Patient Satisfaction of Lasik Surgery

LASIK success is measured by the LASIK industry as uncorrected visual acuity under bright illumination. Patients seeking vision correction are most concerned with elimination of glasses or contact lenses, and are unaware of what it means to lose visual quality. Patient surveys typically show a high level of satisfaction with LASIK. However, an alarming number of satisfied patients also report complications such as visual disturbances in dim light and dry eye.

 In the March, 1994 American Journal of Ophthalmology editorial mentioned previously in this article, Dr. Leo Maguire cautioned about misleading implications of quoting patient satisfaction rates:10
“A keratorefractive patient may simultaneously be happy with the result of surgery and have degraded vision – how can refractive surgery be a potential public health problem if patients are happy with the results? Inherent in this question is the assumption that a patient without complaint is a patient without optical degradation. That argument does not hold up to closer scrutiny. The keratorefractive literature contains disturbing examples of patients who have visual handicaps that place themselves and others at significant risk for nighttime driving accidents and yet they are happy with the results.”


In May, 2001, results from a questionnaire completed by PRK and LASIK patients revealed that 19.5% reported a worsening in functioning, 27.1% a worsening in symptoms, 34.9% a worsening in optical problems, 33.7% a worsening in glare, and 41.5% a worsening in driving.

In one report, researchers suggest that factors such as the Hawthorne effect and cognitive dissonance may play a role in patient satisfaction following LASIK. The Hawthorne effect favorably influences patients’ survey responses merely because patients are aware that they are enrolled in a study. Cognitive dissonance is a change in one’s attitude or beliefs to eliminate internal conflict with negative consequences of an irreversible action.

LASIK industry representatives have argued that no evidence links a poor LASIK outcome with depression or suicide. However, if it is credible that there may be a positive impact on quality of life after seemingly successful LASIK, then we must also accept that there can be a negative impact on quality of life after a poor LASIK outcome.