You'd never know it from the advertising hype and what surgeons are saying to prospective patients, but behind the scenes, surgeons have serious concerns about the safety of LASIK... from dry eyes, and biomechanical weakness of the cornea, to non-healing of the flap, night vision impairment, long-term issues and others.
Read quotes from articles:
Ophthalmology Management, September 2004
"In interview after interview, surgeons mentioned serious flap complications as the main reason they've either stopped performing LASIK or are seeking less invasive alternatives."We've all had to deal with flap complications. The danger is small, but real," says Marguerite McDonald, M.D., clinical professor of ophthalmology at the Tulane University School of Medicine. "LASIK is a high-stress procedure for surgeons. It's been proven by Dr. Ramon Naranjo-Tackman of Mexico that surgeons' heart rates go way up during the cutting of the flap, and the incidence of PVCs, PAT and short runs of ventricular tachycardia go up as well."
"Once we can improve surface ablation to the point at which patients can wake up the next morning and go to work -- and we're just about there with epi-LASIK -- it will be the procedure of choice," asserts Dr. Soloway. "I'm not sure who would need LASIK then, with its problems of dryness, flap complications, ectasia, and the severing of nerves on the cornea."
"The LASIK flap has always introduced distortion into the
postoperative wavefront, and although those effects are often small,
they can be very significant. Wavefront-guided treatments are likely to move surgeons away from LASIK."
Ophthalmology Management, November 2004
"Dr. Soloway discusses the advantages of not using a microkeratome blade or alcohol. "Ultimately, the surface procedure is safer simply because we are not cutting the flap and whatever kind of biomechanical problems that can occur with that." He adds that an additional option will help patients who have special needs. For example, patients who might be at greater risk of developing dry eye would be good candidates for epi-LASIK due to the procedure's less invasive technique."
ESCRS EuroTimes, January 2005
"… combining wavefront sensing with PRK gives patients an excellent quality of vision while avoiding the potential flap and hinge related complications of LASIK procedures”.“The early results thus far have been very encouraging. With wavefront-guided PRK, the clinical outcomes are excellent and there does not appear to be safety concerns”.“Wavefront-and topography-guided PRK seems a valuable tool to correct myopia and compound myopic astigmatism. It could be an alternative to LASIK, especially when dealing with thin corneas and it avoids the risk of flap-induced aberrations”… “I think that there are several clear advantages of surface ablation: there is no concern about flap striae or displacement, no risk of microkeratome-related complications and there is the potential for improved quality of vision with such procedures..."
The article was originally posted at this link which is no longer active: http://www.escrs.com/Publications/Eurotimes/05january/pdf/wavefront.Pdf
Ophthalmology Management, March, 2005
"Surgeons have produced consistently good outcomes using
microkeratomes, but they note that cutting the flap with a
microkeratome is the part of the procedure that presents the greatest potential for serious complications. Though the danger is small, it is real, and surgeons who've been attached to heart monitors during the surgery have shown increased heart rates during the cutting of the flap, along with PVCs, PAT and short runs of ventricular tachycardia. Some surgeons have even abandoned LASIK in favor of surface ablation procedures because of their concerns about flap complications. Refractive surgeons report that patients embrace the idea of a bladeless procedure, and in some cases the elimination of the blade can be the key factor in making the decision to have LASIK."A blade is the last thing most people want near their eye, which is why many of the 55 million Americans estimated to be eligible for LASIK still wear glasses or contacts," says Michael Gordon, M.D., assistant clinical professor of ophthalmology at the University of California, San Diego."
EyeWorld, April 2007
" But, the number one factor driving the move back to surface ablation was safety. As Dr. Lindstrom noted previously, longer-term follow-up of LASIK patients began to uncover cases of cornea ectasia, as well as bad flaps and buttonholes in the short-term."
" Long a proponent of PRK because of higher degrees of safety, Prof. John Marshall, Ph.D., St. Thomas Hospital, London, remembers urging caution when people began to jump on the LASIK bandwagon: “I was the lone voice in the wilderness because I was saying we need to look at this a bit more carefully.” Prof. Marshall was not surprised when people began to reconsider PRK."
Marguerite McDonald, M.D.: "I haven’t done LASIK in three years now."
Daniel S. Durrie, M.D.: “But in the public’s eye, it’s a good news, bad news scenario with quick visual recovery but problems with dry eye and keratoectasia.”