• S.

  Very informative web site! I am scheduled for PRK next month using the Novatec laser. After reading your article I have some serious doubts now. I am a -3.5D...

• Al

  ...your site is one of the best sites that I have seen telling the truth about refractive "surgery" ...

• tsm

  thanks for your eyes site. It contains lot of answers i was looking for. And great job!

• Ro

  wish i'd known. you trust doctors; or at least i used to. if it wasn't safe, they wouldn't do it, would they? ***bull***.....

• Ron

  I ran across the URL for your web page while browsing the NG's. I've only read a portion but have found it to be very informative. I'm bookmarking the page for future reference.

• R., Midwest

  Lots of good info...although mostly negative. Here is my rationalization. I'm blind without glasses. How much security will I have if I get the operation and can at least find my butt with both hands? Probably more security than I have now.

• R.M

  Thank you for providing this very helpful information.

• T.

  Congratulations! You won the grand prize! A deluxe coffin and 68 Cadillac hearse for the best 'doom and gloom' site!... But seriously, a very interesting and informative site. I do agree that everyone should do their own homework as you clearly point out and make up their own mind about these surgeries.

• rk

  I think your site is doing a service to the public and applaud your efforts.

• Gary

  ...Your site is definetly one sided and only stresses the perceived negative side of refractive eye surgery. We only get one chance in life, so one must live life to it's fullest! Decisions have to made daily in our lives and this one was a no brainer!

• M.S.

  Thanks for creating your website. It has been a great source of information for me....

• R.K.

  Just a private message re: your site. Good website. Obviously biased but informative and reasonably fair....

• O.B.

  That is a very impressive Web Site. I saved the text and will read it tonight.

• P.

  Thanks for your wonderful and disturbing website.

• E.W.

  Thank you for the webpage I was almost certainly going to get PRK before now I am very unsure.

• P.M.

  Thanks for taking the time to develop the most useful site or information that I have seen that addresses the subject of refractive surgery. Any practitioner, if he/she has the best interest of their patient at heart, should welcome this information and have his/her patient read your site completely.

• H.

  ...I really think your message is important. But you didn't quite convince me. I am having PRK next Wednesday afternoon. Right now I am -4.75/-5.00, corrected to a perfect 20/20 with glasses. I feel I am an informed consumer. I know the risks, and I decided I could live with them. Wish me luck.

• P.S.

  I found your Website recently, in my search for info on refractive surgery. Thanks for making such comprehensive information available! It's really great to see an alternative view after the floods of "info" from the commercial sites....

• h.R., MD, JD

  I read much about medical or legal or litigation or health subjects individually and collectively. Have been around the block more than a few times. Yours IS one of the BEST sites produced by a private person for good reason. Good luck.

• H-T

  THANKS FOR HELPING ME SEE THE LIGHT!

• R.S.

  Thanx for the very important information.... What a Site/sight!!!

• C.P.

  I've read all the negative aspects about refractive surgery, I'm sure there's some positives too. I've presonally considered having the operation done but, after reading this site I'm convinced, that I rather wear glasses or find another alternative to my nearsightedness!

• B.

  ... Thank you for taking so much time to put together your web site. It offers more information about the risks and negative aspects of refractive surgery (even for "successful" outcomes) than any other that I have found....I have a few issues with your site, but they require more research on my part. I may be wrong, and I'm not going to "bust your balls," so to speak, until I check for myself.

• JrS

  Excellent website! I wish I had found it before I had my lasik surgery, but I don't think it would have stopped me from having the sugery. I was a -12.00 prior to lasik and I'm a -0.75 now. Many of the post-op problems I have were discussed in advance. That does not make them less of a problem, but they are not a surprise either. Without my glasses, there is some fuzziness under low light conditions and I have to stare at small objects for a few seconds before my vision clears. However, before sugery I was vitually blind during the day without glasses and, at night could not see a person standing still in the dark at a very short distance. Also, the thought of losing a contact lens or getting a speck of dust in my eye while driving was not a pleasant thought. After 12 hours of wearing gas perm contacts, my eyes were puffy, vision was not as sharp, and it was a relief to remove the lenses and rub my eyes. I was scared to have the surgery but it turned out fairly well, I'm six months post-op. For me, the most important factor in having the surgery was the skill of the doctor. I believe him to be one of the more skilled surgeons in this field, having done several thousand proceedures over the years. A doctor who buys a laser and instantly becomes an expert with it is indeed a scary thing. I have seen far too many ads for lasik in the last six months and wonder where these doctors have gained all their experience. Thanks again for a most informative site.

