wondering about Lasik

[shells]

Yeah, do you guys ever wonder how our attitudes would be if we did have good outcomes? Like before my surgery I was nervous, and all my friends who had successful lasik tried to calm me down and told me it was no big deal. I remember one of them saying "it is easier than getting your teeth cleaned". I mean, I can't really blame them, they just don't know any better, and maybe none of us would either had we had good outcomes. I wonder had my outcome been perfect, if I would be one of those people cheering on the masses to go get their eyes lasered. It kind of makes me sick to think that had everything turned out OK, I would have recommended it to so many people over the last 18 months instead of telling them to stay away from it. Anyway, just my random thoughts for the evening. The football game is over now, so I'm off to bed.

[YGB]

The ultimate solution would have been for all of us to never have heard about LASIK since it should not have been FDA approved with little to no oversight. For the folks who are "happy" with their outcome, they are living in "ignorant bliss". "Side effects" such as dry eye can set in several years after LASIK. I thought the summary from the web link that Neil posted a few days back described LASIK very well. Here's the link and here's the segment I am referring to in italics ... http://drjoeross.com/refractivesurgery.htm

"One question that is consistently asked is "Why do some refractive patients lie?" when it is obvious they continue to experience optical aberrations and ocular disease symptoms. There is a social stigma to stating that your results are less than perfect. If a patient states that they have problems, the person they tell wonders 'why they did it?' and may become concerned for the individual. The emotional and quality of life issue for post operative patients is complex and difficult to segment into only a few subgroups. Over time, perceptions change. Some patients adjust and become 'happy' that were not happy, some who were 'happy' become 'unhappy', others become disillusioned and chronically depressed, and some get on with life and live with the results. Some patients appear to be in a state of 'determined denial' or cognitive dissonance. Cognitive dissonance is the clinical psychiatric diagnosis for people who realize that they've made a wrong decision but because that decision is irrevocable and, to keep their psyche intact, they decide that it really was the right decision after all (even though to the unbiased observer it obviously wasn't.)

Some patients are clearly misguided. Patients are always told " you're the rare exception that has persistent side effects". They are consistently assured that the side effects like GASH will "go away, give it time". These statements, although assuring, wear thin after the first year. As one ophthalmologist EyeKnowWhy spoke with put it, "There are a lot of people walking around with some pretty poor looking corneas and bizarre vision, and you can't tell by just looking at their corneas with the naked eye.""

I know it's a downer to talk about this subject, but at a minimum, hopefully some of the "guests" on this site see it and become better informed about their possible decision to have LASIK. Also, for me, I will hopefully fit under the category of getting on with life and living with the results (hopefully the results will get better). Fortunately or unfortunately depending on which way you look at it, my personality simply does not allow me to be in denial of what happened.

[Rebecca Petris]

Yeah, do you guys ever wonder how our attitudes would be if we did have good outcomes?

I have often thought about this. I'm pretty vocal and am sure I would have become a walking advertisement for LASIK if I had had good results. Worse yet I might have become one of the people out there smugly thinking that the ones with problems didn't select a good doc, didn't do their homework, etc. Ah, and if I'd had a good outcome there wouldn't be a LaserMyEye or a DryEyeZone, or rather somebody else would have had to start them and without the benefit of The Almighty on the graphics & technical end of things. So all in all, I have no regrets.

[shells]

I can understand why patients with only minor symptoms would lie. Personally, I feel embarassed about having the surgery. Here I am suffering with this awful condition, and it is all because of an elective procedure. As much as I want to warn people about it, it isn't always the easiest thing to admit and to discuss. People just look at you like you are insane when you tell them what happened, and since I'm still quite emotionally fragile at times, it can be very hard. On the other hand, I would never downplay it all when asked by a prospective lasik patient. I make sure I give them all the nasty details.

