Skip to main content

  • Postoperative Symptoms and Satisfaction With LASIK Surgery

    By Lynda Seminara and selected by Neil M. Bressler, MD
    Add to My Bookmarks

    Journal Highlights

    JAMA Ophthalmology, January 2017

    Download PDF

    Eydelman et al. reviewed surveys from the 2 PROWL (Patient-Reported Outcomes With LASIK) observational studies to determine patient satisfac­tion and document the frequency of patients’ ocular symptoms. They found that patients were more likely to report adverse symptoms on self-administered questionnaires than directly to their health care providers.

    Participants in the PROWL-1 (active-duty U.S. Navy personnel) and PROWL-2 (civilians) studies under­went LASIK (N = 534) for myopia, hyperopia, and/or astigmatism. They completed a web-based questionnaire both preoperatively and postoperative­ly. Ocular symptoms evaluated were dry eye, double images, glare, halos, and starbursts. Clinical assessments included visual acuity, refractive error, slit-lamp evaluations, and posterior segment eye exams. Visual symptoms and dissatisfaction with vision were common preoperatively.

    Although most participants were satisfied with their results, the rates of postoperative dissatisfaction with vision ranged from 1% to 4%, and dissatisfaction with the surgery ranged from 1% to 2%. The overall prevalence of symptoms decreased postopera­tively, but many patients reported new symptoms within 3 months (43% of PROWL-1 participants; 46% of PROWL-2 participants). The pro­portion of participants in PROWL-1 with normal Ocular Surface Disease Index (OSDI) scores was 55% at baseline, 66% at 3 months, and 73% at 6 months. The percentage of participants in PROWL-2 with normal OSDI scores was 44% at baseline and 65% at 3 months (no assessment was done at 6 months). Among all study participants with normal baseline scores, approx­imately 28% had symptoms of mild, moderate, or severe dry eye 3 months after surgery.

    This study is one of a few noting the occurrence of new visual symptoms after LASIK surgery. Previous research has shown that patients are reluctant to report negative effects to their health care professionals and that the admin­istration of questionnaires in a private setting, with assurance that the health care provider would not be privy to responses, leads to increased unbiased reporting of such effects.

    The authors concluded that typical methods of reporting symptoms after LASIK surgery may lead to under­estimating true incidence rates by a factor of 2 to 4. Thus, they recommend making the validated PROWL ques­tionnaire publicly available as a tool for the ophthalmic community.

    The original article can be found here.