Lasik’s Risks Are Coming into Sharper Focus • Hacker News Board

Re: Lasik’s Risks Are Coming into Sharper Focus

#201

Post by tsmarsh » Tue, Jun 12, 2018, 4:43 PM UTC

pnutjam wrote: post #188

WaltPurvis wrote: post #179

Earlier quoted context omitted.

I had LASIK almost 20 years ago, from one of the leading practitioners in the then-fairly-young field, and I scrupulously followed the post-op regimen, yet I still experience noticeable halos and starbursts with lights at night, and my eyes are considerably more sensitive to the sun (I basically can't tolerate being outside in the daytime for any length of time without sunglasses, whereas I never even owned a pair of…

I've never had Lasik, I'm severely nearsighted, but I've become much more sensitive to light as I've aged.

I'm barely nearsighted, really just use glasses so that I can read presentations in meetings... and yeah, my eyes have become significantly more sensitive to both light and change rapid changes in light.

Re: Lasik’s Risks Are Coming into Sharper Focus

#202

Post by alex_berg » Tue, Jun 12, 2018, 4:53 PM UTC

An elective procedure which very likely adds lifelong negative side-effects?

Doctors do no harm unless absolutely necessary. Lasik surgeons know of these life-altering negative symptoms and still happily take your money to give you your dream realized. As their industry exists right now, they serve consumers, not sick patients. Lasik surgeons must not consider themselves a doctor, so don't trust them like they are one.

It doesn't matter which eye surgery is used, ocular surgery destroys nerves in the surface of the eye which are essential for communicating to the rest of the body the needs of the eye, like adjustments to tear composition to ensure tear quality necessary for maintaining ocular health.

Negative side-effects may be just an inconvenience for a few decades, but they can easily turn into terrible complications should your body's general health degrade such that slightly inconvenient eye symptoms becomes chronic eye pain.

For dry eye pain, there is no known cure. Dry eye pain can only be mitigated, but never cured. Dry eye pain causes tension in the muscles in the head and neck which can be triggered to form severe headaches. The muscle tension caused by dry eye pain can trigger psychological changes such as anxiety, chronic bouts of drowsiness, decreased stress tolerance, and heart palpitations. Chronic pain, such as from dry eyes, can cause chronic physical exhaustion.

The Lasik/elective eye surgery industry is terribly wealthy, and its side-effects is not well understood and suspicious. More research is necessary to determine exactly the scope and severity of its long-term side effects -- there really is very little data here and that should be terribly concerning for a procedure which is sold as incredibly safe.

Be skeptical of it and support predicating its growth on further research of the scale, scope, and severity of its side-effects.

If you're considering having a Lasik-like procedure performed on your eyes, first join a Lasik complications group/forum on the internet. In addition seek third-party research which attempts to assess the true scale of complications and how to cure those complications should they arise in you. It's far more than 1-2% which have complications, think closer to 10-30%.

Re: Lasik’s Risks Are Coming into Sharper Focus

#203

Post by jcadam » Tue, Jun 12, 2018, 4:58 PM UTC

gameshot911 wrote: post #40

I think this is a unique view, but I've come to appreciate nearsightedness. Partially because I like having the ability to soften the external world by removing my glasses (like wrapping myself in a warm fuzzy blanket), but even more so because it grants me the ability to see things near me in sharper focus than someone with 20/20 vision. I can put on contacts or glasses to see something at a distance just as clearly…

Bah, my eye Rx is -8.5 diopters. Taking off my glasses/contacts doesn't "soften" the external world - it makes me unable to function. If I forget where I put my glasses after taking out my contacts at night before going to bed, I have to call my wife to find them for me. If I try moving around too much, I'm liable to hurt myself.

I'll probably want to get LASIK at some point :)

Re: Lasik’s Risks Are Coming into Sharper Focus

#204

Post by gm-conspiracy » Tue, Jun 12, 2018, 5:02 PM UTC

sageabilly wrote: post #197

alexhutcheson wrote: post #184

Earlier quoted context omitted.

