October 8, 2013
“LASIK is safer than contact lenses” is a myth that began with a letter from three biased LASIK surgeons, Mathers et al, to the editor of the journal Archives of Ophthalmology in 20061. In the letter, Mathers and colleagues draw some bizarre conclusions about the safety of contact lenses vs. the safety of LASIK, based upon a couple of published articles of eye infections from contact lenses and LASIK.
You’ve heard the phrase, “Lies, damned lies, and statistics”… The logic of Mathers and colleagues is so ridiculous that even other ophthalmologists have scoffed at it. But it does make a really good marketing soundbite, and so it has been widely adopted by LASIK surgeons seeking to scare patients into having LASIK. (Note: In 2009, Mathers co-authored a LASIK vs. contact lenses “decision analysis” based on a literature review2, which again failed to make the case that LASIK is safer than contact lenses.)
LASIK frequently leads to chronic dry eyes and night vision problems3,4. Some patients suffer lasting eye pain. The bottom line is this: If you follow proper lens hygiene and don’t sleep in your lenses, contacts may be worn safely for a lifetime. LASIK, on the other hand, is an unnecessary surgical procedure performed on a very necessary organ of your body, which leads to permanent consequences such as incomplete healing of the flap with associated lifelong risk of flap dislocation, reduced and disordered corneal nerves which may lead to persistent pain and dry eye disease, risk of corneal ectasia (bulging) with associated vision loss, problems with future cataract surgery and glaucoma screening, and increased risk of eye infections. Furthermore, if you wear contacts and your vision changes, you can simply get a new pair. If you’ve had LASIK and your vision changes, you’ll face increased risk with repeat surgeries.
Any LASIK surgeon who employs the scare tactic “LASIK is safer than contact lenses” is a menace to society!
Update August 2015: The U.S. Center for Disease Control (CDC) issued a press release concerning risk behaviors associated with contact lens-related eye infections. A survey of contact lens wearers found that more than 99 percent of respondents reported at least one risky behavior. Clearly, if contact lens wearers clean, disinfect, wear, and store their contact lenses as directed, the risk of infection is extremely low — much lower than the risk of complications from LASIK.
1. Mathers WD, Fraunfelder FW, Rich LF. Risk of Lasik surgery vs contact lenses. Arch Ophthalmol. 2006 Oct;124(10):1510-1.
2. McGee HT, Mathers WD. Laser in situ keratomileusis versus long-term contact lens wear: decision analysis. J Cataract Refract Surg. 2009 Nov;35(11):1860-7.
3. Sugar A, Rapuano CJ, Culbertson WW, Huang D, Varley GA, Agapitos PJ, de Luise VP, Koch DD. Laser in situ keratomileusis for myopia and astigmatism: safety and efficacy: a report by the American Academy of Ophthalmology. Ophthalmology. 2002 Jan;109(1):175-87.
4. Bailey MD, Zadnik K. Outcomes of LASIK for myopia with FDA-approved lasers. Cornea. 2007 Apr;26(3):246-54.