Unfortunately, the satire of this piece strikes very close to the truth.
"Good evening ladies and gentlemen. On the day of your surgery, I will first stretch your eye open with a metal device that has the potential for causing nerve and goblet cell damage. Your goblet cells make proteins that keep your eyes lubricated. Ladies, remember how you were always told to be very gentle with the tissue around your eyes? Forget that, I will stretch the daylights out of it. You may have a sagging lid or eyes that don't close all the way when I'm done.
Then I'll apply a huge amount of suction to pull up floaters and potentially damage your retina and optic nerve! Next I will sever your corneal nerves with a knife that often leaves metal debris behind in your eye for the rest of your life. You will also have permanent nerve loss with the potential of painful dry eye. I usually tell people this is temporary, if I tell them about dry eye at all - but that's sure not true for everybody and I know it. It is just so hard to tell who will have dry eye problems, and if I were honest about the risks nobody would have surgery. Sometimes even really young males who are not in what we surgeons consider a high-risk group get it. I don't understand this at all, but it doesn't slow me down! You will experience some dry eye for sure, and perhaps permanent dry eye. If not now, maybe later in life when you get older, or go through menopause if you're female. Females are at higher risk for dry eye anyway. I should probably tell them all this, but that's bad for business too.
Oh, by the way...lots of junk gets left behind inside your flap. You can get inflammation from this junk called DLK that could make you go blind! After I have cut your corneal nerves, I will fry some more of them with an imperfect, fluctuating laser device that isn't really designed to treat something round like an eye. Your corrected area will be smaller usually than I had hoped, especially if you have astigmatism and/or a high correction. But hey - they are your eyes and not mine. Corrected area too small? Kiss your night vision goodbye! Whenever it is dark, you will have some seriously bad vision.
Prominent doctors have stopped doing LASIK because they realized it has problems, but I don't know what else to do with myself right now and I like the money. I REALLY started pushing LASIK hard when medicare drastically cut the reimbursement I would receive to do cataract surgery!
Where was I.... OH! After I fry your eyeball with the laser, I'll put the flap back down and that's where random chance takes over. Sure, ALL patients end up with a wrinkled flap that's sort of like a Ruffles potato chip. But some people have VERY irregular healing that screws up their vision a lot. It is impossible to tell with my lame tools (an aberrometer at best) if your problem is underneath the flap or in the flap itself... so some people are made WORSE in retreatment. For this and other reasons.
Hey, did I tell you that LASIK creates imperfections in your eye called higher order aberrations? We don't really understand their impact on visual quality fully, aside from the fact that many of you do have poor vision that is associated with these larger higher order aberrations. Especially at night. We give you those starbursts and halos that rob you of your enjoyment of evening forever, right here in our clinic! If I tell you that wavefront or custom wavefront doesn't increase these aberrations, on average - I'm LYING! Shame on me! Yes, I know all about LASIK-induced aberrations, and was just keeping it to myself because I know you would RUN SCREAMING if YOU knew!
You won't be hearing me tell you about loss of contrast sensitivity (everything is sort of dimmer and less distinct) but there are experts out there who say that all patients have this after LASIK. I don't measure your contrast sensitivity so that I can pretend it's not an issue. Good luck finding things in dark drawers and closets. Also, your vision may be less 'crisp' after LASIK than before with your glasses. For life. We think this is from the higher order aberrations, but we like to keep this quiet, too. Shhhhhhhh.
If you have large pupils, thin corneas, a large correction ... watch out. You are at higher risk for a poor outcome. You deserve to have all of this explained to you clearly. But I may not warn you about your personal risk profile because I want as much money as possible. Again, the truth just seems to scare the customers away.
What I call an enhancement is really another surgery I sometimes have to do because LASIK is imprecise and I'm just guessing what kind of correction you will get. I have very little control over the situation, but you'd never know it by my confident demeanor! I don't have the guts to call a second surgery an 'enhancement' when I'm with my colleagues because they know better. It's a special euphemism just for patients, who don't.
