Surgeon warns of laser eye cure
dangers of treatment not made clear
LASER eye surgery firms
are underplaying the risks associated with the operation and
doing too little research on its long-term effects, a leading
Scottish expert has warned.
Dr Alistair Adams, one of
Scotland’s most senior ophthalmic surgeons, believes that as
many as one in 10 patients who undergo the corrective
procedure ‘successfully’ could develop complications in later
But Adams, a consultant at the Princess
Alexandra Eye Pavilion, Edinburgh, believes the companies
involved are allowing patients to underestimate the risks.
Adams also revealed that he gave up practising an
earlier form of laser eye surgery because so many of his
patients returned with complications.
Scots each year pay around £1,000 per eye to undergo laser
surgery in the hope of throwing away their glasses or contact
lenses for ever.
But while the number of patients has
rapidly increased in recent years, so too have the warning
signs. Public health watchdog NICE recently said its use
should not be funded by the NHS because too many questions
Adams once practised a form of
laser eye surgery called PRK, or photo refractive keratectomy.
It involved scraping through the surface of the eye and
reshaping the cornea with a laser. At the time, patients had
one eye treated at a time on safety grounds.
until recently chairman of the special advisory board on
ophthalmology at the Royal College of Surgeons in Edinburgh,
told Scotland on Sunday: "I did approximately 100 cases of
PRK, but I stopped doing it around five years ago because
around 10% of people I treated didn’t want to have their other
eye done, and were happy sticking with their contact lens.
"That was mostly due to their vision at nighttime,
driving in the dark or dim light, as their vision wasn’t as
good as it was with their contact lens.
"One or two
people had it done with both eyes and could no longer drive at
PRK has been replaced with the LASIK
technique, which involves slicing into the cornea. It costs
between £2,000 and £3,000.
But Adams says he has no
intention of performing the procedure himself.
said: "I have looked at LASIK several times, and have many
friends, particularly in America, who say it is wonderful.
Patients, generally speaking, are very happy.
"However, I do have reservations about the surgical
procedure. With LASIK, between 5% and 10% may have persistent
problems and may wish they hadn’t had the surgery done. It is
quite invasive, with a slice made in the cornea, for a problem
that is actually solvable with contact lenses or glasses.
"I have a question mark over the long-term results,
and I think there may well be complications which we haven’t
suspected. Already they are beginning to find more
complications than they thought."
He added: "One of
the defects of the present system is that the majority of
these clinics which do the treatment do not keep the
statistics of long-term follow-up.
is marketed as being very simple and very safe, and I suspect
that probably is just not true. To be fair, a lot of the
clinics do offer good information, but patients who are set on
throwing away their glasses don’t necessarily take it all in.
"A lot of companies say that 95% of patients have
20:20 vision after the treatment, but that doesn’t tell you
that 10% of them might not be able to drive at night.
"Apart from the major risks of infection, there are a
significant number of people with dry eyes, double vision or
who see halos around lights. In some cases, such as persistent
haziness. The patient can be left with an impairment of vision
that is permanent.
"Some people’s lives have been
turned upside down by having LASIK because of complications
that they felt they were not fully informed about."
added he was concerned at the increasingly popular practice of
operating on both eyes at once. "If there was a problem, like
an infection, then you might well have it in both eyes," he
The Royal College of Ophthalmologists, the
profession’s training body, is currently producing guidelines
on the LASIK technique and is urging more research. "Current
evidence suggests the treatment is effective for selected
patients with mild or moderate myopia but the College
recognises the importance of more research into the long-term
effects," said a spokeswoman.
But Christopher Neave,
chairman of the Eye Laser Association (ELA), which represents
the largest providers of laser eye treatment in the UK, said
that the figure of 10% with complications was simply wrong.
He said: "Since 1990, some 280,000 people in the UK
have been treated, and we estimate that fewer than 0.1% have
experienced persistent problems. LASIK is a life-enhancing
treatment and we believe that it is a discretionary decision
by an individual."
He also pointed to independently
verified research on patients treated at the Ultralase
clinics, which showed that 98% of all its clients achieved
driving-standard vision or better.
Neave, who said
there was an "outstanding level of clinical care in our
industry", said that the risks were made clear to patients
both in writing as well as in verbal