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Saturday, April 13, 2013

1:10 PM EDT

 GTA

 The terrible aftermath of a once-lauded eye surgery

Thousands of Canadians had radial keratotomy surgery, or RK, in the 1980s and ’90s to correct their nearsightedness. Many lost much of their vision.

 

 

STEVE RUSSELL / TORONTO STAR

In 1994, Toronto dentist Brent Jesperson had the now-obsolete surgical procedure radial keratotomy to correct his nearsightedness. He ended up with seriously compromised eyesight and lost his profession.

 

By: Robert Cribb Julian Sher Jennifer Quinn Published on Fri Apr 12 2013

 

Staring through eyes that could no longer focus, Dr. Brent Jesperson retreated into the darkness of his bedroom four years ago, away from his wife and two boys.

With the shades drawn, he lay in bed, pondering how to end his life.

In 1994, he had undergone a first-generation corrective eye procedure, one that thousands of other Canadians had during the 1980s and ‘90s. Afterwards, his vision became permanently hazy.

But one thing did become clear: his career as a dentist was finished.

 

“I thought my life was over,” the 51-year-old says. “Imagine the stress of losing your business, your eyesight, your life. And you paid to have it done to you. It’s unimaginable.”

Jesperson has just filed a $12-million lawsuit against Dr. Yair Karas, the Toronto ophthalmologist who performed the now-obsolete procedure, called radial keratotomy or RK, on Jesperson.

The procedure involved making microscopic incisions in the eye radiating outwards from the centre. The slits were intended to correct nearsightedness by flattening the cornea and allowing light to better focus on the retina.

Thousands of Canadians got RK to correct their myopia, many lured by aggressive ads promising freedom from contact lenses and eyeglasses. And many experienced improved vision from the once-innovative procedure, at least for a time.

But long-term complications are now an accepted legacy of RK.

The Star has reviewed thousands of pages of documents and interviewed more than a dozen RK patients, some whom refer to themselves as guinea pigs for an industry that placed profits over public health.

Jesperson and six other Karas patients interviewed by the Star say the procedure eventually made their vision, and their lives, dramatically worse. Two say they are also preparing to sue Karas.

A 2001 lawsuit by a former RK patient claiming negligence on the part of the ophthalmologist was settled out of court.

“It was a complete failure from Day 1,” says Daniel Twomey, who filed the lawsuit. “My eye is irreparable. I’m stuck.”

With dozens of lawsuits filed in the U.S. over the past two decades by RK patients claiming damaged eyes and lives, Jesperson’s lawsuit could be an early distant warning of a looming health-care tragedy in Canada involving an aging generation of RK patients.

When contacted this week about Jesperson’s allegations, which have not been proven in court, Karas said: “We will deal with this in the courtroom.”

But, also refusing to comment on the allegations of other former patients interviewed by the Star, 71-year-old Karas said he has “no regrets” about conducting 10,000 RK procedures during his 36-year career.

“I think it’s the best thing I’ve ever done. There’s 1,000 police officers in Toronto that got into the police because of what I did, there’s 50 pilots in Air Canada that are flying with my surgery — otherwise they wouldn’t get in — and there is at least 1,000 firefighters in Canada . . . clergymen, like bishops, judges in the Supreme Court, most of the important families in this country . . . Most of the doctors in the U.S. know my name.”

Last year, the Ontario College of Physicians and Surgeons dismissed a complaint Jesperson filed against Karas, ruling that while his vision problems are now recognized as a complication from RK, the procedure was accepted at the time, and he had signed a consent form acknowledging the risks.

The Star has obtained two other similar complaints against Karas from patients who also allege long-term vision damage from the procedure. The college responded identically when dismissing the complaints.

Karas’s public record remains clear on the college’s website. And the college does not make public details on any complaints or internal disciplinary actions against physicians that don’t reach a public disciplinary hearing.

In 2006, Karas signed an undertaking with the college to stop performing RK.

Each year, millions of Canadians pour into private clinics for well-advertised eye surgeries, cosmetic procedures and fertility technologies such as IVF in which they undergo groundbreaking techniques with limited independent oversight.

So how do new medical breakthroughs enter into widespread use without independent review or government approval?

These patients “can be the canaries in the mine shaft,” says Dr. Martin McKneally, a long-time thoracic surgeon who is now a professor emeritus at the University of Toronto’s Joint Centre for Bioethics.

“It’s not fair to expose heroic people who say, ‘I want to be first to have this done’” — their consent or willingness is necessary, but insufficient, he says. “There also has to be assurance that what they are about to experience is reasonable and reasonably safe.”

Jesperson concedes he signed sign a consent form when he agreed to the procedure in 1994. But his statement of claim alleges the form didn’t spell out the risks, and that Karas “hid, omitted, or otherwise failed to disclose” them.

The statement alleges Karas adjusted the consent form “in an effort to promote the procedure and hide known risks.” Jesperson alleges the removal was intentional “and designed to increase sales of his services to the public and, in particular, to Dr. Jesperson.”

During the 1980s and 1990s, RK — costing between $1,200 and $1,800 per eye — was heavily marketed across North America by hundreds of ophthalmologists. “Throw away your glasses for good,” magazine ads and ophthalmology brochures proclaimed. “Live life with clear vision.”

But now, most experts agree the procedure is an example of what can happen when an experimental, unregulated, elective breakthrough goes wrong.

Dr. Edward Boshnick, a Miami optometrist who now specializes in treating RK patients, including Canadians, who suffer fading sight, says the procedure has left “a trail of disaster around the world.

“These were money-driven procedures. There’s no medical need for any of these procedures. This was all done on hokey advertisements, and false promises to have you throw away your glasses. It’s not true.”

RK was first devised in Japan during the 1930s, and in the 1970s was further developed by a Russian ophthalmologist named Dr. Svyatoslav Fyodorov. By the early 1980s, RK was being practised in North America with few standards.

While it was very popular — thousands of Canadians, and at least a million Americans, had it done — it has since fallen out of practice amid mounting concerns about long-term damage to vision caused by weakened corneas.

While Health Canada regulates medical devices, it does not oversee medical procedures. The provincial colleges of physicians and surgeons — mandated to regulate the practice of medicine in Canada — are reactive, taking action only after complaints or legal actions point to negligence, often long after the fact.

The economic burden of RK’s now-acknowledged failures is shifting to the public purse.

Health-care costs poured into treating Canadians whose vision was impaired by the procedure could represent millions. Since 2009 alone, Jesperson says, he has attended close to 100 appointments with doctors to deal with the RK aftermath.

“We’re offsetting the true costs of this onto the public system,” says Michael Munro, Jesperson’s lawyer.

RK patients interviewed by the Star — who talk about pain, depression and impaired vision — all say they weren’t warned that the procedure permanently weakened the cornea, although that information was presented in medical journals and ophthalmology publications at the time.

In Canada, Karas was among RK’s most prolific practitioners. Former patients — even those who now say they have suffered debilitating long-term vision problems — describe him as a charming and personable physician.

“He was very supportive and accommodating,” says Marlene Kirby-Schugt, a Whitby psychotherapist who had RK with Karas in the late 1980s.

She now suffers blurry, fluctuating vision that glasses won’t fix.

“I always thought of him as a great person.”

