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- June 03, 2002
- Vol. 57
- No. 21
For Millions, Lasik Eye Surgery Means No More Glasses or Contacts. But Sometimes It Spells Disaster
Unfortunately, Tonya could barely see her son's big moment, even though she and her husband, Rob, were in the stands. The world, in fact, has been something of a blur to her ever since 1998, after she and Rob underwent LASIK surgery, the increasingly popular process in which lasers are used to reshape the cornea. LASIK (laser-assisted in situ kerato-mileusis), introduced in the U.S. in 1996, has become the second most common eye operation in the U.S. after cataract surgery; last year 780,000 patients received the treatment. In Rob's case the surgery lived up to its promise, correcting his nearsightedness. But for Tonya, the procedure may have caused life-altering harm. During the next year her ophthalmologist Dr. Thomas Abell operated three more times, to no avail. Today a devastated Oliver is legally blind in the left eye, with deteriorating sight in the right. "You don't realize the value of vision," she says, "until you have lost it."
Tonya sued for malpractice, and last November a Fayette County jury awarded her $1.7 million. It was the largest payment in the more than 300 LASIK malpractice suits that have been filed to date. Although the American Academy of Ophthalmology released a study in January showing that LASIK is generally safe and effective for patients with low to moderate degrees of nearsightedness or astigmatism, no operation is without risks. Ron Link, 42, who runs a Web site for patients with postoperative eye problems (www.surgicaleyes.org), points out that if problems occur in just 5 percent of LASIK operations, as some researchers estimate, that adds up to almost 40,000 people a year. "In many cases their lives have been severely compromised," says Link, a former Lakewood, Ohio, firefighter who had to resign in 1995 after his eyes were left with night-vision problems by radial keratotomy, a precursor of LASIK.
Moreover, experts warn that LASIK is not for everyone. "Those who definitely shouldn't undergo the surgery include people with dry eye, large pupils and thin corneas," says Link. And critics charge that some surgeons, eager to make a profit, are operating on patients who shouldn't have the procedure. "It is critical that patients are educated about the risks and benefits—LASIK should not be sold to you like a used car or a stereo," says Dr. Robert Maloney, a spokesman for the AAO. "If you feel there are any high-pressure sales tactics, go somewhere else."
When Linda Scott consulted Torrance, Calif., ophthalmologist Dr. Wendell Wong about LASIK, he didn't give her the hard sell. But she's convinced he never should have operated on her. The Pasadena workmen's-compensation attorney claims LASIK-related problems—severe dryness and corneal distortion—have harmed her career. "I used to read files in bed," says the divorced Scott, 44, who underwent LASIK for nearsightedness in February 1999. "These days I am likely to read 3 pages versus 50 pages. No one has any idea what I have gone through to keep things afloat. I basically don't do anything but work."
In February Scott reached a $ 150,000 out-of-court settlement in a malpractice suit against Wong. The crux of her case was that Wong allegedly failed to recognize that she had keratoconus, or a cone-shaped eye, an indication that she was not a suitable LASIK candidate. (Defense witness Dr. Yaron S. Rabinowitz, vice chief of ophthalmology at Cedars-Sinai Medical Center in L.A., testified that Scott actually has a rare degenerative condition that was very difficult to diagnose.) When Wong, who had performed LASIK at least 5,000 times, walked in to operate, Scott says, he asked if she wanted to join him in prayer. "I was kind of in shock, but I said okay," she says. "I guess he didn't pray hard enough."
A week after the 15-minute surgery, Scott's right eye seemed cloudy. After examining her, Wong said he had identified the problem. In LASIK, a device first cuts a flap of tissue so that the surgeon can zero in on the cornea with a laser. Wong determined that Scott's flap had wrinkled. "I opted to reposition her flap and try to smooth out those wrinkles," he testified. It didn't work. "Ultimately," Scott says, "I found myself an inch or two from my computer screen. I was barely functional."
She now wears two sets of prescription contact lenses—soft ones to protect her eyes from the hard lenses on top of them. Scott's dry eyes make her blink excessively. Because judges have wondered if she were winking a signal to a witness, she now makes sure to inform them of her problem. Eventually, she has been told, she will need corneal transplants. Still, Scott is grateful for the sight she has. "Thank God," she says, "I am not blind."
Neither is Tonya Oliver—but she leads a drastically diminished life. She can read only for short periods before her vision blurs. She cannot drive at night—oncoming headlights make her see halos and star bursts. Failing depth perception has robbed her of a lifelong passion for golf. She and Rob had teamed up to win several local championships, but after her surgeries her scores went from the low 80s to the 130s. "We can't play together anymore, because it's no fun for her," says Rob, 42, who owns a used-car dealership with his wife of 16 years. The jury in Oliver's case was swayed by expert witnesses who testified that Abell had operated on the wrong axis (that is, angle) during the second surgery and that he had caused further injury with two additional surgeries. Declares Oliver: "Dr. Abell needs to look me in the eye and say, I made a mistake.' "
That seems unlikely. "I have never operated on the wrong axis," insists Abell, 48, a veteran of 11,000 LASIK surgeries, who has appealed the judgment. "I know without doubt that my medical care was appropriate and I did everything correctly." But Dr. Avrom D. Epstein, a Columbus, Ohio, neuro-ophthalmologist who recently examined Oliver, found "something wrong in the part of the eye that picks up light and transmits it to the brain. It is clear that this is not in her mind. Exactly how this happened is hard to tell. LASIK usually goes very well."
In January 2000 Oliver received a corneal transplant from Dr. Woodford Van Meter of the University of Kentucky. Success was limited. "The vision is not as blurry as it was," she says. "But I still can't see well." At the trial Van Meter said her "irregular cornea was consistent with that which would come from multiple LASIK procedures." Abell defends all four surgeries. "I try very much to get perfect results for all our patients," he said. But after a May 21, 1998, operation, Oliver's left eye was so weak she could no longer read the huge letter E on the eye chart. A week later Abell operated again. He performed the fourth surgery in October 1998, because, he says, Oliver's left eye had been overcorrected from nearsightedness to farsightedness. "I thought that operation went extremely well," he said. "Her visual acuity was as good as it was the first day I saw her."
Oliver, of course, would dispute that claim and says she cannot see beyond an inch with her left eye. She feels anger rise whenever she sees Abell, which is usually at Tyler's baseball games—the surgeon's son plays for another team. "Dr. Abell, in my opinion, pretty much stole my vision," says Oliver. "At this point in my life, I don't have a forgiving heart. Maybe at some time down the road the Lord can help give me one.
Giovanna Breu in Lexington
- Giovanna Breu.
January 31, 2015
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