I’m currently doing some research on LASIK (Laser-Assisted In Situ Keratomileusis) surgeries, and this includes related procedures too.
I’d love to know from any readers who have done such surgeries, so please leave a comment below or contact me via email. I’d really appreciate your thoughts as I am considering having this procedure done myself.
The post serves as a handy place for me to record the research I’ve done so far.
There are millions of people who have been treated over the past 25 years or so that the technique has been in use to correct myopic vision (and similar conditions).
I’ve used lenses since I was 16 and by and large, am fine wearing them. The only major discomforts are the wintertime when it’s dry and windy, as my eyes feel dry very easily in those conditions. And of course, you’re always aware that your ability to function is wholly dependent on these delicate items you have in your eyes. I’ve never had any accidents with lenses, but still, the sense of dependence on them is not great. I know that without my lenses or glasses I would not be able to perform any of my daily activities, and I don’t like that feeling. From that perspective, surgery like Lasik would indeed be life-changing, and that is what I keep reading on forums and other outlets from people who had successful outcomes.
Now that I have kids, I also have much closer contact with them (hugging, playing etc) and glasses are a major nuisance in those situations. I also feel psychologically much better without glasses, but there are situations where they don’t perform as well as having good vision, for example while working at a computer.
Types of Refractive Laser Surgery
SMILE, LASIK, LASEK, and PRK are all refractive surgical procedures that use laser technology to correct vision problems such as nearsightedness, farsightedness, and astigmatism. Here’s a brief overview of each procedure:
- SMILE (Small Incision Lenticule Extraction): This is a minimally invasive procedure that uses a laser to create a small lenticule, or disc of corneal tissue, which is then removed through a small incision. The remaining cornea is reshaped, improving vision.
- LASIK (Laser-Assisted In Situ Keratomileusis): This is the most common refractive surgical procedure. During LASIK, a laser is used to create a corneal flap, which is then lifted to allow the underlying corneal tissue to be reshaped with the laser. The corneal flap is then repositioned over the reshaped tissue.
- LASEK (Laser-Assisted Subepithelial Keratectomy): Similar to LASIK, LASEK involves reshaping the cornea using a laser, but instead of creating a corneal flap, the top layer of the cornea, called the epithelium, is removed and then replaced after the laser treatment.
- PRK (Photorefractive Keratectomy): This is an older refractive surgical procedure that involves removing the top layer of the cornea and then reshaping the underlying corneal tissue with a laser. Unlike LASIK and LASEK, PRK does not involve the creation of a corneal flap.
Each procedure has its own advantages and disadvantages, and the best choice depends on the patient’s individual needs and anatomy.
While I’ve always heard that it is a fairly safe procedure, I also know that many optometrists and ophthalmologists don’t take undergo the surgery themselves, so I wanted to really dig a bit deeper to find out what the risks are and how many people are affected.
What I uncovered is that pretty much every country has its own associations of people who have come forward to share that they have had issues after undergoing the surgeries (see the one in Spain, or the one in the USA), some of them having quite horrific side effects, and some even being driven into depression and suicide. I feel deeply for people who have tried to improve their lives through surgery, only to bring on themselves a heap of misery. I’ve gone through similar experiences myself and I totally understand the despair and regret that can eat you from the inside in such situations.
The websites of such associations are a good place to start, however, they are not the best place to obtain a balanced opinion on the subject. Reading through such websites will inevitably leave you depressed and doubtful about the surgery. You can find such websites about many other types of surgeries, and I’ve even encountered several websites
Now I’ve seen many dubious clinics offering refractive surgeries here in Spain, and with those, you’re really asking for trouble. They usually don’t have the latest machinery and you might get operated on by someone who has only been recently trained.
Sure, they might have a special offer in place, or just be significantly cheaper than other centers, but do you really wanted to be cheap when it’s your eyesight you’re gambling?
The lack of experience comes into play in the pre-operative consultancy phase. A good surgeon will be able to identify which patients he should operate and which don’t meet the pre-requisites for LASIK and should be directed to other methods of vision correction, or even dissuaded from doing any surgery. Unfortunately, some don’t have the experience needed to make these judgment calls, while others are just happy to operate on even those that are obvious 50/50 cases if it means pocketing a few more thousand euros.
So far, from my research, it definitely seems like this is a surgery that has risks, like any other surgery. These risks are compounded by the fact that the eyes are some of the most sensitive parts of the body, and are deemed absolutely essential to one’s quality of life.