It is awkard though. The other day at lunch it started as a simple conversation with a co-worker who was considering lasik, and next thing I knew the whole lunch table was silent and listening to me and asking me all these questions. I honestly felt like some kind of a freak show. So, I can definitely see how someone with mild dry eye or some other problem that isn't consuming would brush it off like it was no big deal, even if inside it is bothering them.

[shells]

Ah, and if I'd had a good outcome there wouldn't be a LaserMyEye or a DryEyeZone, or rather somebody else would have had to start them and without the benefit of The Almighty on the graphics & technical end of things. So all in all, I have no regrets.

I think we are all happy to have LaserMyEye, DryEyeZone, The Almighty, and you around here! It is great to have a community of people who understand, but at the same time upsetting that so many of us have been through this.

[Rebecca Petris]

[I]"One question that is consistently asked is "Why do some refractive patients lie?" when it is obvious they continue to experience optical aberrations and ocular disease symptoms.... Some patients appear to be in a state of 'determined denial' or cognitive dissonance.

[my bold highlights]
I have always disagreed with this characterization when used as a sweeping statement about those who don't say anything about defects they have. Sure, it's true of some. But I think that there are people who genuinely relate to it differently, are honestly not bothered in the same way by the same things, and do not connect them with the surgery in the same way. Often they are people who had defects before surgery, or people who are experiencing perceived benefits so good that their quality of life is to them much improved even if not "perfect". To describe them as being in denial, or as lying, seems to me narrowminded.

[YGB]

Some patients appear to be in a state of 'determined denial' or cognitive dissonance. Cognitive dissonance is the clinical psychiatric diagnosis for people who realize that they've made a wrong decision but because that decision is irrevocable and, to keep their psyche intact, they decide that it really was the right decision after all (even though to the unbiased observer it obviously wasn't.)

The key word is "some patients". I agree that there are some who even had they known prior to LASIK that they would not see as crisply or might have some form of mild higher order aberrations or they might have mild dry eye or night driving issues, etc., they would have still decided that the benefit of no glasses or contacts outweighed the cons. However, there are some who are truly in denial since they cannot go back in time and change the process. It's quite natural and I agree that it does not apply to everybody. The folks that are in denial are not bad people. It's just unfortunate that for some, this denial/cognitive dissonance can be so strong that they actually believe that the procedure was great and help convince others to have LASIK done.

I suppose at least 1 question that should be asked at LASIK pre-screening that is certainly currently not asked is ... are you willing to likely sacrifice at least some precision and quality of your vision for the benefit of not wearing glasses or contact lenses? For those who answer no they don't mind the sacrifice, then they should proceed. For those who answer yes, then they should be eliminated as potential candidates. MD's measure LASIK success by how close a patient gets to 20/20 on the Snellen chart. Many post-LASIK patients have had the misfortune of learning that you can be 20/20 and be suffering (possibly severely) due to loss of quality of vision as noted above.

[dianat]

I think the notion of having flushed $1500 - $3000 down the toilet can explain cognitive dissonance.

Funny thing, this thread. Clintsmommy started it by saying, "How's your vision?" and look how far we've come...

I have an interesting story about cognitive dissonance...or at least what I think might have been.

A guy I casually know was at a school meeting with me one evening. He was excited to mention to me that he was scheduled for LASIK the next morning. Now, I understand this "freak show" feel Shells mentioned, and I was short on time. So, what I did was told him I needed 3-5 minutes of his time. I told him the very, very shortened version of what had happened to me.

I followed that with the only thing I requested of him: take what I've told you, I'll send you some web sites, links, stories that I'd like you to look at tonight. I did not insist he cancel his surgery. I simply told him to consider postponing it for a few days while he and his wife had the chance to filter through everything I'd given them.

Following my short diatribe, he seemed shocked and told me he'd asked many other LASIK patients from his inner personal "circle" about their experiences and all of them were really happy and thought it was great. (My usual response to this is, "Well, thank goodness they had good experiences.") It's not like I want there to be casualties.

