her stint as a Navy ocean systems technician, Brenda Ross ripped
four tendons off her right kneecap and spent months in painful
recovery in hospitals in Iceland and the United States. She was
married in a wheelchair wearing a pair of her husband's sweatpants,
and spent the next five years struggling with knee pain and learning
to lose her limp. But that injury now seems to Ross like a sunny
stroll on the beach compared to her collision with LASIK
|Chris Duffey |
|With LASIK, the vision of
Danville's Frank Santos went from 20/50 to 20/40, but
now he's seeing double.
|From the Week of Wednesday,
April 23, 2003|
How to Die
Because hospitals treat death as a failure
of modern medicine, Felicidad Gomez couldn't die
with the dignity she deserved.
Antiwar activists not permitted; Hey, why
steal just one?; Emeryville caves, disabled roll
on; And the liberators strike again.
for the week of April 23-29,
Your snotty vulgarity only makes
competition welcome. Your inspired tribute to
rugby is a credit to the profession.
In 1999, during a procedure to correct her nearsightedness, an
eye surgeon cut and lasered too deeply into the 37-year-old's right
eye. Recognizing his error, the doctor stopped the surgery before
touching the other eye. "LASIK left a hole in the back of my
cornea," said Ross, a mother of four. "I've had injuries in the
past, but none of them affected me like this one."
Surgery had turned her world into a blurry, warped collage. "If
somebody was standing in front of a light source, whatever was in
the background behind them would end up looking like it was on top
of them." Not only was there distortion, but Ross saw a veiny veil
over everything, as if she were seeing her own eyelid. To make
matters worse, she said, her surgeon was completely unreceptive to
her plight. She recalls him saying, "I don't see what your problem
is; people drive with one eye every day."
Over the next year, the Oregon resident visited five different
ophthalmologists searching for answers. It wasn't until she traveled
to the San Ramon office of Arthur Ginsburg, director of Vision
Sciences Research Corporation and Visual Forensics Corporation, that
she began to understand what had happened to her. At his office,
Ross went through hours of exams to measure her impairments. "My
surgeon had hidden a lot of the truth," she said. "When I went down
to see Dr. Ginsburg, there were several things he was able to
explain to me. He was the most informative person I have spoken to.
... He's just a wonderful, amazing man."
A meticulous scientist who has devoted much of his career to
vision research, the Cambridge-trained doctor of biophysics has
invented a test that goes beyond the eye chart and measures
"contrast sensitivity" -- for example, how well someone can
distinguish shades of gray in a dimly lit setting. "With each group
of tests he would explain more and more about my vision," Ross
When the surgery cut deeper than it should have, fluid in her eye
leaked and caused a bulge inside. Ginsburg explained that this had
thrown a permanent wrench into her central optical axis. To make
matters worse, it was in her dominant eye, which made it impossible
for her to ignore the distorted input.
But because her brother had already undergone successful laser
vision correction in both eyes, Ross found it tough to convince her
family and friends how horrific her own sight had become. "I was
becoming so terribly depressed and giving up all hope," she recently
recalled. "When I finally saw Dr. Ginsburg, he put that spark of
hope back in, not that I was going to find a cure necessarily, but
that this wasn't all in my head, that I wasn't making this up. ... I
felt like 'Oh my gosh, I'm being validated. For once, somebody
Ginsburg gave Ross several computer simulations to take home so
her family and friends could experience the world she was seeing.
Upon seeing those pictures, their typical response was: "How do you
When laser vision-correction surgery doesn't deliver the promised
results, the impact can be profound. Ross is one of tens of
thousands of patients whose lives have been turned upside down due
to improper risk screening, malfunctioning machines, or shabby
surgical techniques. Instead of the carefree new lifestyle these
patients anticipated, they have received an involuntary lifetime
admission ticket to their own personal laser light show. At best,
they face glare, halos, starbursts, multiple images, or poor depth
perception. At worst, they face chronic pain, corneal transplants --
even blindness in rare cases. For those already damaged, the
road to rehabilitation is frustrating and slow, and sometimes the
only good remedy is an entirely new pair of eyes.
Laser eye surgery is the most popular elective surgery in the
United States today. Data provided by the American Academy of
Ophthalmology indicates that approximately 2.5 million American
patients had undergone LASIK by the end of 2002. According to a
recent survey conducted for American Demographics magazine,
30 percent of all Americans would like to have the surgery.
By all accounts, the majority of patients enjoy successful
surgery. Data from the 9,000-member American Society of Cataract and
Refractive Surgery suggests that LASIK surgeries are successful 97
percent of the time. But transcripts of US Food and Drug
Administration proceedings suggest that failure may be much more
widespread. In August 2002, discussion by the members of the FDA's
Ophthalmic Devices Panel indicated that 10 percent of clinical study
patients have been consistently unsatisfied with their laser-based
refractive surgeries. The panel also admitted that one patient in
five will have a tougher time seeing in dim lighting -- the
dimension of vision that Ginsburg's innovative new test examines.
Depending on which satisfaction estimate one accepts, somewhere
between 75,000 and 250,000 people so far have left their eye
surgeon's office with considerably less eyesight than they had when
they first walked in.
According to the eye chart, at least, Steve Williams of San
Lorenzo is one of LASIK's success stories.
