myCityscrewups

New York, NY - medicine

DANGERS OF LASIK

Are there screwups in laser eye surgery? More than 50% 0f the world populations wear or need glasses. There are several surgical options attempting to correct our vision in order to enable us to see clearly without glasses or contact lenses. Laser Eye Surgery (LES) is the most common surgical procedure performed nowadays in the world. It is easily done, takes about a minute and cost a lot of money (Relatively speaking). What exactly are these procedures commonly known as "Lasik"? Are these procedures completely safe? What are the possible complications? How frequent are these complications? What should the candidate for LES know and ask before signing the consent form? I shall try to answer these questions in the following articles, but let me first explain briefly why do we need glasses, what is 'Lasik' and what the possible dangers are. The acceptable scale by which we examine vision or visual acuity (Va) is the Snellen chart (Pic 1). If we can see the small figures, our VA will be 20/20 (6/6 in Europe), namely - this line, designated 20/20, is the smallest line that can be seen by a person with normal VA at a distance of 20 feet. Accordingly – a person with 20/40 vision will see from 20 feet what somebody with 20/20 will see from 40 feet and so on.

So- we need optical correction, be it glasses or contact lenses. The function of the optical correction is to help the cornea and the lens of the eye (Pic 2) to focus the image on the retina (Providing that the retina and the optic nerve are healthy) and thus have a "20/20 vision". So, what is the goal of the various LES? First, we need to define 3 more terms: Myopia – nearsightedness, hyperopia-farsightedness and astigmatism - an irregularly shaped cornea. For myopia we need a concave lens, for hyperopia we need convex lens (Pic 3) and for astigmatism we need a specially irregular curved lens. Since we can not change the power of the physiological lens but we can change the shape of the cornea (That serves as a magnifying glass) and make it optically weaker – or stronger with different curvatures, laser eye surgery was invented and with the proper marketing, as I said - have become the most common and most popular surgical procedure in the world. The purpose of this article is to bring to the public attention not the description and the success rate of LES that can be found all over the web, but the complications the screwups that exist but not necessarily emphasized by the doctors performing this procedures all over the world.

CASE REPORT: IG, a healthy 22 year old healthy female had mild myopia (-3.50 diopters) since the age of 10 that did not change in the last 3 years. She wanted to get rid of the glasses and the eye doctor was only so happy to recommend LES. The family history revealed a grandfather that had keratoconus (A progressive disease manifested by cone (warped) like cornea. She was thoroughly examined, her Va with her glasses was 20/20, pachymetry (The thickness of the cornea) was 520 - normal in both eyes and the corneal topography (A colored map of the corneal surface) was interpreted as "normal", so she was found to be a good candidate for LASIK. A few days after the operation she had a Va of 20/20 without glasses and she was extremely happy. After a year she noticed some blurred vision in her left eye. An optometrist said that she developed some astigmatism in this eye and fitted her with contact lens after which the Va came back to 20/20. 6 months later she noticed a further deterioration of her left eye and this time she went to an eye doctor that diagnosed a larger, more severe astigmatism (Now her Va even with the contact lens is 20/60!) and recommended that she should go back to the Lasik surgeon. The diagnosis now is keratoectasia, a thin and bulging cornea with very bad Va, and very poor prognosis. What is it? Why did it happen? What can be done? Is there a medico- legal issue in this case and should she be compensated? All the answers – in the next article and your comments are welcome. Isaac Gutman MD

from: aadoctor

city: New York, New York

category: medicine

date uploaded: 3/3/2009 3:58:29 PM

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