Top Ten Reasons Not to Have LASIK Surgery

This list is not approved by Dr. Stephen Updegraff of Updegraff Vision.

Reprinted with permission. Source

1. LASIK causes dry eye
Dry eye is the most common complication of LASIK. Corneal nerves that are responsible for tear production are severed when the flap is cut. Medical studies have shown that these severed nerves never return to normal densities and patterns. Symptoms of dry eye include pain, burning, foreign body sensation, and eyelid sticking to the eyeball. The FDA website warns that LASIK-induced dry eye may be permanent. Approximately 20% of patients in FDA clinical trials experienced “worse” or “significantly worse” dry eyes at six months after LASIK.(1)

2. LASIK results in loss of visual quality
LASIK patients have more difficulty seeing detail in dim light (loss of contrast sensitivity) and experience an increase in visual distortion at night (multiple images, halos, and starbursts). A published review of data for all FDA-approved lasers showed that six months after LASIK, 17.5 percent of patients reported halos, 19.7 percent reported glare (starbursts), 19.3 percent had night-driving problems and 21 percent complained of eye dryness.(1)  The FDA website warns that patients with large pupils may suffer from debilitating visual symptoms at night.

3. The cornea is incapable of complete wound healing after LASIK
Researchers found that the flap heals to only 2.4% of normal tensile strength.(2) LASIK flaps can be surgically lifted or accidentally dislodged for the remainder of a patient’s life. The FDA website warns that patients who participate in contact sports are not good candidates for LASIK.

Collagen bands of the cornea provide its form and strength. LASIK severs these collagen bands and thins the cornea, resulting in permanent weakening.(3) The thinner, weaker post-LASIK cornea is more susceptible to forward bulging due to normal intraocular pressure, which may progress to a condition known as keratectasia and corneal failure, requiring corneal transplant.

4. The true rate of LASIK complications is unknown
There is no clearinghouse for reporting of LASIK complications. Moreover, there is no consensus among LASIK surgeons on the definition of a complication. The FDA allowed laser manufacturers to hide complications reported by LASIK patients in clinical trials by classifying dry eyes and night vision impairment as “symptoms” instead of complications.(1)

5. LASIK results in loss of near vision
Nearsighted patients who do not have LASIK retain the ability to see up close naturally after the age of 40 simply by removing their glasses. LASIK patients over the age of 40 may discover they have traded one pair of glasses for another.

6. There are long-term negative consequences of LASIK
LASIK affects the accuracy of intraocular pressure measurements,(4) exposing patients to risk of vision loss from undiagnosed glaucoma.

Like the general population, LASIK patients will develop cataracts. Calculation of intraocular lens power for cataract surgery is inaccurate after LASIK.(5) This may result in poor vision following cataract surgery and exposes patients to increased risk of repeat surgeries. Ironically, steroid drops routinely prescribed after LASIK may hasten the onset of cataracts. (Read how Dr. Stephen Updegraff, MD treats post-LASIK patients who return for cataract surgery: Link)

Research demonstrates persistent decrease in corneal keratocyte density after LASIK.(6) These cells are vital to the function of the cornea.  Ophthalmologists have speculated that this loss might lead to delayed post-LASIK ectasia.

7. Bilateral simultaneous LASIK is not in patients’ best interest
In a 2003 survey of American Society of Cataract and Refractive Surgery (ASCRS) members, 91% of surgeons who responded did not offer patients the choice of having one eye done at a time. Performing LASIK on both eyes in the same day places patients at risk of vision loss in both eyes, and denies patients informed consent for the second eye. The FDA website warns that having LASIK on both eyes at the same time is riskier than having two separate surgeries.

8. Serious complications may emerge later
The medical literature is filled with reports of late onset LASIK complications such as loss of the cornea due to biomechanical instability, vision-threatening infection, inflammation resulting in corneal haze, flap dislocation, and retinal detachment.(7) Complications may emerge weeks, months, or years after seemingly successful LASIK.

9. Rehabilitation options after LASIK are limited
LASIK is irreversible, and treatment options for complications are extremely limited. Hard contact lenses may provide visual improvement if the patient can obtain a good fit and tolerate lenses. The post-LASIK contact lens fitting process can be time consuming, costly and ultimately unsuccessful. Many patients eventually give up on hard contacts and struggle to function with impaired vision. In extreme cases, a corneal transplant is the last resort and does not always result in improved vision.

10. Safer alternatives to LASIK exist
Some leading surgeons have already abandoned LASIK for surface treatments, such as PRK, which do not involve cutting a corneal flap. It is important to remember that LASIK is elective surgery. There is no sound medical reason to risk vision loss from unnecessary surgery. Glasses and contact lenses are the safest alternatives.

1. Bailey MD, Zadnik K. Outcomes of LASIK for myopia with FDA-approved lasers. Cornea. 2007 Apr;26(3):246-54.

2. Schmack I, Dawson DG, McCarey BE, Waring GO 3rd, Grossniklaus HE, Edelhauser HF. Cohesive tensile strength of human LASIK wounds with histologic, ultrastructural, and clinical correlations. J Refract Surg. 2005 Sep-Oct;21(5):433-45.

3. Jaycock PD, Lobo L, Ibrahim J, Tyrer J, Marshall J. Interferometric technique to measure biomechanical changes in the cornea induced by refractive surgery. J Cataract Refract Surg. 2005 Jan;31(1):175-84.

4. Cheng AC, Fan D, Tang E, Lam DS. Effect of Corneal Curvature and Corneal Thickness on the Assessment of Intraocular Pressure Using Noncontact Tonometry in Patients After Myopic LASIK Surgery. Cornea. 2006 Jan;25(1):26-28.

5. Wang L, Booth MA, Koch DD. Comparison of intraocular lens power calculation methods in eyes that have undergone laser-assisted in-situ keratomileusis. Trans Am Ophthalmol Soc. 2004;102:189-96.

6. Erie JC, Patel SV, McLaren JW, Hodge DO, Bourne WM. Corneal keratocyte deficits after photorefractive keratectomy and laser in situ keratomileusis. Am J Ophthalmol. 2006 May;141(5):799-809.

7. MEDLINE database of citations and abstracts of biomedical research articles. Go to PubMed

Whether you have LASIK at Updegraff Vision or anywhere else, LASIK carries serious risks and results in long-term adverse effects.

If you are considering LASIK, I suggest you print this page and take it with you to discuss with Dr. Stephen Updegraff of Updegraff Vision.