Monday, September 11, 2017

12 Things You Should Know If You Are Considering Lasik Eye Surgery that Lasik surgeons probably won’t tell you

Your chances of a bad outcome with Lasik are 1-in-5. Those are great odds at a casino roulette wheel, but before you take that sort of risk with the future of your eyes, you really need to do your homework.

I prepared this report for two reasons. First, after Lasik eye surgery 5 years ago left me with double vision, impaired visual acuity, and chronic eye pain and fatigue, I discovered that bad Lasik outcomes are far more common than the Lasik industry says they are, and that I was one of thousands of people for whom getting Lasik was the worst mistake ever made. While most people are reasonably happy with their outcomes, it is nowhere near the 99% rate claimed by the Lasik industry.

Furthermore, no one knows what the very long-term complications will be, though there are early indications that people who get Lasik at a young age might experience serious problems with dry eye disease and other ocular problems at a higher rate as they get older. Second, the more I looked into it the more I discovered that many Lasik surgeons (including those at the clinic where my Lasik was done) behave in ways that violate fundamental principles of medical ethics, largely due to a financial conflict of interest that places profit ahead of patient welfare. Even a cursory web search reveals literally hundreds of Lasik casualties accusing surgeons of unethical, incompetent, and negligent behavior both before and after the surgery. For these reasons, I feel an obligation to share the information in this report, and in the 12 videos that I’ve posted to YouTube, links to which are included at the end of this report.

12 Things You Should Know If You Are Considering Lasik Eye Surgery

1. Lasik is not the fail-safe procedure the industry claims it to be. Life-diminishing complications happen much more frequently than Lasik surgeons will admit. For an overview of what can go wrong, watch this testimony by Dr. Lauranell Burch at the 2008 FDA hearing. Anyone contemplating Lasik should also watch videos of others testifying at the 2008 FDA hearing on Lasik at this link. There is a summary of testimony given at the FDA’s hearing from the industry publication Cataract and Refractive Surgery. Other resources for information about the risks of Lasik are posted at LasikFDA and Lasik Complications. Whether or not to get Lasik is one of the most important decisions you will ever make – do as much research as you can before agreeing to the surgery to make sure it doesn’t also become the biggest mistake you ever make.

2. Dr. Morris Waxler, who as Food and Drug Administration (FDA) Chief of Diagnostic and Surgical Devices Branch was responsible for approving Lasik in 1996-8, is now leading the campaign to outlaw the procedure. He has filed a petition charging the Lasik industry with having submitted deceptive data in order to gain approval; with continuing to cover up bad outcomes by failing to report them to the FDA (which they are legally required to do); and with settling lawsuits for the most catastrophic outcomes out-of-court so they never come into the public eye. Anyone considering Lasik should carefully read Waxler’s FDA petition and discuss it with the surgeon before the operation takes place. Waxler’s petition can be viewed at this link. This brief excerpt summarizes the arguments made in that petition:

“Published scientific data shows LASIK devices induce an average adverse event rate of about 22% that persists beyond six months to five or more years. Moreover, the published data (Section B) shows that LASIK devices transform healthy corneas into sick corneas… LASIK manufacturers and their collaborators [i.e. Lasik surgeons] made and are making false statements to FDA [in order to gain and keep approval of the procedure].”

Note: Doctors have an ethical duty to make sure patients are fully informed of the risks of any surgery. If the Lasik surgeon you’re considering does not encourage you to read Dr. Waxler’s petition so that the two of you can have an honest discussion about what it says, you really must question whether he or she is motivated by your welfare or your wallet. As I explain in one of my YouTube videos (links below), whether or not a Lasik surgeon brings this up without your prompting is the acid test of his or her integrity as a professional.

3. More than 600 people – mostly victims of bad Lasik outcomes – have signed an online petition supporting Dr. Waxler’s initiative. The most common theme among these Lasik casualties is some variation of “Lasik ruined my life.” In at least three cases that was literally true, because the petition was signed by a relative of someone who had committed suicide following a catastrophic Lasik outcome. If you are considering Lasik, you should read through the posted comments and ask yourself these questions:

    If Lasik is as safe as the industry says it is, why are so many people reporting such horrible outcomes?
    How well would you personally adjust if you were one of the misfortunate ones for whom Lasik was a life-diminishing catastrophe?

