Concerns raised over laser eye surgery

BEIJING — When Wang Wenting, a 26-year-old Beijing resident, discovered the safety of laser eye surgery was one of the hottest topics on Sina Weibo, a twitter-like micro blog service in China, she was in a dilemma as to whether to proceed with the operation she was previously interested in.

The discussion on Sina Weibo was triggered by news that Ray Tsai, an ophthalmologist and laser eye surgery pioneer in Taiwan, announced on Feb 14 that he would stop performing the operation because some of his early patients were experiencing a sharp decline in vision.

“I knew there were risks and couldn’t make up my mind. Now I have become even more unsure,” Wang said.

She is not alone. So far, there have been more than 4.2 million micro blogs on the topic, and the number is increasing.

People are talking about the inconvenience they suffer from myopia, the eagerness of getting rid of glasses or contact lens, as well as the worry about the health risks of the operation, especially the uncertainty of what will happen in the future.

A vote initiated by a Sina Weibo user named Jiaqi Tutu on whether to have laser eye surgery attracted nearly 8,000 voters. About 19 percent of respondents say they had already had the operation, 13 percent say they will have it, 31 percent say they are weighing it up and 32 percent say they will definitely not have the operation. About 5 percent of people voted for “other ideas”.

Laser eye surgery involves reshaping corneas to correct myopia, hyperopia and astigmatism, said Guo Xiaoping, an ophthalmologist at Beijing Hospital.

A process known as laser-assisted in situu keratomileusis (Latik) is more widely used than other eye surgery because it is less painful and produces better and quicker results, Guo said.

During the operation, a thin flap on the surface of the cornea is cut and folded to enable remodeling of the tissue beneath with a laser. The flap is repositioned and the eye is left to heal. Patients will likely be able to see clearly six hours after the operation.

Zhang Yang, a young woman working for Baidu Inc, said she didn’t regret having the surgery.

“I didn’t panic at the news at all. I was very calm,” Zhang said.

“I had already thought through the benefits and risks of the operation before I had it.”

Zhang underwent the surgery in Beijing in January 2011. Long before that, she said she had diligently researched the subject online.
“What people are discussing on Sina Weibo is nothing new to me,” Zhang said.

“Some of the wrong information I encountered online before undergoing the operation was even more frightening.”

Zhang said she went through a series of examinations before the operation and the doctors told her all aspects of the benefits, the risks and the possible side effects of the surgery, asking her not to jump to a conclusion. “

The surgery has strict indications and contraindications since it has to change the shape and structure of the cornea to correct myopia, hyperopia, and astigmatism,” said Guo, the laser eye surgery specialist at Beijing Hospital.

Before the surgery, surgeons will measure the thickness and surface contour of the patient’s corneas.

Patients are unable to undergo this surgical procedure if problems show up such as keratoconus or tendency of keratoconus, a degenerative disorder of the cornea in which the cornea is too thin and changes to a more conical shape than its normal gradual curve.

Patients with some eye diseases such as viral keratitis or immune system diseases, such as lupus erythematosus, cannot undergo the surgery.

The preoperative examinations also detect astigmatism and other irregularities in the shape of the cornea, so that the doctors can calculate the amount and the locations of corneal tissue to be removed during surgery.

Patients who wear soft contact lenses are usually instructed to stop wearing them 5 to 21 days before surgery, which can only be carried out on adults because their eye structure is more stable.

“About 30 to 40 percent of patients coming to Beijing Hospital cannot have the surgery,” Guo said.