Is LASIK the issue or is choosing the right refractive surgery for the right patient the real issue?

Implications: I welcome the FDA investigation of LASIK, as thousands of patients are undergoing the elective cosmetic procedure, with some achieving less than optimum results.  Will the study show that LASIK is not safe, or will it show that LASIK is not the real issue, rather that patient selection is the true issue?

Analysis: LASIK has been around now for more than a decade with thousands of satisfied patients, including hundreds of mine.  The complaints the FDA study is investigating, I feel, will come down to the fact that most of the patients with complaints should have never undergone LASIK to begin with.  Patients with corneas too thin to undergo LASIK, patients with large pupils, patients with severe dry eyes, patients who were not properly counseled on the effect that correcting their nearsightedness would have on their near vision after age 40 (effect is the same for any means of correcting nearsightedness), and patients with expectations beyond the capabilities of LASIK will make up the vast majority of the complaints the FDA will assess.  Proper patient counseling pre-operatively, as well as better screening by the surgeons---the large percentage already properly do both---will greatly reduce the adverse results with LASIK.  Finally, I agree with Dr. Packer that other refractive surgery options may work better for patients in whom LASIK is not the best option.