The Dry Eye Zone

Rebecca's Blog

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New York Times article on LASIK problems

A recent New York Times article which spotlighted persistent problems some patients experience after LASIK dredged up a lot of memories and emotions for me. 

I underwent LASIK on July 20, 2001. While the surgery was, technically, uncomplicated and picture-perfect (I even had a video in evidence), I experienced significant permanent vision complications as well as corneal nerve pain and dry eye. At the time these things happened to me, there was, and would continue to be for some years, insufficient medical knowledge and inadequate technology to even begin to understand or assess what was wrong, let alone repair it. The wavefront aberrometers that would later measure irregularities in the cornea that could scientifically explain the visual distortions I was subject to were not available then. Yet even in ensuing years with improved technology, doctors have routinely failed to use available technology to diagnose patients experiencing visual symptoms like mine. The improved understanding of dry eye disease, and the emerging understanding of neuropathic corneal pain, might be serving the patients of certain top tier specialists, but are not in evidence at LASIK surgical centers and therefore have rarely been immediately accessible to LASIK patients unless and until they chose to move on to other doctors for assessment and treatment.

This is just skimming the surface of the issues with the US LASIK industry's complacency and culpability for their unconscionable failures to serve the patients who experience complications and adverse effects. 

Blurred Vision, Burning Eyes: This Is a Lasik Success? (June 11, 2018)

....The Food and Drug Administration approved the first lasers to correct vision in the 1990s. Roughly 9.5 million Americans have had laser eye surgery, lured by the promise of a quick fix ridding them of nettlesome glasses and contact lenses.

9.5 million people for whom we have never had quality epidemiological data about their long term ocular surface results, either in clinical or symptom terms. The industry is far too well served repeatedly re-iterating its "satisfactions rates" and always eluding any meaningful conversation about the speciousness of satisfaction rates in the context of scientifically meaningful data, again, on either clinical or symptomatic results.

There is also a wide perception among patients, fostered by many eye doctors who do the surgery, that the procedure is virtually foolproof.

Yes. That perception is the crowning achievement of ~25 years of LASIK. The commoditization of an elective surgery to an incredibly delicate part of the eye has been so effective and thorough that the form you have to sign before you do it is a quarter the length of the form you sign to open a bank account.

As far back as 2008, however, patients who had received Lasik and their families testified at an F.D.A. meeting about impaired vision and chronic pain that led to job loss and disability, social isolation, depression — and even suicides.

Ten years ago, I testified at that very FDA hearing. So did many patients. And many attendees on the other side of the 'fence'.

Tuesday night when I read this New York Times article, I grimaced, I skimmed, I raged, I tweeted, I read, I deleted. Then I wandered down memory lane, did a little googling and ended up watching the video of my testimony, after all these years.

Have you ever listened to your own self talking, ten years ago? It's surreal.

To me, it was a painful listen. It took me straight back to the day of the hearing. The extreme polarization of the groups assembled ought to have been striking to anyone who wasn't on one side or the other.

On the one hand, patients and advocates, passionately, vehemently, urgently pouring out our pent-up concerns not just on our own behalves but for all those who could not be there. Patients with lives disrupted for years, not simply by poorly understood eye ailments but by the unexpected and crushing complication of their physicians' refusal to acknowledge what they were experiencing or assist them to find any sort of redress. And vulnerable patients whose lives were lost to suicide.

On the other hand, physicians, including an unexplained but powerful DOD contingent, dispassionately, cynically and effectively defending and marketing their trade at an event that was supposed to have been arranged in order to allow the public to voice its concerns. These physicians were palpably present as "industry representatives", period, as opposed to being present as doctors. It was clear from the outset there was no intention whatsoever on their side to be conciliatory. They were there to defend the inherent righteousness of their industry, without any concessions.

What I saw on these doctors' faces as I and others spoke, what I heard from their mouths when they spoke - these things weren't surprising, after almost seven years of conversing and emailing daily with patients who had experienced these things personally. But you can be shocked without being surprised, and I was shocked. Utter disregard for human suffering is always shocking, especially when coming from a profession that purports to exist for healing. Instead, they harmed: and the emotional harm inflicted by this profession, in my opinion, far outstrips any physical harm ever caused.

Even now, serious questions remain about both the short- and long-term risks and the complications of this increasingly common procedure....

It is unquestionable that a majority of LASIK patients (1) are satisfied and (2) have good results. But the fact remains that the success of the majority of patients in these 25 years has come at great cost to the minority of patients who experience problems, Their suffering has been tragically compounded by the failure of this industry - and I stand firm in calling it an industry, not a profession to care - medically, and as humans - properly for those who have been harmed.