By Dr. W. Gifford Jones
August 27, 2000
Á "Caveat empor" (let the buyer beware), was good advice in Roman times. It's still sound counsel today. Last year, I cautioned readers about the possible complications of LASIK eye surgery. Now, a report from London, England, shows it remains prudent to think twice about throwing away your eye glasses. And that laser surgery may affect the death toll on our highways.
Á Those who advocate LASIK surgery make it very appealing. After all, who wouldn't prefer good vision without glasses or contact lenses? Laser surgery, they say, can make this dream come true.
Á People who are nearsighted have an eyeball and cornea that are too arched. This means images are focused just in front of the retina (the back part of the eye). Not on the retina as intended. LASIK surgery corrects this problem by altering the shape of the cornea.
Á The problem is that anyone who tells you it's possible to do surgery without the risk of complications is either a liar or a fool. And surgeons who make bundles of money from this operation find it easy to underestimate the possible risk.
Á There are several reasons why laser eye surgery needs considerable thought. For instance, improper treatment of the cornea might necessitate another operation.Á There's also the possibility of post©operative infection, scarring, or a one©percent chance of less vision, even with glasses, than before the surgery.
Á The peeling of layers of tissue off the cornea tends to weaken it making it more susceptible to injury. Laser surgery may also make it more difficult to perform cataract surgery later in life.
Á In one study 435 people who agreed to this operation were examined five years later. 36 percent of the 323 who had surgery on both eyes still needed glasses.
Á But the report from Johns Hopkins University ran the largest warning bell. It claimed that 15 percent of patients following surgery required glasses occasionally, especially at night, or when lighting was poor.
Á Dr. William Jory, an ophthalmologist at the London Centre for Refractive Surgery, reported another worrying finding. He told the American Society of Cataract and Refractive Surgeons in Boston, that even patients who did well after the surgery, nevertheless showed a decrease in night vision.Ô 0*0*0* "What really concerned me" he said, "was that 41 percent had gained day©time vision, but some of those had lost nighttime vision."
Á Dr Jory added this thought©provoking remark. "In Germany it would have been illegal for these people to drive on the roads!"
Á In another study of short©sighted people who had laser surgery 80 percent could not see a traffic sign at 55 meters (15 car lengths). And 40 percent could not see the sign at 15 meters (4 car lengths).
Á This fact may make your hair stand on end. I worry while driving at night about the number of drunken drivers. This year over one million North Americans will have laser eye surgery. One wonders how many of these are driving at night.
Á There's another concern. The one thing laser surgery cannot stop is aging. And as the eye ages night vision decreases. How often have we heard older people say, "I don't like driving at night any more". It's simply because they can't see as well.
Á So what happens to the night vision of patients who have had laser surgery as they age? Some face a double©whammy, the effects of aging, plus the affects of surgery. And this means more deaths on the highway.
Á I called several ophthalmologists to seek their opinion. They confirmed that they've heard scary stories from laser patients of near automobile misses during night driving.
Á One ophthalmologist reported that he advises patients to drive with the overhead light on at night. Or provides them with eye drops to make their pupils smaller.
Á I think all this is scary. It convinces me not to toss away my eye glasses. The risk simply isn't worth it. But also, what about the risk laser surgery places on everyone else on the road at night?
Á Dr. Jory claims an independent international study should be done immediately to assess this problem. In the meantime I'd suggest that ophthalmologists and patients take a second breath before rushing headlong to laser treatment.
Á An old American adage says, "Don't monkey with the buzz©saw. Today you could add, "Don't monkey with new fancy technology unless it's proven absolutely necessary."
`Á This caution goes for all types of surgery. One of Harvard's most noted surgeons once remarked, "There's no such thing as minor surgery. But there are a lot of minor surgeons".
W. Gifford-Jones M.D is the pen name of Dr. Ken Walker graduate of Harvard. Dr. Walker's website is: Docgiff.com
My book, �90 + How I Got There� can be obtained by sending $19.95 to:
Giff Holdings, 525 Balliol St, Unit # 6,Toronto, Ontario, M4S 1E1
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