And he came highly recommended.

Monika Wright, a Toronto real-estate agent, went to Karas’s clinic on the recommendation of a friend who sang his praises. In 1993, Gilbert Roy, a 25-year-old Sudbury steelworker tired of wearing thick, heavy glasses, sought out Karas for RK after reading a newspaper story.

Gene Costain had RK the same year after researching Karas and the procedure, and coming away convinced it was “solid.” In 1994, Denise Bosse, concerned about meeting the vision requirements to become a police officer, took the advice of a member of the OPP who had RK from Karas.

When patients stepped inside Karas’s Richmond Hill clinic, they were met with a persuasive display: hundreds of pairs of glasses left by former patients.

“I said, ‘Wow, this is just amazing,’ ” Roy recalls. “That sold me right there.”

RK was the first real medical solution for the nearsightedness that limited the vision of millions of North Americans. Newspaper and magazine advertising made bold promises.

In one early-’90s newspaper advertisement for the Karas Vision Centre — “Tired of Wearing Glasses or Contact Lenses?” — Karas claimed to have performed the “well-established” procedure more than 3,000 times on people from Canada, the U.S. and around the world.

“About 95 per cent of these patients no longer require glasses or contact lenses,” the ad reads.

Karas’s website, no longer online, promoted him as “one of the world’s leading eye surgeons,” who “brought the gift of sight to over 10,000 people.”

RK emerged as an economic pick-me-up for the ophthalmology profession.

On the cover of the February 1995 issue of Ophthalmology Times, a fistful of dollars emerged out of a giant eyeball with the headline: “RK: Don’t wait to grab on.”

The article said, “the basics can be learned in a weekend.”

A 1993 brochure pitching a $950 weekend course for ophthalmologists urged: “Don’t miss this chance to see how you can successfully diversify your practice and prosper through the ’90s.”

And in 1994 — the year the U.S. Federal Trade Commission began probing advertising claims related to RK based on “numerous inquiries concerning potentially misleading promotions” — Jesperson walked into Karas’s clinic to find out more about the surgery.

The Greater Toronto dentist had suffered from myopia his whole life. He found contact lenses uncomfortable and wanted to shelve his glasses for good. A classmate in dental school had given Karas positive reviews.

The ophthalmologist “convinced me it was safe. I liked him.”

On the day of the procedure, Jesperson’s wife, Irena, drove him to Karas’s clinic. The doctor made eight tiny incisions in each of Jesperson’s eyes.

It worked, for a short time.

Two years later, Jesperson was back at Karas’s office for a second series of incisions — a tune-up — and again, his vision improved.

Jesperson had his glasses mounted on a plaque and placed with the others on display at Karas’s clinic.

Though his vision had improved, it was never perfect. He returned for other procedures, including one in 1999 during which Karas crossed the previous incisions in a T-shape, he says.

“This was the straw that broke the camel’s back. It weakened my cornea again — the beginning of the end for my left eye.”

By the end of 2008, his vision was failing in his left eye, and pain and headaches from eye strain were making work difficult.

“I had no depth perception, and I work in 10ths of a millimetre on teeth — braces, implants, surgery, wisdom teeth,” he says. “I stopped doing the harder procedures and stuck with the easy ones to get through it.”

On July 2, 2009, Jesperson left his dental office for what he hoped would be a few weeks. He had an appointment with a corneal specialist to try to repair the damage to his eye.

He never returned to work.

Feeling as though he had failed himself, his patients, his family and his staff, Jesperson became despondent.

“During this time, I’m constantly fighting with thoughts of hurting myself,” he says. “I knew I was suffering from depression. But I didn’t know if I could live like that. These thoughts permeate your mind.”

Irena, his university sweetheart and wife of 29 years, feared for his life.

“He was lying in the dark in horrible pain and couldn’t see,” she recalls. “I couldn’t even leave the house to get groceries because I didn’t know if he’d be dead when I got home.”

Three decades after RK’s emergence, the message about its effectiveness and safety from the ophthalmology community has changed dramatically.

“For (RK patients) treated aggressively . . . the legacy on those patients is pretty bad,” says Dr. Richard Abbott, an ophthalmologist at the University of California San Francisco.

“It was risky for doctors to be so aggressive. But every metropolitan area had their more aggressive surgeons who pushed the marketing envelope.”

Dr. Michael Easterbrook, a University of Toronto ophthalmologist who co-authored a landmark 1996 study raising concerns about weakened eyes from RK, says he and many of his Canadian colleagues were never willing to perform the procedure.

“Most ophthalmologists felt it was inherently unsafe,” he says. “It was an effective procedure but it was obvious to anyone that it was weakening the eye, and most of us looked and said, ‘You can’t do this.’ ”

For some Karas patients, such as former real-estate agent Monika Wright, vision declined gradually.

For others, what remains is lifelong trouble.

Gilbert Roy, the metal worker from near Sudbury, eventually had to quit working in dimly lit steel fabrication shops because he could not see well enough. “It was devastating,” he says.

Denise Bosse, now 41, had six procedures over a dozen years with Karas — four on her left eye and two on her right. She was left with more than 20 incisions in her eye — and a bill of nearly $5,000.

Today, her vision remains fuzzy, fluctuating throughout the day. So, she says, getting a prescription for glasses is impossible.

“He has ruined my vision,” Bosse says. “I would have never done this procedure if I would have known that this could happen.”

But not all of Karas’s former patients say RK was a failure.

Two decades after undergoing the procedure, former Toronto journalist Gene Costain says he hasn’t suffered any consequences to his eyes. But he remains cautious.

“I’ve been very lucky, but my luck has not been shared. It was horrifying to hear that some had different outcomes, so it’s always in the back of my mind.”

Today, there is a milky cloudiness in Jesperson’s left pupil.

To see for portions of the day, he wears an over-sized contact lens in his left eye called a scleral. It costs him $5,000 a year.

His trust in his physician and the regulatory system in place to protect patients was abused the moment the knife touched his cornea, he now declares.

“It was a human experiment. They all knew. But they didn’t stop it.”

Tomorrow : Who looks out for the public good when a new procedure is introduced?

 

 

 Stories from others whose vision was harmed by radial keratotomy

Four other people who had radial keratotomy surgery to correct their myopia have all suffered some deterioration of their vision.

 

Monika Wright, a visual artist and photographer in Nova Scotia, says her eyesight deteriorated after she had radial keratotomy surgery in Toronto in 1992.

Published on Fri Apr 12 2013

 

Dr. Yair Karas says he’s performed radial keratotomy, or RK, on 10,000 patients — including police officers, firefighters, pilots, judges and clergy — during his 36-year career and says he has “no regrets.” He is currently the target of a $12-million lawsuit filed by Brent Jesperson, a former patient who received RK in 1994 and now alleges the procedure left him with permanently damaged vision that ended his career. Karas says he will address the allegation in court. The Star has interviewed six other Karas patients who had RK during the 1980 and ’90s. The stories of four of them:

 

Gilbert Roy:

 As a tall, 25-year-old worker in a steel fabrication shop who liked the nightlife and bars, Gilbert Roy hated his thick, ungainly glasses.

So back in 1993, when he heard about the promise of RK, he ignored the warnings from his optometrist not to risk the relatively new procedure and went to see Toronto ophthalmologist Dr. Yair Karas.