> Articles such as the one here tend to gloss over patient adherence to post-surgery self-care, which is one thing I believe makes or breaks successful LASIK (in my personal experience and from what I have read). This means eye drops on schedule round the clock, antibiotic eye drops on schedule round the clock, eye protection at night for the first week, avoiding dusty conditions for however long the doctor prescribe…

Right, so does that mean the post-surgery care that I was recommended is on the "extremely conservative" end and your doctor was more lax, or does that mean your doctor wasn't as well-read as others, or something else? Like the comment up-thread, how does one pick a good doctor for something like Lasik, which is seen as a minor medical procedure but is absolutely a major surgery?

You ask your Lasik doctor if he were to get Lasik surgery, what doctor would he personally use?

Re: Lasik’s Risks Are Coming into Sharper Focus

#205

Post by gm-conspiracy » Tue, Jun 12, 2018, 5:06 PM UTC

jcadam wrote: post #203

gameshot911 wrote: post #40

I think this is a unique view, but I've come to appreciate nearsightedness. Partially because I like having the ability to soften the external world by removing my glasses (like wrapping myself in a warm fuzzy blanket), but even more so because it grants me the ability to see things near me in sharper focus than someone with 20/20 vision. I can put on contacts or glasses to see something at a distance just as clearly…

Bah, my eye Rx is -8.5 diopters. Taking off my glasses/contacts doesn't "soften" the external world - it makes me unable to function. If I forget where I put my glasses after taking out my contacts at night before going to bed, I have to call my wife to find them for me. If I try moving around too much, I'm liable to hurt myself. I'll probably want to get LASIK at some point :)

I am -7.5 and agree w/ GP, especially for identifying SMD components and other details.

But, yes, sometimes I need help finding my glasses, too.

Re: Lasik’s Risks Are Coming into Sharper Focus

#206

Post by wccrawford » Tue, Jun 12, 2018, 5:07 PM UTC

ra33it wrote: post #193

Thankfully others have already pointed out this article's lack of journalistic merit or rigor. As a follow-up, I'd like to state: I don't wear glasses or contacts anymore thanks to LASIK. After 30 years of squinting, jamming fingers in eyes, staring through fogging/scratched/dirty/broken lenses... I have better than perfect vision each morning when I wake, "naturally", thanks to a quick and near painless surgery. For…

After ICL and Lasik, my vision isn't as good as when I wore glasses. I've taken to wearing glasses that my eye doctor has told me I don't actually need so that I can read signs in the distance.

In addition, I used to have amazing near vision. When I'd work on small projects, I could see them amazing well. Now I have to hold things almost at arm's length to focus on them well. I was told that it would get better as my eyes strengthen, but it hasn't really changed much in the years since the surgery.

To compound things, I'm about 40 years old and my near vision is now deteriorating anyhow. I was warned about this and fully expected it, but the other problem wasn't something I was warned about.

I also knew that my vision was bad enough that Lasik wasn't good enough and would weaken my eyes too much, and so ICL was used with Lasik to fine-tune it. I did know to expect my vision might not be 100% perfect.

In short, I now get to wear much lighter, cheaper glasses when I want to see far in the distance, and wear no glasses at all for most day-to-day things. But I have trouble reading at less than 2/3 arm's length.

If I were given the opportunity to choose differently, I might choose to keep my money instead and continue to wear glasses. I'm not angry, but I'm certainly not fully satisfied with the procedure.

Re: Lasik’s Risks Are Coming into Sharper Focus

#207

Post by wccrawford » Tue, Jun 12, 2018, 5:08 PM UTC

wlll wrote: post #118

gameshot911 wrote: post #40

I think this is a unique view, but I've come to appreciate nearsightedness. Partially because I like having the ability to soften the external world by removing my glasses (like wrapping myself in a warm fuzzy blanket), but even more so because it grants me the ability to see things near me in sharper focus than someone with 20/20 vision. I can put on contacts or glasses to see something at a distance just as clearly…

I have the same situation. When I take my glasses off and move stuff close to my eyes (really close, like around ~4cm) it's like looking through a microscope.

