Refractive surgery has been promoted as a path to happiness and freedom from glasses and contact lenses—it is not. The 20/happy method of evaluating success is not a scientific method to evaluate the success of eye surgeries or vision correction. Approximately 20% of refractive surgery patients have complaints immediately or in the short term; 50% are back in glasses within five years, and at that time correcting vision can be more difficult due to an irregular cornea; and most people who have refractive surgery will develop complications, adverse effects, and/or vision difficulties in the long term, even decades later. The significant rate of complications has even generated new industries promoting treatment for dry eye and specialty contact lenses, and an entirely new category for reporting corneal transplants, in post-refractive patients. Too many patients have committed suicide, due to intractable eye pain (corneal neuralgia) that can develop after refractive surgery—a risk not disclosed on the consent form and for which no treatment relieves the pain.
Refractive surgery is a best guess and the equipment used has a standard deviation, in a situation in which microns (1/1000th of a millimeter) matter to the outcome. The chance of 20/20 vision after refractive surgery, in both eyes, is low; the likelihood of complications in the second surgical eye is higher than in the first eye; and loss in the quality of vision is almost universal. No refractive surgery has withstood the test of time, and the most current innovation in refractive surgery (SMILE) is no different. Each time doctors say “so sorry we did not know but we have something better now”, and each time it has turned out to be a false promise.
Refractive surgery a point of no return, with limited options to restore good vision and eye comfort after surgery when the patient is “unhappy”; and many will reflect upon having refractive surgery as the worst decision of their life!
“Relationship between lipid layer thickness, incomplete blinking rate and tear film instability in patients with different myopia degrees after small-incision lenticule extraction.”