• B.A. (optometrist)

  I commend you for this site.... I have been an optometrist for 30 years and have warned all my patients of the dangers of refractive surgery. These cornea wounds are so large, they NEVER heal! I see all too frequently the handiwork of these surgeons, and the great unhappiness they have caused. I have printed your site in its entirety and placed multiple copies in our reception area so our patients can learn the truth about these surgeries.... Again, thank you for creating this site.

• Jun

  Subj: Appreciation
  Date: 97-09-25 07:01:04 EDT
  From: Jun
  
  You guys are cool! Thanks for coming up with this web site. Just this Wednesday afternoon I had a personal consultation about refractive surgery. I've been wanting this (which is what everyone who wears glasses or contacts wants: perfect 20/20 vision) for some time now. My surgeon told me I was a "good candidate." I asked him if my eyes will be sensitive to light and he said, "No." I told him about a girl I meet in college who had eye surgery and could not drive at night. Would that happen to me? Again he said, "No." I asked if I have to wear glasses after the surgery, and again he replied, "No." Now that was really exciting. No more glasses camping, no more contacts dancing and clubbing,...Wow...He said I could even have the surgery tomorrow if I wanted. Really?! I got so excited I wanted it done IMMEDIATELY! I signed all the paperwork briefly, and I mean briefly and quickly reading it. I just initialed all the little boxes, thinking, "What the heck! It has to be safe, I saw 'FDA' somewhere in there. And who cares! By next week my vision will be PurrFECT!!" Well, my PRK or PARK (I'm not clear which one it is) appointment was scheduled for Friday, not tomorrow. Thankgoodness because I got some time to do some research. Every freakin' web site was made by some insitution or Dr. All the information I was getting was the same -- until I got to yours. You are very much appreciated with all the research effort and time you put into this site. Ignore that one surgeon who told you guys to find a satisfying job, you already have at least one. It's important to inform the public. Can I ask you for one more favor? Can you please call my LaZer/ PRk/YXz surgeon and cancell my surgery procedure for Friday? :)
  

• T.C.

  ... Wish I had known. I had PRK over a year ago, and although I can see 20/20, my night vision is trashed. I was enthusiastic about the results initially, but now I wish I hadn't done it. Maybe if your site had been around when I made this decision, things would be different now.

• J.D.

  Your site is incredible, great job. It made me wonder - Will PRK and LASIK be the breast implant scandal of the 21st century?!?! Now THAT IS SOMETHING TO THINK ABOUT!

• D.S. (refractive surgeon)
  ...
  FYI, I received the following from a recent patient that was not diverted by your site. Contrary to your rantings and ravings, the ability to make patients like this happy is the real reason most of us do refractive surgery. Maybe you need to find an occupation that is as satisfying.
  
  Subject: Thanks
  Date: Thu, 24 Jul 1997 17:33:34 -0400 (EDT)
  From: xxxxxx@aol.com
  To: ds@eeeee
  
  Hi, Dr. St, It's xxxxxxx from xville. I just wanted to say THANK YOU!!! I couldn't be more pleased with my surgery results. I saw Dr. T. this morning and everything looked good. I was so excited when I got back to xville I went by xxxxxx's office to thank him for telling me about the LASIK procedure, and he was as excited as I was and very impressed with how my eyes looked. He called in xxxxxx and xxxxx and a couple of other people to see the results, and we had quite a party!
  
  I am just so grateful to you, especially for working with me on my left eye. You were right -- once I had tasted success, I was starved for more. This is fabulous! I told T. to use me as a reference if he needed to, and I'll tell you the same. I'm on such an adenaline high -- I feel like a new woman!
  
  Thanks for everything, and I'll see you in three months --
  
  
• E.S. (ophtalmologist; does not do refractive surgery)

  You have made some excellentpoints at your WebSite, and I am impressed by the technical accuracy (I am an ophthalmologist but I don't do refractive surgery).

  1. It is important to stress that Institute means NOTHING. A one man ophthalmologist can have a little solo practice office in a a crumbling old medical building and can name it the YOURTOWN (or YOUR STATE or QUAD CITIES) LASER VISION INSTITUTE, and have cards printed up with DIRECTOR OF THE INSTITUTE. It's NOT an institute, like Columbia or Georgetown Medical Center-- it's just him, his secretaries, and maybe some employee ophthalmologists/optomotrist/ secretarties he's trained to do eye exams, working for him as his employess, not his professional colleagues.

