Comment by vladgur | Hacker News Reader

Comment by vladgur | Hacker News Reader

The article links to a FDA study on outcomes [1] but is very selective at what it chooses to highlight.

Here is what article singled out: “In a recent study, the FDA found nearly half of participants who had no visual symptoms prior to the surgery reported having some complication three months after surgery.”

AND here are ALL the conclusions from the linked study results:

* Up to 46 percent of participants, who had no visual symptoms before surgery, reported at least one visual symptom at three months after surgery.

* Participants who developed new visual symptoms after surgery, most often developed halos. Up to 40 percent of participants with no halos before LASIK had halos three months following surgery.

* Up to 28 percent of participants with no symptoms of dry eyes before LASIK, reported dry eye symptoms at three months after their surgery. This is consistent with previous studies. * Less than 1 percent of study participants experienced "a lot of difficulty" with or inability to do usual activities without corrective lenses because of any one visual symptom (starbursts, ghosting, halos, glare) after LASIK surgery.

* More than 95% of participants were satisfied with their vision following LASIK surgery.

* Participants were more than twice as likely to report their visual symptoms on a questionnaire than to tell them to their health care provider

So what this means is that more than 50% of participants of the study had NO visual symptoms 3 months after the surgery and including those that did have some symptoms, 95% of ALL participants were happy with the outcome.

Add me to those 95% -- I had my Lasik done a decade ago at the Stanford Eye Center and had a quick recovery with zero complications and zero side effects

[1] https://www.fda.gov/medical-devices/lasik/lasik-quality-life...

I suspect the halo thing is not an objective problem. People just get alert and start noticing it, or could not see it before due to blurriness. That was my impression after having several conversations with my wife who had LASIK and complained about halos.

It finally convinced her, when several consecutive days I had what she described as "halos" because I was tired and could not properly focus at late night.

Myself having a nearly perfect vision at the time never paid attention to them before she expressed her concert about that effect after surgery.

I'm not sure in your wife's particular case, but halos are a negative side effect of LASIK in some cases. It is not something that is always there the patient can now see. It has to do with the size of a patient's pupil versus the size of the area that can get corrected. Patients with very large pupils are told not to get the surgery period due to adverse halo effects.

I have large pupils and no halos more than 2 years post surgery.

I have decided against LASIK due to the potential for halos. I am susceptible to optical migraines and when I have one I see halos and it drives my nuts. I would hate to have even a fraction of that experience every day.

If you believe my conclusion, the halos after LASIK are not a real problem: there's actually no difference in experience between people who underwent LASIK and complain about halos and a healthy person: both see the same halos under the same conditions (e.g. night time and/or being tired). It is just that people after LASIK suddenly start paying attention to those halos.

I suspect it is a very mild form of post-surgery paranoia. I have a very similar thing after a minor surgery in the abdomen area: I started paying waaay more attention to what happens in my stomach.

Unrelated, but you're the first person I've ever heard who had optical migraines, which I have too. I experience them as shooting lights followed by essentially a shut down in vision in the affected eye. Never thought about Lasik making it worse but glad to never have done it if that's the same experience. It's miserable when it happens.

I have halos after LASIK and they don’t bother me. I understand how they would have a negative association because you experience them at the same time as a migraine, but they don’t cause me any suffering. They’re just... things that in my visual field that I don’t pay much attention do. When I notice them, they are a gentle reminder of how fascinating brains and eyes are.

And honestly, three months doesn't seem long enough for a followup. My wife got LASIK and I think it was about six months before her eyes were back to normal (wrt halo and dryness).

All of the symptoms listed were clearly discussed and raised as risks of LASIK when I got it (also at the Stanford Eye Center, with the only issue being somewhat more frequent dry eyes)

Up to 46 percent of participants, who had no visual symptoms before surgery*

Why would you undergo elective surgery if you had zero symptoms?

Because having to deal with glasses/contacts is a small but annoying life problem.

Poor visual acuity is a significant, life-affecting symptom, and neither glasses nor contacts are full-time, all-conditions-suitable corrective measures.

The quoted statistic literally says "no symptoms". Like you, I assume "can't see well" is itself a symptom.

They mean of all the people who did not have one of the three side-effects of LASIK before the surgery, 46% now suffer from such symptoms after LASIK. Basically suggesting that LASIK caused these complications.

Reminds me of the time Ralph Nader tried to ban cataract surgery...

https://www.eyeworld.org/article-marcus-welby--md--knew-best

From your article, his group tried to get lens implants classified as drugs making them subject to FDA regulation.

And the FDA had already decided to ban them until there was a public outcry that drove Congress to override the FDA. That's in the article too.

No, it is not. The FDA wanted it's use ruled "experimental" meaning it would need to go through more rigorous testing before being available.

So this quote isn't in the article or the person who wrote the article is a liar? Gotcha.

"Even though the FDA had already made up its mind to ban IOLs, the directive came down from Congress that you can study IOLs, but you can't ban them."

He was directly asked if the hearings could have potentially killed IOL's and replied

>they were shooting very hard for control. They said intraocular lenses are drugs and the FDA needed to control drugs

He is one man giving his opinion on what the opposing side was thinking during a debate over thirty years ago. The FDA likely had legimate reasons to continue their fight, they aren't actively hoping people can't see.

Reply on news.ycombinator.com