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Public still wary of LASIK vision correction

07 Sep 2010

Millions now undergo refractive laser eye surgery each year, but more than 80 percent of people still have reservations about the procedure.

Twenty years after the very first laser-assisted in situ keratomileusis (LASIK) procedure was carried out, the technique is now used to perform some 3.5 million vision correction operations annually in Europe.

But despite that huge uptake, and overwhelmingly positive responses from patients who have undergone the procedure, most people still have reservations about laser eye surgery.

As a result, the European Society of Cataract and Refractive Surgeons (ESCRS) has launched a new awareness campaign and web site to provide accurate information about LASIK.

ESCRS says that the need for better information was prompted by a recent survey of 1000 Europeans in which more than 80 percent of respondents admitted to having reservations about laser eye surgery.

José Güell, the ESCRS president, said, “LASIK can be a life-changing procedure, but these survey results show that people do not understand just how safe and effective modern LASIK is in the hands of a well-qualified and experienced surgeon.”

Although the vast majority of patients who have undergone LASIK would recommend it to somebody else (40 of the respondents surveyed had already undergone LASIK, and only one said that they wouldn’t recommend it), two-thirds of people cited some degree of fear about the prospect of laser vision correction. Some 17 percent admitted to being frightened about the potential side effects.

Side effects are rare with LASIK but, like any surgical procedure, there is a chance that things can go wrong. ESCRS’s own new web site includes in its “patient information sheet” a list of possible problems that makes for unnerving reading.

Potential side effects
Although the precise level of risk of side effects is difficult to quantify, for many surgical procedures a figure of 3 percent is quoted, and ESCRS suggests a similar level with LASIK. “There is a risk (between 2.7 percent and 4.8 percent) of a reduction in the quality of vision following LASIK,” states the ESCRS information sheet. Not all eyes are perfectly corrected after one procedure, and the so-called “enhancement rate”, where either a follow-up LASIK procedure or conventional correction is needed to obtain the expected outcome is rated at between 5 percent and 15 percent.

Technological innovation in laser-assisted vision correction has played a key role in improving LASIK outcomes over the past decade, with techniques such as wavefront-guidance for “customized” procedures, and ultrafast lasers now routinely used. Because femtosecond sources deliver laser energy over such a short period of time, the likelihood of collateral damage is lower.

But, as with any medical procedure, the key advice for patients is to seek advice from a general practitioner initially, and to find out as much as possible about any laser eye surgeons that are recommended. ESCRS suggests that potential patients ask how long a surgeon has been performing LASIK, how regularly they carry out procedures, and what proportion of their patients experience complications following the procedure.

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