May 9, 2023 – For people with poor vision, waking up in the morning without immediately needing to find your glasses or rushing to insert contact lenses sounds like a dream. That’s why LASIK eye surgery -- laser-assisted in situ keratomileusis -- is one of the most popular elective surgeries in the U.S.
But since the dawning of the surgery, concerns have surfaced from a growing number of LASIK patients who aren’t satisfied with their results. While the FDA says the majority of LASIK patients are satisfied, some have said the surgery has done more harm than good, not just to their vision – but to their mental health.
The procedure uses a laser to permanently reshape the cornea to correct nearsightedness, farsightedness, and astigmatism. Roughly 600,00-700,000 LASIK surgeries are performed each year, according to recent data, and it takes about 30 minutes to perform (with costs varying between $1,500-$2,500 per eye).
The possible relationship between LASIK and adverse mental health outcomes isn’t a new idea. In 2008, during an FDA meeting, LASIK patients and their families were able to share their stories.
One testimony came from a father of a LASIK patient who died by suicide at 28 years old. Gerald Dorrian, father to the late Colin Dorrian, said his son had no history of mental illness before he got the procedure for his poor vision and astigmatism. Colin Dorrian was warned that there was a small chance that his large pupils could increase the risk of longer-term side effects, but he proceeded with the surgery.
He’d eventually experience problems, from seeing overlapping triple images, halos, and a number of other vision issues. In a final letter, which Gerald Dorrian read aloud to health officials, Colin Dorrian wrote, “If I can’t get my eyes fixed, I’m going to kill myself. At the time of this writing, I have lived for 6-and-a-half years like this, and it drives me more and more crazy every single day. ... Every single thing I look at ... looks ugly and confusing to me. I just cannot accept the fact that I’m supposed to live like this.”
Since Colin Dorrian’s death, the FDA has continued to make a point of warning people about the complications that could come from LASIK, urging doctors to be as transparent as possible with prospective patients.
The most common side effect of LASIK is dry eye. Studies have shown that a majority of patients report dry eye symptoms in the weeks and months following their surgeries, with 95% reporting dry eye immediately after surgery. According to the data, dry eye tends to peak a few months after the procedure, and then most patients see improvements within 6 to 12 months.
And although studies from the FDA concluded that an overwhelming majority of LASIK patients are satisfied with their surgeries, there continues to be a smaller but growing number of people who feel that LASIK has caused them lifelong visual impairments. Halos, difficulty driving at night, light sensitivity, and seeing double – all of these can have a negative impact on patients’ quality of life.
Kira Manusis, MD, an ophthalmologist at Mount Sinai Hospital in New York, says that, like any surgery, LASIK has its complications but the rate is very low. And while it’s not protocol for doctors to ask patients about their mental health history before the procedure, Manusis says it’s evident that someone wouldn’t be a good candidate for LASIK when they come in with “unrealistic expectations” for their post-surgery vision.
“They may or may not need a touch-up, there may be a complication [that results in] loss of sight from laser vision correction ... but that risk is extremely low,” says Manusis. “So if someone is unable to comprehend it, or deal with that as a possibility, then that's a big red flag. That's someone who should not have laser vision correction.”
In the summer of 2022, the FDA issued a draft guidance to inform the public about some of LASIK’s adverse outcomes, including the potential risk of “psychological harm.”
The draft document garnered more than 700 comments from the public, ranging from many happy LASIK customers whose lives have been changed for the better to a smaller group who says the surgery and its lasting negative effects have taken enormous tolls on their mental well-being.
Studies have clearly shown that LASIK has a high satisfaction rate, but when it comes to evaluating the frequency of LASIK complications, depression, and even suicide, “it’s currently an unknowable thing,” says ophthalmologist Julie Schallhorn, MD, an associate professor from the University of San Francisco’s ophthalmology department who specializes in the study of refractive surgery outcomes for patients.
“LASIK is a really common procedure. A lot of people get LASIK every single day. Mental health issues are also very common in the United States,” Schallhorn said. “Is the fact that somebody who got LASIK and had mental health issues caused by LASIK? Or is it just the fact that people get LASIK and people have mental health issues and those two things happen to be temporally related?”