The dark side of LASIK surgery
October 10, 2024 at 12:35 a.m.
More than 20 million Americans have undergone laser-assisted in situ keratomileusis, more commonly known as LASIK surgery, to correct their vision since its inception in 1998.
It’s a procedure approved by the Food and Drug Administration (FDA) that takes about 15 minutes an eye and, according to those who perform it, boasts a high success rate.
But there’s a group of people who have been arguing that LASIK creates more complications than advertised. Among them is Rye Brook resident Dr. Cynthia MacKay, who has been fighting against the procedure from the get-go.
She served as an executive producer for the documentary film, “Broken Eyes,” which sheds light on the thousands of patients who have been left with permanent side effects resulting from LASIK.
The award-winning movie has been screening around the world—most recently at the SoHo International Film Festival in New York City on Sept. 23, where it won Best Showcase Documentary Film.
“I was one of the first people in the world to hear about LASIK because Steve Trokel, the man who invented it, was a colleague of mine,” she said during a conversation in her home on Stone Falls Court on Tuesday, Oct. 8. “He came tearing into my room one day and shoved a piece of paper in my hands.”
It was a photo of a cornea he had reshaped using an excimer laser.
“I thought it was ridiculous,” she said. “I knew from the very beginning, from the first time he said it, that it was a terrible idea.”
She spent the latter part of her 40-year career as an ophthalmologist, and her time in retirement, advocating against the procedure in hopes of getting it banned.
MacKay argues that proponents of LASIK misconstrue its success rate and that its FDA approval was rushed, because at its core, the procedure does much more harm than good.
The basics of LASIK
While there are variations in how the procedure occurs, including cutting a flap in the eye to gain access to the cornea or scraping off the superficial layer of the eye for the same reason, the end-goal of the surgery is the same: to reshape the cornea.
As the outermost lens of the eye, the cornea plays a large part in how light enters it. Nearsightedness can be the result of a cornea that is angled too sharply, while a flatter one can be the cause of farsightedness.
“LASIK, and its derivatives, is centered on cutting the cornea to reshape it. There’s no way to get around that,” MacKay said. “And what that really means is taking a healthy eye and making it sick.”
It’s a phrase she repeats often, drilling home the reminder that the procedure has no real medical necessity—it’s purely cosmetic.
“It’s all about looks. It’s not curing a disease or anything like that,” she said. “LASIK surgeons like to say that glasses are a crutch and that contact lenses have the risk of infection. But LASIK actually causes many more complications.”
The cornea is home to one of the densest clusters of nerves in the human body. The use of the excimer laser to alter the shape of that section of the eye, no matter how slight, results in the severing of various nerve endings.
“When those get cut away, there’s a lot of damage being done,” MacKay said. “A patient might not actually feel it because there are no more nerves to feel it, but there are many complications that can arise from the procedure.”
Unforeseen consequences
According to a report released by the FDA in 2021, 46% of LASIK patients reported developing a new visual issue within three months of receiving the surgery that wasn’t present before.
They include double vision, halos around light sources, glares and reduced night vision.
“A third of patients see a life-altering effect immediately,” MacKay said. “But I think 100% of people end up with some form of complication, because the nerves will never be the same again.”
One of the more drastic side effects is something known as “LASIK dryness.” While referred to as a form of dry eye by LASIK surgeons, MacKay said it’s a far worse symptom.
“The damaged nerves never heal to what they were before,” she explained. “It becomes a neuropathic pain that can develop well after the surgery, or immediately.”
In some cases, the pain can be unbearable.
“It’s driven people to suicide,” she said. “It can be a constant, debilitating pain. It can take away a person’s livelihood and actually put others in danger. There are people on the road or flying planes going through this.”
Treatments for those living with negative consequences of LASIK can be both expensive and uncomfortable.
“There are, for example, scleral contact lenses or serum eye drops that can be used,” MacKay said.
While most contact lenses are made to be soft for the sake of comfortability, a scleral lens is made of a hard material that pushes down on the eye.
“The cornea becomes so warped and disported that a soft lens doesn’t make full contact with it,” the retired doctor said. “A hard lens is needed to actually smooth out the peaks and valleys that have developed on the surface.”
Serum eye drops, also known as autologous serum tears, involve a more invasive procedure.
“Doctors make them by drawing blood from the afflicted patient, remove the red blood cells through a centrifuge and add a saline solution,” she explained. “The resulting serum can be dropped into their eyes to relieve the pain and quiet the damaged nerves.”
The process is repeated every three months and drops should be applied every hour.
“These kinds of issues and procedures aren’t talked about by LASIK surgeons, but they know about them.”
A rushed approval
MacKay said while the FDA approved the procedure in 1998, it was presented under a different light.
“It was presented without doing any studies on the long-term effects,” she said. “Morris Waxler, who was the head of the FDA committee that approved it, said all the side effects were temporary and mild. But in reality, they are permanent and devastating.”
She said the reason surgeons were pushing for approval was simple: money.
“The fact is simple: they are making a lot of money from LASIK,” she said. “Compensation for various surgical procedures in ophthalmology was reduced greatly over the years by insurance companies. But they don’t cover LASIK, so it became a way for them to circumvent that.”
In the years since approving LASIK, Waxler has regretted the decision and has advocated for its prohibition, testifying before the FDA alongside MacKay in 2011 and 2018.
Their work has resulted in backlash from their peers.
“There aren’t many doctors who will speak out against this,” she said. “I’ve had people write letters of complaint against me to the head of the New York State Ophthalmology Society. They’ve tried to discredit me and say that I don’t know what I’m talking about. It’s just so wrong.”
While she became a pariah in the eyes of their peers, her work put her in contact with those who were more willing to talk about the dark side of the surgery.
Putting together ‘Broken Eyes’
MacKay was able to connect with like-minded people after Paula Cofer, a Florida woman who uses serum eye drops, created a Facebook group in 2014 to help others suffering LASIK related problems.
Cofer rallied others, eventually creating a nonprofit called LASIK Complications that advocates against the surgery and funds relief treatments for those who can’t afford them.
“It was through the Facebook group that I came to know Dana Conroy,” MacKay said.
Conroy, a Minnesota-based Emmy Award-winning documentarian, found the group after her procedure left her needing to use both scleral contacts and serum drops.
“She and Paula had, at one point, considered suicide because of their LASIK damage,” MacKay said. “But they decided to fight and make this movie.”
MacKay’s involvement with “Broken Eyes” was almost a certainty once development began.
“The anti-LASIK movement is a very small world,” she laughed. “So I became attached to the production and appear in the movie to explain the procedure from the medial point of view.”
It premiered at the Minneapolis International Film Festival in April and has been screened at other festivals around the world.
“It’s really been everywhere,” MacKay said. “It’s been to Toronto, New York and Dubai. The hope is that it will get picked up by a distributor and made available to the public.”
She said the film provides a voice for those who have suffered or lost loved ones because of LASIK and offers valuable insight for those considering going through the procedure.
“When people see this film, I’m sure they’ll have second thoughts about LASIK,” she said.
While her work on the documentary is completed, her fight isn’t.
“At the same time we were making the film, I wrote a book with Morris about the dangers of LASIK,” MacKay said. “I’m not going to stop advocating against it until it’s banned. I would like to see this stopped for the immoral scam that it is. I became a doctor to help people and save sight. The fact that this is going on is unbelievable.”
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