I am trying to decide whether or not to have LASIK surgery. I have worn gas permeable lenses for about 35 years. Lately my eyes do not tolerate the lenses well. I tried switching to soft lens but they irritate my eyes and I can not see as well out of them. So I decided LASIK was the answer. My doctor says that I am a great candidate for monovision since I have been doing that with contacts for about 2 years. But since I decided to try LASIK I have been flooded with horror stories. Everyone I know that has had the surgery loves it, but there are a million stories of unhappy patients. When looking at the statistics is there any way to take into account the quality of the physician or clinic that performed the LASIK? I am wondering if the more reputable clinics and doctors have a higher success rate? My doctor is Dr. Steven Jackson in Murray, Utah. I am just trying to tell which statistics to believe.

When the stories are “horror”, a dozen will seem like millions, but the actual percentage of people who have had poor refractive surgery outcomes is certainly less than millions. In fact, if you trace the origins of those stories, my bet is that you will find they all derive from a very small number of very anti-refractive surgery/surgeon/industry zealots. Their warnings should be noted, but do not assume that the incidence of problems with LASIK is overwhelming, or would even apply to you.

If you visit our Should You Do It? page at http://www.usaeyes.org/faq/do_it.htm you will see that about 3% of refractive surgery patients have an unresolved surgery-induced problem at the end of the normal six month healing period. About 0.5% have catastrophic problems that require significant maintenance and/or invasive treatment. Only you can decide if these amounts are acceptable to you, and your individual circumstances may vary.

As an example of a variable, you are becoming contact lens intolerant. This may be due to dry eye and LASIK can induce drier eyes. If you have dry eye, this needs to be treated and managed before having surgery.

As for how to choose a surgeon, our organization has some thoughts on that. 50, to be exact. You may want to look at our 50 Tough Questions For Your Doctor at http://www.usaeyes.org/faq/tough_questions.htm.

Monovision with LASIK may be a good idea for you, since you have been successful with monovision contacts. Much will depend upon the exact nature of your refractive error, what treatment is best, etc.

Glenn Hagele
Council for Refractive Surgery Quality Assurance
http://www.USAeyes.org
http://www.ComplicatedEyes.org

I am not a doctor.

Rebecca,

Don’t pay too much attention to Glenn Hagele. His job is to market refractive surgery to those doctors who pay him for his services.

There are not millions of people with bad outcomes but there are a lot. The major complication rate still ranges in the 2-3% range. This percentage excludes a lot of things the average patient would consider to be a complication. Simple math tells you that 3% times the 6 million people who have had lasik in the United States equals 180,000 people with compromised vision that may be permanent. Glenn will immediately counter with the claim that the rate is not this high but he cannot post unbiased data that comes from outside the refractive surgery industry.

Hagele wrote:
“In fact, if you trace the origins of those stories, my bet is that you will find they all derive from a very small number of very anti-refractive surgery/surgeon/industry zealots.”

Hagele fails to note that the people who are anti-refractive surgery and are against it are primarily people who have had refractive surgery (lasik or prk mostly) and have had horrible results. They were promised clear vision and are now handicapped for life. Hagele seems to spend most of his time on internet bulletin boards attempting to silence people who bought his product and are now visually handicapped.

Hagele wrote:
“Their warnings should be noted, but do not assume that the incidence of problems with LASIK is overwhelming, or would even apply to you.”

This is very typical of the language used to market lasik. It does not deny that bad things can and do happen every day but it does suggest that you don’t need to worry about a disastrous outcome as long as you go to a good surgeon.

Hagele has not had refractive surgery himself and will not, even though he is physically the perfect candidate. He had admitted that the reason he will not have refractive surgery is that he knows will not get the same crisp vision that his glasses give him now and does not want to settle for the loss of quality vision that is fairly common with refractive surgery.

Best of luck to Rebecca, whatever you decide.

Terri

Hello Terri. You have not been around sneering at my posts lately and I began to worry that something was wrong. I’m glad to see you are apparently well and up to your usual complaints.

Terri is one of those anti-refractive surgery zealots I was talking about, and normally posts in this forum quite often. In the thread at https://asklasikdocs.com/forum/main/3039.html you will find my previous responses to several of her most common accusations. Rather than me repeating all the detail here, just jump to that thread.

The short response is that I do not sell refractive surgery, and never had. Our funding is from certification fees charged to physicians we evaluate, similar to every other certification organization with which I am familiar.

