Holy observation bias, Batman! The only thing even resembling actual negative statistics in this article is the ballpark estimates by the ex-FDA advisor, and those are just guesses.
You can find negative experiences, sure, but what is the actual incidence of that? Without that data, this is utterly meaningless. It certainly isn't damning.
A recent clinical trial [2] by the F.D.A. suggests that the complications experienced by Mr. Ramirez are not uncommon.
Nearly half of all people who had healthy eyes before Lasik developed visual aberrations for the first time after the procedure, the trial found. Nearly one-third developed dry eyes, a complication that can cause serious discomfort, for the first time.
The authors wrote that “patients undergoing Lasik surgery should be adequately counseled about the possibility of developing new visual symptoms after surgery before undergoing this elective procedure.”
I wonder how people who got dry eye will age. As you age dry eye symptoms tend to increase and can be associated with recurrent corneal erosions which, aside from being painful, can get infected, which can be absolutely terrible and vision threatening in extreme cases.
Dry eye is hell especially if you work at a computer.
As an aside, Ocusoft Retaine drops are the best thing I’ve found for dry eye; I’ve never met anyone else with the problem who uses them but it’s like night and day.
Eye drops do not treat the underlying cause of dry eye (unhealthy/insufficient tears, inflammation (e.g. blepharitis), or in rare cases neuropathic pain). They are just symptom relief.
For anyone reading this who manages their dry eye with eye drops, please do some reading or see a specialist. If all you do is use eye drops, your dry eye will likely get worse.
Eye drops bolster your tear film and help prevent desiccating stress to the eye surface, but they lack growth factors and other important compounds found in biological tears, and can even contribute to washing those away.
Last, whatever you do, don't use eye drops with preservatives (e.g. benzalkonium chloride).
How many quality opinions did your friend get? I also know people with DED and from my experience not all docs understand the disease well. Obviously you know more than I do, but I'm very skeptical that there isn't more to the story than "a lifetime of drops". Also, I hope your friend has tried autologous serum drops.
That is a great suggestion IMHO. ASTs are pretty amazing but they're not a cure for everyone.
In the case above, I'm referring to my spouse. Her entire family has this problem - dry eye, frequent / continuous corneal erosions - setting in by their mid-late thirties. These are the people who end up wearing sleeping goggles, ointment, taping their lids shut, etc. It's not a lack of tear production, it's poor corneal basement layer adhesion for some undiagnosed reason and, probably, eyelids drifting open during sleep.
Specifically, "Visual symptoms and dissatisfaction with vision were common preoperatively. Overall, the prevalence of visual symptoms and dry eye symptoms decreased, although a substantial percentage of participants reported new visual symptoms after surgery (43% [95% CI, 31%-55%] from the PROWL-1 study and 46% [95% CI, 33%-58%] from the PROWL-2 study at 3 months)."
Anecdotal, obviously, but the only person I know that has had Lasik now has terrible, chronic dry eyes. I took stats with her; she said it never even crossed her mind that it might actually be pretty risky.
Yeah, the headline scared the heck out of me, since I had lasik done about 10 years ago, but (at least in the article) there's no way to tell if the people who are having problems wouldn't have had problems if they hadn't gotten lasik in the first place.
MY STORY:
I was recently interested in Lasik because I could no longer wear contacts. I ran into Dr. Oz's expose video right away, and realized that since at least 2013 there was a constant local/national news cycle promoting the lasikcomplications.com group.
This freaked me out quite a bit.
I read many of the negative posts, not all, but a large number said something like "Dr's told me my cornea wasn't thick enough but I had the procedure anyway."
In the U.S. ~9 million people have had Lasik, internationally it's 30 million. There FB group has effectively no membership, their FDA petition has less than 2k signers.
The site mentions suicide rate prominently, but the baseline suicide rate from https://afsp.org/about-suicide/suicide-statistics/ is 14.0 per 100,000, and it didn't seem like that rate was higher for people who got Lasik, it seemed lower really.
Ok, so I was confident that people with real complications have an outlet, and that outlet seems to be concentrated in this single group, so english world complaints should be pretty reliably represented in this group... and there just aren't that many complaints.
so...... statistically outcomes look great.
RESULT:
I got Lasik 4 months ago, couldn't be happier with the outcome, due to my risk tolerances if I could have kept wearing contacts I wouldn't have gotten it but everything has been hunky dory. On the plus side because I can easily wear sunglasses again my light triggered migraines (transitioning to sunlight is a problem) have all but disappeared and I am back long distance cycling again because my vision isn't jostling on the bike any longer.
Also, this group definitely juices its numbers by focusing on the large percentage of people who have dry eyes and halos during the recovery period and they include those as "complications", I had those for the first month, I've since met a surprising number of people who got Lasik (they come out of the woodwork once you get it) and people have different lengths of recovery from dry eyes, the longest I've met was 7 months and they were still very happy with getting it.
You can find negative experiences, sure, but what is the actual incidence of that? Without that data, this is utterly meaningless. It certainly isn't damning.