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EDITIONS
Tuesday, 18 February, 2003, 10:19 GMT
Laser eye surgery risks highlighted
Human eye
Around 100.000 people have laser surgery each year
Consumer experts have warned that patients undergoing laser eye surgery are not being told about the risks they could be taking with their sight.

Laser surgery, which can cost thousands of pounds, is increasingly popular.

But the investigation by Health Which? also reveals any doctor can carry out the treatment after just a few days of training - they do not need a specialist qualification.

The magazine also found complication rates vary between surgeons and clinics.

Around 100,000 people, tired of wearing glasses or contact lenses, undergo corrective laser eye surgery in the UK every year.

While some people will be able to throw away their glasses, this won't be the case for everyone

Sue Freeman, Health Which?
The procedure is seen as quick and simple, and has received many celebrity endorsements.

Health Which? looked at clinics offering the Lasik procedure - the most popular on offer.

But whilst some highlight a low risk of complications with the procedure, others say the risk is non-existent.

'Misleading adverts'

In very rare cases, complications can lead to corneal ectasia, where fluid pressure builds up on the eye.

Patients can need a corneal transplant to correct the condition.

Other complications, though deemed "minor" by clinics, occur "relatively frequently", according to a review by the American Academy of Ophthalmology.

Patients can experience dry eyes or night vision problems, which can affect ability to drive or work in the evening or in dim light.

Health Which? also says that the Medical Defence Union and the Medical Protection Society, both doctors' insurance companies, are raising the fees they charge doctors working in this field because of increased compensation claims by patients.

Questions

David Gartry, a consultant ophthalmologist at Moorfields Eye Hospital has helped draw up Royal College of Ophthalmologist' guidelines on who should carry out laser eye surgery.

The guidelines say that only doctors with specialist training should carry out the procedure.

Mr Gartry told BBC News Online patients should find out as much as possible about the surgeon likely to carry out their operation.

"This is a situation where patients are responding to adverts, or even incentives.

"Patients should be asking the sort of questions they would ask if they were having, say, a hernia operation.

"What are the complication rates? What will happen if something goes wrong? Will I see the surgeon again?"

Dan Reinstein, who is developing safety guidelines for the Medical Protection Society, added: "Expert surgeons are better equipped to avoid complications even if they have not previously seen them.

"And when these do occur, trained experts will have the knowledge and ability to correct them."

'Highest clinical standards'

Sue Freeman, managing editor of Health Which?, said: "Patients shouldn't be taken in by claims about the safety and success rates of laser eye surgery and in particular about so called 'minor complications'.

"While some people will be able to throw away their glasses, this won't be the case for everyone."

She added: "Patients should be fully informed of the possible risks and of the complication rates of clinics and individual surgeons.

"Until patients are able to make informed choice, they need to do a lot of research and ask a lot of hard questions of surgeons and clinics."


Here are a selection of your comments on this subject.

If my wife had known what it was going to be like she would never have had it done

G Fuller, UK
My wife had corrective laser treatment in November 2002 and all the literature she received quoted 'best case' examples of people being back at work the next day. Unfortunately she experienced massive discomfort and complete blindness for a week which failed to be controlled by the painkillers and sleeping pills prescribed by the clinic. In her own words "if she had known what it was going to be like she would never have had it done".
G Fuller, UK

Following surgery at the age of 44, I now have 20-20 vision, can use normal sunglasses (essential in Australia and at high altitude) and no longer have problems with rain or fogging. I saw a specialist surgeon in Belgium who used the latest equipment. I have had one (free) adjustment operation to correct some astigmatism in one eye.

I have experienced some minor double-vision, slight loss of night vision, and initially starbursts/haloes around strong light sources - the latter now much reduced. For me these are very minor compared with the joy of being able to see the stars with the naked eye for the first time. I was given a video recording of the operation but this is not for the squeamish, and best seen afterwards.
Charles Barran, Australia

After many years of consideration I finally took the decision to have laser treatment in December 2001. I opted for Lasek and was talked through all the possible complications and even had to take a little test to ensure I was fully aware of all possible side effects. After a thorough consultation I then had both eyes done simultaneously. I won't pretend the days following the treatment were bliss, I was in some discomfort for 3 to 4 days but after that had passed my eyes soon began to heal.

It was strange but having worn glasses for so long for a month or so afterwards I was still trying to push glasses that weren't there back up the bridge of my nose! It is now over a year since and I have perfect 20/20 vision. Just very occasionally my eyes are a little dry in the morning but I consider this a tiny inconvenience.
Edward Lacey, UK

I'd like to know if Sue Freeman would recommend micro lenses inserted into the eye as a better option than Lasik eye surgery. Would she be so kind as to find out on my behalf. I would like to lose my glasses. I did intend to have Lasik surgery but have now been scared off with the latest news regarding unsuccessful operations.
Vincent Jones, Dorset, UK

I had Lasik surgery last year and it was the best thing I ever did. I was fully informed by the company regarding any potential risks (and clear details on the procedures are on their website anyway). It was great just waking up the next day and not having to fumble around looking for glasses, and no fussing about shoving bits of plastic in my eyes each day!
Dave, UK

I had laser surgery in June 2001 and have been more than satisfied with the results and the service I received. I felt under no pressure to make a decision and that I was able to make an informed choice to go ahead with the procedure. I agree though that you do need to ask questions and be aware that there are risks - but isn't this the case for any sort of medical procedure? It is also essential to use a reputable company, unfortunately there are rouges out there, look at cosmetic surgery.
Kate Austin, England

 WATCH/LISTEN
 ON THIS STORY
The BBC's Karen Allen
"Consumer groups worry about aggressive marketing"
David Cartwright, spokesperson for Boots
"Before surgery all of our patients go through an extensive consultation"
See also:

31 Jan 03 | Health
13 Nov 02 | Health
05 Jun 00 | Health
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