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Clearing Up Picture On Laser Eye Surgery

Feb 26, 2004 | CNN Millions of Americans are flocking to eye doctors, wanting laser surgery to correct their vision problems. Many people are happy with the results, but for some, it can do more damage than good.

Experts say finding the right doctor and understanding the risks can help prospective patients get a clearer picture of the results they can expect.

According to the American Academy of Ophthalmology, Lasik surgery the most common eye laser procedure that reshapes the cornea to correct focusing power was performed on an estimated 1.8 million people in the United States in 2002.

In 1998, Linda Shope had the surgery for the same reason a lot of people do. "I just wanted to throw the glasses away," Shope said.

But instead of getting better, her eyesight is worse, and she is now legally blind in her left eye.

"I cannot see small print. I cannot see any writing on the TV. I cannot go out at night," she said. "I have to wear these dark glasses. [Even] during the day I have to wear the glasses."

In Shope's case, she had severe astigmatism, a condition where the cornea is irregularly shaped and causes blurry vision.

Experts say Shope should have been ruled out as a candidate for surgery because of the severity of her condition. The fact that she wasn't, they say, emphasizes the need for consumers to be informed about the surgery and the specific doctor who will perform it.

The U.S. Food and Drug Administration, which approves what types of lasers doctors can use, says possible risks or complications from surgery include the possibility of permanent vision loss, the need for additional treatment or eyeglasses to achieve 20/20 vision and the chance that improvements may not last forever.

Last year, the American Academy of Ophthalmology found that Lasik was effective for correcting low-to-moderate nearsightedness and astigmatism but less predictable for more extreme conditions.

Doctor: Consider more than price
Finding the best doctor for the job takes research, and experts say looking for the best price is not the best place to start.

"[Patients] wouldn't want to get discount open heart surgery or budget brain surgery," said Dr. Terrence O'Brien of John Hopkins University's Wilmer Eye Institute in Baltimore, Maryland. "Yet some people devalue their eyes and would risk a major complication to have a discounted eye surgery."

The ads for some clinics also could contain red flags, O'Brien said.

"If you have an advertisement that boasts of thousands and thousands of procedures being performed, one should be cautious," he said. "[It may be a] commercialized outfit that is more interested in quantity than quality."

Instead, O'Brien said, look for a clinic with good preoperative screening. This approach should rule out people with severe nearsightedness or extreme astigmatism.

Experts also recommend checking for thorough postoperative care to ensure clinics can handle problems that may arise after the procedure.

The ophthalmology association reports that about 5 percent to 15 percent of Lasik patients return for additional surgery.

Lasik surgery cannot be reversed, and the procedure is still too new to know if there are any long-term ill effects beyond five years after surgery, according to the ophthalmology association.

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