Refractive Vision Surgery Gives Long-Term Stable Results

Although many people worry about the long-term stability of the results they get with LASIK or other refractive procedures, recent studies are showing that the results of LASIK are indeed stable over the long term and lead to most people experiencing satisfaction with their vision for many years after receiving treatment. According to one study, about 88% of people who get refractive surgery have as good or better vision 12 years after, and another study shows that nearly 85% of people are satisfied with their vision correction 14 years after surgery.

A Lack of Long-Term Data

In 2006, an editorial in the Journal of Refractive Surgery pointed out that no-one had published a significant study of 10-year safety data on LASIK. This article pointed out that if the officially acknowledged complication rates were true, then the number of people who experienced some complications would be 23-75 times more than actually observed. The lack of published results was touted as "no news is good news," but also used as a call to surgeons to publish their actual complication rates to educate the public about the safety of laser vision correction.

Supplying the Lack

In the same issue of the Journal of Refractive Surgery, a 12-year follow-up of a small population of laser vision correction recipients. The study compared 2-year results of an initial population of 80 patients (120 eyes) to 34 patients (58 eyes) that returned after 12 years. According to the study, 87.9% of eyes had maintained their vision, and 34.5% of them had actually gained one line of visual acuity. 67% of eyes had uncorrected visual acuity of ≥20/20. Complications noted were a trace haze in 17.2% of eyes, and night vision problems in 41% of eyes. Night vision problems were only considered severe in 2.7% of eyes.

More recently, a study published in the June 2009 issue of the Journal of Refractive Surgery shows the results of a survey of refractive surgery recipients over 14 years after receiving surgery. This survey included 31 patients (49 eyes) who had surgery between 1991 and 1993. The patients were divided into two groups: those who had surgery for low myopia and those who had surgery for high myopia. Among the low myopia group, 84% were still satisfied with their vision, and among the high myopia group 75% were satisfied.

Significant Data Still Needed

Unfortunately, these two studies are typical of reported results. A small number of studies exist focusing on the long-term safety of refractive surgeries like LASIK, and those that exist focus on a very small number of patients and eyes. With millions of procedures being performed every year, there should be plenty of raw material for studies. Why are ophthalmologists not performing these studies and publishing their results?

Faced with anecdotal reports of severe complications and negative outcomes, the Food and Drug Administration has decided to take matters into its own hands. It is currently performing investigations into the long-term safety and complication rates of LASIK and other refractive surgeries and may soon publish new guidelines.