Roy says Karas assured him he was “the perfect candidate” for RK.

Soon after surgery on both his eyes, Roy complained he could not see well outside in the dark or indoors with poor lighting, but Roy says Karas assured him “it was temporary.”

“ ‘It will be fine. Don’t worry,’ ” Roy says the doctor told him. “ ‘You trusted me when I cut your eyes. Just trust me — your eyes are going to get better.’ ”

They didn’t, according to Roy.

Popping three Tylenols a day to get through the pain and discomfort in his eyes while working in poor light at the industrial plant, he eventually had to quit his job.

He now runs his own water-bottling and delivery company in Noelville, about an hour south of Sudbury, the daytime work in the outdoors offering him the plentiful light he needs to see.

But he has to wear glasses all day or extra-large and expensive contact lenses that cover the cornea and the white of the eye.

“I am very bitter,” he says.

Monika Wright:

 

An active backpacker and scuba diver, Monika Wright was tired of contact lenses that fell out and bothersome cleaning solutions.

On the recommendation of a friend, while working as a busy real estate agent in Toronto she took the plunge and had RK surgery done by Dr. Yair Karas in 1992. She says he promised her she would “ ‘not need glasses until you’re 90.’

“I wasn’t really nervous, I was convinced I was in competent hands.”

She says afterwards the doctor assured her she had “healed like a teenager.”

“At the time I was flattered,” Wright says. “Vanity, I guess.”

Within five years, she returned to see Karas, she says, because her eyesight was “failing.”

He offered more surgery, but Wright says she declined.

Over the next decade, she tried various combinations of soft and hard contact lenses, none of them satisfactory because she says the surgery left her with dry eyes and irregular, lop-sided eyeballs that caused the lenses to float.

Wright even went back to wearing glasses and underwent Lasik surgery on one eye.

Today, it can still take up to an hour in the morning before she can read and see well, not an ideal situation for the new career she chose a few years ago as a visual artist and photographer in Nova Scotia.

Her advice for people hunting for a surgery to fix their eyesight?

“Do your research more in-depth than I did,” Wright says.

 

 Marlene Kirby-Schugt:

 As a new mother back in late 1980s, Marlene Kirby-Schugt had a simple reason for trying what was then a very new and promising eye surgery.

“It was very dismaying not being able to see your child in the crib without putting on your glasses,” she says. “It was quite debilitating.”

After her husband did some research, she decided to have Dr. Karas operate on both her eyes.

“He saved my life,” Kirby-Schugt says, grateful that she enjoyed five to eight “solid years” of markedly improved vision.

But in recent years, the Whitby psychotherapist has been beset by vision problems.

“Ever since I had the surgery my eyes are very vulnerable,” she says. “You can feel the scars.”

She cannot drive at night because of poor vision.

She cannot read a book or a restaurant menu without a direct light shining on the page, a problem that reading glasses won’t fix.

She wears progressive glasses all day, but has to remove them when things get blurry, as her vision fluctuates constantly.

“I am distraught in that I have to struggle with my vision,” says Kirby-Schugt, “and I can only imagine that it will get worse.”

 

Grayce Perry:

Grayce Perry jokes that she used to need glasses just “to eat breakfast.”

So two decades ago, when she saw a newspaper article mentioning Dr. Yair Karas and RK, the idea of freeing herself from her heavy frames was enticing.

She drove from Elora, where she lives, to Karas’s clinic.

So she drove from Elora, where she lives, to Karas’ clinic.

“He said that he would do it on his own son, that it was that safe,” recalls the 59-year-old artist and former teacher, her voice a bit shaky. “The risk of complications was very small — I’d just have to wear glasses when I got older for nearsightedness.”

And it worked: “It just seemed like a miracle. I felt like I was on cloud nine.”

But a year later, things started to go wrong. One eye felt “weird.” She returned to Karas a few times for improvements.

But things aren’t good now. She sees better at different times of the day, she’s constantly changing glasses, she has dry eyes, she can’t drive at night — and she is terrified she’ll go blind.

“It really, I think, has led to a feeling of depression and fear and anxiety in my life that is really uncharacteristic for me,” Perry says. “I’m living with this constant fear of my vision going.”

Ultimately, Perry, who had been teaching Grades 7 and 8, left her job early. She’s now wearing a special contact lens and that helps, but her eyes are continuing to deteriorate. And Perry believes all the problems dates back to her eye surgery.

“I constantly have these imaginings: if I could change one thing, one thing, I would go back to that day, and not do it. Oh, absolutely. Or I’d say I’d give up everything I own in this world to go back to before that decision.”

 

—ROBERT CRIBB, JULIAN SHER AND JENNIFER QUINN


A victim of radial keratotomy speaks out

Dr. Brent Jesperson, who lost his livelihood as a GTA dentist after having radial keratotomy surgery to correct his myopia, tells his story.

 

 

Dr. Brent Jesperson in a 1994 photograph taken after he underwent radial keratotomy surgery to correct his nearsightedness.

 

Published on Fri Apr 12 2013

 

Brent Jesperson is a former Toronto dentist who gave up his profession in 2009 due to failing vision from radial keratotomy procedures he underwent in the early 1990s. He has filed a $12- million lawsuit against his former ophthalmologist, Dr. Yair Karas, alleging negligence. In an interview, Karas said he would address the allegations in court and that he has “no regrets” about performing RK on thousands of patients during his 36-year career. Jesperson explains why he went public with his story:

I struggled greatly with the dichotomy of my right to confidentiality and the greater good. I have tried my best for the appropriate governing bodies to take action to warn all those at risk. When no action was taken I decided to come forward with this story to warn all RK patients of the weakened and susceptible state of their corneas, as it is the right thing to do.

My story could have happened to any of us who had RK surgery. To prevent devastating visual problems, all RK patients need to protect their corneas from daily living trauma to a greater extent than the general population. Each person who had RK has their own unique risk level depending on the number, length and depth of their incisions. It is well known that RK weakens the cornea for life. Therefore, these precautions will be needed lifelong.

 

I desire for all RK patients to understand that the cornea never heals to its former strength. RK surgery carries a multitude of lifelong sight-threatening risks for each patient, the worst possible scenarios being traumatic eye rupture, which would not occur in an untreated eye, and wound re-opening with even minor focal forces. Both can be devastating. RK was performed “on an organ from which we receive 80 per cent of our information” (Dr. George O. Waring III, EyeWorld, July 2001). When something goes wrong the consequences are devastating and life-changing.

 

There needs to be a mechanism put in place to collect data that is freely given by treating ophthalmologists who are not in fear of being whistle-blowers. This way a logical approach can be taken to educate the profession how best to treat a post RK patient. The problem issue will persist for possibly 50 years, until this generation of victims no longer exists.

In the larger picture of refractive surgery in general, there needs to be implemented a mechanism of mandatory adverse event and patient satisfaction reporting. Only with the accumulation of real-world data can we know whether any cutting of the cornea, regardless of the method used, is wise. We could be setting up another generation of damaged patients due to the poor healing ability of the human cornea. History does tend to repeat itself.

I realize that possibly thousands of my previous patients may read this story. I apologize that I had to step suddenly away from your care due to the effects of this procedure. Things were unfortunately beyond my control. I miss you all greatly and am sure you will receive great continuing care from your current provider.

