What you must know

What does the evidence show?

It's not easy to sort through the evidence about vision-correction surgery. Much of the research comes from surgeons who do the procedure and may be more likely to publish positive results. Critics have emerged—doctors and patients—who have expressed concern about the safety of the procedure. Moreover, the Food and Drug Administration says on its Web site that the long-term safety and effectiveness of Lasik surgery is not known because there's insufficient data. The FDA recently convened a panel that identified a number of concerns, and urged consumers to be aware of the risks and report problems with the surgery to the agency.

Currently the evidence shows that:

• Several laser vision-corrective surgeries are available. Various surgeries and lasers offer advantages in specific circumstances, but the lack of well-designed comparisons makes it impossible at this time to identify one as better than another overall.
• Satisfaction is high with laser vision-corrective surgery regardless of which procedure is used or when the procedure is done.
• However, as we also found in our survey, a significant portion of patients still need glasses following these procedures. While many of them require glasses to help see up close, 14 percent still need to wear glasses all of the time or almost always.
• A significant portion of patients experience side effects soon after surgery (53 percent in our survey) and many patients experience them six months after surgery, especially dry eyes and visual symptoms like halos, glare, and starbursts around lights. Within a month of laser vision surgery, many Consumer Reports respondents reported some problems, such as glare, dryness, sensitivity to light, or blurry vision in one or both eyes, problems that persisted six months after surgery for 22 percent.

What could go wrong?

A recent review of Lasik complications organizes adverse events as follows:

1. Problems that occur as a result of the flap that is created in the eye surface.
2. Problems that occur as a result of the laser application to the cornea.
3. Problems related to healing, infection, and inflammation.
4. Other problems.

Complications can be sorted into common (greater than 10 percent), somewhat common (1 to10 percent), or rare (less than1 percent).

 Reducing the thickness of the cornea can result in inaccurate testing results for pressures within the eye. As a result, more expensive tests have to be used to screen for glaucoma or to monitor glaucoma treatment.

Source: Data compiled from a review of Lasik complications from the American Journal of Ophthalmology (April 2006) and Consumer Reports National Research Center survey of 793 adults in March and April 2009. Frequency of side effects within four weeks of surgery for glare, halos, and starbursts; hazy, blurry vision; inflammation, irritation; and night-vision problems derived from Consumer Reports survey. Data on other side effects as well as corroboration with Consumer Reports findings came from the April 2006 review. Both sources identify dry eye as a common side effect; the April 2006 review found that dry eye could occur in up to 48 percent of patients in the first six months after surgery.