Ophthalmologists keen to see eye to eye on laser surgery

Concern about the commercialisation of ophthalmology is a key issue on eye doctors’ agenda

The eyes have it: surgery is often performed by surgeons from outside the country, who are unavailable for post-operative patient care or complications. Photograph: Thinkstock

The eyes have it: surgery is often performed by surgeons from outside the country, who are unavailable for post-operative patient care or complications. Photograph: Thinkstock

Tue, May 13, 2014, 01:00

The Irish College of Ophthalmologists (ICO), the recognised training and professional body for eye doctors in Ireland, has expressed concern about what it regards as the continuing commercialisation of ophthalmology, particularly in the area of laser eye surgery.

During its agm, which will be held in Limerick this week, the college will announce details of a major policy meeting that will tackle the lack of regulations in medical advertising in Ireland.

The meeting, which the college will host in September, will also look at the areas of dermatology and plastic surgery, which have also been significantly affected by the commercialisation of certain procedures.

Laser eye surgery is performed by highly trained eye specialists and, in most cases, the results are satisfactory, according to the college’s chief executive, Siobhán Kelly. However, such surgery poses certain risks, which, in some cases, can cause the eye to regress to its previous refractive error within about six months. If this happens, the patient may need a second operation or may need to start wearing glasses or contact lenses again.

As is common with the performance of any surgical procedure, complications can arise. These can include dry eyes, which can affect vision; poor quality of night vision due to halos and glare, which sometimes affect the patient’s ability to drive at night; and a serious condition called corneal ectasia, which is a weakening and bulging of the cornea.

Severe cases may need to be treated with a corneal transplant or implant.

Mark Cahill, a consultant ophthalmologist at the Beacon Consultants Clinic in Dublin and a spokesman for the college, says the public might assume that if a procedure is openly available on the main street and widely advertised, it must be safe.

The idea that refractive laser surgery is simple and straightforward and has no potential risks or complications is unfair on the public, he adds.

The college says that patient safety and quality clinical outcomes are not always the primary focus within commercial medical organisations, such as main-street chains that offer laser eye surgery. In addition, pre-surgical consultations are often not performed by a medical doctor but by an optician, says Cahill.

In some clinics, surgery is often performed by surgeons from outside the country, who are unavailable for post-operative patient care or complications. A number of eye surgeons who spoke to The Irish Times said they had had to deal with referrals for patients who had experienced complications in such clinics.


Advertising
The ICO says it is concerned that direct patient advertising is being increasingly used to promote laser eye surgery, with special offers and little mention of the potential risks.

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