 

—DR. BRENT JESPERSON

 

 

 How radial keratotomy, or RK, was supposed to work

The downside of radial keratotomy was that the incisions made in the cornea weakened it and could become fault lines for future troubles.

 

The idea behind radial keratotomy — or RK — eye surgery in which a doctor makes multiple incisions in the cornea, was tantalizingly simple and appealing.

“The purpose of the incisions is to reduce the steepness of the curvature of the cornea,” explains Dr. Leon Solomon, a veteran Montreal ophthalmologist who has been doing eye surgery — though never RK — for four decades. “That permits a more normal refraction of light coming into the eye and thus you should see better.”

But the downside of this, he says, is that the structure of the cornea has been weakened along each of these incisions, and they can become fault lines for a variety of future problems.

Those complications include daily fluctuating vision, increased susceptibility to surface infections and irregular astigmatism.

To make matters worse, the RK incisions are made by hand — not by a computer-programmed laser, as is common today.

“And a free hand doesn’t exactly always go straight,” Solomon says.

“The concept behind RK was correct, but the actual technique turned out to be questionable.”

 

—JULIAN SHER

 

 So far, Canada has seen scant litigation over radial keratotomy

Dating back to the early 1990s, dozens of lawsuits have been argued in U.S. courts by former radial keratotomy (RK) patients claiming the same kinds of long-term vision problems now being alleged in a $12-million lawsuit by former Toronto dentist Brent Jesperson.

Caroline Merchant, a litigation lawyer in Albuquerque, New Mexico, has spent much of her career suing for clients whose eyes have been damaged — including about two dozen RK patients.

Collectively, those physicians paid out “multi-millions” in damages, she said in an interview.

When physicians are “making money off what you’re doing,” it’s buyer beware, she noted.

Even while litigating RK claims in the 1990s, Merchant herself was tempted by the powerful RK pitch from physicians.

“ ‘It’s so easy, it’s a miracle for yourself, it’ll change your life,’ ” is how she recalls it being pitched. “ ‘Let me look at your glasses — oh, you’re a perfect candidate.’ Just the whole pitch about it: precise, predictable and accurate, which is what they promoted. RK surgery was none of the above. It was never precise, predictable or accurate.”

She says there are “many, many more injured people than actually sued.”

In Canada, RK litigation has been limited so far.

In 1992, B.C.’s Supreme Court awarded a 27-year-old man who lost sight in his right eye following an RK procedure more than $95,000 in damages. The decision found the physician — Dr. Donald George Johnson — “wholly liable.”

Three years later, the same court found the same physician negligent in his care of Lorraine Stubbins, a then-39-year-old woman who lost functional vision after having RK in both eyes to overcome myopia. She was awarded $50,000 in damages.

“It’s the worst thing that’s ever happened to me,” Stubbins said in a recent interview.

Dr. Yair Karas, the ophthalmologist who performed RK on Jesperson, has faced at least one previous lawsuit, filed in 2001 by a former Whitby patient named Daniel Twomey.

A statement of claim filed in court claimed damages of $500,000 from a 1990 RK procedure which Twomey alleged left him with injuries to his left eye, “severe and permanent physical impairments,” “severe pain and suffering” and “reduced income earning capacity.”

Karas’s statement of defence denied the allegations, claiming his treatment was “careful, competent and diligent.”

That case settled out of court, and Twomey says he is prevented from speaking about the details of the settlement.

Unlike other RK patients, Twomey had only his left eye done, choosing to wait before returning to the clinic for the other eye.

Had he had them done simultaneously, he said in an interview he “would have been, for all intents and purposes, blind.”

Some experts believe there are thousands of Canadian RK patients who remain unaware that a bug in their eye, a deployed car air bag or even a pillow fight could irreparably damage their vision.

And that could mean more lawsuits to come with time, says Jesperson’s lawyer, Michael Munro.

“For many years no one could obtain a judgment against a well-organized and well-funded tobacco industry . . . despite an overwhelming correlation between cigarette use and lung cancer. Whether the dearth in RK claims, in particular, and refractive surgery claims, in general, reflects a true lack of incidence or whether other forces are at work will be revealed with time.”

In addition to Jesperson, two other former Karas patients have retained Munro with the intention of taking legal action for what they call failing vision from permanently damaged corneas.

“Your national healthcare system is paying for the consequences,” says Merchant. “And worse, these people have other social and economic problems, on top of their health problems, that can be devastating over time.”

 

—ROBERT CRIBB, JULIAN SHER AND JENNIFER QUINN



Do new medical procedures get enough scrutiny?

 

New surgical techniques aren’t subject to the same testing and approval process that new drugs and medical devices are. So who protects patients?

 

 

A 1995 article in Opthalmology Times suggesting practitioners consider taking up radial keratotomy surgery.

 

By: Robert Cribb Jennifer Quinn and Julian Sher, Published on Sat Apr 13 2013

 

You’re lying on a surgical table about to undergo an innovative new medical procedure that you have been told is safe, reliable, life-changing.

You assume those claims are supported by independent oversight and intensely scrutinized evidence from the medical establishment or some government regulatory body.

You could be wrong. Brent Jesperson was. And the former dentist believes it cost him his vision, and his career.

In a $12-million lawsuit filed in court this week, Jesperson blames a “breakthrough” — and now abandoned — eye surgery widely performed during the 1980s and ’90s for nearly destroying his life.

The claims haven’t been proven in court, and the target of that lawsuit, Toronto ophthalmologist Dr. Yair Karas, says he will address the allegations before a judge.

 

In an interview with the Star, Karas said he has done 10,000 RK procedures during his 36-year career and has “no regrets.”

“I think it’s the best thing I’ve ever done,” he said. “There’s 1,000 police officers in Toronto that got into the police because of what I did, there’s 50 pilots in Air Canada that are flying with my surgery otherwise they wouldn’t get in and there is at least 1,000 firefighters in Canada . . . clergymen, like bishops, judges in the Supreme Court, most of the important families in this country . . . Most of the doctors in the U.S. know my name.”

But Jesperson’s experience raises important questions. Who is looking out for the public when a new procedure is introduced? How heavily should new surgical techniques — which can be groundbreaking and life-saving — be policed by the authorities? And who do patients turn to when these procedures go wrong?

In 1994, Jesperson paid nearly $4,000 for a procedure called radial keratotomy, or RK, to address his nearsightedness. Tired of a lifetime of wearing glasses, he says, he figured it was safe. If it wasn’t, he reasoned, certainly someone would stop it.

“At the time I had it done, I thought, ‘If it were bad, wouldn’t they (the Ontario College of Physicians and Surgeons) shut him down?” Jesperson, 51, said in a recent interview.

While Karas is the only target of the lawsuit, Jesperson — and many of the dozen other RK patients interviewed by the Star — say they lay equal blame for vision problems that compromised their careers and personal lives at the feet of a regulatory system they believe failed to protect them.

Unlike drugs or medical devices, which undergo government testing and face approval processes that can last for years, surgical techniques tend to spread much more quickly as doctors experiment and exchange information at medical conferences and in journals.

Their decisions on whether to practise an experimental procedure are sometimes guided by personal ethics rather than independent oversight.

