Doubts About LASIK

Implications: The media reporting on the FDA hearings on LASIK has generally highlighted unhappy patients' stories and the comments of FDA officials and panel members.  However, The Washington Post's Lauran Neergard has written an insightful article that foresees an important future trend in refractive surgery.  She correctly notes that the key to a successful outcome is finding a surgeon who does not have a "favorite" procedure and instead is "qualified to evaluate patients for all of the options."   Equating refractive surgery with LASIK (or laser vision correction in general) unfairly limits a field which includes Refractive Lens Exchange and Phakic Refractive Lenses as well as inicisional techniques, corneal implants and other investigational modalities.  Given the increased doubt engendered by media attention to LASIK, patients who nevertheless seek freedom from glasses will turn to trusted surgeons who perform a range of procedures and can tailor the surgery to fit the patient's desires.  

Analysis: The desire to achieve independence from glasses and contact lenses is the starting point in the decision to have refractive surgery.  The means to achieving that goal vary with the patient's age, refractive error and lifestyle.  Patients in the presbyopia age range (over 45) may be better suited by Refractive Lens Exchange with a multifocal or accommodating intraocular lens (e.g., ReZoom from AMO, ReStor from Alcon or crystalens from eyeonics/B & L).  New technology likely reaching approval in the next 1 - 2 years includes the Tecnis Multifocal (AMO) and the Synchrony (Visiogen).  When these new devices come to market there will very likely be an upswing in the adoption of these procedures.