Read comments by these 600+ Lasik casualties at this link. There are also dozens of websites, blogs, and YouTube videos posted by victims of Lasik disasters (something you don’t see with almost any other form of surgery). Anyone considering this high-risk procedure should do an extensive search on Lasik complications. Pick out ten or so and go over them with the surgeon; ask what guarantee you have that those things won’t happen to you.

4. Ray Tsai, M.D., who was the leading Lasik surgeon in Taiwan, recently announced he would no longer do the procedure because he is seeing people developing serious complications 8-10 years after having had it done. According to the China Times, “Tsai said that many patients receiving Lasik surgery have suffered significant losses in eyesight 10 years after the surgery, suggesting that the surgery led to keratitis, inflammation of the cornea.” Tsai said it was a matter of medical ethics that he stop performing the procedure. But rather than immediately launching a retrospective study of patients who’d had Lasik performed ten or more years ago, which would have been both the ethical and medically correct thing to do, Lasik surgeons circled the wagons and have tried to label this doctor as a misguided alarmist, and to encourage potential Lasik customers to believe the fallacy that the procedure is perfectly safe.

5. Lasik-Induced Dry Eye Disease (LIDED) is far more prevalent and in many cases far more painful and long-lasting than Lasik surgeons admit (I speak from personal experience in saying that LIDED can make reading, working at a computer, riding a bike, and a whole lot of other once pleasurable activities become physically miserable). Before the advent of Lasik less than 20 years ago, the eye drop section of a department or grocery store was several bottles of Visine; today it’s an entire bank of shelves of different brands and varieties, some of which are marketed specifically to people who are suffering from painful dry eyes caused by Lasik. Lasik-Induced Dry Eye Disease has been a goldmine for the makers of the prescription eye drop Restasis, which is widely prescribed by Lasik surgeons for LIDED. Unfortunately, Restasis does not work for many people. It is also quite expensive.

Special note for people with allergies: LIDED will make hay fever season even more miserable.

6. The most common emotional downside of a bad Lasik outcome is depression. The problem is eloquently summarized at the Lasik Memorial website: “When [Lasik] complications occur, your life splits in two. There is the person you were before LASIK, and the person you are now... the person whose dry eyes hurt all the time, the person who sees multiple images of everything, who can’t drive at night, who can’t fulfill his or her responsibilities as a parent, or his or her potential as a human being, the person who suffers from PTSD, depression, and various states of dread about the future.” Dr. Roger Davis has written about what he calls “Refractive Surgery Shock Syndrome.” Anyone considering Lasik should watch the 5-minute video of his testimony and read through his slide presentation (the slides are intellectually challenging, but this is about the future of your eyes, so it’s a worthwhile investment of time).

I’ve personally spoken with dozens of Lasik casualties and – without exception – every single one of them talks about being depressed. The most depressing consequence of my own Lasik misfortune has been prolonged sleep deprivation. Chronically sore and strained eyes make it tough to get to sleep, and I have to get up several times during the night to put in eye drops (it’s also the first thing I do before I get out of bed).

At its worst, Lasik-induced depression results in suicidal thinking (watch this video of testimony by the father of Colin Dorrian, a young man who committed suicide after suffering a Lasik disaster). As Colin said in his suicide note, nobody who has not had their eyes mangled by Lasik can really understand the depth of depression that constant eye pain and blurred vision can cause. (There is more on Lasik-related suicides at this page on the Lasik Complications website). At a refractive surgeons’ conference, three Lasik surgeons actually put on a short skit making fun of Lasik-related suicide victims. You can view the video at this link (begin at the 44- second point) – it will tell you a lot about the mindset of those Lasik surgeons who put profits ahead of people.

7. Young people who get Lasik are literally guinea pigs in a massive medical experiment. Because Lasik is relatively new (it has become commonplace only in the past 15 years), nobody knows the long-term health effects. Will people who get Lasik in their twenties have more trouble with dry eye disease, night blindness, or other Lasik complications as they age? Nobody knows! If the experience of Dr. Tsai is an indicator, there is a real possibility that over the next several decades we will see an epidemic of serious eye problems in people who had Lasik when they were young. Unfortunately, because the Lasik industry has refused to compile and analyze data on long-term clinical outcomes, this is a medical experiment that will only be resolved when a sufficient number of Lasik disasters are reported in the media. While the minimum age for getting Lasik is currently accepted to be 21 years old, some Lasik surgeons are pressing to be able to operate on the eyes of teenagers, equating Lasik to having braces. This is the Lasik Nightmare Scenario: a generation of people who had Lasik at a young age end up being miserable in their “golden years” because of chronic dry eye disease, eye pain, loss of vision, and other delayed Lasik complications.

