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Home > Archive > Lasik Eyes Surgery > December 2004 > Surgeon Warns Of Laser Eye Surgery Risks
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Surgeon Warns Of Laser Eye Surgery Risks
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| gospa68@aol.com 2004-12-26, 7:10 pm |
| Sun 26 Dec 2004
Surgeon warns of laser eye cure risks
Expert claims dangers of treatment not made clear
PETER MARTELL
LASER eye surgery firms are underplaying the risks associated with the
operation and doing too little research on its long-term effects, a
leading Scottish expert has warned.
Dr Alistair Adams, one of Scotland's most senior ophthalmic surgeons,
believes that as many as one in 10 patients who undergo the corrective
procedure 'successfully' could develop complications in later life.
But Adams, a consultant at the Princess Alexandra Eye Pavilion,
Edinburgh, believes the companies involved are allowing patients to
underestimate the risks.
Adams also revealed that he gave up practising an earlier form of laser
eye surgery because so many of his patients returned with
complications.
Thousands of Scots each year pay around =A31,000 per eye to undergo
laser surgery in the hope of throwing away their glasses or contact
lenses for ever.
But while the number of patients has rapidly increased in recent years,
so too have the warning signs. Public health watchdog NICE recently
said its use should not be funded by the NHS because too many questions
remain unanswered.
Adams once practised a form of laser eye surgery called PRK, or photo
refractive keratectomy. It involved scraping through the surface of the
eye and reshaping the cornea with a laser. At the time, patients had
one eye treated at a time on safety grounds.
Adams, until recently chairman of the special advisory board on
ophthalmology at the Royal college of Surgeons in Edinburgh, told
Scotland on Sunday: "I did approximately 100 cases of PRK, but I
stopped doing it around five years ago because around 10% of people I
treated didn't want to have their other eye done, and were happy
sticking with their contact lens.
"That was mostly due to their vision at nighttime, driving in the dark
or dim light, as their vision wasn't as good as it was with their
contact lens.
"One or two people had it done with both eyes and could no longer drive
at night."
PRK has been replaced with the LASIK technique, which involves slicing
into the cornea. It costs between =A32,000 and =A33,000.
But Adams says he has no intention of performing the procedure himself.
He said: "I have looked at LASIK several times, and have many friends,
particularly in America, who say it is wonderful. Patients, generally
speaking, are very happy.
"However, I do have reservations about the surgical procedure. With
LASIK, between 5% and 10% may have persistent problems and may wish
they hadn't had the surgery done. It is quite invasive, with a slice
made in the cornea, for a problem that is actually solvable with
contact lenses or glasses.
"I have a question mark over the long-term results, and I think there
may well be complications which we haven't suspected. Already they
are beginning to find more complications than they thought."
He added: "One of the defects of the present system is that the
majority of these clinics which do the treatment do not keep the
statistics of long-term follow-up.
"Unfortunately, it is marketed as being very simple and very safe, and
I suspect that probably is just not true. To be fair, a lot of the
clinics do offer good information, but patients who are set on throwing
away their glasses don't necessarily take it all in.
"A lot of companies say that 95% of patients have 20:20 vision after
the treatment, but that doesn't tell you that 10% of them might not
be able to drive at night.
"Apart from the major risks of infection, there are a significant
number of people with dry eyes, double vision or who see halos around
lights. In some cases, such as persistent haziness. The patient can be
left with an impairment of vision that is permanent.
"Some people's lives have been turned upside down by having LASIK
because of complications that they felt they were not fully informed
about."
He added he was concerned at the increasingly popular practice of
operating on both eyes at once. "If there was a problem, like an
infection, then you might well have it in both eyes," he said.
The Royal college of Ophthalmologists, the profession's training
body, is currently producing guidelines on the LASIK technique and is
urging more research. "Current evidence suggests the treatment is
effective for selected patients with mild or moderate myopia but the
College recognises the importance of more research into the long-term
effects," said a spokeswoman.
But Christopher Neave, chairman of the Eye Laser Association (ELA),
which represents the largest providers of laser eye treatment in the
UK, said that the figure of 10% with complications was simply wrong.
He said: "Since 1990, some 280,000 people in the UK have been treated,
and we estimate that fewer than 0.1% have experienced persistent
problems. LASIK is a life-enhancing treatment and we believe that it is
a discretionary decision by an individual."
He also pointed to independently verified research on patients treated
at the Ultralase clinics, which showed that 98% of all its clients
achieved driving-standard vision or better.
Neave, who said there was an "outstanding level of clinical care in our
industry", said that the risks were made clear to patients both in
writing as well as in verbal consultation.
This article:
http://scotlandonsunday.scotsman.co...id=3D1465082004
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| Glenn - USAEyes.org 2004-12-26, 10:07 pm |
| It's no surprise you brought this one up, WizKid. The doctor sounds
exactly like your type.
This doc did 100 PRKs five years ago, got bad outcomes, and has blamed
the procedure and any procedure that is similar ever since. No, it
could not possibly be that the doctor did a poor job, it must be that
the procedure is defective (sarcasm knob turned to 9).
