Posted on May 1st, 2014
I’m always surprised that the most common fear about laser vision correction I hear in clinic is, “My eyes work now, they just need contacts or glasses. I haven’t done this yet because I worry that I could go blind and be in the dark.” If I was being hard on myself, I’d say that this surprises me because I’ve been a doctor long enough that now I’m out of touch. If I was trying to give it a good spin, I’d say that it surprises me because of what I know about the safety of modern laser surgery. I choose the second one. Saying I’ve become out of touch with people’s ideas about laser because I’m a laser surgeon is about as silly as thinking a 213 nanometer solid state laser and 193 nanometer argon-fluoride laser will have similar absorption through balanced salt solution.
The truth about blindness and laser is pretty comforting. There’s only one thing I know of that can make somebody go blind from laser: tremendous infection. About that, I see several people a week who either currently or recently have had an infection from their contact lenses. With LASIK, I’ve read about them, and seen a couple that had an infection years before that’s now resolved with good vision. I’ve never caused one or seen an active one.
Don’t get me wrong, contact lenses are wonderful, and still super safe when properly cared for. It is just that contacts are familiar and laser is unfamiliar, so it can be hard to categorize risk. The same thing happens when people drive a car with zero worry and then get very anxious to get on a plane. The pilot thinks, “What? Your car ride here was statistically a much greater risk than this flight. Breaker breaker niner.” But the pilot doesn’t realize that planes are unfamiliar, and that my wife is very smart and very logical, but would still rather drive a car than fly.
I only choose a comparison with contacts because people are comfortable with those, and like driving vs. flying, the statistics don’t mean that you’re going to get in a car wreck or that contacts are going to cause a problem. Almost 100% of infections with contacts (or in LASIK for that matter) end up with fantastic vision after antibiotic treatment. I just feel like every now and then it is helpful to contextualize what actual risk is involved in laser.
For good candidates with good LASIK surgeons, I can say without reservation that the risk of laser can be viewed with the same level of anxiety as contacts. (This helpful article shows some of the science behind this.) So by all means, wait on LASIK until you’re comfortable, but don’t let yourself suffer from anxiety over ideas that aren’t accurate. That would be as silly as not purging a laser’s beam path with nitrogen before doing fluence testing.