Posted by: "Muhammad Masry massrii
Tue Mar 18, 2008 9:09 am (PDT)
Lasik Surgery: When the Fine Print Applies to You
By Abby Ellin on March 15, 2008
Dr. Belmont told me that sometimes women of a certain age who are undergoing hormonal changes or who take certain medications get dry eye. It would have been nice if I’d known my advanced age (39) might be problematic before I sat in the chair.
I cut out all prescription and nonprescription pills. Didn’t help. The doctor told me to use Refresh Plus, over-the-counter drops that temporarily help dry eye. The drops cost around $12 a box; I go through two boxes a week. She also prescribed Restasis eye drops, which can help increase tear production. They didn’t for me.
True, I no longer wear glasses. But the 20/20 line on the eye chart is blurry. I can make it out only if I squint, and it takes about a minute to read. My doctor views this as proof of the surgery’s success.
“I do see it as a success,” Dr. Belmont told me in a recent interview. She also has said repeatedly that these troubles will pass. “In 18 years of practice, I’ve never had a patient whose symptoms don’t go away. Most patients take three to six months to heal.”
But I see my slow-squint reading as a sign of failure. I thought I’d be able to decipher words in the real world at a glance. My consent form said: “The patient understands that the benefit of the Lasik/P.R.K. procedure is to have an improved uncorrected visual acuity.” I took that to mean that my eyesight would be 20/20. Most doctors, on the other hand, focus on the words “improved uncorrected visual acuity.”
“Not every patient has the potential to see 20/20,” Dr. Belmont told me this month. So, if your eye can see 20/20 with glasses or contacts, the doctors try to replicate that, but there are no guarantees. Dr. Belmont said, “You do the best that you can.”
On its Web site (www.fda.gov/ cdrh/lasik/ risks.htm) , the F.D.A. cautions patients to “Be wary of eye centers that advertise ‘20/20 vision or your money back’ or ‘package deals.’ ” (Still, some refractive eye surgeons’ phone numbers end in 2020.)
Nearly a year later, my problems remain. Still, I’m not mad at my doctor. I’m mad at myself. No one forced me to do it. In our quick-fix culture, we forget that there are risks with any surgery, elective or not.
Between 1998 and 2006 the F.D.A. received 140 negative reports relating to Lasik, including double vision, dry eye and halos, said Mary Long, a spokeswoman. Granted, this is not that many, but Ms. Long said, “If this many people are responding to an adverse event, there are probably others who are not.”
After concluding that too few well-designed studies have examined quality of life after Lasik, the F.D.A. put together a task force in 2006 to design a clinical trial to explore the subject. A pilot study is now under way at the National Eye Institute in Bethesda, Md.
LOOKING back, I do not think my doctor and the other experts I consulted adequately represented the pitfalls. It’s one thing to say that dry eye is “annoying,” as Dr. Belmont did; it’s another to explain how feeling as if your eyes are coated in Vaseline may make every waking moment a chore.
Perhaps it depends on what your definition of success is.
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