Hacker News Reader

Comment by xyst | Hacker News Reader

Was LASIK surgery experimental back then? Would have alleviated the issues John experienced on a frequent basis with those pesky rigid contact lens.

I think I had similar diagnosis of myopia and astigmatism as John and its worked wonderfully for me. Fortunately this was completely recently where the techniques have been perfected/improved with technology.

View on HN

I've met so many people who've had issues with Lasik at this point that I've decided I'm not going to risk it unless absolutely necessary.

What types of issues? I understand there are a wide range of issues that would exclude a person from being a good candidate (ie, persistent dry eye, uncontrolled diabetes, age, other eye conditions). But any good surgeon would clearly explain that to a patient and not recommend the surgery if it wasn’t ideal.

In my case, the only possible complication was dry eyes prior to surgery. If it wasn’t resolved, then would be canceled.

but fortunately was mitigated with over the counter and some prescription eye drops applied liberally.

I too was skeptical but I think the key is finding a good surgeon with a looong history of doing these surgeries.

I can’t keep my eyes open for the glaucoma test. I’m pretty sure that LASIK Would be impossible for me (unless they have A Clockwork Orange–style devices holding the eyelids open).

> (unless they have A Clockwork Orange–style devices holding the eyelids open).

That’s how it works yes.

Remember the Space Quest zombie?

https://2.bp.blogspot.com/-ZtY3nJ2WptU/VUt7x1dPTQI/AAAAAAAAC...

I’m not sure if it’s the exact device depicted in that film. But the lids are forcibly held in an open state during surgery while you hold your head still on a table and focus on a green light.

I was something like -8, -9.5 before getting LASIK at about 21.

My eyes couldn’t focus beyond a reading distance afterwards. No lens could get me to a legal driving eyesight.

Surgeon had no idea why. He re-lifted the flaps afterwards and flushed beneath them on the hunch that it might be from slight ripples. Horrible experience, didn’t fix it.

Hard contacts worked, but a second surgeon advised against having anything in my eye while we figured it out.

After about a year, it healed enough that eyeglasses could refract me to good vision again.

So I still wear glasses, but my vision is much better without them. (-2ish range these days.) Pretty awful experience, but I like glasses and it was a big improvement from where I was before.

Shit that’s terrible. Wonder if your eye was still undergoing changes. 21 is relatively young.

My surgeon requested vision history from my referring optometrist. And did his own work up at the office. Took 2-3 months of follow ups and “adjustments” (ie, prescribing eye drops to fix dry eyes) to ensure vision was stable and dry eyes wouldn’t impact outcome.

I think there was some guidance around waiting 2–3 years since your prescription changed, which I met—though that's obviously imperfect.

There was never any clear cause/effect. My best guess is that it was from being super tense during the surgery. I found it extremely uncomfortable and intense to be fully conscious, knowing it would be bad news if I moved my eyes during the procedure. (They're holding a flap of your eyeball open during it, etc—super fun.)

Would have requested a little higher dose of Valium if I could do it over again. :) And maybe crossed a border to a high-volume specialty shop instead of my local ophthalmologist.

In many cases (nearing 40%) people end up with worse vision after some number of years. A very high percentage end up with significant problems such as really bad astigmatism. Severe issues such as near blindness, detached corneas, etc are also way too common. There are several good YouTube videos on the subject.

And anecdotally, half of the people who I know that got it done 10+ years ago have had their eyesight regress back to the way it was before or worse.

I honestly don’t know how lasik is allowed to persist with such high risk of complications.

Me too. It's why I won't even consider such a procedure at this point.

Glasses work well for me, so a permanent surgical solution is only something I'm willing to consider if the risk of it adversely affecting my vision is very close to zero. Right now, that's not the case (as evidenced by the fact that I know multiple people who have had adverse effects in the longer run).

This is a very clear-cut case of selection bias. People who have a bad experience are much more likely to talk about it.

Lasik has a less than 70% long term success rate and a fairly high severe failure rate. Apologies but I cannot recall the stat in that one but it was multiple percents. And by severe, I mean near blindness.

Maybe that’s acceptable to you, but not to me.

can you cite the studies? Considering LASIK and most things I google for are just blogspam, I prefer peer reviewed papers

No. The first Laser did not even exist until mid-1960, so they were definitely not in surgical use in 1963-1966. Even the Soviets did not develop Radial Kertotomy surgery until 1974. RK uses a physical scalpel to make small radial incisions around the iris, and the scarring that occurs during healing causes the eyeball to shrink and warp the lens.

https://en.wikipedia.org/wiki/Radial_keratotomy

LASIK hadn't even made it to the conceptual stage then. Early trials for vision correction via radial keratotomy were ongoing at the time of his death.

LASIK wasn't a thing until starting around the late 80's/early 90's.

Before that it was radial keratotomy which my Mom had. Maybe it is apocryphal but she told me they discovered it when a Russian someone got exploded glass in their eye and it improved their vision.

https://en.wikipedia.org/wiki/Radial_keratotomy

According to the wikipedia article, it was a Russian child that fell while riding a bike and his glasses broke and sent pieces of glass into both eyes. The doctor made radial cuts to remove the glass, and discovered that his vision improved afterward.

Makes sense, ha. I only briefly read it was invented in the 50s. But 90s for mainstream adoption and approval sounds about right

I also had a great success with LASIK, but it wasn't invented before his death.

https://en.wikipedia.org/wiki/LASIK#History

A man who died in 1980, of course, couldn't have benefited from a surgery that was FDA approved in 1995.

It's like asking why JFK didn't use the Internet.

Are you saying JFK didn't use the Internet?

Is there any empirical evidence that he did not??

Reply on news.ycombinator.com