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An Outspoken Few Are Disillusioned With LASIK Surgery

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Kristin Pisacano, MD, medical director of refractive surgery at the New York Eye Surgery Center in the Bronx, also wants to help consumers understand what they're getting into.

"It's hard to tell what went wrong with Roger and Howard," who posted on the Surgical Eyes site, says Pisacano, author of the book LASIK Vision Correction. But they likely had complications which, if they were treated in a timely manner, could have been corrected.

The more serious complication, called "sands," creates a painful, dry-eye condition that is treatable -- but must be treated correctly and immediately, she tells WebMD. "Nobody knows exactly what causes it," she tells WebMD. It's treatable with drops, or sometimes the surgeon needs to perform a minor surgical procedure to lift the flap again and irrigate the area with solution. "But it is treatable," Pisacano says.

Wrinkles in the flap are rare, but can occur, she says, especially in people who rub or squeeze their eyelids -- sometimes in their sleep. "Those are more tricky to treat, but they are treatable if you're seeing someone who knows how." That condition must also be addressed right away to maintain optimal vision.

The longer such conditions are ignored, the less likely they can be corrected, Pisacano says.

Vision undercorrection and overcorrection are "pretty common," and correctable with a touch-up procedure performed two months after the original operation.

Most LASIK price packages include any follow-up procedures, Pisacano says, except those from many discount operations, which depend on getting patients in and out fast. "That's why I'm a little leery of those places," she tells WebMD.

Finding a good LASIK surgeon and having reasonable expectations are key to satisfaction, she adds. "Most patients are happy. They have realistic expectations when they go in. You need to find a doctor who will realistically explain things to you and not say you're going to see things 20/20 the next day, guaranteed."

Not everyone is a good candidate for LASIK surgery, she adds. "However, discount places aren't turning them away."

In fact, LASIK is one of the few surgical procedures that are marketed competitively, says William W. Culbertson, MD, director of refractive surgery at the Bascom Palmer Eye Institute of the University of Miami School of Medicine. "When the goal is to recruit people and sell them on the procedure, the potential risks are minimized, and patients who are not good candidates are encouraged to have it."

Further, patients often have unrealistic expectations about LASIK, Culbertson says. "I had a patient who had 20/20 in one eye and 20/25 in the other. She was extremely upset that both weren't 20/20. That's not always possible. But her perception was that she was going to have perfect vision.

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