CYBERPUNK: Eye Opener

It was weird. One person in the office where I work had casually mentioned that he is looking into laser eye surgery -- the elective procedure that can correct nearsightedness through the use of a laser. Within 24 hours three other people -- in an office of a dozen -- said they too are checking out the procedure.

One co-worker confided to me that he is doing research on the possible dangers for his girlfriend, who's thinking about getting the treatment. Someone else commented, "I hear there's nothing wrong with the procedure. No side effects. It's very safe."

Indeed, for those of us who have long suffered glasses or contacts, this procedure almost seems too good to be true (even if "vision-corrective surgery" does sound vaguely futuristic). For a few grand, you no longer have to worry about putting on your disposables in the morning or some flying softball wrecking your $250 pair of Kenneth Coles. A clinic specializing in laser in situ keratomileusis (LASIK), the latest refractive surgery technique, will slice open your corneas, flip up the tops, vaporize the excess tissue with some laser pulses, then flip the flaps back down as though your eyes were pieces of Tupperware (Understanding LASIK: www.lasersite.com/lasik/index.htm). A few hours later, you're back out on the street, enjoying your yuppie lifestyle once again, sharing with your pals another miraculous success of laser-sculpted 20/20 vision.

But as more and more people undergo this procedure, more stories of cases gone awry are appearing. Ron Link, executive director of the Surgical Eyes Foundation (www.surgicaleyes.org), a nonprofit watchdog group that keeps an eye on eye surgery, estimates he's gotten more than 1,000 testimonials from people whose quest for perfect vision yielded less-than-perfect results.

"There is a lot of frustration, for there is no plan B" for improving laser-botched vision, Link says. Some individuals' corneal surfaces heal in an irregular fashion that can no longer be adjusted for by the use of contacts or glasses. "It's very difficult to get back into contact lenses or glasses after refractive surgery," Link says. "You can see a little better, but not much."

Link formed the foundation himself after his own refractive eye surgery in 1995 left him unable to drive at night. He later found out that his family eye doctor, who had recommended the procedure, had gotten a hefty referral fee for Link's operation. After some research, Link found his case wasn't an isolated one, nor was the procedure foolproof. He created the Web site for other victims to share their experiences: "There was just no forum for people to discuss these things, people who have found that their life course has changed due to an elective surgery."

One doesn't need perfect vision to see what all these tales of woe add up to -- the Surgical Eyes site is filled with complaints of post-op glare, poor night vision, dryness of the eyes, swollen corneas, and cloudy vision. There's the physician who had the treatment done in 1996 only to have his right eye recede into an astigmatism; now, he reports, he needs to wear glasses over a pair of contacts, and he still experiences haze and sees flares around lights.

Then there's Gail, who suffered from inability to read signs or drive at night. She writes on the site:


I now know that much of my vision is gone forever. Never again can I walk in the mountains by moonlight, as contrast sensitivity has faded. I cannot work all day and stay up late into the evening reading the latest science-fiction novel or watching a movie. I cannot share driving all night with my spouse so that we can go skiing.... I spook real easy in dimly lit parking garages and won't meet friends for plays or concerts at night. My world has gotten very small.
Since the U.S. Food and Drug Administration approved the procedure in 1991, approximately 770,000 people have had LASIK surgery. Almost that many will get it this year. Although major mishaps are kept track of, people experiencing lesser symptoms aren't tabulated.

"I was being overrun by patients wanting consult for complications from LASIK centers," Dr. Steven E. Wilson, chair of ophthalmology at the University of Washington in Seattle, told ABC News.com ("Eyes Wide Shut"). "I was having so many of these patients with bad flaps that I had to limit my clinic to emergencies because I wasn't having time to see my own patients."

Of course, leave it to the media to exaggerate these things. The vast majority of procedures result in crystal-clear, trouble-free vision. The laser-eye-surgery industry contends that 92 to 98 percent of the cases result in 20/40 vision (which is nearly perfect) or better. But that leaves as many as 61,000 people who will undergo the surgery this year and not get the benefit -- who might, in fact, suffer as a result. All to avoid the inconvenience of glasses?

Early on, much of the popularity of laser eye surgery resulted from word of mouth, Link says. Such informal marketing has an interesting effect: People who have successful outcomes will tell four or five friends, whereas someone who ends up with less than optimal results might not tell anyone, fearing embarrassment. "They feel they're an anomaly," Link says. "It's not really rare. That's what we're getting at."

E-mail: joabj@charm.net.

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