Suicide and Laser Refractive Surgery

Laser refractive surgery (LRS) is one of the most frequently performed and successful operations in medicine with 96% postoperative patient satisfaction.[1] The possible sequelae of LRS include dry eye syndrome, blurred vision, glare, and night vision disturbance that are usually transient, but sometimes persist.[1] Psychiatric complications such as psychosis, depression, suicidal ideation, attempted suicide or completed suicide (PDS) following LRS are rare,[2] but generate marked media attention.[3, 4] Given the tragedy of suicide after LRS, we reviewed the PubMed, Embase, PsycINFO, and Google Scholar databases from inception to October 2019 using keywords and MeSH terms “laser refractive surgery” and “suicide”. We found the details of six patients, mainly young men, who completed suicide after LRS (Table 1).[2, 4–7] The patient-support website lasikcomplications.com[8] lists approximately 34 patients with PDS following LRS. From 2007 to 2018, approximately 8,230,000 LASIK procedures were performed in the United States.[9] Given that, the incidence rate of completed suicide and PDS in the US is estimated to be 7 per 100,000,000 individuals and 4 per 10,000,000 individuals undergoing LRS per annum, respectively. In the US, the age-adjusted suicide rate has increased by 33% over the last two decades, with 13.9 suicides per 100,000 individuals reported in 2018.[10] The proportion of patients with either completed suicide or PDS after LRS is markedly lower than the proportion of suicide in the general population (P < 0.001).