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New site details downsides of laser eye surgery

Tuesday, October 12, 1999

By Virginia Linn, Post-Gazette Health Editor

Chances are you've heard people at a party or on the job rave about the wonderful results they've had with laser eye surgery. Their vision has been corrected so much, they say, that they no longer have to wear glasses or contacts.

Indeed, roughly 1 million people in the United States this year are expected to undergo laser eye surgery to correct nearsightedness, farsightedness and astigmatism, a testament to the success of this relatively new procedure, eye surgeons say. On the Internet last week, a procedure using one of the lasers, the VISX, was performed live amid great fanfare.

But a growing chorus of dissenters wants people to hear the other side of the story. A Web site,, was developed in May by a grassroots organization in New York City to help people who are trying to cope with the effects of their unsuccessful laser eye surgery.

"We are not opposed to refractive surgery," according to founders of the site. "We are opposed to refractive surgery not done with patients' best interests in mind before, during and after the procedure."

More than 100,000 people have visited the Web site, which includes testimonials from patients about their complications.

  For more information

For information on LASIK from the American Academy of Ophthalmology, you can write to the organization, Attention: Customer Service, Dept. PPG, P.O. Box 7424, San Francisco, Calif., 94120-7424 or visit

The Council for Refractive Surgery Quality Assurance,, certifies refractive surgeons and lists some tough questions consumers should ask of their doctors.


Many say they didn't receive adequate explanations about potential risks and side effects. They were told by surgeons they were a "perfect candidate," and felt pressured by doctors after they started having second thoughts before surgery.

"Unfortunately, there's no Plan B," said Ron Link, the site's executive director and himself a casualty of the procedure. "People, in effect, are left out in the cold."

LASIK, short for laser-assisted in situ keratomileusis, is the most popular of these procedures, followed by PRK, (photorefractive keratectomy) an older version of LASIK.

Currently, there is no tracking of bad outcomes of the surgery, Link said, and it's left up to each surgeon to determine the best candidates.

But several trends have emerged over the last couple of years since the FDA approved these lasers to indicate who is most at risk of complications, Link said.

Those with large pupils, eye muscle problems or who need the most correction report the most problems. These may include seeing halos around lights at night, glare, clouding, experiencing severe dry eyes or poor night vision.

The latest studies of LASIK and PRK reported by Consumer Reports in June estimate an 80 percent success rate, which is defined as achieving 20/40 vision or better.

An eye surgeon can indeed restore your eyesight to 20/20 as promised, Link said, but there are so many other factors that determine quality vision that can be affected -- and can leave you with worse vision than before the surgery.

Link, 40, now of Manhattan, was working as a firefighter in Lakewood, Ohio, when he had RK (radial keratotomy) and AK (astigmatic keratotomy), two types of refractive surgery. He was left with severe polyopia, (multiple vision), ghost images, poor contrast sensitivity and other problems.

He could no longer work as a firefighter, nor drive at night, he said. During a recent visit, his 67-year-old father pointed out that Link was wearing two different sandals. He couldn't detect the contrast in color and texture between the two styles. Cutting toenails is a "real chore" because he can't see the difference between his toenail and cuticle. He was startled to discover that a watch he recently purchased had a Velcro band; because of his poor contrast sensitivity he thought it was leather.

Link found others like himself through exchanges on the Web, and several of them founded the Surgical Eyes Foundation last spring. One trustee is Geri Cross-Madsen, who says she is legally blind as the result of PK and PRK.

The common reaction many have when they learn of the site, is "Oh my God, I thought I was the only one [with complications]," Link said. "We're like a lost tribe."

Link hopes his Web site will heighten awareness of the risks and encourage potential patients to get more thorough pre-op screenings and be diligent in choosing the best doctors. The FDA regulates machinery, but increasing the standard of care must come from within the medical community, Link said.

The industry estimates 1 percent to 5 percent of patients may experience serious post-surgical complications. Between 10 to 15 percent of patients need second surgeries for adjustments.

"Even with a 1 percent complication rate, that's 10,000 people with potentially severe quality of life issues [on 1 million procedures done a year]," Link said. "Is that acceptable for an elective procedure?"

The site gives no medical advice, but is developing a medical advisory board of surgeons and optometrists to help evaluate new surgical procedures for consumers.

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