Are you a candidate for LASIK?


So, you’re thinking about LASIK or some other form of surgical vision correction – PRK, LASEK, etc. You owe it to yourself to do your homework, and considering the fact that you’re reading this article, we say, “You’re on the right track!” Everybody’s eyes are different, so let’s look at some hypothetical cases. Most answers apply to all forms of corneal refractive surgery. We’ll also examine common myths.

    • My prescription is not very bad. I’m just a little nearsighted. Am I a candidate?

We actually consider people with low myopia as poor candidates because you have the least to gain. Being slightly nearsighted is actually desirable after you reach your 40’s. If you decline LASIK, you won’t need reading glasses until much later in life, if at all (the more nearsighted you are, the longer you can avoid reading glasses). Reading glasses aren’t just for reading – without them you can’t even see your mobile phone! Don’t believe them when they say, “Everyone needs reading glasses after age 40 whether you have LASIK or not”. That’s simply not true. Many LASIK patients over age 40 have discovered that they simply traded one pair of glasses (distance) for another (reading).

    • I am moderately near-sighted or very near-sighted. Am I a candidate?

The more nearsighted you are, the more likely you are to regress, which means you may need more surgery (with greater risks), or you’ll be back in glasses after spending thousands of dollars for surgery that you thought would be permanent. Don’t fall for one of those “lifetime guarantees”. Repeat surgery on your eyes is not advisable! Also, the more nearsighted you are, the greater your risk for night vision problems and corneal ectasia. LASIK-induced ectasia is a serious, sight-threatening eye disease that may require corneal transplant.

    • I’ve heard it’s fast and painless.

LASIK is certainly fast when the procedure goes according to plan. However, not everyone has a pain-free experience. Anesthetic eye drops generally numb the pain during surgery, but not in every case. Corneal nerves are damaged during surgery, which leads to loss of corneal sensitivity for a period of time. These nerves slowly regenerate, but not completely and not in normal patterns. Some patients experience debilitating long-term nerve pain after surgery, for which pain medication is the only available treatment. While we’re discussing pain, we should mention that dry eyes, which are very common after corneal refractive surgery, can actually be a very painful condition.

    • LASIK must be safe because it’s approved by the FDA.

Many FDA-approved medical devices and drugs were later found to cause serious harm or even death and be recalled or withdrawn. Read the section about Dr. Morris Waxler to understand why the man who headed the FDA review of LASIK clinical trials now feels that the procedure should be banned.

    • I will save money in the long-term on glasses, contacts, and contact lens solutions.

While most people do save money on glasses and contacts for several years, others find that LASIK is the most costly medical expense of their lifetime. Read Does LASIK Save Money? Are you really prepared to take that chance?

    • Going to a top surgeon reduces the odds of having a problem.

Surgeon skill is important, but all surgeons encounter bad outcomes (whether they admit it or not). What’s more, there are adverse effects of LASIK in 100% of eyes treated, such as non-healing of the flap, permanent loss of corneal structural integrity, and problems with future cataract surgery and glaucoma screening. Dry eyes and night vision problems are commonly reported by LASIK patients, regardless of the surgeon’s experience. If a surgeon denies ever having a patient with a bad outcome, he’s likely going to dismiss your complaints if you have a problem.

    • I have large pupils, but the LASIK clinic staff said it’s not a problem with the latest wavefront technology.

This is absolutely false. Patients with large pupils are at much greater risk of night vision problems, even with the latest laser technology employing larger treatment zones. Depending on severity, night vision problems can be debilitating. The only solution is to wear hard-to-fit, expensive hard contact lenses.

    • No one has ever gone blind from LASIK.

Not true. While it has happened, it is extremely rare for someone to lose all light perception (total blindness) in an eye due to a complication from LASIK. Legal blindness has happened more times than they admit. Loss of “best corrected vision” – when a patient who was correctable with glasses to 20/20 can no longer be corrected to 20/20 – is more common. Is it really worth the risk?

    • I know several people who have had it, and they are all happy.

We did some research into patient satisfaction after LASIK and turned up some surprising facts. We found that patients experiencing side effects may still report satisfaction with their surgery. It turns out we aren’t the only ones scratching our heads. In 1994, Leo Maguire, M.D. wrote, “The [refractive surgery] literature contains disturbing examples of patients who have visual handicaps that place themselves and others at significant risk for nighttime driving accidents and yet they are happy with the results.” Perry Binder, M.D. published a case report in 2007 of a LASIK patient who developed corneal ectasia — a serious, sight-threatening complication — in both eyes, and yet the patient was satisfied with the surgery. In a 2005 report by Garamendi et al, the authors suggest that cognitive dissonance may play a role in this phenomenon. Cognitive dissonance is a change in one’s attitude or beliefs to eliminate internal conflict with negative consequences of an irreversible action. Although most patients are initially happy, the picture changes several years later as many patients find themselves back in glasses. Problems from LASIK may not present for years after seemingly successful surgery. The majority of LASIK-injuries reported to the FDA are reported several years after surgery.

    • In a worst-case scenario, I can just go back to wearing glasses or contacts.

This is a common misperception. Glasses and soft contact lenses cannot correct vision problems caused by LASIK. Hard lenses are often required, which vault over the irregular corneal surface. In a worst-case scenario, a corneal transplant may be necessary; however, the patient may still face a poor visual result.

