Exposing the LASIK Scam

When I joined the memberlist at this website, I also got put "into the loop" of emails that seem to circulate daily, if not even hourly, between the most activist patients who have been harmed by LASIK. My first reaction to the activism was to just sit back and watch the flow. Now that I have watched these mails go circling for a few weeks, I thought my 2 cents might be in order.

First, I admire your dedication to the cause. I think that you are standing up for a noble cause. That being said, I want to help channel that activism to things that might be changed..not just stabbing at windmills.

You cannot sue the FDA, any more than you can sue Congress. The Constitution forbids it. You can only influence the FDA by writing to their bosses...your Congressmen, or by testifying before them. Elvira's decision to write to her local representative, who put her letter in her Congressional Newsletter, was simply a brilliant idea.

For those of you who actually think that most people dislike their LASIK result, give it a rest. Two million people have had LASIK in the past 12 months, and I venture to say that 90% are ecstatic about their results.
Another 5% are a little upset, but "getting over it." The last 5% are the miserable group. Keep in mind that 5% of 2 million is one hundred thousand unhappy people. Those hundred thousand are the people you are trying to help. Don't delude yourself into thinking that you can change the mindset of the other 1.9 million happy patients.

When I was doing post-operative exams on 20 people per day on patients who were having RK during the 1990s, there was about a 90% happiness quotient. If we asked people if they liked their result, 9 of 10 said yes. When we created a questionnaire that asked if they saw halos at night or had variable vision through the day, 70% said yes. Once again you are seeing the power of cognitive dissonance. When we make a decision, we reinforce the choice we made by making the other choices less appealing. You can interview husbands and wives that will go down a checklist that says their spouse is fat, lazy and doesn't make enough money...but we love them anyway and aren't even thinking about a divorce.

Activism works. Talk to your local newspaper if you can. When you are on a discussion group on Google, and see an ad from a LASIK provider, click thru to their website and sign their guestbook or tell them about your unhappy result. Let your family optometrist know you had a bad result, because I am watching a profound drop-off in the number of optometrists who refer regularly for LASIK. No one likes to send patients out to have a miserable result.

Write to Oprah, write to Dr. Phil, write to "Good Morning Toledo" and just talk about all the things you've learned about loose flaps, bad blades and crappy corneas. You are truly helping...one changed mind at a time.

The government enjoys sovereign immunity, and it is a waste of time and money suing the FDA. You might get some records released, but the individuals who work there will never have to pay a penny out of their own pockets defending a lawsuit.

In my opinion, a small number of bad surgeons, executives, and fake patients advocates (i.e. Glenn Hagele) cause the most problems. Have you ever heard of the 20/80 rule? I suspect that this rule applies to the LASIK industry, and that if the bottom 20% of surgeons, executives, and 100% of the fake patient advocates were eliminated, that most of the problems would go away.

Just in general, because there was an evolutionary tradeoff between how much cornea you need to maintain corneal stability and how thin the cornea should be for good visual quality.

Corneal refractive surgeons are robbing the non-renewable corneal tisue in an attempt to make a refractive compensation for an abnormal overall eye shape.

As a result, corneas are thinned past the point that is safe, and the limits posed on ablation size and depth to prevent ectasia are and always will be in conflict with the need for larger, deeper ablations to accomocate large pupils and maintain a prolate eye shape. You can't do both well, and the 'compromise' of some corneal instability and some degraded vision is unacceptable.

Removing corneal tissue to compensate for myopia, hyperopia and astigmatism will always cause eye health and visual *issues* for this reason.

Then there is the whole inevitable nerve damage/dry eye scenario...

Corneal refractive surgery: bad idea. Mother nature is against it. You can't circumvent limits posed by both biology and physics that are the basis of corneal refractive surgeries' inherent problems.

Dr. Minarik,

There are some big issues that are being overlooked in this discussion. For starters, an AAO report says that dry eyes and night vision disturbances occur frequently after LASIK. Patients might say they are happy, but are they hiding these complications, or denying that they exist? You mentioned cognitive dissonance. That's a factor in the satisfaction rate for sure. Satisfied/happy is one thing -- being free of complications from a medically unnecessary surgery is another. Many of these same patients who say they are happy are not seeing as well at night as before LASIK and some are suffering from recurrent corneal erosions from dry eyes. And one of the biggest problems I have with this is that, even though it is well-known that these complications occur after LASIK "frequently", patients are not told before LASIK that they are "frequent". There is no informed consent -- patients are deceived and misled.

