Safety and efficacy

The reported figures for safety and efficacy are open to interpretation. In 2003, the Medical Defence Union (MDU), the largest insurer for doctors in the United Kingdom, reported a 166% increase in claims involving laser eye surgery; however, the MDU averred that these claims resulted primarily from patients' “unrealistic expectations” of LASIK rather than “faulty surgery”. A 2003 study reported in the medical journal Ophthalmology found that nearly 18% of treated patients and 12% of treated eyes needed retreatment. The authors concluded that “higher initial corrections, astigmatism, and older age are risk factors for LASIK retreatment.”

In 2004, the British National Health Service's National Institute for Health and Clinical Excellence (NICE) considered a systematic review of four randomized controlled trials before issuing guidance for the use of LASIK within the NHS. Regarding the procedure's efficacy, NICE reported, "Current evidence on LASIK for the treatment of refractive errors suggests that it is effective in selected patients with mild or moderate short-sightedness" but that "evidence is weaker for its effectiveness in severe short-sightedness and long-sightedness." Regarding the procedure's safety, NICE reported that "there are concerns about the procedure's safety in the long term and current evidence does not appear adequate to support its use within the NHS without special arrangements for consent and for audit or research." Leading refractive surgeons in the United Kingdom and United States, including at least one author of a study cited in the report, believe NICE relied on information that is severely dated and weakly researched.

Industry concerns

There are many concerns and movements to change the way the LASIK industry operates. Primarily these are based on the distribution of information by surgeons to potential patients. It is often argued that patients are not given sufficent information regarding the possible complications, their side effects, and final outcomes.[Please name specific person or group] A survey in the United Kingdom indicated that most LASIK patients expected their vision to become at least 20/20 after surgery and few knew it could potentially be worse.

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