“Surgery is one of the few areas of medical innovation that is not very well regulated,” says Thomas Schlich, a professor of the history of medicine at McGill University in Montreal. “That tension has been around forever: if you want to try something new, you have to try it out. Somebody has to go first. But there is always a certain risk.”

So is there a way to better monitor medical innovations that hold the risk of harming patients?

While the provincial colleges of physicians are responsible for regulating the practice of medicine, they aren’t proactive about assessing the safety of new procedures.

Instead, they typically take action only after the fact, when medical harm has already been committed and victims file formal complaints that lead to disciplinary hearings — far too late to prevent tragedy.

“The colleges don’t go in and check on anybody in their private clinic to see if they’re being a good doctor,” says Dr. Martin McKneally, a surgeon and professor emeritus at the University of Toronto’s Joint Centre for Bioethics. “I think that the colleges could do more, but that is not in their current mandate — their mission is to protect the public, but not in a policing function.”

Ontario’s College of Physicians and Surgeons has no policy of issuing statements about medical procedures, a spokesperson confirmed.

Millions of Canadians every year undergo elective, unregulated procedures —such as cosmetic surgery and in vitro fertilization — in private clinics without vigorous oversight. And sometimes, it goes terribly wrong.

In 2004, Micheline Charest, one of Quebec’s most famous TV and film producers, died at age 51 after complications from plastic surgery at a clinic in Montreal.

 In 2007, a 32-year-old mother named Krista Stryland died after undergoing liposuction at a Toronto cosmetic clinic. A year later, a Calgary woman named Ashish Toews died following a tummy tuck procedure in an independent clinic.

“There is so little oversight in some of the details of what goes on in private clinics, there can be times when there are adverse consequences,” says Dr. Keith Barrington, chief of newborn medicine at Ste.-Justine University Hospital Centre and professor of pediatrics at the Université de Montréal.

His 2011 study published in the Journal of Pediatrics concluded that close to 100 babies could die or suffer severe brain injury every year in Canada because of the lack of control in the unregulated in-vitro fertilization business, which has led to an “epidemic” of multiple births and dangerously premature babies.

Some doctors and ethicists argue for stronger oversight of new procedures by hospitals and medical colleges, along with better-informed patients. But they also warn that over-regulation would stifle the kind of innovation that has resulted in life-saving techniques.

“The problem in medicine is that you are living now and not 10 years from now,” says Dr. Steve Arshinoff, a leading ophthalmologist who practises at Humber River Regional Hospital. “So when you go for any operation, you unfortunately get the knowledge and the standards of the time and not the knowledge and procedures that we’ll have 10 years from now.”

That was the dilemma for a generation of nearsighted people in the ’80s and ’90s who were assured RK would safely correct their vision.

As the first mainstream medical procedure to correct myopia, RK — a precursor to modern laser eye operations — was swiftly embraced as a leap forward. Many ophthalmologists began practising it on patients after simply taking a weekend course advertised in ophthalmology magazines.

But most experts now agree the widespread adoption of RK surgery has led to thousands of permanently damaged corneas, resulting in ruined careers, limited lifestyles and, in some cases, depression and suicidal thoughts.

Ottawa ophthalmologist Dr. David Edmison, a former board member of the Canadian Ophthalmology Society, says many like him shared concerns about RK’s long-term implications at the time.

“I felt that the risk-benefit ratio was skewed toward potential risk,” says Edmison, who never performed the procedure. “As soon as you get your licence to practise medicine, you are licensed to pick up a scalpel and do whatever you wish with it. So it escaped the umbrella of regulatory approval.”

But while regulatory bodies remained silent, so did the ophthalmology community, which was quietly raising concerns internally.

“They didn’t feel it was either up to them, or they didn’t feel it was important to them to step in and try and sanction the few that did take it up,” Edmison says. “Anybody in medicine was quite reluctant to point fingers at colleagues and say, ‘Thou shalt not do this.’ There wasn’t the same feeling for the patients’ best interests that they were willing to risk censure.”

In retrospect, he says “there’s no question I wish there had been more evaluation of this procedure.”

RK’s path — from a Russian-developed experimental technology in the 1970s to widespread adoption in North America — is a case study in unchecked medical innovation that many now view as reckless.

A review of medical publications and literature revealed there were concerns about the procedure as early as 1985.

An article in the Ocular Surgery News warned of “an ongoing concern” among RK surgeons about incisions that “weaken the cornea, do not heal adequately, and leave patients susceptible to traumatic wound rupture.”

Among those raising issues was Dr. Maurice John, one of the first North American ophthalmologists to begin practising RK. He travelled to Moscow in 1980 to learn the technique in a two-day seminar with its innovator, Dr. Svyatoslav Fyodorov.

Twenty-eight years later, John says that while many patients experienced good results from RK for many years, cataracts and farsightedness have proven a chronic long-term outcome.

“There’s an evolution of all of this stuff, and this was part of the evolution of (eye) surgery,” says John, now 69 and semi-retired after performing RK on as many as 8,000 eyes between 1980 and 1997 in Louisville, Ky.

“We didn’t fully understand what was going on,” he says in hindsight. “Was there over-promising? Sure.”

Those who questioned it at the time were ostracized.

A Texas ophthalmologist named Dr. John J. Alpar, who publicly questioned the ethics behind his industry’s widespread adoption of an unregulated, untested procedure, says he was “hated” by his colleagues at the time.

In a 1985 medical journal article, Alpar argued that despite its infancy and mysterious long-term outcomes, RK was promoted by many ophthalmologists in newspaper and magazine advertisements “with claims that at the present time are not completely justified.”

His explanation for their collective conduct: “A great amount of cash income, uncontrolled and unregulated by the government, can be collected with relatively little work.”

Today Alpar, 87 and still practising in Amarillo, says his instincts were tragically prescient.

“It was never a safe operation. (RK patients) should never have been subjected to this unnecessary suffering. I still see patients whose eyes are screwed up considerably because of RK.”

Morris Waxler, a former U.S. Food and Drug Administration chief scientist in the late 1990s, has witnessed the emergence of new eye procedures first-hand.

RK, he says, was easily adopted by ophthalmologists because it required no unique devices subject to regulatory government approval.

“It was ophthalmologists and refractive surgeons in control of themselves,” Waxler says. “They have a long tradition of doing what they think is best.”

At its core, any system of heightened patient protection has to be open and transparent, he argues.

His solution: eye surgery patients sign a declaration ensuring their outcome will become public through an independent body.

“(Eye) surgeries have traditionally operated under a cloak,” he says. “It’s the Wizard of Oz behind the curtain doing his magic. He doesn’t tell you how many were injured. There’s no reason for keeping patient outcomes secret. They keep it secret because it’s to their own economic benefit.”

Coming clean with patients on long-term outcomes of new procedures is at the heart of balancing patient rights with innovation, says Julia Hallisy, founder and president of the California non-profit group the Empowered Patient Coalition.

“We must use a robust informed-consent process in which patients clearly understand that they are test cases for some of these new procedures. The need for innovation never outweighs the responsibility to ensure patient safety in our medical treatments.”

As the pace of medical breakthroughs accelerates, some hospitals have moved to exert more control over them.