    • I heard that you can go blind from wearing contacts, and that LASIK is safer.

This is a myth that began with a letter from three biased LASIK surgeons, Mathers et al, to the editor of the journal Archives of Ophthalmology in 2008. In the letter, Mathers and colleagues draw some bizarre conclusions about the safety of contact lenses vs. the safety of LASIK based on a couple of published articles of eye infections from contact lenses and LASIK. You’ve heard the phrase, “Lies, damned lies, and statistics”… The logic of Mathers and colleagues is so ridiculous that even other ophthalmologists have scoffed at it. But it does make a really good marketing soundbite, and so it has been widely adopted by LASIK surgeons seeking to scare patients into having LASIK. The bottom line is this: If you follow proper lens hygiene and don’t sleep in your lenses, contacts may be worn safely for a lifetime. LASIK, on the other hand, leads to permanent adverse effects in 100% of eyes treated and carries significant risk. (Note: In 2009, Mathers co-authored a LASIK vs. contact lenses “decision analysis” based on a literature review, which again failed to make the case that LASIK is safer than contact lenses.)

    • My eye doctor said that complications are a thing of the past with newer laser technologies.

Not true. It is well-documented that problems after LASIK, such as night vision difficulties and dry eyes, occur frequently after LASIK, even with the latest custom wavefront and bladeless LASIK technologies. Inherent adverse effects of the surgery include non-healing of the flap, permanent loss of corneal structural integrity, problems with future cataract surgery and glaucoma screening, and reduced and disordered corneal nerves. LASIK is surgery. Would you consent to surgery on any other healthy organ in your body?

Consider that 1) your eyes are your most vital sensory organ, 2) problems from LASIK may present years after the surgery, and 3) LASIK is unnecessary. In hindsight, those of us who had the surgery ask ourselves how we could have been duped by the slick advertising into risking our eyesight!

    • I read on the surgeon’s website that everybody needs reading glasses after age 40.

The truth is, if you are nearsighted and decline to have LASIK, you can delay or avoid the need for reading glasses after age 40. A nearsighted individual can simply remove his or her glasses to read. Some LASIK patients are very unhappy to discover this truth after surgery, especially those who spend a lot of time reading or working on the computer. Imagine having to find your reading glasses every time you receive a text message or need to make a phone call! Don’t have LASIK, and you’ll preserve your near vision.

    • Glasses are unattractive and get in the way, and contacts are a hassle.

Since LASIK does not eliminate the need for reading glasses after the age of 40 and studies show that visual outcomes of LASIK decline over time, LASIK patients will likely end up back in glasses – sometimes sooner rather than later. If you have an undesirable outcome, you may find that glasses no longer correct your vision to pre-LASIK clarity. Many LASIK patients are now dependent on hard contact lenses to restore visual clarity, and they would say that the hassle of glasses and contact is nothing compared to living with LASIK complications. Besides, newer contact lens materials are more comfortable, and glasses can be fun and stylish. If you hate your glasses, it’s time for a new pair!

    • 95% of LASIK patients are satisfied, so it must be a safe procedure.

You might be surprised to learn the facts about this deceptive marketing sound bite. LASIK surgeons are notorious for hiding important facts that don’t paint LASIK in a favorable light. Read The Truth Behind LASIK Satisfaction

    • I can’t tolerate contact lenses.

This is a serious contra-indication for refractive surgery. If you can’t tolerate contact lenses for long periods of time, its an indication of dry eye problems. You really should avoid laser eye surgery at all costs.

    • I am excited about not needing to wear glasses again, I can’t wait for the freedom!

We understand how you feel, we have been there, and we know that feeling. So let’s clear this up, you think you won’t experience problems because you are a perfect candidate, and you are going to a great surgeon and having the newest technology used on your eyes. Every person we have come across who has had problems (and it’s a lot), was told they were the perfect candidate, including us. Many of their surgeries was performed with the latest Wavefront technology, with a highly experienced surgeon. It was not a good outcome. Also, there is a very high (if not certain) chance you will regress back to needing glasses. It’s not a permanent change in refraction, but a permanent and negative change in the stability of your cornea, and your dim light vision.

    • I can’t believe that so many people have had this procedure, and you claim for it to be a medical cover up!?

Please read Dr. Morris Waxlers petition in detail, and the personal stories FDA Adverse Events.

    • If i have a bad outcome, the problems can be fixed, or it will get better naturally.

Refractive surgery works because your CORNEAS DO NOT HEAL. The laser re-shapes the cornea, the very fact that this is how laser eye surgery works, should show you that the cornea has very limiting healing ability.

    • If the clinic tell me i’m a good candidate for surgery, then the risk is very low.

Many of us were told we were good, even perfect candidates for surgery. The truth is that the evaluation / assessment is a sales pitch. Even coming from medical professionals, and of course you would never expect them to put money above the welfare of another human being, but that is not the case. Also even the best surgeons make mistakes, and that the long term safety is completely unknown. Remember its your eyes, a vital organ in your body. Ask yourself, could you live your life happily without your eye sight? If there is even a fractional risk, that means it could happen to you. If you believe it could happen to you, then laser eye surgery is not for you.

    • I’m a bit of a perfectionist / I value my vision.

You really are not a good candidate!