The article you mentioned follows: What is bad news for
TLC, is good news for FVC. FVC instances of complications
are probably the lowest of any clinic in the US/Canada -
they will be responding accordingly. I guess we know where
TLC clients will be going for their surgery.
________________
College warns of laser eye surgery risk
The Vancouver Sun
Pamela Fayerman, Sun Health Issues Reporter
A sight-threatening complication of laser eye surgery is prompting the B.C.
College of Physicians and Surgeons to warn patients and doctors about the risks.
Patients at clinics across North America, including Vancouver, have been hit by
the complication, which is believed to be caused by a bacterial toxin.
The complication occurs most commonly in LASIK surgery, a technique in which the
surgeon nicks the cornea with a scalpel, folds it back, then alters the shape of
the cornea, removing tissue with a laser before closing the flap. The problem
occurs as an inflammation under the flap of cornea.
It is estimated that up to 25,000 people will pay anywhere from $1,000 to $3,000
to get laser surgery this year in B.C. in a bid to banish their eyeglasses.
Already, more than 100,000 Canadians have had laser surgery, of which LASIK is
most common.
"There have been outbreaks at various clinics. It's a generic problem which can
occur at any site doing this kind of corneal refractive surgery and all clinics
appear to be vulnerable to it. Any who haven't had it are just lucky," said Dr.
Morris VanAndel, deputy registrar of the college.
The complication hasn't been formally reported until now, but it has been
discussed in medical circles for about five years. However, its incidence was
thought to be rare and no one has been able to track its cause.
The college's warning, believed to be the first public advisory about the
problem, is in response to an alert by Dr. Simon Holland, an ophthalmologist at
The Laser Centre (TLC) in Vancouver.
Holland had observed a complication rate of 18 per cent (38 out of 210 patients)
during a just-completed four-month study period at TLC.
If quick action is not taken within a few days of the surgery, patients can lose
some vision "crispness" -- or two lines on an eyesight chart -- as a result of
the complication, known as Diffuse Lamellar Keratitis (DLK). It is nicknamed
"Sands of the Sahara Syndrome" because when it occurs, doctors see patterns like
swirls of sand on their patients' eyes.
When the complication occurs in the early post-operative period, vision is hazy
and the eye is painful and teary. There is also an intolerance of bright light.
When the problem is detected quickly, the corneal flap can be relifted, washed
and then repositioned. Then potent steriod drops are put in the eyes as
frequently as every 20 minutes until the condition subsides.
Holland strongly suspects the problem is caused by an endotoxin produced by
bacteria in deposits on the lining of pipes in sterilization systems.
Dr. Michael Melenchuk, regional director of TLC, said the clinic has been able
to "drastically reduce" the incidence of the problem by painstakingly
sterilizing the equipment in a different manner, using chemicals, not heat.
Dr. Shaun Peck, acting provincial health officer for B.C., said Wednesday he
will ask ophthalmologists at the eight B.C. clinics performing this kind of
surgery to cooperate in a surveillance program to determine the extent of the
problem.
Peck said while the monitoring program will answer how often the complication is
occurring, another study on animals, proposed in Alberta, with funding being
sought from the Laboratory Centre for Disease Control, will try to isolate the
source of the toxin.
"It's believed that 80 per cent of clinics in North America have reported the
problem to some degree, but the actual numbers aren't clear," said Peck.
"There are all kinds of theories about the cause, like lint getting in the eyes
or particles from the surgical blades or even the saline solution used, but we
really don't know for sure at this point," Peck said.
VanAndel said the emergence of a new "wrinkle" in laser eye surgery should serve
as a caution to people contemplating the surgery.
"The numbers of people getting this done is staggering and since it's a
cosmetic, elective procedure, it should be even more safe than operations that
are lifesaving because in those, you can at least justify the risk," he said.
He praises Holland for bringing the matter to the college's attention and said
while he doesn't intend to make the lives of ophthalmologists "miserable," he is
concerned about the competition in the laser eye surgery field.
"It's no longer talked about as medical care, it's an industry. And I have a lot
of letters on my desk from unhappy campers about their results."
Laser surgery clinics have been told by the college they must include a specific
mention of DLK in the consents patients sign before surgery.
The article you just read is from The Vancouver Sun newspaper in Vancouver BC.
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