Why do ophthalmologic (eye) surgeons often prefer to wear corrective lenses, such as glasses or contact lenses, rather than undergoing Laser-Assisted In Situ Keratomileusis (LASIK) themselves?

From the Guidelines

Ophthalmologic surgeons often prefer wearing corrective lenses rather than undergoing LASIK surgery themselves due to several professional concerns, primarily the potential impact on their near vision and depth perception critical for delicate eye surgeries. The primary reason is that LASIK permanently alters corneal structure, which can affect near vision and depth perception—critical skills for performing delicate eye surgeries, as noted in the refractive surgery preferred practice pattern 1. Many eye surgeons require excellent near vision for microsurgical procedures, and LASIK may lead to presbyopia symptoms earlier than would naturally occur. Additionally, surgeons understand that LASIK can occasionally result in complications like dry eye, glare, halos, or reduced contrast sensitivity, which could compromise their surgical precision, as highlighted in the refractive surgery preferred practice pattern 1. There's also the consideration that LASIK creates a permanent change, while prescriptions may continue to evolve throughout a surgeon's career. Glasses or contact lenses offer the flexibility to adjust vision correction as needed, allowing surgeons to maintain optimal visual acuity for their specific working distance. Furthermore, having personal experience with corrective lenses helps surgeons better understand and relate to their patients' visual experiences and concerns.

Some key considerations for ophthalmologic surgeons include the risk of ectasia, which is higher in patients with abnormal topography or tomography, and the importance of preoperative evaluation to identify unusually thin corneas and estimate residual stromal bed thickness, as discussed in the refractive surgery preferred practice pattern 1. The patient's preoperative expectations and psychological characteristics also play a significant role in satisfaction with LASIK, with depressive symptoms associated with decreased patient satisfaction with visual quality after LASIK, as noted in the refractive surgery preferred practice pattern 1. In contrast, contact lenses, such as daily disposable lenses, can provide a safe and comfortable alternative for vision correction, with low rates of adverse events and minimal damage to the ocular surface, as reported in the refractive errors preferred practice pattern 1.

Key factors influencing the decision to undergo LASIK surgery include the potential benefits and risks, as well as the individual's lifestyle and professional requirements. For ophthalmologic surgeons, the potential risks and limitations of LASIK surgery, including the impact on near vision and depth perception, may outweigh the benefits, leading them to prefer corrective lenses over surgery. Ultimately, the decision to undergo LASIK surgery should be based on a thorough evaluation of the individual's needs and circumstances, taking into account the latest evidence and guidelines, such as those outlined in the refractive surgery preferred practice pattern 1 and the refractive errors preferred practice pattern 1.

From the Research

Reasons for Ophthalmologic Surgeons Not Undergoing LASIK

• Ophthalmologic surgeons may prefer not to undergo LASIK due to various reasons, including the potential risks and complications associated with the procedure 2.
• Some studies have reported that a significant proportion of patients who undergo LASIK may still require glasses or contact lenses after the procedure, particularly in low-light conditions and as they age 2.
• Additionally, LASIK may not be suitable for all types of refractive errors, and some patients may have conditions that warrant caution or contraindicate the procedure, such as excessively dry eyes, contact lens intolerance, or chronic pain syndromes 2.

Complications and Limitations of LASIK

• LASIK has been associated with various complications, including dry eye, visual disturbances, and vision-threatening complications, although these are rare 2, 3.
• Some studies have reported that LASIK may not provide optimal results for patients with high myopia or astigmatism, and alternative procedures such as surface ablation may be more suitable for these patients 3.
• The procedure also has limitations, such as the potential for undercorrection or overcorrection, and the need for additional procedures or enhancements in some cases 4, 5.

Alternative Options for Refractive Correction

• Contact lenses may be a viable option for patients who are not suitable candidates for LASIK or who experience complications after the procedure 6.
• Intraocular lenses, implanted following cataract extraction, may be an alternative to LASIK in older patients 2.
• Other refractive surgery procedures, such as surface ablation, may also be considered as alternative options for patients who are not suitable candidates for LASIK 3.

Prevalence of LASIK Among Ophthalmologic Surgeons

• There is limited data available on the prevalence of LASIK among ophthalmologic surgeons, but it is likely that many surgeons may choose not to undergo the procedure due to their knowledge of the potential risks and complications 4, 5.
• Some studies have reported that a significant proportion of patients who request refractive surgery may not be suitable candidates for LASIK, and it is likely that ophthalmologic surgeons may also be aware of these limitations and exercise caution when considering the procedure for themselves 4, 5.