One, refractive surgeons wanted to make sure that the first eye was going to be okay before moving on to the second eye. To put that caution into context, this was at a time when laser was so new that a refractive surgeon was a very small, almost fictional group of ophthalmologist. The guy I trained under, Dan Durrie, was one of those early refractive surgeons and he would tell me stories about some new technique getting invented and then the handful of other refractive surgeons would fly to wherever that was being done and learn it, and then fly back home and try it. In those days, you can see why doing one eye at a time was a good idea.
The other reason for not performing LASIK on both eyes at the same visit was that the results, while miraculous at that time in history, were wildly erratic by today’s standards. There was a need to figure out how this person’s eye responded, prescription-wise, to the first treatment and then modify the plan as necessary for the second eye.
If I’m honest with myself, there’s no possible way I could have been one of those pioneers. I don’t even mean that as a humble brag. They created the laser procedure that we have today, and their patients were super happy. I meet someone who had laser 20 years ago nearly every week, and even the ones that need an enhancement procedure done rarely have anything but praise for the procedure that was for them, at that time, a miracle.
I tried to be careful to say those early pioneers in laser vision correction created the procedure we have today, and not that they were doing the procedure that we have today. The reason is that it would have been very difficult for any of them to imagine, in concrete scientific terms, what LASIK would look like in the year 2015. They were inventing it all along the way, but to show one of them the machine that we get to use to fix people’s vision today would be like handing 1980 Steve Jobs an iPad. Or showing 1980 Bill Gates a modern PC with an Intel i7 CPU. The capabilities of modern laser and computers is science fiction from the vantage point of the 1980s.
That fact is the long way around to answering the question of why we can do LASIK on both eyes at the same visit today. The simple reason is that there’s no need to avoid it. The major complications that were closely monitored back then like infection or an internal eye injury are so vanishingly rare now that I have literally never seen one in any of my LASIK patients ever.
LASIK results are so accurate now that doing each eye a week apart would only cause the annoyance of having one eye that sees 20/15 while the other one stays terrible until a return visit for round two. It’s the reason that I feel kind of guilty when I say I never could have been one of those early pioneers in refractive surgery. I am incredibly spoiled with how nearly perfect LASIK is today. The good news is that’s what all those geniuses were working towards to begin with. Also, people trying to get out of glasses or contacts these days can pretty effortlessly get amazingly good vision. That’s probably the best part, actually. I probably should have led with that.