  INSTITUTE should be a regulated term. To consumers, its means great knowledge, a large staff of professors, medical reasearch and medical ethics, and to be the director is a great honor.

  (It cracks me up when a patient tells me, "I had surgery at the Jones Eye Institute, and Dr. Jones HIMSELF did the surgery". WHO ELSE would have done it? The RECEPTIONIST?)

  2. Why are people with provably poor results after surgery still "happy" with their results?

  • a. You make the excellent point of who is doing the survey; results can be skewed by asking in a certain way.
    
  • b. The decision to have a second eye done is not necessarily an endorsement of the procedure, it is a testimony to the misery of anisometropia. Most people cannot function with anisometopia of greater than 3 D. I have done cataract surgery on people with high refractive errors, and made them temporarily anisometropic for a few weeks until I do the 2nd eye (i.e., a person with bilateral cataracts and bilateral -6.00, who I made temporarily -2.00 and -6.00,), and they were miserable during that times because the imags out of each eye are of unequal size. They were miserable and diploplic, both corrected and uncorrected. The only answer was an extended wear contact lens.
    
  • c. "Cognative dissonance" is a psychiatric term for people realizing that they've made a wrong decision but it is an irrovocable decision, so therefore (to keep their psyche intact) deciding that it really was a right decision after all (even though to the unbiased observer it obviously wasn't.)
    
  
  3. The most important point you made is that the vision you get may not be as good as the vision you get with your glasses. And before you say, "Oh, I'd rather have 20/30 without glasses thatn 20/20 with, it's and ecellent idea to fog your glasses for a day with vaseline and try to function-- Driving, both map reading (is that route 280 or route 230?) and navigating (Is that Kennedy Street?) and reading and working. Intermittently my contacts are cloudy and I have 20/30 vision and I HATE it.
  
  4. You might address the market forces that are driving refractive surgery.When I started in ophthalmology in 1987 we were paid about 2,300 to do a cataract. Now we are paid 980 and its going to 600. Refractive surgery starts to look great financially. Additionally, optomotrists are negociating with mega-managed care companies to to the primary eye care, and getting legistlation passed nationally to prescribe medications for eye diseases. Some of us just work harder and longer. Others turn to refractive surgery.
  
  5. My husband thinks I'm nuts to be writing to you at all but I beleive that the doctor and the consumer are allies, not enemies, and that an informed patient is the best patient of all. I personally applaud your work and I have mentioned (and will mention) your site to others. You might consider sending a summary to the health editors of newspapers; you are making important points not usually mentioned.
  
  
• J.B.

  ..Your description of the lay media was uncanny.. If every 'medical breakthrough' pronounced on the nightly news or in the newspaper or magazines was true, we would live to be a thousand, and never get sick. NOT!.....
  
  

• S.G. (ophthalmologist, not refractive surgeon)

  I am a retinal (not refractive surgeon) who agrees with most of your information. I believe your definition of elective is incorrect. Elective basically means non-emergent. For example if a patient has a vitreous hemorrhage, surgery is scheduled electively to remove the hemorrhage. It does not mean that the procedure is not required. ED. NOTE - The definitions for elective, medically necessary and medically unnecessary will be clarified.
  
  

• J.K.

  I wish that I had found this page before my surgery. I was nearsighted with approxamitely 8 dopters, 20/400, and significant astigmatism. I am 2 months into the recovery of both of my eyes. The first eye is at 20/30 or so they say. I feel it is more like 20/40 due to some serious secondary immages or reflections behind the letters. I think this is an astigimatism problem. The second eye came out much better approx 20/25 with far less problems. The doctor is currently unresponsive to my concerns about the first eye. Guess he falls in the slash for cash cagegory. :) The page is excellent and informative, even if it proves that I was an idiot to buy into the hype. Hope I can scare my coworkers out of the sugarcoated dreams presented to me. Thanks for listening and great page.

  
  
• TCO

  I have no agenda or axe to grind (I am contemplating PRK though.... It is very informative, perhaps negatively biased, but well done and quite complete.

  
  
• AM
  

  I had RK surgery in January of '94. My night vision is awful. I did sign a consent form. I was told that the operation will leave very small scars but that I would not be able to see them. Have you heard of an RK lawsuit being won when the patient did sign a consent form? If so, can I have the attorney's name? I'm glad you have the EyeKnowWhy site. I wish I would have found some information like this before the operation.

