Myopia surgery: patients report halos and incomplete vision

Myopia surgery: the surgeons who perform it still wear glasses

An operated eye has no spare. That phrase, repeated in a thousand ways in the debate over refractive surgery, sums up the real state of affairs: myopia is corrected with glasses, and everything else —LASIK, PRK, FemtoLASIK, ICL— is a gamble. The anecdotal evidence that circulates most is not a clinical study, but a common-sense observation: the ophthalmologists who operate on others wear glasses themselves. If the surgery were so good, why don't the people who know the postoperative period best go under the knife?

The issue is recent: a patient operated on this very year with ICL lenses —the intraocular ones, the ones that don't reshape the cornea— describes "tremendous" halos around any light source and vision that doesn't reach 100%. His ophthalmologist tells him he's perfect and headed straight for the success statistics. "I'm afraid to find out what the failure statistics look like," he sums up.

What ICL is and why it's not the same as LASIK

The technical discussion matters because the umbrella term "myopia surgery" lumps very different procedures into the same drawer. LASIK reshapes the cornea with a laser and is irreversible. ICL implants a lens —a permanent contact lens— through a lateral incision, without touching the front of the cornea, and is reversible: it can be removed by going back into the operating room. The prices involved: around 7,000 euros for both eyes, with lenses custom-ordered to the prescription.

That doesn't save everything. A patient operated on at a clinic that presents itself as a national and international reference reports that in his left eye he doesn't see at 100% —a 0.25-diopter deviation— and suspects he was measured wrong or the lens was placed rotated. The halos, he says, don't go away: his brain doesn't ignore them. Another account, however, maintains that halos fade over time because the brain learns to ignore them, and that the initial adaptation —distorted vision for a few days, halos for a few weeks or months— is part of the process.

The argument nobody rebuts: surgeons don't get operated on

The most repeated and most uncomfortable observation is the ophthalmologists' glasses. It's phrased in several ways: if 40% of the population wears glasses, then 40% of ophthalmologists do too; and if the surgery were so good, with their knowledge of the postoperative period and their connections among surgeons, you wouldn't see a single one wearing glasses. At conferences, they say, they all wear glasses. It's an adverse-selection argument: whoever knows the risk best doesn't take it.

Against that, positive cases exist and are told without embarrassment. One man operated on in 2004 on a single eye: "Not a single problem and no drops." Another, fifteen years after a LASIK: "Like a dream. At night I saw with a sharpness that blew me away." A third, operated on for cataracts with myopia correction thrown in: halos "once a month or every two months," warned he would lose near vision, and driving on the second day. The distribution matters: it's not that it goes badly for everyone, it's that it goes badly for some and there's no way to know who before going under the knife.

The recurring after-effects: halos, dryness and lifelong drops

The catalogue of side effects that appears in the testimonials is consistent: chronic pain, extreme dryness with a constant need for artificial tears, and halos around light sources. The cornea is a highly sensitive area and the eye has no spare. Those who defend a ban argue from there: myopia is solved with simple glasses, and everything else means taking on an irreversible risk to fix a problem that already had a reversible solution.

There's an economic nuance that usually gets missed: leaving you at 0.25 diopters can be a favor. When presbyopia appears, that residual myopia compensates and delays the need for pogre lenses. What the patient experiences as a scam —not seeing at 100% after paying 7,000 euros— may be, with twenty years of hindsight, an unintended advantage.

Alternatives: contact lenses, glasses and the Bates method

The range for those who don't get surgery runs from conventional to heterodox. Contact lenses have their own problem: the cornea gets its oxygen from the air, and covering it with plastic causes allergies, dryness, possible ulcers and, in extreme cases, vision loss that would require a corneal transplant. Glasses, with their breakages and lens changes, remain the option with no side effects. And then there's the Bates method, which is recommended with consistency, patience and fifteen minutes a day: it improves while you practice it, like going to the gym, and it's lost when you quit.

The question left without a clear answer is age. From what age do they no longer operate on you? The answer going around: they'll operate at any age you want. Whether it pays off for the patient is another matter. For the clinic, of course, it always does.

---

The point where this gets stuck is always the same: there's no way to know, before going in, which side of the statistics you'll land on. Those who come out well recommend it enthusiastically. Those who come out badly can't undo it. And those who know the procedure best still wear glasses.