For the past 8 years, I have counseled with LASIK patients who have experienced complications with LASIK surgeries. Complications are relatively rare in LASIK but when they do occur they can be traumatic and difficult for patients to manage. LASIK complications result in dissatisfaction with the results and often a reduction in vision quality or comfort. Oftentimes LASIK patients no longer trust their LASIK surgeon and feel that the surgeon was dishonest or disingenuous with them. Patients frequently feel that the surgeon is not forthcoming with information and/or secretive regarding the events that occurred.

The vast majority of LASIK patients, perhaps 95% to 99%, are very pleased with the results and more than half would say that their decision to have LASIK was one of the best decisions that they had ever made. Having said that, there are many LASIK patients, although fewer than 1% of all LASIK patients, who say that their decision to undergo LASIK was one of the worst decisions that they have ever made and they seriously regret that decision. With as many as a million patients undergoing LASIK in the USA every year, the number of patients that regret having LASIK could be as many as 10,000 a year. While LASIK technology has advanced significantly in the past 10 years, the procedure is still not risk free and adverse events still occur.

One person that I counseled with was an eye doctor who questioned whether LASIK was the right choice for her since she is still experiencing frequent eye dryness despite having performed the procedure more than 10 years ago. Prior to LASIK, this doctor’s contact lens prescription was considered highly myopic and continual contact lens use would certainly have caused discomfort as well. Contact lens use is known to have higher risks of bacterial infection and oxygen deficiency to the cornea which can result in corneal neovascularization. Additionally, most people will eventually experience contact lens burnout and be unable to wear contact lenses at some time in their life as well.

If you feel that LASIK surgery is the right choice for you and you are willing to accept the risks of complications, however small, there are certainly ways to lower your chance of experiencing complications from LASIK surgery. Do not shop for the lowest price for a LASIK surgeon. Shop for the best surgeon (but not the most expensive surgeon although this could be the case). If you buy a used car that turns out to be a lemon, you can always return it. LASIK Surgery can have permanent effects for the rest of your life.

Here are 5 mistakes that can result in increased risks for LASIK surgery:

1. Going to a part-time LASIK surgeon. If the LASIK surgeon does not perform the surgery on a regular basis (at least 10 or more treatments per week for the past 3 years), they are not trustworthy to perform the procedure. I would expect a skilled surgeon to have performed a minimum of 2,000 procedures, preferably many more although more is not necessarily better. There are poor surgeons who have performed 20,000 or more surgeries but have higher rates of complications so very high numbers are not necessarily better.
2. Going to a low cost LASIK doctor. There are significant expenses to performing LASIK surgery. Anyone offering a price that is significantly lower than the rest of the LASIK providers is either cutting corners on equipment or planning to up charge for options that should be considered standard medical practice. Studies have shown that “low price” providers generally up charge in order to receive the same fee as the “higher priced” competitors.
3. Going to a LASIK doctor with older technology. LASIK is a relatively new procedure. LASIK technology advances significantly every 3 years and LASIK providers should be upgrading to newer technology at a similar pace. Newer upgrades are expensive and require higher prices but result in better treatments in the long term. Oftentimes low priced providers offer two options old technology and older technology. They then upcharge to the less outdated of the two treatment modalities.
4. Going to LASIK surgeon who is learning to use newer technology. New technology is a gamble. It has the potential to provide better treatments than the older technology but there is always a learning curve as LASIK surgeons adjust to the newer technology. Early adopters face increased risk but stand to obtain better results. When I had LASIK many years ago, I chose an experienced, skilled surgeon who was just beginning to use the newest and most advanced laser that was just beginning the FDA approval process. In retrospect, it was a gamble that paid off with excellent results.
5. Being unable to communicate adequately with their LASIK doctor. Communication between doctor and patient is essential. A breakdown in communication can be the fault of either the doctor or the patient. Sometimes the doctor assumes the patient understands. Sometimes the patients assume that the doctor will make the best choice without needing to be consulted. Some excellent surgeons are poor communicators and some excellent communicators are poor surgeons. It is important to find an excellent surgeon and obtain adequate communication that no mistakes are made in the decision process. I have found excellent surgeons who have made mistakes because patients withheld important information which could have improved the results. I have also found poor surgeons, who I rate based on observations of their skill during surgery, have happy patients because they are capable of clear and open patient communication. I cringe during surgery but their patients are happy and these good communicators have fewer lawsuits and fewer disgruntled patients than better surgeons who have poorer communication skills.

I have found that nearly every complication will fall into one of these categories. Oftentimes patients simply don’t understand the risks prior to undergoing the procedure. While LASIK complications have decreased over the past two decades, patients need to be well-informed before making this life changing decision. For most patients, LASIK is one of the best decisions that they have ever made. For others they continue to regret the decision after more than a decade.