Laser eye surgery, also known as refractive surgery, is a procedure that uses lasers to improve short-sightedness, long-sightedness and astigmatism. It reshapes the front surface of the eye (the cornea) so that light enters at a different angle and focuses more accurately on the retina, which in turn improves vision. If successful, the surgery can relieve patients of the need for glasses or contact lenses. The benefits of treatment are obvious and appeal to the masses: over 100,000 people undergo laser eye surgery every year.
According to the Royal College of Ophthalmologists, more than 95% of patients who undergo refractive surgery are happy with the results. However, in 5% of procedures there is a poor outcome, where patients suffer from some of the known risks and recognised complications, including discomfort, visual disturbances (such as glare, halos and flashes), and dry eye. In many cases these complications are resolved within a few months but they can sometimes be permanent.
The Royal College of Ophthalmologists has put together a checklist of questions that patients might consider asking their surgeon prior to agreeing to go ahead with treatment to ensure that surgery is the best option. These include finding out about the risks and complications of treatment, and whether pre-existing conditions contraindicate surgery, or make those recognised risks and complications more likely. The concern, however, is that not all patients will read the leaflet prior to attending a laser eye clinic to discuss the possibility of refractive surgery. It is the surgeon’s duty to ensure that he/she knows the patient’s history, finds out what their needs are and how they want to improve their vision. The surgeon must advise the patient of the recognised and frequently occurring risks that are material to them, and the patient must be advised on alternative methods which are available. If the surgeon does not advise the patient properly, then he/she has failed to obtain their informed consent to treatment.
An investigation by The Times has revealed that Britain’s biggest laser eye clinics (Optical Express, Ultralase and Optimax) are ignoring guidelines produced by the Royal College of Ophthalmologists and failing to outline the risks of surgery to help patients make informed choices and to mention the possible disadvantages of procedures.
Arran Macleod, an associate in the clinical negligence team at Penningtons Manches LLP, said: “Thousands of people in the UK require glasses or contact lenses and desire treatment that will improve their vision. As laser eye clinics have opened up on high streets all over the UK, laser eye surgery has become more and more accessible.
“Although the majority of surgery is carried out without complication, the risk of injury to eyesight should not be underestimated. It is not acceptable that laser eye clinics are failing to warn their patients of known and recognised risks and, in some cases, leading them to believe that there is no downside to treatment whatsoever. Loss of eyesight, even if temporary, is a serious injury and for many will have wide reaching implications on their life and livelihood. Patients should be given all of the information about the treatment they are agreeing to before making a decision.
“Surgeons owe their patients a duty of care to warn them of all material risks and complications, and alternative treatment options, which should include doing nothing at all. If patients have not consented to treatment, and suffer complications, they may have a claim for compensation.
“If you have any concerns about the advice you were given before laser eye surgery, and you have developed problems after your treatment, we would be happy to discuss the options available to you.”