Several of the teaching hospitals at the University of Toronto have instituted an “enabling innovation” protocol for new surgical procedures, says the U of T’s McKneally.

The measures include detailed reviews by the surgeon-in-chief, endorsement by at least two other “informed colleagues” and rigorous follow-up of the outcomes for the first patients.

Part of the protocol for new procedures at U of T teaching hospitals requires surgeons to insert what he calls the “Columbus Clause” — a reference to the explorer Christopher Columbus — into standard consent forms to explicitly warn patients about the risks of innovative medicine.

 

While heading into uncharted medical waters is always uncertain, it’s made all the more treacherous with the growing number of potentially risky procedures taking place in private clinics outside the control and surveillance of hospital review committees.

“There is oversight in the hospital setting,” says McKneally. “It’s a little less clear in the private clinics.”

He, like others, suggests the various professional colleges that are supposed to oversee doctors and specialists might have to step in to play a bigger role.

But can college regulators reasonably be expected to monitor innovative techniques?

“What happens if you are the innovator, if you’re the guy who invented something?” asks Arshinoff. “There will be a very limited number of people who are in any position to comment on whether what you are proposing to do is better or worse than was historically done.”

And stifling innovation with red tape has its own implications, he says.

He notes that while a lot of patients eventually developed problems with RK eye surgery, the procedure also helped advance newer techniques now widely used in cataract surgery.

“You have to balance those two things: where do you say the doctor was too slow to learn something new or too fast to try it?”

That’s cold comfort for RK’s victims.

In the aftermath of permanently damaged corneas, uncorrectable vision, a lost career and subsequent depression, Jesperson sought help from every medical authority in Ontario he could think of.

Health Canada, in a 2011 written response to his inquiries, directed him to the province, which is responsible for the “administration and delivery of health-care services.”

 

The Ministry of Health and Long-Term Care sent him to the College of Physicians and Surgeons. His complaints to the college, which is charged with oversight of the medical profession, have been dismissed, along with those of two other former RK patients interviewed by the Star.

“For patients like me,” Jesperson says, “there’s really nowhere to turn.”


Comments 



freddie148

I was a client of Dr. Karas about 22 years ago. For a period of 6 years, my eyesight was excellent. It began to regress to the point of needing glasses again just to get close to where my eyesight was prior to the procedure. I was very impressed by him at first and I talked to several people who underwent the operation before me. I took a long time to decide before I was convinced that it was safe and success was certain. I was told that the worse that could happen was that I might eventually require glasses for reading. This seemed like a reasonable risk at the time but, had I known that my eyes would diminish beyond my original eyesight and produce a condition of "star bursts" and intermittent eyesight, I would NEVER have gone forward with the procedure! Before going ahead, I don't believe that Dr. Karas informed me of ALL the negative results I could face in the future. I now regret the results I have to live with and wish I hadn't even heard of the procedure!!!




Ontario taxpayer

Doctors are sworn to "do no harm". Unfortunately, greed and drug company tampering often take priority and patient safety gets put on the back burner. The mighty buck sells and doctors are very prone to being influenced by $$. Engineers are responsible for their designs for life, and since doctors are compensated by the public at a rate well in excess of everyone else, they must be held responsible for any harm they do. On top of this, the taxpayer should not be the source of the compensation, the responsible individual should be.



linguinee

The facts of the article challenge your assertion: 
 
Dr. Michael Easterbrook circa 1996: “Most ophthalmologists felt it was inherently unsafe,” he says. “It was an effective procedure but it was obvious to anyone that it was weakening the eye, and most of us looked and said, ‘You can’t do this.’ ”




Jeannie06118

Many of you are mistaken about waivers. A waiver isn't worth the paper it's written on. You can still sue. Ask any medical malpractice lawyer.



Koremins

True. I sued a banquet hall one time in small claims court, they had a coat check for a party I attended there, and I paid my 5.00 for the coat check, they took my coat, and at the end of the night the coat was gone, it was a 2000.00 coat. There was a sign posted saying they are not responsible for any loss or damage to items checked. In court the judge laughed at them when they stated that the sign which was posted is a waiver...that I knew the risk, and that the sign absolved thems of liability....the judge said to them, and I quote "I don't care how big the sign was or if it was a sticky, the fact is what took place was a business transact, you took her 5.00 in exchange for caring for her coat throughout the evening, she upheld her end of the bargain by giving you the 5.00, you breached the contract by not ensuring her coat was safe....posting a sign is not a waiver and neither a sign nor a waiver relieves you of liability in a situation where you have failed."




mohammad

Thank you Star for this story. This is a very helpful story and has warned me about the dangers of this type of eye surgery. 
 
Mo




mjenn

This is or was elective surgery. I liken it to plastic surgery (liposuction etc). I wear glasses and have since I was 7. I would never consider the surgery as the risk of loss of sight was too great and the procedure was too new. Rather see with glasses then not see at all.




Fake Name

Don't mess with how God made you. Use glasses or contacts as they are an external tool to improve your sight. Never get procedures unless they have been around for at least 10 years. I have never understood why people get medical procedures for convenience and aesthetics where they have to sign away their ability to sue later if something goes wrong. That should be a sign that it is very risky. Emergency procedures to save your life are a different matter. I doubt any of these people will succeed in their lawsuits.




aym

What's scary to think about is the Russian experience. When I first heard about RK, it was in relation to the procedure being done because the long term resource requirements for glasses was too high. In a poor nation, it was felt that this offered a solution to near sightedness that would be quick and effective while reducing future needs. This meant that it was adopted wholesale in Russia. One has to wonder what the statistical outcomes of all those surgeries were. Especially in comparison to our experience. 
 
BTW, I wear glasses. The surgery, whether by laser or not, is highly limited. For higher degrees of near sightedness or astigmatism, it wouldn't fully work. You'd still have to wear glasses. That and the possible side effects made it a simple decision.




EternalOptimist

Yes, it's tragic when there are exceptions to the thousands of success stories that occur when people undergo surgery. I feel for these people. I really do, but they did sign a medical waiver




JeffThorn

I had RK surgery from Dr. Karas in 1993. He corrected corrected severe myopia in both eyes and severe astigmatism in my left. Literally within two days, I had perfect vision in my right eye and near perfect vision in my left. He even accurately predicted the amount of correction in both eyes. I had the starburst effect for 2 months after but even that disappeared. I adhered precisely to the after care instructions and I had no ill effects. I think I possibly became farsighted earlier and with increased severity because of having RK, but I had 15 years of uninterrupted crystal clear vision and farsightedness was coming for me eventually anyway. Currently, my vision is correctable by glasses or contacts and I don't regret my decision in the slightest.



toobaditstaken

"It was a human experiment. They all knew. But they didn’t stop it.” Im not sure this is true, clearly there were many successful cases. Dr K did 10,000+ and had 3 complaints?  
 
PRk was considered superior but now has many long term issues - it turns out the cells on the outside of the eye are special, and once burnt away don't actually heal properly. This leads to dry eyes and other complication from that.  
 
Now we have Lasik, circa 2000, which is considered safer, but we wont' really know until another 15 year from now will we?



spiritofwicca

I'm sure there are a great many more people out there suffering with impaired vision.. Obviously the Star couldn't cite every case but you can bet more and more will be coming forward.




