Thinking of Lasik surgery? Don't rely on ads alone

Jessica Jaganathan
Fri, Dec 07, 2007

The Straits Times

(Dec 5) The competition has heated up so much among private clinics and hospitals providing Lasik surgery that some have even run advertisements offering patients 'discounts' for signing up immediately or for doing both eyes at once.

The 'market' for Lasik is certainly sizzling with many hoping to correct myopia this way and dump their spectacles.

But clear vision has not been the result for some who have had the operation. They've complained instead of shoddy service, even worse eyesight and inadequate before and after care.

One patient last month filed a report with the Singapore Medical Council against the doctor who operated on her. She regretted choosing a clinic based on its price and claimed that it was clinic assistants who had pronounced her fit for surgery, and that the doctor did only a summary examination before the procedure.

The Ministry of Health (MOH) has warned eye specialists about using misleading Lasik advertisements to attract customers. On Nov 23, it announced three taboo areas for eye surgery ads - no celebrity endorsements, no mention of the number of operations done and no highlighting of success stories.

Mind Your Body spoke to eye surgeons for their opinion on what you should ask your doctor if you are considering Lasik surgery.

Before surgery

Be mentally prepared for Lasik, say surgeons. And decide if you really need it. Lasik is appropriate for those with myopia, astigmatism and far-sightedness.

You are not suitable for Lasik if you are:
- Below 18 years old because you are still growing and eye power is not stable yet

- Pregnant- Have a pre-existing eye condition like cataract and glaucoma

- Have extremely thin corneas or high myopia (more than 1,500 degrees).

Scour the Internet for information and ask friends who have already undergone Lasik for their feedback before you choose your doctor.

'Another good thing is to ask your family doctor,' said Dr Lee Hung Ming, medical director of Parkway Eye Centre. 'The most important thing though is to not base your decision just on advertisements.'

To be thoroughly prepared, jot down all questions you plan to ask the surgeon during the pre-surgery consultation.

Pre-surgery consultation

Doctors should spend adequate time explaining the procedure to patients. Ask your doctor how many cases he handles per week.

'If the doctor says 1,000 cases a week, you think to yourself, how many seconds does he have for the patient? One case a week is also too little. So there needs to be a balance,' said Dr Jerry Tan, an ophthalmologist in private practice.

Enquire about the doctor's background and whether he has had any appropriate training in Lasik. Ask the doctor for his results. According to an MOH study released last year, which was based on four centres offering Lasik surgery, 98 per cent of patients achieved 6/12 vision or better. But Dr Tan warned that some may mislead patients by showing other people's results.

Ask for the doctor's enhancement rate. This is used to determine how many people return to the doctor to correct the procedure because of unhappiness with their results. Doctors interviewed showed an average of a 2per cent enhancement rate.

Find out about the characteristics of your eyes from the surgeon and ask why the particular type of Lasik procedure recommended is appropriate for you.

A pre-surgery consultation would take three to four hours during which a series of tests is done to check your eye power and cornea thickness. Eye drops are used to dilate the pupils in order to check the retina. There should be a gap of at least 24 hours between consultation and surgery, to allow for the natural constriction of the eye as the effect of the eye drops wears off.

Surgery

It takes about 15 to 20 minutes, depending on the technique used.

Doctors are divided on the practice of doing Lasik surgery on both eyes at the same time.

Dr Jerry Tan cautioned that some centres might be tempted to use the same blade for both eyes which, in turn, made the second cut more blunt.

But Dr Lee said he had not seen any discernible difference in doing one eye at a time and both eyes at the same time.

Post-surgery

There are usually at least four consultations with the doctor: One day after surgery, one week later, one month later and three months after.

Avoid strenuous sports, swimming, vigorous rubbing of eyes and eye make-up for up to one month.

Complications that could arise from Lasik surgery include dry eyes and night-vision problems like halos and glares. But these usually disappear within three to six months of surgery, said Dr Lee.

More severe problems involve the flap which can be irregularly cut or cut off totally, resulting in scarring of the cornea. But this is rare if the procedure is done using a bladeless laser technique.

In the most extreme case, infection could set in, causing blurred vision.

There are a variety of Lasik procedures available, so ask your doctor to recommend the type which is most suitable for your eyes. It depends on individual characteristics.

'It's not like buying the cheapest stereo or television, so it's important to do your homework,' said Dr Chan Wing Kwong, head of refractive surgery service at the Singapore National Eye Centre.

Article from: http://www.asiaone.com/Health/News/Story/A1Story20071207-40084.html