Williams was nearsighted with 20/600 vision and astigmatism. He
hated glasses, and never could tolerate having hard contact lenses
in his eyes. "It was like having a Coke bottle in my eye," he said.
"It drove me crazy. I hated them." But as an avid athlete, he wasn't
happy with the way glasses inhibited his skiing, golfing, and
tennis. So he considered laser vision correction. The turning point
in his decision was taking off his glasses during a dip in the ocean
in Hawaii, then being unable to locate his towel once he got back
out. Even though he was apprehensive, he decided to have the surgery
In the midst of surgery, following his first eye treatment, the
laser shut down inexplicably. Williams was asked to get off the
table while the doctor reset it. Then his second eye was done. Now,
Williams can't help but wonder whether that glitch was behind the
poorer surgical results in his left eye, the second one treated. "My
right eye is a perfect 20/20, and my left eye is double-vision and
fuzzy, though it's 20/30," the Internet network manager said.
Two weeks after surgery, the numbness wore off and dryness set
in. "I'm pouring in drops every five minutes," he recalled. He used
so many, in fact, that the skin around his eyes became red and
tender, as if from a chemical burn. Conventional eyedrops only made
his eyes worse, and lubricating eye gels weren't any use, either.
Williams eventually tried to resume playing tennis. But staring
at the ball on a windy court caused dry, painful spots -- corneal
erosions -- to develop on the surface of his eyes. "I would play
once and it would take three weeks to recover," he said. "It feels
like you have a stone in your eye."
He remembers the situation as "hideous." He worried that he would
be one of those LASIK patients for whom dry eyes never improve. "I'm
a tough guy, but believe me, it's very frustrating," he said. Then
last December, Williams discovered a Web-based support and advocacy
group for people injured by LASIK, http://www.surgicaleyes.org/,
and read about other patients' success with an innovative
prescription eyedrop. Formulated by dry-eye expert Frank J. Holly
and available only at a single Dallas compounding pharmacy,
Apothecure, the new drops finally made the difference for Williams.
He applies them at least five times a day: first thing in the
morning, before he goes to bed, and periodically throughout the rest
of the day. He never leaves the house without them. "Dr. Holly's
drops turned me right around," he said. "I don't know what I'd do
without them. I'd be miserable, to tell you the truth."
The 47-year-old now finds he needs glasses for reading. He also
has reconciled himself to once again using glasses at night and
while driving. And he said he has learned to tune out the
double-vision that flares up when he looks at green lights with his
bad eye. "I'm right-eye dominant, and my right eye came out
perfect," he said. "If I had my dominant eye 20/30 and my
nondominant eye 20/20, I'd be a wreck."
But all in all, Williams considers himself a success, even though
he still visits the SurgicalEyes Web site a few times a week.
Skiing, golf, and tennis are easier post-LASIK, despite regular
eyedrop breaks and the fuzzy double vision in his left eye. "The
advantages it gives me for those kind of outweigh the negatives," he
The most common complaint voiced by people who aren't as happy
with their own LASIK surgery is that they were never fully warned of
their individual risks. How does a potential LASIK buyer beware?
First, it pays to understand the procedure and its risks.
Truly savvy consumers pay a thorough visit to the Web site of the
federal Food and Drug Administration at www.fda.gov/cdrh/lasik. It
contains a laundry list of LASIK risk factors in plain language, and
explicitly notes that the surgery is risky for people with large
pupils, thin corneas, dry eyes, a history of eye diseases, or anyone
prone to frequent eyesight changes. It also warns would-be patients
to skip LASIK if they are pregnant, have autoimmune problems, or
engage in contact sports. Finally, the FDA prominently warns that
people are "probably NOT a good candidate for refractive surgery" if
they are not "a risk-taker."
A good place to learn more about those risks is SurgicalEyes,
where visitors encounter vivid details about what life is like when
LASIK and other refractive surgeries fail.
But more typically, consumers rely on word-of-mouth from other
patients or advertising from financially motivated information
sources. In the Bay Area, such consumers might reasonably expect to
find reliable information on the Web site of UC Berkeley's
Refractive Surgery Center (http://www.caleyecare.com/).
Its frequently asked questions page could, to the uninitiated, seem
like a good place to start collecting salient details. Concerning
LASIK safety, it reads: "Any kind of surgery carries some potential
risk, but with LASER VISION CORRECTION surgery, there is a
remarkably low rate of complications. Unlike the older, nonlaser
procedure known as RK, the computer- controlled VISX 'excimer' laser
does not weaken the eye."
This statement is surprisingly deceptive, coming from a
university-backed facility. In fact, LASIK does weaken the eye.
First, the surgeon slices a thin flap across the eye's center with a
disposable blade. Then, while the flap is folded away, the doctor
reshapes the eye with a laser. (Treating nearsightedness, for
example, involves flattening the curve of the cornea.) Afterward,
the flap is smoothed back, the eye is bandaged, and the healing
begins. But the eye is unquestionably weaker, and that's why contact
sports are off-limits for LASIK patients and why Clarke Newman, a
fellow of the American Academy of Optometry, says it's still a
matter of debate whether eyes ever fully heal.
» Page: 1
| originally published: April 23, 2003
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