BY SABINE VOLLMER
(Raleigh) News & Observer
Millions of Americans have undergone laser eye surgery to correct bad vision, and along with the procedure's popularity something else is coming into focus: its hazards.
Advertising stresses the surgery's safety, and most procedures are successful. Tiger Woods, who relies on keen eyesight as the world's best golfer, pitches it as a quick and painless way to restore sharp vision. Even the U.S. Air Force, long skeptical of the surgery, changed its policy in May to let people who had LASIK apply for pilot training.
But every year, thousands of Americans who undergo LASIK are left with chronic pain, dryness of the eyes, distorted night vision and even night blindness, according to Food and Drug Administration statistics.
LASIK - which stands for laser-assisted- in-situ keratomileusis -uses lasers to cut and reshape the cornea. It can improve eyesight without complications, but equipment flaws, a surgeon's error or a failure to screen out patients whose eyes are ill-suited for the treatment can cause the operation to go awry.
The American Society of Cataract and Refractive Surgery, which represents about 9,000 ophthalmologists specializing in laser eye surgery, estimates that 2 percent to 3 percent of the more than 1 million LASIK surgeries each year are unsuccessful. But Food and Drug Administration records of clinical studies show that six months after the surgery, up to 16 percent had blurry vision and up to 18 percent had difficulty driving at night.
How many LASIK patients develop post-surgery complications is obscured by a lack of regulation and reporting. Because health insurers don't pay for LASIK, they generally don't track complications. The FDA doesn't require reports from doctors, and regulatory enforcement has been largely limited to recalling malfunctioning lasers.
One of the Triangle's leaders in the procedure is Duke Eye Center, whose LASIK surgeons are among the best-trained and best-equipped in the field. But even surgery at Duke's level has damaged a few patient's eyes beyond repair.
One of those patients is Matthew Kotsovolos, 38, of Raliegh. He was the Duke Eye Center's head of finances and received the surgery for free June 8, 2006. It gave him 20/20 vision but left him with intensely dry eyes and excruciating facial pain. He wakes up with sore eyes every morning, wears special goggles to preserve eye moisture and wonders when the pain in his face will kick in.
"I traded in my glasses for permanent head pain, eye pain and these things," Kotsovolos said, pointing to the goggles.
He is organizing a support group for LASIK patients with complications.
"It may help inform people that this is a surgery with real risks that are understated by LASIK surgeons," Kotsovolos said.
Alan Carlson, head of the Duke Eye Center, said his experience with LASIK is that complications are rare. Carlson, who did not operate on Kotsovolos, said only a handful of the roughly 6,000 LASIK patients he has treated at Duke since 1996 ended up with problems. The eye center does very well in patient satisfaction surveys, he said.
"I had nothing but a great experience," said Jim Branch, 55, a Raleigh real estate developer who had LASIK at Duke about five years ago.
But Carlson acknowledged that the procedure can cause serious complications.
"It's imperfect surgery in an imperfect world," he said.
Post-LASIK lenses
Evidence of problems is accumulating. Some of the strongest is the growing market for contact lenses designed for people who have undergone LASIK and still have vision problems, some seeing worse than before the surgery. One of the leading post-LASIK lens maker is MedLens Innovations, a Front Royal, Va. company founded in 2000.
Robert Breece, an optometrist and MedLen's president, said his company provides hard contacts to more than 2,500 post-LASIK patients annually and business is increasing about 10 percent every year. Breece said his company serves more than 200 people per year who have been seriously disabled by the surgery.
"I don't get to talk to happy LASIK patients," he said.
By the end of the year, SynergEyes of Carlsbad, Calif., plans to bring to market the first line of contact lenses designed specially for laser eye surgery patients with complications who cannot tolerate hard lenses.
A trial version of the SynergEyes contact lenses have given Paula Cofer, 49, of Tampa, Fla., some relief from dry, itchy eyes and night vision so distorted that she sees up to eight moons.
The specially fitted contacts cost $300 every six months, Cofer said. Contact lens solution, sterile saline solution, artificial tears and lens rewetting drops run another $150 to $160 per month.
"Life was very simple then," she said about the 30 years she wore glasses. "Now, it's very complicated."
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