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Clearer warnings on lasik eye surgery recommended

WASHINGTON — In fury and despair, people harmed by lasik eye surgery told federal health advisers Friday of severe eye pain, blurred vision and even a son's suicide.

The Food and Drug Administration advisers recommended that the government warn more clearly about the risks of the hugely popular operations.

About 700,000 Americans a year undergo the elective laser surgery, hoping to throw away their glasses, just as the ads say.

While the vast majority benefit — most see 20-20 or even better — about one in four people seeking lasik is not a good candidate. A small fraction, perhaps 1 percent or fewer, suffer serious side effects: worse vision, severe dry eye and inability to drive at night.

Colin Dorrian was in law school when dry eye made his contact lenses so intolerable that he sought lasik, even though a doctor noted that his pupils were pretty large. Both the dry eye and his pupil size should have disqualified Dorrian, but he received lasik anyway — and his father described six years of eye pain and fuzzy vision before the suburban Philadelphia man killed himself last year.

"As soon as my eyes went bad, I fell into a deeper depression than I'd ever experienced, and I couldn't get out," Gerard Dorrian read from his son's suicide note.

The sober testimonies illustrated that a decade after lasik hit the market, there still are questions about just how often patients suffer bad outcomes from the procedure, which costs about $2,000 per eye.

St. Petersburg ophthalmologist Stephen A. Updegraff said he welcomes new studies by the FDA. Such studies could determine whether problems are more frequent with older lasik technology or with less-skilled surgeons, he said.

"There's no question that a lot of the things that would have occurred even in 2000 would be impossible today," said Updegraff, who has performed lasik on more than 40,000 patients. "We have things that make it a lot safer."

For example, older technology uses a blade to cut a flap in the cornea before a laser reshapes the eye surface. Updegraff favors a newer, all-laser method. Newer technology also positions the laser more accurately over the pupil.

The FDA advisers recommended that the agency clarify the warnings it already provides about lasik. For example:

• Add photos that illustrate what people suffering certain side effects actually see, such as glare or a "starburst" of light.

• Clarify how often patients suffer different side effects, such as dry eye.

• Clarify the conditions that should disqualify someone from lasik, such as large pupils or severe nearsightedness.

• And spell out that anyone whose nearsightedness is fixed by lasik is guaranteed to need reading glasses in middle age, something that might not be needed if they skip lasik.

Times staff writer Lisa Greene contributed to this report.

Clearer warnings on lasik eye surgery recommended 04/25/08 [Last modified: Tuesday, April 29, 2008 4:58pm]
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