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    Looking back—and ahead—at LASIK’s potential

    Numbers may be on the decline, but the procedure continues to strengthen

     

    Some complications revealed earlier on via the peer-review literature included flap-related problems, ectasia, dry eye, and infections. One common infectious issue, atypical mycobacteria, has nearly been eliminated because of antibiotics and the realization that tap water is a contaminant, Dr. Donnenfeld said.

    Studies related to dry eye and LASIK have found that although there is a significant loss of corneal sensation with LASIK, it improves after 3 to 6 months.

    An FDA hearing took place in 2008 to review LASIK concerns, said Dr. Donnenfeld, who both spoke on behalf of LASIK at the hearing and listened to many of the patients giving testimonies with stories about depression, suicide, and other mental issues tied to previous LASIK.

    “Overwhelmingly, the most common concern I heard patients felt is abandonment by their surgeon,” he said. “I promised myself that would never happen at my practice.”

    After the hearing, the only action the FDA took was updating some of the LASIK-related information on its website, Dr. Donnenfeld said.

    More recently, results released last year from the FDA’s PROWL 1 and 2 studies showed that 99% and 96% of subjects achieved 20/20 bilateral UCVA, with no enhancements needed.

    The study also demonstrated LASIK’s safety. Dr. Donnenfeld was surprised to learn from the research that most subjects with glare and halo before LASIK actually had a reduction in these symptoms after LASIK. He had always presumed that these patients were not good candidates for the procedure.

    Although the FDA studies did show that 30% of patients got new dry eye after LASIK, that was evaluated at 3 months; Dr. Donnenfeld believes the results would have been lower had they waited until 6 months.

    Research that focuses on patient satisfaction has found that LASIK has the highest patient satisfaction rate of any procedure done on an elective basis today, with 91% to 100% of patients satisfied in various studies, Dr. Donnenfeld reported.1

    Researchers also have busted the myth that ophthalmologists do not get LASIK done on their own eyes—they are actually four times more likely to have laser vision correction compared with the general population.2

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    • Dr. Nancy Burleson
      Dr.Donnenfeld, Complications are not uncommon. My son, Max Cronin, age 27 years old, an Iraqi War Veteran and college student, committed suicide 1-14-16, as a direct result of complications he experienced from Lasik. He left suicide letters stating this and kept details of his complications. He experienced vision loss, constant eye pain, dry eyes, haze, and loss of quality of life resulting in depression and his suicide. He was unable to work or continue his life goals due to his eye complications. As a medical physician, I can definitely state that Lasik/PRK complications can lead to depression and suicide. For an elective procedure, the risks and long term complications are understated. The industry ignores the catastrophic complications from this elective procedure. The resultant complications and negative quality of life issues increase the risks of depression, attempted suicide, and suicide. Nancy L. Burleson MD FACOG Texas

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