Just because a patient is happy today doesn't mean he/she won't experience late onset complications. LASIK complications can occur weeks, months, or even years later. You know this, of course.

And what about the fact that LASIK patients will have no warning if they begin to develop glaucoma until permanent vision loss has occured due to the fact that IOP measurements after LASIK are falsely low. We all know that IOP measurements are an important part of eye exams. Glaucoma is a leading cause of blindness. About 2% of the population ages 40-50 and 8% over 70 have elevated IOP. Glaucoma is the second leading cause of blindness in the world. What about LASIK patients who develop high IOP and don't know it??? Prospective LASIK patients should be warned about this before they decide to have LASIK so they can decide not to risk vision loss in the future.

Let's talk about cataracts. Any kind of eye surgery can trigger cataracts, including LASIK. Everyone who lives long enough will develop cataracts. LASIK surgeons do not warn patients that LASIK causes miscalculations of the IOL power for cataract surgery. They call this "refractive surprise" because, like a box of chocolates, the post-LASIK cataract patient never knows what VA they are going to get with cataract surgery. Patients have a right to know this, but this is being withheld, along with all the other dirty little secrets they keep.

And then we could get into all the other things like, the flap doesn't heal except minimally at the margin, the flap can be dislodged years later, all LASIK corneas are bulging and a some will buldge progressively to the point of needing a transplant, all LASIK eyes have reduced visual quality, etc., etc., etc. LASIK permanently damages 100% of eyes and there are medical studies that prove it.

Nothing anyone says will change any of these facts.

My sister originally was extremely happy with her LASIK. She still has 20/20 acuity seven years later. But I worry about her because of her thin residual bed. She sees some aberrations at night, not debilitating. And just recently was prescribed Restatis for erosions. She is the classic LASIK success.

Dr. Minarik,
I'm new to this site, and I appreciate your ideas about informing the public about the dangers of LASIK and similar types of surgeries. It's nice to see someone in your position helpiing people who have suffered as a result of these surgeries. I do want to echo what Broken eyes said though in regards to your comments about the percentage of people who are ecstatic, a little upset, or miserable with their results. I think that's something that is very hard to guage, especially considering that no studies have been done on the long-term effects of these surgeries on people. When the FDA makes their decisions about whether or not to approve these surgeries, they basically just check whether the patient can see or not, probably have them read an eye chart and have an MD look at their eyes, and that's pretty much it. they don't wait and do studies on the long term effects, both physically and emotionally, of these surgeries on people. They also don't look at the fact that even though a person may be able to read an eye chart after this surgery, it does not mean that their vision is "normal". There are many different aspects to eyesight. For example, for me personally, these surgeries (PRK and LASIK in my case) have screwed up my depth perception and have weakened my eye muscles so that my eyes can't focus on anything for more than a second or two. So, yah, I can read an eye chart without glasses, but that sure isn't worth all the problems i'm having now with my vision.

I know and have met many people who, when they first told me about their results from LASIK, PRK, or RK, said that they were happy with their results, some even saying it was the best thing they ever did, but then these same people, later on, have told me about problems they are having with their vision. In fact, a few of these people, literally right after they told me that they were happy with their results, would then start talking about difficulties they were having with their vision since the surgeries. And then they would say something like "but other than that the surgery worked fine".

From my own experience, and from hearing about the experiences of other people, I think that this surgery causes a lot of people to feel very disoriented. But then the doctors are often telling these same people that their eyes are fine and that the surgery was successful (some doctors even make the patient feel that it's the patients fault if they're not "enjoying" the results of their surgery). So it's very confusing.

I've changed minds simply by talking to people.
I've talked seven people out of having it done... without even trying. They've come to me, excited, "So you got the lasik, eh?!" And I smile, say "Yes" then sigh and continue, "But, I've had some annoying side affects." Usually, they tilt their heads like dogs, "Side affects???" Then I tell them about my dry eyes and halos and floaters. I'm lucky; mine are minor. I can drive at night. According to several blog sites, some people end up with permanent vision problems. Then my friends usually change their minds, shouting "FORGET IT! I'M NOT HAVING IT DONE." At which point, I say "Well, if you do, research it like a maniac. There are dangers that the public isn't talking about." They usually start running away from me, "NO WAY! I AIN'T HAVING IT DONE!" I continue, "Don't just take my word for it. There are plenty of bloggers online to talk to." They pick up the pace, "NO WAY!!!" As they run away, I holler, "Are we still on for lunch?"