I wrote a huge comment in reply to someone else, but I had this "superpower", too, and wasn't told that I'd lose it after having my vision corrected. I miss it.

Re: Lasik’s Risks Are Coming into Sharper Focus

#208

Post by gm-conspiracy » Tue, Jun 12, 2018, 5:14 PM UTC

enraged_camel wrote: post #116

aschneid wrote: post #29

I had Lasik done at a university teaching hospital by a surgeon who had done thousands of surgeries. This was in 2003. Every follow-up was by a resident and then the full surgeon. I had significant dry eyes and blepharitis (probably from the dry eyes) for about 12-18 months. 15 years later, I can still see 20/20 in one eye and 20/25-30 in the other. I still occasionally have dry eyes and blepharitis. I wear glasses a…

>>However, folks who ask me about it, I tell them if they can still wear contacts, not to have it done. Contacts carry their own risks. Even if you have excellent hygiene habits, they can cause eye infections. And if you accidentally fall asleep in them...

I use daily-wear contact lenses (you throw them out in the evening), but usually wear glasses unless there is a specific reason to wear them (usually a sports-related activity).

I also purchased a 2nd pair of prescription sunglasses, so that has also helped.

Re: Lasik’s Risks Are Coming into Sharper Focus

#209

Post by bgroins » Tue, Jun 12, 2018, 5:15 PM UTC

sp1ffy1 wrote: post #187

bgroins wrote: post #185

Earlier quoted context omitted.

> I have no evidence to back this up, but I'm guessing... I don't understand. You have admittedly have zero evidence that paying less for a LASIK procedure results in more complications, yet you seem to have a very strong opinion about it. What does the cost of the procedure or advertising techniques of the practitioner have to do with the quality of outcome? If you get a great deal on a new car, do you think that ca…

I think it's pretty obvious that on the whole, quality is generally proportional to cost. There are plenty of times when I choose the cheapest option, but surgery that permanently affects the rest of my life is not one of them. Additionally, I would say that buying a used car is a more apt analogy since new cars don't usually differ in any way. Different surgeons use a variety of different equipment and have widely v…

> I think it's pretty obvious that on the whole, quality is generally proportional to cost.

There are numerous examples that this is not true, and is a very common consumer misconception. If you found a LASIK place that charged $50,000 for the procedure, doesn't that make it a better quality procedure by your own definition? What about $500,000? Expensive wine comes to mind. It's easy to find examples of consumer perceived value in the wine industry. I can get a $20 bottle of wine at Costco that costs $40 at a nice restaurant. I'll still pay the $40 because it adds to the dining experience, but at the end of the day I'm drinking the same $20 wine. Natural diamonds have massive perceived value but you can get a lab produced, flawless version for a fraction of the price. Consumers put a higher value on natural diamonds because of clever marketing and decades of supply chain manipulation to make them seem rare.

> Different surgeons use a variety of different equipment and have widely varying levels of experience.

That's true and definitely something to consider other than just the cost. The cost of something shouldn't be the sole indicator of the quality, so telling people to stay away from cheap LASIK centers solely on cost is not giving a complete picture. It's going to vary from center to center often times regardless of cost. Here's a good read on perceived value: https://moneyandvalues.blogspot.com/2008/03/psychology-of-mo...

Re: Lasik’s Risks Are Coming into Sharper Focus

#210

Post by naravara » Tue, Jun 12, 2018, 6:02 PM UTC

driverdan wrote: post #199

naravara wrote: post #168

Earlier quoted context omitted.

I played tennis competitively as a teen. So that was about 1 to 2 hours a day, every day in the Florida sun. Still developed myopia by the end of high school though. . .

That's why studies look at aggregate data and not individual anecdotes. Individuals vary from the trend.

Based on the Nature article it looks like the conclusions within the research community are still pretty unsettled.