  
  
• NC
  

  I just want to thank you for the detailed and straight forward information on refractive surgery. I have serious astigmatism and AK was recommended to me by my optician. I had doubts about the reliability of such surgery and was looking for some solid information and statistics on it over the internet. It sure was difficult to find. I think you are providing a very important service to educating the consumers and I hope it helps many others as it helped me.

  
  
• GL (Ophthalmologist,not a refractive surgeon)
  

  I found your site very informative, and in many ways highly objective, but a bit slanted in terms of outcomes vs risk/benefits and completely ignores the problems highly myopic patients experience before they decide to have corrective surgery performed. Much of what you say is true, and some procedures are performed because of market pressures. The overall development of excimer laser for corrective eye surgery has not been higly profitable for the manufacturers, or the surgeons performing the procedure save for a few surgeons who were into "it" early on. There have been patent suits, formation of questionable holding companies so that royalties can be charged for the use of the two approved lasers (VISX and SUMMIT) so that neither company will go bankrupt. At the same time there are newer and much better lasers in the pipeline being developed now. Such as Novatec, Chiron, Autonomous, and others. These lasers use much more sophisticated and better eye tracking systems, and more homogeneous beams for smoother more accurate and graded ablations. This is still a relatively new technology, and many of your statistics are old, and based upon older procedures. RK and PRK/LASIK are like comparing apples and oranges... I would recommend your site to any of my patients considering this procedure, because it is so thorough.

  
  
• BM
  

  Thank you for gathering this information. I have decided to delay, and probably never re-schedule, my appointment for my first eye. I am afraid of not being quite satisfied, of not being "just right". It seems that their may be some justification for this fear, with the numerous side effects or other results. I see just fine with glasses and contacts, and even though i have wanted this type of procedure since I first heard of it many years ago, I think that in my case it is now unneeded. I can wear my contacts when I feel vain, and my myopia may be a gift when time for preysopia sets in. Thanks for gathering this info and making it available on the web!

• J.

  I'm trying to make an intelligent decision. I agree with you in that sometimes it's hard to get the real data out of the doctors. However, you provide even less real data, instead opting for scare tactics. Is the probability of losing an eye more than or less than winning the lottery or a meteor striking earth and wiping out the population? etc. Also, the sue, sue, sue is a turn off for me (and, I hope) most Americans. Why are you doing this? ...

  Our Response: ... We are glad that you are doing your due diligence prior to making a decision to have refractive surgery. We must disagree with you regarding the validity of our data. It represents the most comprehensive and accurate research available on the web, and is backed up with cited references that any visitor may review individually at their nearest public and medical school library. We aren't trying to scare anybody, just presenting facts. If those facts are scary to individuals, that is their interpretation. Refractive surgery will always be controversial and frowned upon by the vast majority of the medical profession and lay public. It is invasive surgery on healthy tissue.

  As for the 'sue, sue, sue' theme, you are wrong. In fact, we paint a bleak picture for anyone who would like to sue after surgery. The informed consent form is a formidable barrier for patients who believe they have been injured by refractive surgery, and we believe it is only corrrect to point this out beforehand. We receive email everyweek from individuals who... are seeking... a solution to their postoperative problems. Time and time again, these individuals express regret for treating the informed consent form as a trivial matter. We highly recommend you read Ralph Nader's new book (No Justice) to understand how the American public is NOT sue-happy at all; that the vast majority of civil suits are companies suing other companies, and just how little compensation is paid to people who have been grieviously injured by dangerous medical devices and unethical and incompetent doctors. You may be very surprised. The idea that surgeons are 'drowning' in the swell of a litigious patient population and frequently must pay exorbitant damages is purely propaganda by the medical profession and their malpractice underwriters. The media only reports spectacular judgments, deeming them as newsworthy and skewing the public's perception of malpractice litigation in America. The reality is very different. We urge you to get the facts regarding medical malpractice in America and its true cost as a percentage of America's health care 'bill'.

  As you meet with prospective refractive surgeons, take along a copy of our complication list, and ask about them. If your surgeon appears evasive regarding these complications, perhaps you need to find another surgeon....

If you wish to speak to one of our visitors who has commented, contact us. We will email them and provide them your email address. It is up to them to contact you. If you would like to ask questions about the surgery, we will give you our opinions with the understanding that we are NOT ophthalmologists or optometrists. Questions and answers are usually not posted on this comments page.

If you have any questions or comments, please contact eyeknowwhy@aol.com.