You may have heard that negative news regarding LASIK was recently prominently reported in the United States.1 On this occasion, I took some time to browse the internet and try to explore the safety of LASIK from a patient’s perspective. It is interesting what one can learn. There are websites with statements such as, “Don’t trust the LASIK surgeon,” “LASIK complications are never reported,” and “LASIK is an unnecessary surgery.” One can also find horrific stories that, although sad, make no medical sense.
As a proud member of the ophthalmic community and Associate Chief Medical Editor of Cataract and Refractive Surgery Today Europe, I understand the effort, clarity, and valor that my colleagues put into their work every day. I also understand that, at the educational and collegiate levels, not only are positive and interesting findings addressed, but also complications and their management. It is unfortunate that, despite the plethora of information available today regarding laser refractive surgery, unreliable websites can portray a specific procedure as “dangerous” and portray surgeons as villains to people who do not have a full understanding of the procedure.
A great majority of surgeons around the world undoubtedly have a deep commitment to providing patients with full disclosure regarding the advantages and disadvantages of laser refractive surgery. LASIK has one of the best safety records in all of medicine, and it addresses a significant visual disability.
When one considers that most people who opt for laser refractive surgery are contact lens users, one has to address the risks and benefits of contact lens use as well, especially when LASIK is portrayed as dangerous. Peer-reviewed evidence has shown that contact lens use, although extremely safe, has a higher risk of serious complications in relation to infectious keratitis than laser refractive surgery at any given time.2 Considering the modern safety record of laser surgery, I have no doubt in my mind that, for a contact lens user, laser vision correction is a safer alternative. However, it is up to the individual patient to decide, assuming that he or she is well educated and well informed.
I believe that we have to show perseverance in the education of our patients and the public at large about the true benefits and potential risks of refractive surgery, specifically laser vision correction. It is unfortunate but true that many people view this procedure as a total solution for all eye health for the rest of their lives, so any ocular problem that occurs after the surgery, such as floaters, retinal tears, or retinal detachments, is attributed to the surgery.
The ophthalmic community should be aware of these issues and be sure that proper informed consent is obtained from patients for medicolegal purposes. I always explain to my patients that, as a physician, I view myself as an expert counselor on their side—not as a person who is trying to sell them something—and that I try to advise them of the best possible solution in their best interest. I do not hesitate to make full disclosure of all the potential complications of the proposed procedure, and, at the same time, I underline the efforts that our team makes to avoid these complications.
I believe that full disclosure, persistent attention to detail, and proper informed consent are invaluable assets to help ensure excellent health care for our patients and success for our ophthalmic community.
A. John Kanellopoulos, MD
Associate Chief Medical Editor
1. Rabin RC. Blurred Vision, Burning Eyes: This Is a Lasik Success? New York Times. June 11, 2018. https://www.nytimes.com/2018/06/11/well/lasik-complications-vision.html. Accessed March 5, 2019.
2. Masters J, Kocak M, Waite A. Risk for microbial keratitis: Comparative metaanalysis of contact lens wearers and post-laser in situ keratomileusis patients. J Cataract Refract Surg. 2017;43(1):67-73.