So I sent him on his way. The next time I saw him he was wearing glasses, and told me he'd cancelled and had no intentions of rescheduling the surgery. I was delighted for him and his family. But, something else he said really shocked me.

He said that after I'd given him my perspective on LASIK, he want back to all those other people he'd contacted initially who gave him the green light. He asked them specifically about dryness and I suppose other assorted negative issues he no doubt learned from the sites I directed him to. He found that this time around, many people admitted some of the issues they were having, and many went so far as to say they would never do it again. He was as surprised as I was at this "about face".

Is this cognitive dissonance?!

D

[YGB]

It sounds like a textbook case of cognitive dissonance to me. From my personal experience, I talked to 3 people prior to LASIK who had LASIK within the last two years. All 3 made it sound like it was a piece of cake and that they were very happy with the results. I would have never known different had I not had such problems post-LASIK. Since the effects of LASIK has obviously been a major focus of my life the last several months, I have learned in talking to the 3 people the following ... Person #1 is an early thirties male who has now confided to me that his vision is not as good as it used to be pre-LASIK. He compared it to looking through a "dirty windshield". Person #2 is a 50 year old male who had one eye done since he was going for monovision and the second eye was to be done several months later. He has been informed by his glaucoma MD that he has dry eye in the one LASIK eye and now he does not want to have the second eye done after all. Person #3 is a 60 year old female (give or take a few years) and she went to get an "enhancement" consult about a month ago since she now tells me that she has not been happy with her vision since having LASIK about a year ago. Her LASIK MD informed her that her eyes are very dry and that she would not be a candidate. Nice of her LASIK MD to inform her of this at pre-screening. Too bad it's during the "enhancement" process.

Also, I have taken interest in new LASIK patients that I come across in my post-LASIK days. I have yet to meet a truly perfectly happy patient although I'm sure these folks exist somewhere. I will say that maybe one is said he is happy despite the fact that he "gets occasional floaters since he had LASIK " Also, he is looking to get an "enhancement" since his vision is not as clear as it used to be. However, for argument's sake, I will put him in the "happy" LASIK outcome category. Another person is only one month post-LASIK, but she had post-LASIK surprise that she now has a plug in her one eye (she also went for monovision so only one eye was done). She was in the early stage of post-LASIK surprise and said her LASIK eye feels like there is a cyclone going on in there the way the tears are moving. The good news for her is that she at least has tears moving at this point.

I believe that the "narrow-minded" ones are the MD's who measure LASIK success solely through the Snellen Chart and how close they can get patients to 20/20 vision. Can you get any more narrow minded than that when you know that visual quality is so much more than just seeing 20/20? Are there patients who are truly happy. I'm sure there are although they likely do not know that there are also some serious long-term risks associated with LASIK. We're they truly informed of both the short and long-term risks prior to LASIK? Will some of them end up having LASIK issues later in life? Probably. Will they be happy then? Based on all I have learned about this flawed LASIK procedure, I am confident that most people would choose NOT to have LASIK done if they were informed of the risks of LASIK, both short and long-term. There is no better proof for this position than the fact that the overwhelming amount of Ophthalmologists wear glasses or contacts (mostly glasses). These MD's are truly informed of the risks of LASIK, but many, if not all, are not sharing this information with John Q. Public. However, they are likely sharing this information to their own family members. In my opinion, the reason is simple ... $'s and the "white wall of silence".

[clintsmommy]

I am definitely not thinking about an enhancement. I think I have abused my eyes enough with the contacts and Lasik. I know glasses is the only option, however, while I was signing the papers that you DO NOT COMPLETELY READ before surgery, there was one paper that said something about glasses not working if my vision regresses. I guess this means like halos and starbursts right? Man was I dumb. I do not dare tell my husband or family how ashamed I feel for having this surgery, because I paid so much for it, and my dad told me not to do it. He also used to tell me not to wear contacts because they were going to damage my eyes. I should have listened. Just add this to my list of regrets.