The Economic Impact of Lasik Surgery: Growth, Costs, and Risks
The laser eye surgery industry has experienced significant expansion since its initial FDA approval in the late 1990s, but growing evidence suggests the economic implications of this procedure extend far beyond the operating room. Former FDA supervisor Morris Waxler, who helped get Lasik approved between 1996 and 2000, later reversed his position after concluding the operation could actually impair patients' vision (NYTIMES). This reversal raises questions about the long-term economic sustainability of an industry built on procedures that may carry undisclosed risks.
Waxler, who passed away on January 2, 2026, at age 88 due to a stroke (NYTIMES), had become increasingly vocal about the procedure's potential complications. In the years before his death, he advocated for the FDA to more prominently warn Lasik patients of the risks on the agency's website. However, he acknowledged the economic power wielded by the industry, stating, "If they make a big dramatic change in their website, the refractive surgeons are going to come down on them as glue. They are going to hit them hard" (TAMPABAY28). This statement highlights the financial interests at stake and the pressure exerted on regulatory bodies.
The FDA database currently holds hundreds of reports detailing significant complications after Lasik eye surgery (TAMPABAY28). These complications represent not only personal tragedies but also economic costs absorbed by the healthcare system. When procedures fail to deliver promised outcomes, patients often require additional medical interventions, specialist consultations, and ongoing treatment for chronic conditions—all expenses that strain both individual finances and insurance systems.
Some patient experiences underscore the severity of these complications. One report described post-surgery pain as "worse than child birth" (TAMPABAY28), while another patient claimed the Lasik procedure was the "worst decision of my life" (TAMPABAY28). These extreme negative outcomes represent outliers in the data but point to potential hidden costs not factored into initial economic analyses of the procedure's value.
Waxler's critique of the procedure focused on specific physiological issues that carry economic implications. According to Waxler, "Sometimes the cuts in eyes don't heal, the eye becomes weak after being cut, and the nerves never reconnect properly, growing 'in whirly gigs and they just end on themselves and they produce uncontrivable pain'" (TAMPABAY28). These complications can lead to permanent disability, reduced workforce participation, and increased healthcare utilization—all factors that translate to economic costs.
The most devastating outcomes linked to Lasik complications involve mental health crises. In at least three documented cases, families say Lasik caused their loved ones to take their own lives (TAMPABAY28). One such case involved Nancy Burleson's son, who killed himself in 2016 after returning from serving in Iraq and getting Lasik eye surgery. In his suicide note, he stated, "I trusted a doctor that destroyed my eyes" (TAMPABAY28). Beyond the immeasurable personal tragedy, these cases represent significant economic losses in terms of productive years lost and the ripple effects on families and communities.
Waxler's personal reflection on his role in the approval process reveals how economic incentives may have influenced the regulatory process. He stated, "I was lied to. I trusted people I shouldn't have trusted and I didn't know a lot of things I know now" (TAMPABAY28). This admission suggests that the financial interests of the refractive surgery industry may have played a role in how information was presented to regulators, potentially at the expense of patient safety and long-term economic considerations.
The industry perspective, represented by Dr. John Vukich with the American Society of Cataract and Refractive Surgery, acknowledges that they're "just now understanding" how certain complications can occur (TAMPABAY28). This admission of limited understanding, decades after widespread adoption of the procedure, raises questions about whether patients have been adequately informed of risks when making economic decisions about elective surgery.
Waxler noted that "the problem is not so much with the Lasik surgery, but with the recovery, as even if a surgeon does everything right, a patient could suffer problems because we all heal differently" (TAMPABAY28). This variability in healing outcomes introduces an element of unpredictability into the economic equation of Lasik surgery, making it difficult for patients to accurately assess the potential return on their investment in the procedure.
The economic burden of failed procedures falls disproportionately on patients rather than providers. Unlike many medical interventions where insurance covers complications, Lasik is typically considered an elective procedure with limited coverage for adverse outcomes. This asymmetry in risk distribution means that while the industry collects profits from successful procedures, the costs of failures are externalized to patients and the broader healthcare system.
Despite these concerns, industry representatives point to high satisfaction rates. According to Dr. Vukich, 96 percent of patients are satisfied after Lasik surgery (TAMPABAY28). However, this statistic must be contextualized within the economic framework of the procedure. Even a 4 percent dissatisfaction rate translates to thousands of patients annually who may require additional care, experience reduced quality of life, or face diminished economic productivity.
Researchers are attempting to better understand why, rarely, things go wrong with Lasik procedures (TAMPABAY28). This ongoing research represents an economic investment in improving outcomes, but also acknowledges the current limitations in predicting which patients might experience complications. Until more definitive screening methods are developed, the economic risks of adverse outcomes remain a factor that potential patients must consider.
The economic implications of Lasik complications extend beyond individual patients to impact healthcare systems, workforce productivity, and even family economic stability. As regulatory bodies like the FDA consider how to balance industry interests with consumer protection, the full economic costs of Lasik complications must be factored into policy decisions and patient education efforts.