Glenn Hagele
Executive Director
Council for Refractive Surgery Quality Assurance
Email to glenn dot hagele at usaeyes dot org
http://www.USAEyes.org
http://www.ComplicatedEyes.org
I am not a doctor.
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| gospa68@aol.com 2004-12-27, 7:09 pm |
| Dear Glenn,
Dr. Adams is an informed surgeon and a man of integrity. For you to
attack him on the basis that "he did 100 PRKs five years ago, got bad
outcomes" is what we all have come to expect from you and the CRSQA. I
know many surgeons, myself included, who have done a couple of hundred
or none, and have deep concerns about laser procedures, particularly
LASIK, longterm. This group is not wedded to the income stream of laser
surgery nor the demands required by the significant investment required
to be a laser based doctor.
To disqualify and demean an opinion, as you have done, is unfair to Dr.
Adams and potential patients. You continue to show the altruistic side
of your approach to "patient advocacy" - attack anything that does not
agree with what you and the CRSQA thinks is best for the patient.
I think that the knobs you have turned, and they were turned long
before I became a contributor here, is the one called denial and the
other called deafness. You are not a doctor nor are you a patient
advocate.
WK
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| Glenn - USAEyes.org 2004-12-27, 7:09 pm |
| An opinion publicly pronounced that is based upon such flimsy data
should be disqualified and demeaned by anyone who seeks real
information, and most certainly by a patient advocacy who wants to
promote patients making an informed decision.
Let's put it another way WizKid, if a refractive surgeon said he had
done 100 PRKs five years ago and they all came out perfect, therefor
PRK. LASIK, and all derivatives thereof today and in the past are
absolutely wonderful and everyone should have them, you would blow a
gasket. This doctor has done exactly that, but pronounced an opinion
that is consistent with yours.
There are many doctors who have strong reservations about refractive
surgery and express their negative opinions. IMO there is absolutely
nothing wrong with that, so long as they substantiate their opinion
with relevant, objective, and reasonably complete data. That is not
the situation in this instance.
It is not surprising that you would call this person a "man of
integrity" WizKid. His opinion seems to be backed with about as
little data as your own opinions. At least he has the intestinal
fortitude to identify himself and subject himself to scrutiny so
others can consider the validly (or lack thereof) of his claims..
Glenn Hagele
Executive Director
Council for Refractive Surgery Quality Assurance
Email to glenn dot hagele at usaeyes dot org
http://www.USAEyes.org
http://www.ComplicatedEyes.org
I am not a doctor.
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| gospa68@aol.com 2004-12-27, 10:08 pm |
| Keep shooting yourself and the CRSQA in the foot. I think there are
others lining up to say more on this subject. WK
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| gospa68@aol.com 2004-12-27, 10:08 pm |
| Keep shooting yourself and the CRSQA in the foot. I think there are
others lining up to say more on this subject. WK
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| gospa68@aol.com 2004-12-27, 10:08 pm |
| Keep shooting yourself and the CRSQA in the foot. I think there are
others lining up to say more on this subject. WK
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| gospa68@aol.com 2004-12-27, 10:08 pm |
| Keep shooting yourself and the CRSQA in the foot. I think there are
others lining up to say more on this subject. WK
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| Glenn - USAEyes.org 2004-12-27, 10:08 pm |
| An intelligent and substantiated opinion is always welcomed, even if
it is one with which few agree. An opinion justified with flaky
irrelevant data is not particularly desirable to me.
Glenn Hagele
Executive Director
Council for Refractive Surgery Quality Assurance
Email to glenn dot hagele at usaeyes dot org
http://www.USAEyes.org
http://www.ComplicatedEyes.org
I am not a doctor.
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| serebel 2004-12-28, 2:08 am |
| That's 'cause the Wizzer has been studying at the Brent & sandy school
of paranoia.
Graduated psycho cum loon.
SErebel
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| gospa68@aol.com 2004-12-28, 11:16 am |
| If you take the time and go back to the original FDA PRK phase II and
III studies (the second eye was done six months after the first), you
will find that 10% of the patients treated chose not to have their
second eye done for the same reason - quality of vision was poor when
compared to the untreated eye.
Some here forget that once you do both eyes, as is done today, there is
no control eye for the patient. He/she no longer has a reference point
from which to measure his/her improvement or lack thereof.
I suspect that those here who are critical of Adams will also be
critical of these FDA studies. Adams' data is not flawed nor is his
conclusion.
WK
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| Glenn - USAEyes.org 2004-12-28, 7:15 pm |
| What you and Dr. Adams are attempting to do is use the results of PRK
surgeries from years ago (in your case 10 years ago in FDA trails, in
his case 5 years ago from his own patients) and claim that this is the
state of LASIK today. You are both wrong.
Glenn Hagele
Executive Director
Council for Refractive Surgery Quality Assurance
Email to glenn dot hagele at usaeyes dot org
http://www.USAEyes.org
http://www.ComplicatedEyes.org
I am not a doctor.
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