British lawsuits over eye surgery

By REBECCA WALSH

It costs about $2000 an eye and is praised as one of the most successful operations around, especially by American sports stars.

Tiger Woods had laser eye surgery in October and won his next five PGA tour events.

Atlanta Braves baseball pitcher Greg Maddux had his vision corrected in July, and won nine of his next 10 games.

Yet one in 5000 laser eye treatments in Britain has resulted in legal action against doctors. Lawsuits have doubled in the last six years.

New Zealand eye surgeons worry that reports of increased litigation could give the laser technique a bad name.



They say the standard of care here is high - only consultant opthalmologists can perform the surgery - and they do not expect an influx of patients taking legal action.

Professor Charles McGhee, the head of opthalmology at Auckland University, said the number of people having laser surgery had soared since the Lasik technique was introduced in 1998, and had probably doubled in the past four years.



Corneal laser eye surgery has been performed on between 40,000 and 45,000 eyes in New Zealand in the past 10 years.

In England, where about 100,000 people a year have the operation, the Consumers Association has warned that patients are gambling with their sight.



The Medical Protection Society in New Zealand would not say if problems had arisen in any local cases. A spokesman said it was "confidential between us and our members".

But Professor McGhee said the standard of consent in New Zealand was high.

People were told about the risks and were warned that they should not expect to be able to throw away their glasses, especially for reading or driving at night.

"What they should expect is a much-reduced reliance on spectacles."

Up to 90 per cent of those with moderate short-sightedness could expect to have 20:20 vision after laser treatment.

For people with more severe short-sightedness, the success rate dropped to about 80 per cent.

The success rate was relative - someone who was extremely short-sighted might gain driver's licence vision after surgery, "which for them is a miracle, a transformation".

In less than 1 per cent of cases, vision would be worse after surgery.

Professor McGhee said 5 to 10 per cent of patients needed second treatments.

Dr Dean Corbett, a consultant opthalmologist at Auckland Eye, said the retreatment rate at the Remuera clinic was 2 to 3 per cent, and was more common in extremely short-sighted patients.

Both men attributed the high litigation rate in Britain to some clinics employing relatively junior surgeons with little experience.



"The spectrum in the UK goes from the top-notch senior experienced surgeon in a great laser centre, to a High St centre with a guy who has perhaps done only a couple of years of training," Professor McGhee said.

Many clinics in Britain ran on high volumes and low cost.

Professor McGhee said a doctor might do 40 eyes in one day, and on a recent trip he saw one company advertising Lasik treatment for $700.

"You would have to wonder what sort of skill is involved."

In New Zealand, the cost is between $1800 and $2400 an eye.

Dr Corbett said the standard of care in New Zealand was high.

"It's very difficult to be a bad specialist in this country. You will stick out like a sore thumb."

How it works:


* A machine cuts a thin flap in the surface of the cornea (the clear window at the front of the eye).

* The flap is turned back and laser treatment is applied to the exposed surface.

* The flap is put back in place and seals within minutes without stitches.

* The operation takes about 20 minutes for each eye and accounts for at least 80 per cent of laser eye surgery in New Zealand.