderate to severe myopia. I turn down many patients in their late 30's with mild myopia (including one patient who came to see me today).

In summary - the article should be - 5-7 things to know when considering refractive surgery - and a person can again decide whether the benefits of laser eye surgery is worth the risks.

Bill Trattler, MD
Miami, fL

P.S. Sorry for such a long post - feel free to comment further