LASIK satisfies most patients, yet many develop new visual or dry-eye symptoms

LASIK leaves most patients satisfied and yet leaves a substantial minority with new visual or dry-eye symptoms — two findings that are both well documented and must be reported together to describe the surgery honestly [s1][s2]. A worldwide review of quality-of-life studies put overall patient satisfaction after primary LASIK at 95.4%, pooled across 2,198 subjects, with individual studies ranging from 87.2% to 100% [s1]. That is a high satisfaction rate for an elective procedure [s1].

The other half of the picture comes from the PROWL studies, a set of patient-reported-outcome studies run in collaboration with the US Food and Drug Administration specifically to capture symptoms in patients' own words rather than through clinicians [s2]. They found that although the overall prevalence of visual and dry-eye symptoms fell after surgery on average, a large share of people who had none beforehand developed new ones: among participants with normal baseline scores, 43% (PROWL-1) and 46% (PROWL-2) reported new visual symptoms such as glare, halos, starbursts or double images, and about 28% developed dry-eye symptoms by three months [s2].

Reconciling high satisfaction with common symptoms

Those two sets of numbers are not contradictory. Most new symptoms were mild and many resolved over time, and satisfaction stayed high: dissatisfaction with vision ranged from 1% to 4% across the studies, and dissatisfaction with the surgery from 1% to 2% [s2]. In other words, a person can develop some glare or dryness and still be glad they had the procedure — which is what the data show for the majority [s2]. But the PROWL findings undercut any claim that new symptoms are rare; they are common, even when they are minor and even when the patient remains satisfied [s2].

Dry eye is the most frequent complaint and the one most likely to persist, because the surgery temporarily cuts corneal nerves and reduces tear production; for most it improves over months, but a minority have longer-lasting dryness [s2][s3]. Visual disturbances like halos and glare are most noticeable in low light and at night [s2].

Candidacy is where risk is managed

The FDA's patient guidance frames the decision around candidacy: LASIK is not suitable for everyone, and factors such as thin corneas, large pupils, unstable prescription, dry eye at baseline and certain systemic conditions raise the risk of a poor outcome [s3]. The agency has emphasised informed consent — that prospective patients understand the realistic chance of new symptoms, not only the high average satisfaction — which is precisely the gap the PROWL studies were designed to close [s2][s3].

The limits of the evidence

The satisfaction review pools heterogeneous studies with varied follow-up and measurement, and satisfaction is a subjective endpoint that does not capture every functional problem [s1]. The PROWL studies followed patients over months, so they speak less to long-term outcomes, and were conducted at a limited number of sites [s2]. Neither source supports a single number for "success," because success depends on what is measured — sharp vision, freedom from glasses, absence of symptoms, or satisfaction, which do not always move together [s1][s2]. The defensible summary is that LASIK has high satisfaction and generally good visual outcomes, alongside a real and common risk of new, usually mild, visual and dry-eye symptoms — a trade-off best weighed with an eye surgeon against individual candidacy [s1][s2][s3]. This is informational reporting, not medical advice.