Ivan Lussier

The Star should take a look at stories (about people whose lives have been changed by these eye operations) by reading: lasikcomplications.com -- I hope people will go to this site before making any decisions before getting rid of their glasses/contacts. Not everyone goes through a successful eye operation.




LoLoRR

The problem is that people don't realize what they are experiencing is from their RK procedure. After reading the article I know realize what my issues are from. It was a real "eye opener".




K-Man

As with any surgical procedure, there are ALWAYS risks involved. Everyone knows this. But obviously the idea of never needing to wear glasses blinded (no pun intended) everyone. I went to see Dr, Karas when I was in my early 20's. I saw the articles on the walls about people not needing glasses anymore. I had my chat with Dr. Karas as well. He gave me the speech about this being a effective procedure with a history of it being safe, etc. BUT he also warned me that it isn't for everyone. And he told me that even though I won't need glasses for a very long time, eventually the eye will weaken as you age and you'll probably end up needing reading glasses. He TOLD me this. Because Lasik was just new, he cautioned on doing that till they had more studies on this. He had also mentioned, that with Lasik, it burns layers of your cornea off so if there is any mistake by the computer/doctor, you'd have permanent damage. In the end, I never got the surgery and still wear glasses and contacts.




bookman00

I had two RK procedures on each of my eyes. They've actually stood me in good stead. After twenty years, there's been some deterioration, but the eyes are still much better than they were. I gather, though, that my RK history will complicate cataract surgery when it becomes necessary...and it will.




Cheque Mate

In 1993 when I was 20 when I had PRK done (maybe even earlier). I still have 20/20 vision and no scar tissue. Bochner and Herzig were pioneers of laser surgery in Toronto during that time and I'm surprised anyone - especially physicians with access to info on these procedures - would consider any other type of procedure in 1994. I was only a kid and never in my right mind would I have considered touching my eyes with anything that didn't have the word, "laser" in front of it. Long term studies show PRK is even more effective than Lasik.

.



EverHeardOfCommonSense

I wore glasses for years & now contact lenses for over 20 years. A few years ago I considered LASIK. I thought long & hard about it as I would finally be rid of corrective lenses. But, as this story relates, even though 1000s have the surgery with great results, there always are those who come out worse in the long run. And as this story also relates, there is no way to correct afterwards. I know people who had the surgery many years ago & they are fine. However, I didn't want to be that exception so I am still wearing contacts.




PeDro73

Exactly my feelings, too. considered both Lasik and RK back in the day, but never had the courage to actually go through the procedure. I have only two eyes and if anything goes wrong and lose my sight, that would be devastating.




lili523

I worked in Ophthalmology for 14 years specializing in refractive surgery procedures specifically LASIK and PRK. I also had to deal with many complex cases dealing with individuals who had procedures with other facilities with unsatisfactory results. Many of these cases were RK procedures. RK weakens the corneal tissue which can result in poor fluctuating vision that cannot be corrected with glasses or contact lenses. There are procedures that can help strengthen the corneal tissue such as corneal crosslinking but the long term research is unclear. These procedures are costly and physicians are benefitting financially from these unfortunate people who are desperate to save or restore some vision. PRK and LASIK although very effective carry many risks. It is all about profit, that is why consultants are paid in commission based on whether they can sell you the procedure....no medical procedure should be commission based since that means your best interest vs. their profit.




spiritofwicca

My heart really goes out to all of the patients who are now losing their vision as a result of this surgical procedure. The deterioration of one's vision negatively alters one's life in so many ways. This is the sad result of submitting to relatively new procedures. We simply cannot predict what the long term consequences might be. It would be interesting to know what the percentages are for those who had positive outcomes as opposed to those who had negative ones.




dales

It makes me cringe when I see/hear so many commercials about these eye clinics! When you only can see with those two eyes, you shouldn't take such a high risk. I feel sorry for all the victims of those crooks.




TouchWood

A very good example - one of many - of why for-profit medicine is disastrous. Health care needs to be run solely with a health motive, not a profit motive. As soon as you add the profit motive, people are sacrificed for others' profits.




LGR

 
Eyes that have refraction errors seem to be constantly changing. I was very myopic in one eye, but when other people were putting on reading glasses, I was taking off mine in order to read. Then the presbyopia caught up with me, but not until my late 50's. Now the eye that used to be worse is now the better eye. How can one surgery correct the eye, when the eyeball is constantly changing? Prescription glasses can keep up with the changes; I don't see how surgery can.




Jewmedia

"Last year, the Ontario College of Physicians and Surgeons dismissed a complaint ... he had signed a consent form acknowledging the risks." 
 
lulz




rich1299

Reading this has me grateful for being phobic about damaging my eyes, I got my first pair of glasses when I was 6, I probably needed them earlier, I had no idea by vision was any different than anyone elses until a teacher asked me about something on the chalkboard and I said I couldn't see it clear enough. I developed a real fear of my eyes becoming increasing worse until I could no longer see at all. Its to the point where i cannot wear contacts or even take eye drops out of the panic I feel when something gets too close to my eyes that might hurt them. Because of that I never even considered this surgery. A university friend who did have it done, I assume it was this version since it was 1994, had immediate severe problems that caused him immense pain destroyed his vision and made it impossible for him to continue in school or work. Whenever he called the Dr who did it they would hang up on him. After he had to leave school I have no idea what happened to him.



justmyopinion2

You know , sometimes you just say HMMMM ! 
I thought about this also years ago but some of my friends who have it done now wear glasses again and almost everyone of them needs reading glasses ( something I have not yet needed at 50 ) 
But my eyeglass place alway said they same thing, you only get two of them and do you really want them poking around on them ? Good question , besides, glasses are Ok for distance ...I wear them driving and in the boat I have prescription sunshades......Over the years , I have a small collection and honestly...Being near sighted is not that bad....At least I can still read close up...so far LOL !




Monkie

I considered this surgery about 15 years ago, weary of the heavy, thick Coke bottle glasses I wore since childhood. After lots of research, I still wasn't convinced as it still cried out as too experimental. Thankfully, eye glassses have become much thinner and lighter since then. Contact lenses also help but wear them occasionally for sports and outdoor activities. Having good vision with glasses is better than none at all.




neithskye

As someone with a prescription of -8.50 in both eyes, I agree. I first needed glasses at age seven and still remember the glasses I had to wear as a teen in the 80s -- heavy, uncomfortable, gave me temple-, nose- and face-aches. I got contacts at 15, but was told at age 35 I had to go back to glasses. I was devastated . . . until I got my new glasses. Comfortable, light, thin. I couldn't believe it. I am very grateful for the advancements they have made in the past three decades.



mi.corazon.14224

I am very myopic. I remember asking my optometrist at the time if he would recommend 
that surgery ( although in truth even if he had, I probably would not have gone through with it, since 
to me, vision with glasses is betting than risking losing one's vision altogether, no matter how slight the risk involved...)... 
 
He told me that under no circumstances would he recommend the surgery since it was still 
experimental and that the long term consequences were still unknown.  
 
