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You can find the current article at its original source at http://www.theguardian.com/commentisfree/2015/jan/03/eye-surgery-works-well-what-matters-is-enforcing-standards-of-care
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| Eye surgery techniques work well: what matters is enforcing standards of care | Eye surgery techniques work well: what matters is enforcing standards of care |
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| This article is the subject of a legal complaint made by Oculentis B/V. | |
| As a provider of vision correction surgery for more than two decades, including lens replacement with high-performance lenses for more than 13 years, it is very disappointing to learn of increasing numbers of patients who are experiencing problems as a result of either substandard care or poor implants. | As a provider of vision correction surgery for more than two decades, including lens replacement with high-performance lenses for more than 13 years, it is very disappointing to learn of increasing numbers of patients who are experiencing problems as a result of either substandard care or poor implants. |
| While laser eye surgery has revolutionised vision correction, it is not a suitable procedure for all. Instead, for all those over 50 (far-sighted) and 55 (short-sighted), the option of lens replacement surgery in the correct hands reliably provides correction of vision at all distances. | While laser eye surgery has revolutionised vision correction, it is not a suitable procedure for all. Instead, for all those over 50 (far-sighted) and 55 (short-sighted), the option of lens replacement surgery in the correct hands reliably provides correction of vision at all distances. |
| The procedure is essentially a sophisticated cataract operation performed earlier with more finesse to correct very accurately the power of the eye, so that no glasses are necessary after surgery. The lens within the eye is removed through a 1.8mm incision with the assistance of a laser. Then a high-performance lens, such as a trifocal implant, is inserted in its place to provide a full range of vision. | The procedure is essentially a sophisticated cataract operation performed earlier with more finesse to correct very accurately the power of the eye, so that no glasses are necessary after surgery. The lens within the eye is removed through a 1.8mm incision with the assistance of a laser. Then a high-performance lens, such as a trifocal implant, is inserted in its place to provide a full range of vision. |
| The procedure is an “art form” and patients need to be carefully advised on what to expect. Patients under 50 are undergoing surgery in commercial centres and this is risky because: (a) the natural lens is not impaired in terms of visual quality, and (b) there is an unacceptably high risk of potentially blinding retinal detachment. | The procedure is an “art form” and patients need to be carefully advised on what to expect. Patients under 50 are undergoing surgery in commercial centres and this is risky because: (a) the natural lens is not impaired in terms of visual quality, and (b) there is an unacceptably high risk of potentially blinding retinal detachment. |
| The biggest issue is dissatisfaction from not meeting patient expectations, often because the model of care is centred on making a sale as opposed to looking after the patient. | The biggest issue is dissatisfaction from not meeting patient expectations, often because the model of care is centred on making a sale as opposed to looking after the patient. |
| Care must be highly customised, choosing the appropriate procedure with a high-performance lens that will match patients’ specific optical system and needs. | Care must be highly customised, choosing the appropriate procedure with a high-performance lens that will match patients’ specific optical system and needs. |
| I have not implanted any Mplus X lenses. I stopped using Oculentis Mplus lenses generally more than three years ago. I have seen several very unhappy patients who have had the Mplus X lens. I have replaced the lenses in one patient, and others are considering this option. If they can cope, I have advised them to try to adapt over a six-month period, but I expect some will require lens exchanges over the next six to 12 months. | I have not implanted any Mplus X lenses. I stopped using Oculentis Mplus lenses generally more than three years ago. I have seen several very unhappy patients who have had the Mplus X lens. I have replaced the lenses in one patient, and others are considering this option. If they can cope, I have advised them to try to adapt over a six-month period, but I expect some will require lens exchanges over the next six to 12 months. |
| Laser eye surgery and lens replacement procedures are extremely good in the correct hands and environment. Sadly, the spirit of the standards of care promoted by the Royal College of Ophthalmologists, and broadly covered by the General Medical Council’s “Good Medical Practice”, are not always being followed by high-street providers. As a result there is a potential public health problem. Recommended practice standards already exist: the problem is enforcement. Rather than set up yet another organisation, I believe the Care Quality Commission – which is already responsible for ensuring safe and high-quality care – should establish practice-specific inspection and monitoring to ensure standards are being followed. This, I expect, will evolve in time. | Laser eye surgery and lens replacement procedures are extremely good in the correct hands and environment. Sadly, the spirit of the standards of care promoted by the Royal College of Ophthalmologists, and broadly covered by the General Medical Council’s “Good Medical Practice”, are not always being followed by high-street providers. As a result there is a potential public health problem. Recommended practice standards already exist: the problem is enforcement. Rather than set up yet another organisation, I believe the Care Quality Commission – which is already responsible for ensuring safe and high-quality care – should establish practice-specific inspection and monitoring to ensure standards are being followed. This, I expect, will evolve in time. |
| A big issue is medical advertising, which should concentrate on educating the public rather than enticing them by bargain-basement pricing, along with competitions and time-limited offers. The public should be reminded that this surgery involves the precious sense of sight. They should always be suspicious of heavy marketing and sales and do their research well or obtain a recommendation from their optician or GP. If you had to buy a parachute, would you buy the cheapest? | A big issue is medical advertising, which should concentrate on educating the public rather than enticing them by bargain-basement pricing, along with competitions and time-limited offers. The public should be reminded that this surgery involves the precious sense of sight. They should always be suspicious of heavy marketing and sales and do their research well or obtain a recommendation from their optician or GP. If you had to buy a parachute, would you buy the cheapest? |
| Sheraz Daya is a refractive eye surgery practitioner and founder of the Centre for Sight. | Sheraz Daya is a refractive eye surgery practitioner and founder of the Centre for Sight. |