8. Many Lasik complications are specific to your job, career, and avocational interests. If your work entails extensive time at a computer or lots of reading, driving at night, or up-close work that requires an eye for fine detail, you have special risks involved with Lasik surgery. Likewise, if your outdoor passions involve lots of sun and wind, you need to be aware of the special risks that Lasik-Induced Dry Eye Disease could cause to your ability to enjoy your hobbies. If the Lasik surgeon does not ask about your work and your hobbies, and does not discuss the potential complications in the context of your lifestyle and livelihood, but only gives you a generic warning, then it is not possible for that surgeon to have gotten from you a fully informed consent – which is a violation of medical ethics and law.

9. The economics of Lasik work to the disadvantage of the patient. Most Lasik surgeons have a financial conflict of interest. They get paid for doing Lasik surgery, and are under enormous pressure to do enough cases to pay their bills and maintain their incomes (which are often the highest of any doctors in their communities). Because so many Lasik clinics (and Lasik mills) have sprung up since the procedure was approved, competitive pressure has forced the price of Lasik to fall dramatically while their costs for technology, staff, and office overhead have continued to increased. The typical Lasik surgeon now has to do at least twice as many procedures to bring in the same amount of revenue. Because there is so much competition for patients, they are also pressured to spend large amounts on advertising, all of which must be made up for by convincing more people to have the surgery. Someone helping me with my Lasik website estimates that the Wolfe Eye Clinic – where my surgery was done – spends more than $75,000 on Google ads alone.

10. As a potential Lasik customer, you have no way of evaluating the competence of the surgeon to whom you are about to entrust your future eyesight. No one is collecting, much less reporting, outcomes data on Lasik procedures. While you can go online and check surgical outcomes data for procedures performed in a hospital, you have no way of knowing how many of your prospective surgeon’s patients ended up with LIDED, poor nighttime vision, chronic eye pain, or other problems. In most cases the surgeon doesn’t even know. If a Lasik surgeon tells you he or she has a near-perfect success record, ask to see the data proving it.

While many Lasik surgeons will privately acknowledge that there are unethical Lasik mills and incompetent Lasik surgeons, not one will publicly speak out about them, and the medical profession as a whole has done nothing to discipline these rogue surgeons. That makes Lasik the ultimate “let the buyer beware” procedure in medicine. In a personal telephone conversation, the producer of this TV expose of deceptive Lasik clinic practices told me that he’d never seen anything like the way the Lasik industry is “circling the wagons” to protect dishonest and incompetent Lasik surgeons

11. If you do end up with a bad outcome, chances are that it will be permanent, irreversible, and untreatable. Other than prescribing more surgery, more eye drops, and “giving it time,” Lasik surgeons cannot help people cope with Lasik-Induced Dry Eye Disease, impaired nighttime vision, chronic eye pain, or the other life-diminishing consequences of Lasik gone bad. Dr. Ed Boshnik of Miami, Florida is one of a very few clinicians who specialize in the tedious, frustrating, and all-too-often unsuccessful work of helping the victim of a Lasik disaster cope with the physical and emotional damage. His website describes the serious dangers of Lasik, and includes these comments:

Over the years I’ve had the misfortune of examining hundreds of patients who have lost quality vision and suffered severe depression as a result of Lasik surgery... The known risks and complications of Lasik surgery include severely distorted corneas causing loss of best corrected visual acuity, vision distortions known as higher order aberrations, under correction and over correction of the patient’s vision error, nighttime vision disorders including halos, starbursts, glare, ghosting and double vision. Other risk factors also include infection, corneal ectasia (a gradual protrusion of the corneal surface), severe dry eye and loss of contrast sensitivity (the ability of distinguish between different shades of white and grey)... Because a large part of my ophthalmic practice involves restoring vision to those who have experienced varying degrees of vision loss from LASIK, my advice is not to get involved with this procedure.

12. If you wait a few years before getting Lasik, one of two things will have happened: the procedure will have been outlawed because the FDA concluded that the dangers of an adverse outcome really are unacceptably high, or Lasik technology will have improved or been replaced by a newer technology that it is safer than what is being used today. If you get Lasik now and have a bad outcome, you could well be stuck with the consequences for the rest of your life. Dr. Waxler and other objective observers put the odds of a bad outcome at one-in-five. Those are great odds at the roulette wheel, but are you willing to take them with your precious eyes?