A Second Look

Though most Lasik eye surgeries are successful, for some the dream of 20 / 20 vision has become little more than a blur.

March 24, 2002|By Tom Dunkel | Tom Dunkel,SPECIAL TO THE SUN

Every morning Linda Shope makes herself an optical sandwich. She puts in her soft contact lenses, inserts hard contacts on top of them, then dons a pair of tinted eyeglasses. And she still can't see well enough to drive a car or write a check.

"I'm hoping I can have a cornea transplant," says Shope, 53, of Waldorf. "What hurts is my whole life has turned upside down."

In June 1998, Shope heard a radio commercial extolling the virtues of Lasik eye surgery: Throw away your glasses and contacts -- forever!

She visited the Lasik center mentioned in the commercial and, despite having astigmatism and severe myopia, passed a screening exam. Elated at that news, she decided to go ahead with the procedure.

Four years and $4,850 later, Shope is seeing a psychiatrist for depression and has filed a malpractice suit against her surgeons. Her eyes are now so sensitive to light she rarely goes outside during the day. She had to take early retirement from her administrative job with Maryland's Department of Environmental Resources because she couldn't see well enough to perform basic office functions.

"I feel in my heart I was a guinea pig," says Shope. "I kick myself and say, 'Why was I so stupid?' "

Lasik became publicly available in the mid-1990s and has since become commonplace enough to have earned the sobriquet "flap and zap" surgery.

Simply put, a tiny motorized blade makes a moon-shaped incision in the clear membrane covering the cornea. The resulting flap is folded back like a hinged door, and the surgeon then shaves off micro-thin layers of exposed corneal tissue with a laser (working much the way a sculptor does with modeling clay), subtly changing the contours of the inner eye to sharply focus incoming light on the retina.

Growing complaints

According to Market Scope, a newsletter devoted to the field of optical surgery, a total of 4.5 million Lasik procedures have been performed in this country; 1.3 million took place just last year, generating some $2.1 billion in sales.

Tiger Woods and tennis star Jennifer Capriati are among the celebrity athletes who've had their eyes zapped. But as the popularity of Lasik has grown, so, too, have the complaints.

The American Trial Lawyers Association now has a "Lasik litigation group," and some 200 lawsuits are winding their way through the courts nationwide. Data is sketchy on failure rates, but it is estimated that between 1 percent and 5 percent of patients experience post-operative problems, ranging from chronic fuzziness to "starburst" effects, from poor night vision to painfully dry eyes.

While the vast majority of Lasik outcomes are positive, some experts believe that over-enthusiasm at times has caused doctors and patients to suspend their better judgment.

"The problem has been in pushing the envelope, doing situations where it was even recognized that patients were marginal [candidates] and hoping the technology would work -- and it didn't," says Dr. Richard Abbott, professor of ophthalmology at the University of California-San Francisco and board member of the American Academy of Ophthalmologists.

"There's been a lot of entrepreneurial effort to get into the marketplace and be successful," Abbott says. "Baltimore has some of the most aggressive advertising in the country."

'Like getting ears pierced'

Dr. Anthony Kameen is Baltimore-Annapolis regional medical director for TLC Laser Eye Centers Inc., which has 59 outlets in North America. (He's also a defendant in Linda Shope's malpractice lawsuit, but declined to comment on her surgery.)

Kameen notes that in 1998 there were two Lasik-surgery laser machines operating in the Baltimore area. A year later there were 20. Price wars ensued. Lasik retailers popped up in shopping malls. Some sales staffs worked on a commission basis, just like car salesmen.

"It became almost like getting your ears pierced," says Kameen. "I think patients have to take it more seriously than they have been. I think doctors have to get more involved than they have been."

Ron Link was a fireman in Lakewood, Ohio, when he decided to have radial keratotomy to correct his nearsightedness. (With RK, the precursor to Lasik, surgeons made spoke-like cuts in the cornea to alter its shape; no lasering was involved.) The results were so poor that Link had to leave his profession: He could no longer see well enough to drive a fire truck at night. He now serves as executive director of the Surgical Eyes Foundation, an advocacy group geared toward disaffected Lasik customers.

Link personally has heard from about 3,000 "problem patients," and Surgical Eyes' Web site averages about 60,000 visitors a month.

Link, who's convinced he was a victim of poor presurgical screening, has been critical of the industry's failure to provide appropriate "fair warning."

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