Joel Hunter, MD Refractive Surgeon, Hunter Vision Updated 08/22/19 6:44 PM
Worry about the risks involved in LASIK surgery usually starts with the wrong premise. It has the same feel that you get when people talk about risks involved in skydiving; when really, it should have the vibe of discussing the risks of driving to the store. What I mean is this: when you’re talking about skydiving, the entire conversation about risks only involves different pathways to the same ultimately horrific outcome.
What are the different ways you could end up smacking into the earth at over 100 mph? Well, your parachute could fail to open, you could pass out before opening, you could go into a free spin because of a chute malfunction, another sky diver could collide into your chute, and it goes on from there. No one’s asking about the risk of chafing from the harness, or the chance that they’ll land safely in ankle-deep mud and ruin their shoes. Your skydiving risk conversation is going to revolve around the chance of catastrophe, not inconvenience.
The reason this is the wrong premise when we’re talking about LASIK is because the reality of risk with LASIK is much, much more mundane. It centers almost entirely on inconvenience. Catastrophe fits in the periphery of the conversation kind of like a legally-required asterisk or footnote—the type you ignore because it’s an unremovable sticker on your car’s sun visor that says your airbag can hurt children if they’re driving for some reason.
That’s why I would intentionally compare LASIK risks to those involved in driving to the store. Sure, we agree kids shouldn’t have their face next to an airbag. And if we consider it beyond a moment’s notice, a case study or two that we hope to never think about probably established that as a necessary disclaimer. But a catastrophe like that is something we’ll never see, because we’re not going to strap a three-year-old into the front seat. The same way we’re not going to drive without looking at the road. This extends even into the catastrophic risks of driving over which we have no control. It’s more likely to be thought of as neurotic than cautious if you start your car and think, “I may die on this trip if a semi truck loses control and crashes directly into me.” With driving or LASIK, we don’t have to be sick with worry about catastrophic events like these because there are a thousand intentional safeguards against them. The only significant difference worth pointing out is that LASIK is statistically safer than driving in this regard by an enormous margin.
But there are risks of inconvenience to be considered. If it’s a drive, then it’s traffic or rude drivers or construction. Those considerations help us decide if the trip is worth it. With LASIK too, it’s risks of inconvenience that deserve consideration to make sure you know what you’re getting into. There may be inconvenient extra visits to fix dry eyes over a period of six months instead of three. Lights at night may have halos, and while they get better in a few months and were worse with your contacts, it can be annoying if you didn’t know it could happen. You may be the 1 in 100 who needs a LASIK enhancement because you’re 20/25 instead of 20/20, and that’s inconvenient because you’ve got to wait three or four months to get it. Those, by the way, are the three risks I talk about. Those are the three I’ve worked through with patients. They are the risks of inconvenience.
The risks people are usually worried about when they ask their question, however, aren’t the risks of inconvenience. If there’s any difficulty in giving a satisfactory answer, it’s because they’re talking about skydiving, while I’m talking about driving to the store. I can only give insights based on the absence of experience. I’ve never seen blindness or lost vision from LASIK. It’s hard to assiduously detail all the risks leading to blindness when you’ve never seen it in the first place. Terrible infection can do it, but I’ve never had a patient get any kind of infection. Catastrophic laser malfunction? I can’t even come up with an imaginary scenario where it’s possible. In a non-thriller, real world scenario, if the laser’s multiple monitoring systems measure any component to be off by the slightest margin, it just doesn’t turn on. Which leads us back to inconvenience, because the actual worst-case scenario on laser day is the need to delay a procedure for some annoying, super-rare, safety check related reason.
It’s possible this article wasn’t the type of thing you were looking for when trying to find the risks for LASIK. Honestly, it would be easier to just write out a list of risks. But it wouldn’t help in finding out more about LASIK any more than writing statistics about car engine explosions would help you know what to look out for if you’re thinking about driving somewhere. To get the right answers, we’ve got to start with the right questions. When it’s skydiving, all those questions should be pointed toward how we minimize the risk of catastrophe. When talking about LASIK, all those questions can be spent covering how to get to our goal as conveniently as possible. You’ll find that an experienced and purposeful guide can help get you to that goal safely, too. Anyone can walk the same path a thousand times; very few set out to learn something new on each trip. You’ve heard it said, “practice makes perfect.” Your guide on this journey should believe perfect practice makes perfect.
Author: Joel Hunter, MD is an Ophthalmologist, Refractive Surgeon, and the Founder of Hunter Vision, a LASIK Orlando Clinic in Florida. A recognized and respected specialist in vision correction who has performed a countless number of refractive surgeries, Joel gives lectures across the country and trains fellow doctors in the newest LASIK surgery techniques.