LASIK stands for Laser-Assisted In Situ Keratomileusis and is a surgical procedure that permanently changes the shape of the cornea, using what is known as an “excimer laser.” A mechanical blade device or a laser is used to cut a flap in the cornea. Then the flap is folded back revealing the stroma, which is the middle section of the cornea. The pulses from a computer-controlled laser vaporizes a portion of the stroma and the flap is then replaced. Although a number of people have had success with LASIK surgery, there are tens of thousands each year who sustain severe and even catastrophic injuries undergoing the procedure.
Here are some common reasons why LASIK injuries are caused:
Failure to screen: Not all patients are suitable candidates for LASIK surgery. Yet, some are still approved for three reasons. First, the doctor may be too aggressive in selecting patients for this elective procedure. Second, the doctor may be too busy to notice irregularities in the patient’s tests, such as suspicious patterns on the corneal topographies, or corneas that are too thin. Third, the doctor or laser center may delegate the screening process to persons who do not have a medical degree and are less skill or trained, such as an optometrist.
Corneal flap irregularities: If the corneal flap is not of clinically adequate quality, thickness and size to proceed with the laser treatment, several complications could result. Corneal flap complications could range in severity from something that requires the procedure to be postponed to those that create significant vision complications. Corneal flap irregularities could also result in other visual distortions such as glare, multiple images, poor contrast, halos, starbursts and so on.
Ecstasia: Iatrogenic keractecstasia or esctasia (bulging of the cornea) is one of the most dreaded complications of LASIK. The rate of ecstasia after LASIK is estimated to be 0.67% (or 67 patients out of 1,000) but this number could be low because of underreporting and lack of long-term follow-up after LASIK. Experts believe that several thousand patients suffer from post-LASIK ecstasia in the United States. Reported risk factors for ecstasia after LASIK include abnormal corneal topography, insufficient stromal bed thickness, high myopia, thin corneas, and the patient’s age. There is no cure for ecstasia. A corneal transplant may be required. Ectactic diseases include keratoconus, its sub-clinical predecessor forme fruste keratoconus, and pellucid marginal degeneration. Any of these diseases, or pre-operative suspicion for these conditions, is a contraindication for LASIK eye surgery.
Ocular HSV: If you have ocular herpes and are considering LASIK, you must discuss your condition with your ophthalmologist. Some eye doctors may ask about herpes, but they do not test for it routinely as part of LASIK surgery screening. Ocular herpes increases the risk of complications and possible blindness. Also, laser eye surgery may be interpreted by your body as trauma, which might cause ocular herpes to flare up. Certain immune responses to ocular herpes can also increase the damage it causes to the cornea.
Unstable refraction: If the quality of your vision is fluctuating or progressively worsening, you may not be eligible for LASIK eye surgery. Your surgeon should be screening your eyes for unstable refraction before proceeding with the procedure.
Equipment malfunction: Undesired outcomes can result from equipment malfunction. The flap is created by a small meat slicer, called a microkeratome. If there is a problem with the slicing or creation of the flap, the procedure should stop. However, some surgeons have been known to forge ahead with predictable flap complications.
In 2007, Alcon recalled its LADAR 6000 surgical laser because it was malfunctioning. By its count, more than 150 patients developed “central islands.” Instead of removing tissue in a precise way, the defective medical device created clumps of undesired and uneven tissue in the center of the patients’ corneas.
Similar results have occurred with good lasers that were not well maintained by the surgeons or their staff. Saline is used to irrigate eyes during surgery. If it splashes onto the laser optics, central islands have also been known to occur. Consequently, the failure to maintain the equipment, and check and retest its calibration can also give rise to serious and irreversible eye injuries.
Surgical negligence: Laser eye surgery is supposed to be simple and safe. For sure, in the past decade, the training, skill and technology have all improved. With no disrespect intended to highly educated and trained LASIK surgeons, manufacturers try to make the procedure idiot proof. Unfortunately, there are a few idiots out there who try to test the system. Consequently, in addition to human errors in failing to screen patients, and maintain equipment properly, there are surgical errors in creating the flap, or decentered ablations when the laser misses its intended target. Lastly, some surgeons enter the wrong prescription in the computer and patients wind up over or under corrected, with a prognosis that depends on the size of the error.
Poor screening and hurrying through the procedure could result in devastating consequences for patients. If you have been a victim of such medical malpractice that resulted in LASIK injuries, please contact a LASIK eye surgery lawyer at the Law Office of Todd J. Krouner at (914) 238-5800 or firstname.lastname@example.org for a free, comprehensive and confidential consultation and evaluation of your claim.