Are you near 40? You may already be experiencing difficulty with your close reading. Being nearsighted gives you the ability to see close things later into life if you just take your glasses off, or look under them. This late life 'gift' of myopia is something I will take away. LASIK corrects your distance vision at the expense of your close vision if you are over 40. Which do you do more, read and look at the computer, and work with things that are close to you... or do you spend most of your time golfing (someone else will have to keep score) or in a tower looking off into the distance for forest fires?
Remember me telling you that LASIK is imprecise? Even a slight overcorrection can take years of comfortable close reading away from you! Imagine suddenly not being able to read your watch, your cell phone, even trim your nails or see your food clearly without finding those darned reading glasses. This is why people over 40 are more likely to be dissatisfied with their LASIK. I know this, and I could easily demonstrate what it is like to lose your near vision with a trial contact lens to help you make an informed decision, but 10 minutes of my time vs. a lifetime of regret for you? Well, my time is valuable.
Since there is often some regression after LASIK (reversal of the treatment) I sometimes overcorrect my patients slightly. If they can't read their computer screen clearly for several months it doesn't affect me! Your vision could take 6 months to stabilize, and you will have to deal with whatever vision you end up with and the changes that happen, perhaps with multiple pairs of glasses, usually at your expense. If you end up having an (ahem) 'enhancement' later, your changing vision could keep you busy, head-achy, bothered by eye strain and broke from buying glasses for a couple of years. Maybe longer. Does LASIK simplify your life? Maybe not.
I usually keep the post-op instructions away from you until it's too late because they might scare you off. Also sometimes I may give you your consent forms immediately before your surgery so that you will feel rushed, pressured, and go through with a surgery you may decline if you had proper time to study your materials.
If you are myopic, your cornea will be lumpy but flattened after surgery, and it will be harder to keep your corneal surface healthy and moist as a result. A healthy eye has a smooth, round surface. Yours won't be like that. And forget about wearing regular soft or hard contact lenses if you have a higher correction. Your corneal surface will be WAY too flattened and oddly shaped for those. You will have to really do some hard work with an experienced hard lense fitter to get specially shaped hard lenses and you may not be able to tolerate the lenses anyway because, hey - I cut your nerves and fried more of them. Remember? Those nerves control the comfortable wetting of your eye. So you may be too dry. Just live with your bad vision in this case, and don't expect any sympathy from me. I will brush you off, abandon your continued care...even try to paint you as irrational - I'll do anything I can to make you go away so that I won't be bothered.
Oh, you say you are hyperopic? Your surgeries are much more complicated and prone to failure. If you're not happy with your vision and need to wear hard contact lenses to get back some visual quality - bad news... the lens fitting process for you is even harder than for former myopes.
Your cornea is not like a piece of skin that will heal back together when it is cut. Your LASIK flap will only heal around the edges a bit, and be covered over by a thin layer of epithelium. So it can easily be lifted years later by a surgeon with a simple tool, or be amputated accidentally by a finger poke, air bag, tree branch, or sports accident. At any time, for the rest of your life. You will always have a split cornea after LASIK!
Speaking of flaps, and vulnerable weak corneas... did I tell you about the bulging part? Oh, this is priceless. You are going to lose about 1/3 of the mechanical strength of your cornea with this surgery! We surgeons disagree about how much tissue you need to retain to be safe from eye bulging, or ectasia. We usually keep this disagreement to ourselves, however, because again, we don't want to scare the customers. Some people need a corneal transplant when we're finished with them because their corneas are just too weak to support the pressure from inside their eyes after surgery. Almost all of us who have done a lot of surgery have patients like this, but you can see by the lack of LASIK surgeon suicides in the media.... that we can STILL LIVE WITH OURSELVES! Isn't that remarkable???
Federal trade commission regulations specify that when we advertise a medical procedure we must also list possible complications and side effects. We ignore this rule because nobody is enforcing it.
Call us for an appointment!"