LASIK flap mishaps
Sandy
By BRETT SHIPP / WFAA-TV
Lasik eye surgery is the most popular elective operation performed in
North Texas.
But beneath the buzz is a growing outcry from some former Lasik
patients, who said their eyesight has been damaged - and that they
were never warned of the risks.
Since 1996, more than three million Americans have been able to throw
away their glasses and contact lens thanks to the procedure. Lasik is
billed as a fast, safe and effective way to see better forever, and
there's no question the vast majority of patients are pleased with
their surgeries.
"While your eye is under pressure, we are going to use the
microkeratome, a special instrument that carves a thin flap of your
cornea," the surgeon told Pailet.
Pailet said he was made aware of the hazards by friends who paid less
for Lasik.
"I didn't want to go to just where the cheapest place was," Pailet
said, gesturing towards his eyes. "I've got these things one time -
we're on this earth once, (and) if something goes wrong, that's it."
Experts agree the riskiest part of the procedure is the microkeratome,
a mechanical device which slices a flap in the cornea. The cornea is
then peeled back and the laser applied. For most patients the cut is
clean, almost routine.
But Sharon Guess of Rochester, New York said that part of the surgery
ruined her eyesight. She is suing the manufacturer of the
cornea-cutting machine, Bausch and Lomb. Guess's attorney Al Parisi
said instead of making a clean cut, the blade broke.
"What happened was, with respect to the blade when it separated, it
actually sliced her cornea in a way that is causing her partial
blindness now in the eye," Parisi said.
"The vision is now a glare, making it more difficult for bright lights
- in any case, daylight or nighttime," Guess said.
Bausch and Lomb officials declined an on camera interview, but said
her case is the first report they have received of a blade break. They
also said the patient's account of the incident contradicts her
surgeon's report.
Bausch and Lomb, however, doesn't contest another fact: its nationwide
recall last December of more than four thousand microkeratome blades.
The company cited the reason as "an unusual number of reports of an
eye infection called DLK, associated with those ... blades."
Bausch and Lomb officials said repeated testing has not found anything
to link the returned blades to cases of DLK. But Janie Foster of
Abilene is not so sure: she said one of the recalled blades was used
on her eye in Dallas last November.
"I now have one good eye," Foster said.
Foster said immediately after the operation, her doctor noticed an
inflammation later diagnosed as DLK. Foster said her vision has only
gotten worse and that a corneal transplant may be her only hope for
restored sight.
"I depend totally on my friends, my bosses (and) the people at my work
to take me to the beauty shop, take me to the grocery store, get me to
work and home every day," Foster said.
Denise Aguilar of Albuquerque said Lasik surgery left her legally
blind in her left eye. She said she was never fully informed of the
risks, and now sees nothing but a "big blur" in her left eye.
"Basically I just got a form that had general information about what
risks might occur," Aguilar said. "None of the forms said I was at
risk of being blind."
The Food and Drug Administration, on its Web site, warned "you are not
a good Lasik candidate ... if you are not a risk taker". It advised,
"some patients lose vision" or "develop debilitating visual symptoms".
Former Lasik patient Paula Cofer of Tampa, Florida said the surgery
affected her night vision.
"It's very difficult to read signs at night, and just navigating my
way through these starbursts and halos is almost impossible for me,"
Cofer said.
Attorney Carolyn Merchant of Albuquerque has become well versed in
Lasik complications.
"Lasik Complications Prevention and Management," Merchant said,
reading off a book title. "They have to write books on this because
there are so many places within the procedure where it can go wrong."
Merchant currently represents seven unhappy Lasik patients including
Alissa Browne, whose vision was damaged when the blade malfunctioned
during her operation.
"With Alissa, the keratome cut too deep, and it perforated through the
entire cornea and into the anterior chamber," Merchant said. "Instead
of cutting a slice at the top, it cut completely through the entire
cornea."
Merchant said that cut was a result of a microkeratome malfunction.
She said research she has seen shows that as many of five percent of
Lasik operations go bad.
Kevin Pailet said he did everything he could to make sure that he is
not one of that five percent. But midway through his procedure, while
a News 8 camera was rolling, something went wrong. The top layer of
his cornea was scraped and wrinkled by the keratome. The doctor called
it an epithelial abrasion, and had to smooth the damaged corneal
tissue.
The doctor told News 8 this happens from time to time on patients with
weak epitheliums, and may take an extra week or two to heal.
This update on Kevin's situation: he said after the initial scare, his
eyesight is improving. In fact, he said he is now delighted with the
final outcome of the procedure -and has almost perfect vision without
glasses.
Still he says if he knew problems would occur, he might not have had
the procedure done. Again, though, it should be noted that the vast
majority of people who undergo Lasik say they experience few, if any,
problems.
Dr. Leukoma
news:6c5f759b.03072...@posting.google.com:
I thought that Brett Shipp did a good job on this story. He could have
created quite a sensation for the surgeon whose microkeratome caused the
abrasion "on camera." To an investigative reporter, this would be like
manna falling from heaven. While he obviously found more of a story than
he anticipated, he also used good judgement.
I got to have the final say which was: "If you can wear glasses or contact
lenses, I say stick with 'em." The series received high viewership, at
least judging by the feedback I got from my patients and friends. It was
aired during a winter storm which forced everybody to stay in front of
their TV sets.
As a footnote, immediately following that series, the tone of advertising
changed. The claims became slightly more conservative, and there now seems
to be a greater awareness of what can happen if things go wrong.
DrG