I guess that in retrospect, he was a very good, and cautious optometrist ! Good on him !




somewherewest

Wearing accurate prescription is always the best solution for this type of problem. No cutting, no possible infection, and you can always change lens when prescription calls for new. I was lucky on one major and next one minor operations on one eye. While with poor vision, it really hampered my vision and work, and generated mental stress and fear of the unknown - will my other eye have the same problem? Take care of your eyes, you only have two all your life.



somewherewest

To clarify, the two operations were not the type discussed in this article.




Pedro45

Just remember PRK and Lasik could end up with the same fate as RK given that the history of corrective eye surgery is not good and the procedure is not regulated (only the laser machine is).



Uffy

Very insightful and eye-opening (no pun intended) article. I underwent LASIK eye surgery four years ago and am very satisfied with the results. However, although the LASIK procedure differs from the now obsolete RK technology, very long-term effects of laser vision correction are still unknown. The findings in this article are going to resonate with me for the next little while...




karlakat.kittezable

This article ones again shows us that there is nothing stopping some "Professions" from patting their bank accounts, no matter how many people they hurt in the process.  
 
Shame on you "Optometrists" that did this.!!! 
 
CLASS ACTION LAWSUIT is in order...



josie2

keep up these investigative stories and the follow-up story tomorrow is so important to prevent situations such as this..




Canuckian13

Many years ago, I went see an eye doctor, a Surgeon, in Scarborough. he was recommended by my doctor in the same building! I had a cyst on the inside of my eyelid that needed to be cut out, or shrunk! I informed the eye surgeon of my severe allergies to certain eye-drops, and he assured me he would not use any of them. He cut out the cyst...and put eye drops on the open cut, assuring me it was safe. The receptionist called a taxi. n I asked the driver to let me off at the drug store to fill the prescription for eyedrops. When we got there, he had to walk me to the door of the store..I could not see out of either eye! The Pharmacist refused to fill the prescription, saying it was one I was allergic to! The same drops the surgeon had put in my eye while I was telling him not to use that specific one. When able to see again, I called his office...he refused to talk to me. Same thing when I went to his office...he refused to speak with me! Luckily, my eye healed & my sight returned.



Mister Tom

Sadly "profit over public health" has become the norm in our western culture. It is to the extent that we expect to be legally ripped-off. We live in the midst of a culture that promotes food that has an ingredients list that reads like a chemistry set and where cancer, diabetes and others run rampant - all sold to us under the guise of "free markets" We really do have a choice, however that comes between affordable and healthy. It is no surprise that a procedure such as this would receive aggressive marketing, there are huge profits to be made and it is somebody else's eyes that are getting experimented upon. It is easy to prey upon people's vanity and convenience. Few people really want to wear glasses - myself included.



realist2

This is terrible. Always wonder how many cases we never hear about because they protect each other. I don't trust the medical "system" they bumble around like everyone else. Hope these people get compensated somehow. To loose one's sight must be absolutely devastating. Feel very sorry for everyone who had such a terrible outcome.



arpeggio5757

I feel so badly for those who submitted to this procedure who are now negatively affected by it. Government is in place to regulate and oversee these types of medical procedures. What gov't was it then?... PC. Hudak has made it no secret that he wants to deregulate such bodies, so it would be a lot like the pharmaceutical company that watered-down the chemo drugs, then sold them as "normal" to hospitals, with the end result being that the patient has no idea of quality control or long-term problems. This scenario just cannot be allowed. I hope Kathleen Wynne has read about this so that she can step up regulations, not get rid of them. My reality is that if i had not followed my gut back in 1990, i would be in the same boat as Dr. Jesperson, as i was about to embark on a career with the OPP who said i had to get RK if i wanted to be hired. I declined, thank goodness.




lfrankbaum1939

its just terrible..unfortunately he wont win as this was accepted practise at the time......and unlike a drug there is is no multi-billion company to go after short of the surgeons who created the procedure..i say with due respect i hope he has dis-ability insurance




islander

So much about the for-profit health care



Guinness

Well to some extent the surgery was motivated by greed for the doctor's but also by vanity for the patients. Put this on the same page as silicone implant troubles, botox issues etc. Whats wrong with wearing glasses? If they are needed...they work.




Cheque Mate

Wrooong....some people get headaches and suffer from equilibrium issues from loss of peripheral vision due to glasses. when you have an infection on your eye lid from contact lenses and you are told, 'no more lenses', what choice do you have. OR, you were hoping to be a pilot your whoooole life and they say no, cause you need corrective eye surgery. and the list goes on... for some, like myself, PRK was miracle.



Cheque Mate

i think many did not want to pay for PRK and opted for the more cost effective procedure, RK. PRK was around in the early 90's and if these people's eyes were that important to them, they should have splurged a on themselves.



donnoitall

Those who have slight myopia probably did well. At the time I was going to get the RK procedure done too but thanks god for my good ophthalmologist, he could not recommend it because I am extremely shortsighted and have astigmatism and glaucoma.



jb@toronto

Odd, I was told that the worse your eyesight was, the better chance for success.




GenghisKhan

I feel bad for him, but the man has no case. He signed a waiver and the doctor who operated did not make any mistakes in the once accepted procedure. There are many procedures and drugs that we now know are a mistake, but you go with the information you have at hand at the time.



star_gazer

Dr. Karas performed my RK in 1989. It was all good until my early 40s and then I needed glasses for reading and distance. My declining vision has not stabilzed as yet and I had to have surgery for a detached retina. I visit the eye doctor once a year just to keep on top of the situation. I have said that if I had to do it again, I wouldn't have had the RK procedure. I have had other health issues but it is my opinion that my current eye issues stem from the RK surgery performed.



LoLoRR

I had mine done in Feb 1993, and the same thing happened. Early 40's vision is done. It fluctuates throughout the day, is worse in the morning and is best at night...which doesn't help for work. I asked specifically about having laser instead of RK at the time, and Dr.Karas insisted that RK was proven over decades and the one that would guarantee success.




nosebreather

Engage with medical science at your peril.




Ivan Lussier

The article says: "Thousands of Canadians got RK to correct their myopia, many lured by aggressive ads promising freedom from contact lenses and eyeglasses. And many experienced improved vision from the once-innovative procedure, at least for a time". That was then. Move forward and now they are doing the same thing with "Laser Eye Surgeries". Before making any decision, people who consider having these type of procedures should be very careful -- google: "Lasik Risks and Complications". These stories really make me sad. I hope the Star will also investigate these new Laser Eye Surgeries.



Anonymous11341

An article like this must mention how modern treatments compare.




jb@toronto

This is truly a terrible situation for these individuals - vision is (in my opinion) your most important of your 5 senses - more so than smell, touch, hearing or taste. I recall my eye doctor touting this procedure in the mid 1990's to me. When I asked what would happen if their hand 'slipped' or their equipment malfunctioned, the reply was, 'that doesn't happen'. Based on that answer, I decided that wearing glasses (contacts were becoming a 'pain') perhaps wasn't so bad after all.




LeahYoung

I did not get it done because I could not afford it. I guess poverty saved me - for a change!




northeyjohn

I debated it when I was in my early 20's in the early 90's and my doctor, luckily, was upfront and said 'don't do it'. Very, very glad I listed to him.




jand

I was a patient of Dr. Karas in the mid to late 80's and got the hardsell for eye surgery everytime I went to see him. All I wanted was contacts for mild near sightedness and I could not afford surgery as I was a university student. I stopped going there for that reason.