There are a few points Terri raises that are important and I think I should respond.

The number of people who have had poor refractive surgery outcomes is in the 180,000 range that Terri mentions. That is one heck of a lot of people with poor vision, even if it is 3% of the whole. The probability of some complications suffered by early patients is much lower now, thanks to improved techniques and technologies. The incidence of what we call catastrophic complications has actually gone down to about 0.5%, but refractive surgery is surgery and it is not perfect. Even with these relatively small percentages, that is too many people. One, is too many people.

Not only do I not attempt to silence people with bad outcomes, but we have links to these very people’s websites on our Bad Results webpage. It is important to consider all aspects of prospective surgery, good, bad, and in the middle. Additionally, last year we created a sister website at ComplicatedEyes.org where we focus our efforts to inform and assist those who have poor outcomes.

Terri seems to be reading much more into my post than I actually wrote. I did not state, nor did I suggest, that you (or anyone) would have a perfect outcome if you just select a good surgeon. Even the very best surgeons have unexpected outcomes. I know because we have certified several of them. What carefully selecting a surgeon WILL do is put the odds of getting a good outcome a little bit more on the side of the patient.

The reason I have not had refractive surgery is because I’m a poor candidate, but the details of that are in the link above.

I too wish you the best of luck, Rebecca. Whatever you finally decide.

Glenn Hagele
Council for Refractive Surgery Quality Assurance
http://www.USAeyes.org
http://www.ComplicatedEyes.org

I am not a doctor.

Terri,
You are certainly allowed to comment on the bulletin board at any time. But perhaps saying "don't pay any attention...." is not the best comment - because one can easily just say "don't pay any attention to Terri".
Instead - you can certainly point out that LASIK is a real surgery that has real risks including poor quality of vision and even blindness. The percent of patients who have gone blind is very low, but there is always the risk of a serious complication.
As for the horror stories coming only from zealots - that is certainly not true. Surgeons of course discuss the serious complications that can occur with other surgeons at every refractive meeting, along with potential treatments. And surgeons also discuss the risks of surgery with each patient so that they know that refractive surgery has risks. Any person interested in LASIK can type in LASIK complications in any search engine and read medical reports of the complications that can occur with this procedure.
In general - one of the reasons why LASIK is so popular is because of the rapid visual recovery and because "most" patients do very well. I personally am concerned about issues with creation of the flap and long term issues of having a flap - so I personally recommend surface abltion (LASEK) to my patients. But even surface ablation procedures has risks of vision loss.
The key for any person is to try to determine whether the risks of a serious problem outweigh the benefits. This is very individual answer, as I have many friends and family members who are completely happy in their contact lenses and do not want surgery. I of course have other friends and family members that feel the benefits outweigh the risks - and they have had surgery to correct their vision.

In summary - my points are

1. Everyone is welcome to share their opinion
2. Everyone obviously has different perspectives on the issues of surgery.
3. LASIK has risks. LASEK has risks. The key is determining whether the benefits of surgery outweigh the risks for a particular individual.

Best of luck

Bill Trattler, MD
Miami, FL

I had Lasik done on 13th January 2004.

I came out being able to see 20/20 and am
considered a success. That 20/20 is blurry
and everyday my vision is blurry whether close
or faraway. Yes I can see without glasses but
the quality of that vision is not very good.

I did research Lasik quite a bit but for some
reason I've only found lots of negative stuff
after the surgery. I am not a zealot. I am both
happy and unhappy with my surgery.

I gambled and have taken the risk.

If I knew now what I would lose I wouldn't have
taken the risk.

There are a lot of people out there like me who
are considered a success but the loss of their
visual acuity has made for a not so great
outcome in their lives.

I'm trying to deal with my outcome as best as I
can. Teaching is not the best profession for
my eyes anymore. Maybe I'll need to have a
career change.

"If I knew now what I would lose I wouldn't have
taken the risk."

I wore glasses/contacts for 31 years and my vision is supposedly 20/20 now with Lasik, but the quality of it stinks. Yeah, I can read the letters on an eye chart to a Dr, but put me on the road and have me try to read road signs in an unfamiliary territory and I can't. But yet they call this "success".

Never had dry eyes in my life until Lasik. Wasn't even informed about it before the surgery---just was told I'd have to use eye drops for 4 days. Here I am--over 1 month with Lasik and am using drops constantly all day long, plus I have silicone plugs in my eyes. I also pay $100 a month for Restasis---the new and upcoming drop that Drs' push that takes at least a month to work. And it burns like heck to use them.

