Suicide after Excimer Laser Refractive Surgery: On the Importance of Matching Expectations

Background: Refractive surgery may change the individual life to the better largely eliminating the need for spectacles. However, expectations may vary and postoperative reality may come as a surprise. Aim: To emphasize the need for thorough alignment of expectations and options between surgeon and patient. Methods: A case is presented in which a successful refractive laser operation is a part of a trigger mechanism for a depressive episode leading to suicide. It emphasizes the crucial importance of constructive alignment of expectations between patient and treating physician prior to surgery. Results: The case presented outlines that ophthalmic surgery at the edge of high-tec with all its tempting features is also very attractive to individuals with very well defined and less flexible expectations. The possible irreversibility of some of the refractive surgery may force the patient postoperatively into a psychological corner, immobilizing him/her and restricting his/her options. Conclusions: High-tec operations dealing with one of the most elementary senses we have, vision, demand a thorough estimation of the patients profile prior to any surgery. Only matching expectations between the possible and desired outcome and reconfirmation of the match may reduce the risk of postoperative crisis which may carry a risk the patient’s life.