STEVE INSKEEP, host:
It is Thursday morning, which is the day we often take a look at your health. And today we'll take a look at your eyes. If you've had problems after LASIK eye surgery, the Food and Drug Administration wants to know.
NPR's Allison Aubrey reports on a system that tracks complications, and also on what you should know if you're considering laser eye surgery.
ALLISON AUBREY: Lots of us know someone - a colleague, cousin, or friend - who's had LASIK eye surgery and loves the results. The freedom from glasses or contacts is liberating. And 20/20 vision can feel nothing short of a miracle. But about 5 percent of patients who have the procedure are not satisfied. It's a small fraction, but with almost a million surgeries each year, there are thousands of complaints. Take patient Joseph Schnell, who had LASIK two years ago.
Mr. JOSEPH SCHNELL: If I look to the extreme left I can see like a double. It's hard for me to focus. It's even more pronounced when I'm tired.
AUBREY: Schnell is a 48-year-old tradesman who builds elevators for a living. He says his night vision is a problem. When he looks at streetlights or headlights he sees starbursts where the light explodes out, as if he were staring at a sparkler.
Schnell says he used to be a very confident driver.
Mr. SCHNELL: Now it's sometimes I see headlights coming the other way. It's just like I'm not sure if I see everything clearly beyond the headlights, because they're just the halos and the starbursts. I just don't know if I'm really being safe.
AUBREY: Schnell says when he had LASIK he did not meet his surgeon until a few minutes before the procedure. He says the technician and optometrist who did the pre-surgical exams didn't make much time for questions.
Mr. SCHNELL: I had to pull her teeth as far as getting information out of her.
AUBREY: And one thing never mentioned: LASIK will not fix or prevent the decline in close-up vision, which necessitates reading glasses.
Mr. SCHNELL: No one ever told me that.
AUBREY: Schnell says in retrospect he could have demanded more information. LASIK centers require patients to sign forms disclosing the risk of complications. But patients don't always read or understand the fine print.
Mr. SCHNELL: I mean, I share, definitely, part of the blame for going ahead with this surgery.
AUBREY: But when he spoke publicly at a Food and Drug Administration hearing about LASIK, he found himself in the company of many other patients who say they deserved more warnings and more discussion with doctors about the risks up-front.
Dr. KERRY SOLOMON (Joint LASIK Study Task Force): I do think it's possible that patients may not always be getting all of their questions asked.
AUBREY: Surgeon Kerry Solomon is a leader in the American Society of Cataract and Refractive Surgery. He says if people have unanswered questions before the surgery, they should hold off. The give and take is critical and should be standard.
Dr. SOLOMON: If a patient's in a position where they don't feel people really haven't had a discussion with them about risks, and they're not comfortable with that, then I would get a second opinion.
AUBREY: The FDA says it's not certain how many LASIK patients have problems with their vision weeks or months after their surgeries. The agency's planning a new study to get a better handle on the prevalence. It's scheduled to begin next year.
But there's also a way for individual consumers to report their complications with LASIK directly to the FDA. To do so, you fill out a form on the FDA Web site. The agency's Mary Weick-Brady says it takes about ten minutes.
Ms. MARY WEICK-BRADY (Federal Drug Administration): We encourage as much information as possible here because FDA does look at every voluntary report that comes in.
AUBREY: And the agency uses them to help determine if some new action is needed. When we logged on to try to find this form, we found we needed a little direction.
So we got to the FDA homepage.
Ms. WEICK-BRADY: OK.
AUBREY: What do we do next?
Ms. WEICK-BRADY: If you look on the right-hand column, there's an area that says report a problem.
AUBREY: The page looks a bit like a multiple choice test. The X you're looking for is the one marked adverse event. This is just a jargony phrase which means a bad outcome.
Ms. WEICK-BRADY: If it's a decrease in vision, if it's a halo, if it's a starburst, if it's a problem with night vision, these types of things would be considered adverse events to FDA, and we would want those reported because it has affected your vision.
AUBREY: In the last decade, the FDA has received only about 140 of these adverse event reports, nowhere near the number of patients that surveys and studies estimate to be dissatisfied. It's possible that the unfortunate stories such as Joseph Schnell's are few and far between, but it's also possible that surgeons and patients have underreported complications.
To protect yourself before opting to have the surgery, experts say you should make sure you get a thorough screening.
Dr. SCOTT MACRAE (LASIK Surgeon): It's not uncommon for us to bring the patient in two or three times.
AUBREY: Surgeon Scott MacRae of the University of Rochester says conditions such as dry eye or corneal irregularities need to be checked out in detail and may make an individual a poor candidate for the surgery.
If the system of screening and consultation can be improved upon, it's possible that the 95 percent satisfaction rate with LASIK could rise even higher.
Allison Aubrey, NPR News.
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INSKEEP: If you're wondering whether you might be a good candidate for LASIK or wondering how to choose a surgeon, you can get some answers from physicians and also answers to other questions at npr.org/yourhealth.
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