Health: Keep the risks in sight

More and more people are trying laser sight correction.

ANYONE WHO is short-sighted will have been tempted by the prospect of laser surgery. At last, the chance to wake up in the morning and see the other side of the room without stumbling around for contact lenses or glasses.

More than 8,000 people a year in the UK now have laser surgery to correct their short sight, at a cost of pounds 500 to pounds 1,500 an eye, and a number of others have undergone a similar procedure for long sight.

Most patients are happy with the results - one survey at the Moorfield, the world's biggest eye hospital, for example, found that 93 per cent of patient were pleased with the results. Yet according to another recent survey one in 10 people were "bitterly disappointed", and other reports suggest that, for some people, the surgery leaves a legacy of side effects and problems that include glare, distortion, night halos, astigmatism, scarring, sensitivity to light, droopy eyelids and, in extreme cases, loss of vision.

Laser surgery for correcting sight problems first came on the scene around 15 years ago in America, when volunteers took part in various trials that were then underway.

Despite the successes for the surgery, there are patients who are unhappy about the results. "To the casual observer, laser surgery has all the hallmarks of a miracle, but the technique is still in its infancy and often fails to live up to the glossy promises. Existing research on laser surgery is fairly unsatisfactory and consists of small trials with handfuls of people," says a recent report in What Doctors Don't tell You.

It says that as many as one in five may need some kind of repeat surgery, and points out that in one study, 72 per cent of people suffered with problems. It says that the worse results are achieved among patients with severe vision problems.

A report by the Consumer Association says that most known after effects are short lived, but adds that up to 3 per cent get problems that do not clear up. Some patients also find that the improvements disappear over time, while others get a hazing affect caused by scar tissue on the cornea. "Infection can occur when the cells covering the cornea don't heal properly. It can be sight threatening, but can usually be treated with antibiotic drops," says the report.

Julian Stevens, a consultant surgeon at the Moorfield, says that results are good and that patients expectations are met: "We did a survey and we found that the treatment met or exceeded expectations of patients in 93 per cent of cases. The outcome depends on what is being attempted, what system is used, the surgeon, and the patient's expectations.

"But high quality surgery carried out with high quality equipment should make things like halos and glare at night very rare. If the treatment is done properly there should be no problems with night driving and so on."

He says there are side effects, but that they are rare. "I have only heard of one cases of blindness associated with PRK and that was someone in America who had not used their medication and had developed an infection. With LASIK there are some patients who have gone legally blind because of a haemorrhage in the retina, but these are very rare cases.

"To put it in perspective, the risk of losing vision is about the same as the risk of loss of vision through infection problems associated with wearing contact lenses. On the whole, people are delighted."

Julian Stevens predicts that more people will have the surgery, and that the numbers of people wearing contact lenses will decline: "In America, there are now 500,000 a year, compared to 8,000 here, and in Europe there is five times the activity there is here," he says. "We should remember that, in Britain, it did take 200 years for spectacles to catch on."