Just don't have the expectation that your vision will be like wearing your contacts or with glasses because the clearness/quality will probably not be the same.

I am still undecided as to whether I'm regretting this decision to have had it done. I was told I was being operated on by the best surgeon in the country, by the best place---they shuffled us threw like cows at milking time. My eyes were just a number to them. So don't let "famous" people push you into thinking you've picked the right place to go to. Talk to some of the people that have gone to places, and get their opinions first.

Good luck as to whatever you decide.

> So
>don't let "famous" people push you
>into thinking you've picked the right
>place to go to. Talk
>to some of the people that
>have gone to places, and get
>their opinions first.

T,

Great advice, That's how I chose my surgeon, by talking to people he operated on. Also, skill,etc.
I hope your eyes settle in to a good quality 20/20 soon.

Bulldog

I was told from a physician that most of the opthalmologists, the eye doctors who spent years in medical school and residency, actually do not undergo Lasik eye surgery themselves.

Is this true?

Lancia,

In the 1980's, when the only option for refractive surgery was radial keratotomy, I believe this was true--many ophthalmologists did not have it done themselves.

A couple of years ago, however, a survey was done on this topic, and they calculated that ophthalmologists were having LASIK at 4 times the rate of the general public (once they did the statistics). I've been to professional meetings where a significant percentage of doctors raise their hands when asked whether they've had LASIK or PRK.

I had LASIK done in 1998 on my eyes.

Dr. Furlong

Glenn - please tell me you are aware that the complication numbers that are out there are a complete joke? As I have stated previously I obtained my medical records over a year after my surgery and nowhere could I find the many complications I have complained about anywhere on them. As far as statistics are concerened I am on the "Sucess Story" side of them and that is unacceptable. It would also be ridiculous to assume that I am the only one that this has happened to.

There is a problem here. It seems to be acceptable to sacrifice a small number of people for the majority.

Matthew

I am not a doctor

I hope she reads other posts and realizes complications are possible and real. If she can deal with glasses, obviously its the way to go. It sucks to lose tolerance to RGP as they give the best possible vision. If shes not happy with soft contacts, she may not like the visual quality of lasik. I say go for glasses or maybe consider clear lens exchange IOLs

I have contacted the Intralase website twice regarding my problems and seeking answers. Both times I was completely ignored. That tells me that they are either overwhelmed by similar complaints or they just don't give a rat's *ss once they have your money. I doubt very seriously if there are any honest statistics kept in the lasik industry. I know there is no official rcord of my problems.

I have looked at lasik testimonals some surgeons keep on websites and many are 100% positive. Either the negetive ones get deleted, ignored or edited. The best way to voice your complain is make your own lasik diary or website and keep posting your story for others to hear

I am in the same boat. I am deciding now which direction to go, Lasik or PRK. I have worn RGP lenses for 20+ years. After having children, they just don't feel good anymore, and I hate glasses. I have -6.0 and -6.5 myopia with astigmatism. One doctor says my corneas are too thin for LASIK; one says they are just fine. The number is 524.

As far as complications, I KNOW there are complications. But, frankly, everyone I have spoken to that has had LASIK is thrilled. Seriously, I don't know anyone in real life who is unhappy. Sure, bad things can and do happen. But, there are risks in simply walking across the street.

Seriously, I don't know anyone in real life who is unhappy. Sure, bad things can and do happen. But, there are risks in simply walking across the street.

Just because they arent unhappy doesnt mean they didnt get compromised vision. Seeing you used to wear RGP contacts, you will be very picky due to the crisp vision RGPs gave you. I know this lady in real life who ended with 20/30 to 20/40 vision and impaired night vision but shes still happy. If your expectations are as low as hers, you have a good chance to be happy. If you MUST have 20/20, get used to glasses and stick with those

I am in the same boat. I am deciding now which direction to go, Lasik or PRK. I have worn RGP lenses for 20+ years. After having children, they just don't feel good anymore, and I hate glasses. I have -6.0 and -6.5 myopia with astigmatism. One doctor says my corneas are too thin for LASIK; one says they are just fine. The number is 524.

As far as complications, I KNOW there are complications. But, frankly, everyone I have spoken to that has had LASIK is thrilled. Seriously, I don't know anyone in real life who is unhappy. Sure, bad things can and do happen. But, there are risks in simply walking across the street.