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Tuesday, November 30, 2010

Tempted by laser eye surgery? It's not without risks

By Alison Smith Squire



Regret: Lois Roberts now suffers from painfully dry eyes


The TV advert for laser eye surgery made it sound so straightforward that Lois ­Roberts didn’t think twice.

‘The idea of just being able to see perfectly as soon as I opened my eyes in the morning seemed fantastic,’ says the law graduate.

She’d worn contacts and glasses for short-sightedness since she was 13-years-old and ‘really looked forward to being able to bin them’.


‘I also played a lot of sport such as hockey and found wearing glasses ­annoying,’ she says.

Her parents thought it was such a good idea that they helped pay for the £1,500 cost as a present for her 21st birthday.

Yet, instead of the simple pain-free experience Lois was led to expect, the surgery to correct her short-sightedness left her in agony for days.

Worse, three years on, she still has ­painfully dry eyes as a result of damage to the nerves that stimulate tears.

Lois has to apply eye drops daily - which in itself is a problem, as ­long-term use can raise the risk of chronic eye inflammation. Dry eyes can also lead to serious infections and, ultimately, even loss of vision.

As well as dry eyes, Lois suffers from constant floaters and poorer night vision.

‘The floaters are like clumps of black lines and dots,’ she says. ‘I’ve been reassured they’re harmless, but they are incredibly annoying.’

Floaters occur as a result of a popular form of laser surgery in which a flap is cut into the surface of the cornea — the clear, domed part of the eyeball.

The flap is lifted so that the laser can remove some of the corneal tissue underneath, to reshape it. But if the flap is folded back down with wrinkles in it or doesn’t adhere to the eye properly, it can result in speckles in vision. Poor night-time vision occurs because part of the cornea has been lasered incorrectly.

The good news is that the surgery did correct her short-sightedness ­(previously it was minus 4.5; now she has ‘perfect’ vision).

But I’m upset I wasn’t warned enough at my ­initial consultation that anything like this could happen,’ says Lois, from North Wales. ‘I would have thought much harder about it had I known the risks.’

This is far from a unique ­experience. Marketing manager Sarah Carter, 45, is taking legal action after treatment to correct severe short-sightedness (minus 6.5) left her with such dry eyes she needed further surgery.

Unfortunately, this operation also went wrong, and the laser damaged the rim of her eyelids.

As a result, Sarah, from Maidstone, Kent, ­suffers from painful ingrowing eyelashes, which must be plucked ­several times a month by an ­optician. She is about to undergo further eye surgery at Moorfields Eye Hospital, but there is no ­guarantee of any cure.

Five years since she had the laser eye surgery, she says: ‘I regret ever having it done. It seemed incredibly straightforward and, at the time, I was just fed up of the inconvenience of contact lenses and glasses.

‘But that was nothing compared to the agony I’ve endured since.

‘I can’t wear eye make-up any more, and my days are full of drops, ointment and constant eye irritation.’


Every year, 100,000 Britons undergo laser eye surgery, which alters the shape of the cornea to correct long and short-sightedness.

First carried out in Britain in 1989, the technique was ­marketed as an end for the need to wear contact lenses and glasses.

Since then, a whole range of ­different types of laser surgery have become available.
However, some experts are ­concerned that the multi-­million-pound industry glosses over some unpleasant, and sometimes ­serious, side effects.

Last year, a Which? report claimed six out of ten ­opticians offering laser eye surgery — including branches of big chains such as ­Optical Express, Optimax and Ultralase — gave unsatisfactory advice and failed to point out the risks.

These include not only dry eyes, floaters and poor night vision, but also growths where the eye is cut, double vision, foggy vision, chronic eyelid inflammation and even loss of sight.

Shockingly, there is no law preventing any surgeon from ­operating as an ‘eye expert’ — though the Royal College of Ophthalmologists awards a ­Certificate of Competence after a surgeon has demonstrated ­expertise in laser eye surgery. It ­recommends patients choose a surgeon with a minimum of three months’ formal training in laser eye surgery who performs at least 500 eye laser operations a year.


Laser surgery can have permanent side effects such as dry eyes and poor night vision


The Royal College says at least 75 per cent of patients undergoing laser surgery
should end up with 20/20 vision. However, one in three still need glasses — and even when eyesight is successfully corrected, some will also be suffering from some sort of side-effect.

The ‘overall risk’ of something going wrong with laser surgery ­— including floaters and dry eyes — is ‘less than 5 per cent’, according to its report published this year.

The risk of serious complications — such as losing your eyesight — is less than 0.2 per cent. Worryingly, it admits the risk of complications at individual clinics can be as high as 40 per cent.

Retired optometrist Dominic Devlin was so concerned about the lack of information about potential risks, he set up a website to help consumers.

‘As part of my research, I’ve been to consultations and have been ­surprised how little is made of potential problems that might occur,’ he says. Mr Devlin is also concerned many patients believe laser surgery is a permanent cure and think they’ll never have to wear glasses again.

‘The truth is laser eye surgery is not a lifetime fix. Side-effects from surgery mean some people will still need glasses for night-time and, as eyesight changes as we grow older, the vast majority will eventually need glasses for reading.’

Furthermore, he says, surgery can be much more painful and the recovery time might take much longer than people are sometimes led to believe. As illustrator David Holroyd, 57, learned to his cost.


Eighteen months ago, he ­underwent laser eye surgery for short-sightedness, paying £2,600 for treatment at a private clinic near his Manchester home.

‘I’d seen a TV advert that made it look as if it was something you could have done in your lunch hour,’ he says. ‘I was ­struggling with several pairs of glasses — not only did I need bifocals generally, I also had a pair for reading.’

David says his consultation lasted 20 minutes, the ­surgery sounded straightforward and there was no mention of pain.

Yet he claims that within ­seconds of starting the surgery, he was writhing in agony.

My head was in a clamp so I couldn’t move, but I could feel every brush of the laser.

‘I’d had local anaesthetic drops put into my eyes, but the doctors could see from my face I was in excruciating pain.

‘I was in too much agony to even speak, let alone tell them to stop. Yet all the doctor said was: “We are aware. Try to keep still.”

‘The surgery lasted only minutes, but was terrifying. Had I known how painful it would be, I never would have had it done.’

‘Afterwards, I was in bed for three days, followed by two weeks when my sight wasn’t good enough to go out.’

As well as the pain, like Lois and Sarah he has also been left with dry eyes for which he will need drops for the rest of his life.

Now, though his sight is much better, he has been told his eyes will be permanently dry. ‘I just feel angry that I wasn’t warned about any of this,’ he says.

Mr Devlin is campaigning for a proper independent body where patients can seek advice and complain to if surgery goes wrong. He points out that contact lenses are much more sophisticated and cause fewer problems than they did 20 years ago and may be a safer option than laser surgery.

‘If you have a problem with ­contact lenses or glasses, you can pop back to the opticians where it can be easily rectified,’ he says.

‘But adverse side effects from laser surgery might be ­irreversible and permanent.’

Dominic Devlin’s website can be found at laser-eye-surgery-review.com



Source:Dailymail

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