Lasik Eye Surgery:
Patients are Blindsided By Dangers of Lasik Surgery: Thousands Suffer Lasting Eye Damage after Procedure
by Susan Ferraro
Tom Babich can't see straight. "I see double and triple images on top of each other in the right eye," said Babich, 29, whose trouble began in August when he had Lasik eye surgery to correct nearsightedness.
Diane Iuliucci of Long Island had to go through two Lasik operations before she was able to see well.
These days, the computer programmer struggles through a third of the 1,000 pages of technical material he used to scan each week. Glasses won't help. To limit constant headaches, he wears an eye patch on his right eye.
Babich said his doctor — whom he saw for just 10 minutes, after preoperative work was done by an assistant — told jokes during the procedure and didn't properly adjust the treatment chair until after he'd done the right eye.
"He told me he was so good at Lasik, he didn't need to pay attention," Babich recalls. "He explained Lasik was like flying an airplane: You didn't need to pay attention when you were really good."
Marketed as a high-tech but simple and glamorous option to glasses, the $2.5 billion Lasik eye surgery industry will be the eye care of choice for a million Americans this year who want to end their astigmatism, nearsightedness or farsightedness.
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Lasik stands for laser-assisted in situ keratomileusis: Surgeons wield a special knife to cut a circular flap in the eye down to the cornea, reshape the cornea with the computer-calibrated laser, then replace the flap.
Approved by the Food and Drug Administration in 1995, the procedure takes no more than 15 minutes per eye. It improves vision by allowing light to focus or refract better.
When Lasik eye surgery is effective, it is great, say proponents. "There is nothing wrong with the procedure when it is done right," said Dr. Liviu Saimovici, a Manhattan laser eye surgeon who had his own eyes done.
Lasik was the most common elective surgery in the United States last year and will be the most common of any kind in 2001 — up 27% over last year to 1.8 million procedures, said Steve Kilmer at TLC, the Canadian-based laser eye company with 55 centers in the United States.
But also growing fast are complaints: Most of the millions of hits on the Web site for the Surgical Eyes Foundation, a New York-based group for people who have had problems with refractive surgery, are about Lasik, said founder Ron Link.
An estimated 3% of patients — 30,000 people and 60,000 eyes in 2001 — will have lasting complications such as double vision and halos, or starbursts, around lights at night. Some will have dry eyes or won't be able to read easily.
"Ordinary activities like the movies, candlelight dinners, sunset strolls, seeing your kids playing in the park, not being able to recognize them because of glare and halos — these are called side effects but ought to be called complications," said Link.
Critics, including some eye surgeons who perform Lasik, say hard-sell advertising, discount prices — the cost of the procedure ranges from $399 to $2,800 an eye — and sloppy screening of candidates leads to slipshod work.
"I tend to see four to six people a week who have had problems," said Dr. Barrie Soloway, head of vision correction at the New York Eye and Ear Infirmary.
New Jersey opthamologist Dr. Joseph Dello Russo said 10% to 15% of patients at his Manhattan office come to see him to repair Lasik surgery performed by other doctors.
Problems are bound to be more common with Lasik's mushrooming popularity in a fiercely competitive market, experts say. "This is the first time a medical procedure has been advertised to the public in a competitive way, the way you advertise a six-pack of Coke," said Ken Keith, a malpractice lawyer.
Saimovici said competition creates "a circus" in which ophthalmologists leave pre- and postoperative care to assistants and optometrists.
Adds Soloway: "We are forgetting it is medicine, and it is surgery on your eyes. If you are comfortable with glasses, it can be silly."
Companies that market Lasik aggressively say their critics protest too much.
"The doctors who object are threatened by the market share, and frightened of us," said Brian Fuqua, spokesman for LaserOne, a company endorsed in advertisements by New York Jets star Wayne Chrebet.
"It is a profit-driven business, a retail market, so how do you market it? Chrebet has worked very well for us," Fuqua said. In New York, "about six" LaserOne doctors perform up to 6,000 Lasik surgeries annually for a starting price of $1,000 an eye, Fuqua said.
Enthusiasm also is part of the marketing strategy at TLC, which charges about $2,200 for each eye. "There's the ‘wow' factor — we keep a clock in surgery suites and they get up and they see the clock and read it [without glasses] for the first time," said Kilmer.
Ideally, Lasik delivers 20/20 or 20/40 vision. Many patients are ecstatic about being able to see in the shower, exercise and work without glasses. "It is a six-minute procedure, not invasive, relatively simple, not like removing cataracts," said Fuqua.
The key to successful Lasik surgery depends on screening and preparation, said Keith.
Complications that can occur during the procedure include wrinkling of the Saran Wrap-like flap when it is replaced on the cornea, which distorts vision, and not calibrating the laser or positioning the chair properly.
Elaine Menese, 58, a New Jersey accountant, first called Dello Russo, whose fee is $5,600. "I don't know what overcame my rationale, but I went to someone who charged less," she said.
Afterward, she saw glare at night around "streetlights, headlights, anything with light. It was a little scary. I gave it a couple of weeks. It didn't go away." She returned to Dello Russo, who did a correction for $3,000. Within a few days, the glare was gone.
Yuri Mykolayevych, 46, a Manhattan engineer, depicts what he sees after Lasik surgery made him farsighted in one eye and nearsighted in the other.
"They pretend like they are so experienced," Menese said of her first doctors. "I felt very stupid, to be honest with you. I was angry at myself. I thought, ‘How could you be such a jerk? It is your eyes.'"
Diane Iuliucci's first attempt to have Lasik stopped abruptly when somehow the flap the doctor cut on her right eye did not open properly. He stopped and sent her home to heal for three months.
"I got shaky," says Iuliucci, 34, a banker. She switched to Dello Russo, who found the middle of the flap had been left on the cornea, like a buttonhole. "If they had lasered, they would have lasered right on flap as well as cornea."
Dello Russo redid her procedure, and Iuliucci is delighted with her 20/20 results today. She has a "slight starburst" at night, "nothing that deters me from driving or affects anything."
Ultimately, said Keith, the industry needs better standards for choosing and protecting patients. Even very careful patients can be disappointed.
Yuri Mykolayevych, 46, a Manhattan engineer, waited until the latest technology was available and paid premium fees to an experienced Lasik physician to have his nearsightedness improved.
Instead, he is now farsighted in one eye and his vision in the other is worse than before, even with glasses. "I was appalled, I was in a cold sweat, I lost weight," said Mykolayevych.
Inhibiting lawsuits from less happy patients are consent forms patients sign. "So many give the problem in one sentence and in the next candy-coat it," Keith said.
Said Mykolayevych: "Part of my release says, ‘All my questions have been answered,' but you don't know the questions to ask." But in April 2000, a 30-year-old student and salesman in Massachusetts won a $1.1 million judgment for Lasik malpractice, now being appealed, for improper use of the knife that lifts the flap.
And the American Trial Lawyers Association has formed a Lasik eye surgery committee. "This is going to be a bumper crop for lawyers," said Keith. "People's lives are being destroyed."
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