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Themes, Stances, and Concerns in Social Media Discussion of LASIK: An Infodemiology Study
ABSTRACT
Background:
Public perceptions of LASIK are shaped in part by social media, where people describe concerns and experiences without the constraints of a clinical questionnaire. Whether the issues discussed in social media correspond to those emphasized in formal preoperative consent and postoperative patient-reported outcome assessment is unknown.
Objective:
To characterize LASIK social media discourse and compare post-surgery concerns with those represented in formal informed-consent and patient-reported outcome instruments.
Methods:
We collected 16,529 unique posts from blogs, forums, Twitter/X, YouTube, and Instagram (April 2023–March 2025). Six large language models independently proposed and classified themes; latent class analysis combined their ratings, and two blinded human raters validated classifications. Stance and time since surgery were assessed in additional analyses. We compared post-surgery themes with the Ophthalmic Mutual Insurance Company (OMIC) LASIK consent form and the Patient-Reported Outcomes with LASIK (PROWL) questionnaire.
Results:
Two-thirds of posts (66.8%) were classified as reflecting direct patient experience followed by secondary reports of others’ experiences (18%). Stance was divided overall (28.8% supportive, 26.6% opposed, 32.5% neutral) and varied by theme. Across all posts, the most frequent themes were regret (26.7%), psychological impact (23.2%), pain (22.2%), and fear (20.3%), with positive outcomes at 15.0%. Among post-surgery posts, pain (40.4%), regret (35.5%), and positive outcomes (35.3%) were most frequent. Recorrection concerns appeared at a median of 11 years after surgery, compared with 1.5 years for pain. OMIC addressed 7 of 17 themes; its item count showed weak association with social-media frequency (ρ=0.35), with no clear association between theme frequency and presentation order (ρ=0.25; n=7). The full 110-item PROWL battery addressed 9 themes, whereas the 33-item PROWL-SS subset addressed 2. Five themes were absent from both instruments, all decisional or economic.
Conclusions:
Social media provides a complementary view of the concerns people choose to discuss without prompting. Differences from formal consent and outcome assessment were greatest for psychological, decisional, and economic concerns, identifying areas for attention in counseling and patient-reported assessment.
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