‘I was livid!’ - Unhappy Lasik patients storm the web to spin their tales of woe

Lasik surgery is rapidly growing in popularity as a vision corrective procedure. But it is not always successful and poor outcomes have driven some patients to publicly vent their spleen on the web - and in court.

A PATIENT who experienced a good outcome with refractive surgery will most likely go back happily to work and family, enjoying the benefits of improved vision. But for the unhappy patient, it is another story. That patient may do two things to make sure he is not forgotten: recount his experience in public through a web page and/or express his concerns in private to a lawyer.

Now, with just a few clicks of the mouse anyone can establish a rudimentary outpost on the web through which he can express his opinion to the waiting world.
This fact has not been lost on patients or the legal profession. Patients who create web sites often relay a wealth of information not only on their negative experiences, but also the name (and address) of the surgeon, and the type of microkeratome, laser and software used.

Patient sites offer a range of emotion. Starting on the mild end of the spectrum,
at ‘Kirk’s Lasik history’ (http://usr.ijntb.net/genghis/Lasik/History.htm) a 30-year-old man named Kirk provides “a history of [his] experience with the Lasik procedure, dealing with the after-effects and attempting to find solutions to [his] complications”.
He presents a chronological narrative including preoperative medical history and assessment. The initial surgery undercorrected the astigmatism, with significant associated glare and night vision problems.

An enhancement procedure produced irregular astigmatism and other problems. The narrative continues, describing his frustration and confusion and concluding: “I also hope that this [web page] will effect change in the way Lasik cases are managed and prompt corrective procedures to be developed for the complications created for many by this surgery.”

The emotion is more pronounced at another site www.lasikcourt.com. An unhappy patient from Texas provides a detailed chronology of his unhappy experience with Lasik, including a decentred ablation and a less than happy interaction with a nationwide laser centre.

Along the same lines, at www.lasiksos.com another unhappy patient tells his story. The California man developed diplopia, dry eye and corneal pain following Lasik. The man has become something of a celebrity in his local area. He is famous for standing in front of the refractive surgery centre which performed his procedure with sign that reads: “Lasik impaired my vision.”

The emotions get more raw at www.lasiksucks4U.com where a patient recounts his experience with the procedure including poor visual outcome and poor night vision. The patient focuses on psychological aspects of being an unhappy patient, including depression and post-traumatic stress disorder. He reports: “The surgeon who runs the laser centre told me ‘Deal with it … people lose their sight every day. I'll see you in eight months.’ I was livid!!!”

Another website, www.lasikdisaster.com (subtitled ‘20/20 to 20/Hell’) raises the temperature even further. The site goes beyond an individual’s case report to a strident critique of refractive surgery. This patient expresses her rage in a sizable website. Beyond her own unhappy experience, she expresses her opinion on the marketing of refractive surgery.

“I am gravely disturbed by the attitudes which are commonplace in this area of medicine, in which patients are SOLD a serious and possibly vision-robbing procedure as though it's a haircut,” she says.
Her site also include lengthy sections on related Lasik topics including ‘complications’, ‘more complications’, ‘Lasik lies’, and ‘fatal focus’. In a sign that things are reaching a level of hysteria, she remains anonymous, citing previous death threats and fear for her family.

The next level of response can be seen at www.surgicaleyes.org. This site goes beyond an individual case, offering a portal for unhappy refractive surgery patients, “an organisation founded by people with longer-term complications from refractive surgery to assist others who have had unsuccessful Lasik, PRK, RK, AK, ALK or other elective refractive surgeries”.

The site is unusual in that it contains a medical advisory board, which while weighted to optometry, does include the names of several well-known ophthalmic surgeons.
That site claims 60,000 visitors per month and includes sections on patient stories, types of complications, and prevention advocacy. There is also a ‘legal redress’ section offering links to medical malpractice attorneys, medical boards and prosecuting attorneys.

It also includes a lively online discussion forum with includes more than 50,000 posts. You can discuss your own experiences of many areas including ‘living with complications’, ‘ectasia support group’ and ‘new tech updates’. Patients can even upload corneal topographies for discussion by volunteer vision-care professionals.
There are other online forums where patients discuss their experiences. These include Google SciMedVision (http://groups.google.com/groups?hl=en&group=sci.med.vision) and the Alt- Lasik-eyes newsgroup.

Some patients go beyond the court of public opinion, seeking legal redress for their unhappy refractive results. Perhaps not surprisingly, the next step had to be websites detailing legal remedies and class action suits.

Attorneys in the United States are actively pursuing the Lasik patient business by online means. For example, a New York firm (www.newyork-injurylawyers.com) provides an online form for referral to ‘a specialist in eye surgery malpractice’.

At another site (www.tlcmalpractivce.org) a Florida businessman goes up against a large US Lasik practice group. He reports a poor outcome, and apparently had keratoconus prior to surgery. He also alleges depression and anxiety, and includes affidavits to back it up. He offers to help readers ‘find an attorney to file a Lasik medical malpractice suit’.

In another sign that the legal wave is building, the website www.medifocuslegal.com offers specific research services to attorneys contemplating a Lasik lawsuit.
The site, for a fee, offers to “quickly identify leading medical experts nationwide for case reviews and expert testimony” and to “jump-start your medical experts to ensure that they are well-versed with the published medical literature before depositions and trial”.

That site also offers related resources for lawyers interested in suing an ophthalmologist, including sections on complications of phaco, complications of cataract surgery and a section on the diagnosis and management of endophthalmitis. Fortunately, the complication rates for refractive surgery remain low, with new wavefront approaches promising to lower them even more. It may be that lessons learned from these unhappy patients can also help reduce future complications.

The sites created by these patients are instructive on several levels. Close reading reveals that in many cases the patient may not have been an ideal candidate for refractive surgery to begin with, stressing the need for appropriate preoperative screening.
In other cases, patients report high degrees of disbelief, surprise, confusion, and dismissiveness in the responses of their surgeons to their problems.

To paraphrase the English playwright William Congreve, hell hath no fury like the patient scorned. This highlights the importance of clear communication and a good bedside manner.

It also emphasises the importance of the need for thorough preoperative counselling to create realistic expectations along with comprehensive informed consent procedures to help educate the patient prior to surgery.

Comments or suggestions for this column? Drop me a line at primesite@press1.com

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