I find it very believable when patients say that they have not been given full information before undergoing procedures. I’ve been to many doctors in my life and had my fair share of serious surgeries, and it’s a rare case when you find a doctor that really walks you through what they will actually to do to you, why, and also go through the possible side effects. The latter is the point most doctors ignore, in my opinion. Regulation is not always a good thing.
According to a 2009 study that the FDA conducted to understand the potential risks of severe problems that can result from LASIK, up to 46% of patients reported at least one visual symptom (like glare or blurred vision) at three months post-surgery. Up to 28% of patients reported dry eye symptoms, and less than 1% experienced “a lot of difficulty” with or inability to do usual activities because of side effects from their surgery.
There’s also a risk of infection after laser eye surgery. One recent study shows that this risk is somewhere between 1 in 15,000 and 1 in 30,000. The risk of infection from contact lenses, by comparison, is about 1 in 400. About 2% of people who undergo these procedures may require a second procedure.
On the other hand, according to the American Academy of Ophthalmology, 90% of LASIK patients see their vision improve to somewhere between 20/20 and 20/40.
The most vocal anti-LASIK doctor worldwide is Morris Waxler, although he ends up jeopardising his position through obvious conflict of interest, given that he runs a clinic aimed squarely at helping those who claim to have been injured by LASIK procedures. His claim to fame is that he was on the FDA committee that approved the procedure in 1996, and is now calling for it to be banned.
At the end of the day, like many other things in life, it’s a question of risk. If you’re happy wearing glasses and lenses, and have a small amount of myopia, I see no reason to risk it.
On the other hand, if your level of myopia is such that you are 100% dependent on having a pair of glasses around or using lenses, plus you have a problem wearing either of those and the condition is affecting your enjoyment of life (sport can be a pain with lenses or glasses, for example), then you are more than justified in seeking a solution like LASIK.
Lasik is generally a safe procedure, but like any surgery, there are some risks involved, including:
- Dry eyes: temporary or long-lasting dryness of the eyes, which can cause discomfort and visual problems.
- Glare, halos, and double vision: these visual symptoms can occur after lasik and affect nighttime vision.
- Corneal ectasia: this is a rare but serious condition in which the cornea bulges out and becomes thin after lasik.
- Regression: this occurs when the eye resumes its original shape, causing a loss of visual acuity and a need for additional surgical intervention.
- Starbursts around lights: this is a visual symptom in which lights appear as starbursts and can be caused by the laser reshaping of the cornea.
- Over or under correction: the laser may not remove enough or too much corneal tissue, leading to a need for additional surgical procedures.
- Flap complications: the corneal flap created during lasik can become dislodged, displaced or wrinkled, causing vision problems.
If you’re in Barcelona, the top expert seems to be Dr. Jose Luis Guell, who is a co-founder of IMO, one of the best eye clinics in Barcelona.
The best clinics in Barcelona seem to be:
- Clinica Baviera
In Malta, the best clinic is St James.
I’ve been to one of the more well-known clinics (not IMO) in Barcelona for a study that would determine whether I would be a candidate for Lasik or other similar surgeries. The equipment and clinic were top notch and I was treated very well, however, I got a distinct impression that this was a mass-production system, and I only got a few minutes with the doctor at the end of my two-hour session, where all he said was that I am a good candidate and there would be no problems.
This was followed by a lengthier session with the customer care lady who did the sales talk and assured me how safe it was, how life-changing, etc. I found this last part of the study to be the one that really put me off. I don’t want to discuss anything with a customer care person, I want the doctor to fully explain the risks and evaluate with me whether this is the right choice for my lifestyle and even current life conditions. I’d be ready to pay as much as needed for the doctor’s time, but sadly the whole system seems to be set up to very efficiently pass through a number of patients through the process every day with no further thought to it.
A friend of mine did the same study at another of the top clinics and came out with exactly the same impression.
- What technique is best suitable for me and why? What about the newer Smile technique vs Lasik?
- I have a big fear/reflex of anyone holding my eyes open and putting drops in, will this be a problem?
- Is there any test to determine whether I have dry eyes and whether this could be an issue that would make me not a good candidate for the operation?
- Which are the best machines for LASIK and does the center have them?
- What side effects or potential complications should I be wary of and when should I be worried about them?
- Will the treatment last forever?