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A man’s eye-opening surgery

Rating

0 Star

A man’s eye-opening surgery

Our Review Summary

This live TV report on a vision correction surgery using the Visian ICL (implantable) lens ignores several essential elements of journalistic practice.

Its use of a dramatic stunt–a surgery done in real time with interviews before and after the procedure–implies the surgery is fast, uncomplicated and complete in a single session. This is not an accurate portrayal of the full treatment. 

It uses a single surgery–done on an employee of the same TV network by a surgeon with a commerical interest in selling the device and procedure–to explain the procedure.

Whether the employee paid for this service or whether he received it free or at a discount is not known. If the patient has not paid full price as an independent consumer, his comments should not be considered objective. If he did pay full price, the network should have avoided even the perception of a conflict of interest by finding someone else to profile.  

The report does not include the clinical evidence of effectiveness, the list of potential harms or an assessment by independent clinicians or researchers. All of this is essential information for anybody who may consider the procedure. 

It fails to put this procedure in the context of any vision correction treatment other than Lasik, and does not indicate what qualifies or disqualifies a patient for this treatment.

By creating a dramatic demonstration of a medical procedure and implying its success–without context, independent comment or reporting of potential harms and research findings–this segment violates almost every important principle behind responsible medical reporting. 

Besides all of these observations, we ask NBC:  

  • what makes this news now?
  • what criteria were applied to the reporting and production of this story?
  • why did you feature one of your own employees and did he get the operation free or at a discount?  

Criteria

Does the story adequately discuss the costs of the intervention?

Not Satisfactory

The segment states that the cost is usually $3,000 to $3,500 per eye, and that it is not covered by insurance.

However, the fact that prices are given "per eye" when both must be treated–and that the first price mentioned is "a few hundred dollars per month"–contributes to the implication that the surgery is affordable and a good value.  

Does the story adequately quantify the benefits of the treatment/test/product/procedure?

Not Satisfactory

Aside from what appears to be an immediate positive result for the patient treated on live TV–and the surgeon’s assurances that the treatment is comparable to HDTV, produces an "a-ha" moment and is "growing by leaps and bounds," the segment does nothing to quantify the benefits of the treatment.

An FDA approval report states:

In a clinical study of 294 patients implanted with the Visian ICL™, 95 percent had 20/40 or better vision (considered standard vision necessary to obtain a driver’s license), and 59 percent had 20/20 or better, after three years.

Does the story adequately explain/quantify the harms of the intervention?

Not Satisfactory

The segment mentions a low risk for infection. This is an incomplete reporting of harms.

Even the Visian ICL website itself includes a more complete list of possible risks and complications that includes:

  • damage to the natural lens that may require removal and replacement
  • complications from the iridotomy surgery that must be done one to two weeks prior to the implantation of the Visian ICL. The surgeon uses a laser to cut one or two small openings near the edge of the iris.  Complications from the iridotomy are rare, but could possibly include natural lens or corneal damage, inflammation, temporary increase in intraocular pressure, bleeding, and scar formation.
  • In some cases, there may be an increase in eye pressure that may require the use of additional mediations or another surgery.  

Does the story seem to grasp the quality of the evidence?

Not Satisfactory

The segment provides no evidence that the procedure is safe or effective aside from the demonstration on a single patient. Research has been published, but it is not cited here.

Does the story commit disease-mongering?

Not Satisfactory

Using a single example of a patient who describes himself as "legally blind" without vision correction creates the impression that a lack of permanent correction is a liability or danger. He is likely to be a candidate for other correction approaches.

Does the story use independent sources and identify conflicts of interest?

Not Satisfactory

The only sources providing information are the physician and the patient. No independent experts were used on the air.

Whether the surgeon has a financial relationship with the maker of Visian ICL beyond being a vendor for its products is not reported. 

Does the story compare the new approach with existing alternatives?

Not Satisfactory

The surgeon explains that for patients like the one he is operating on, Visian ICL is a good alternative to Lasik surgery. He does not compare ICL to other treatments, and to those that may be better matched with other patients.

Does the story establish the availability of the treatment/test/product/procedure?

Not Satisfactory

The segment implies availability of the Visian ICL lens and procedure, but does not specify whether it is available in many places, a few–or, for that matter, exclusively from the Boxer Wachler Institute. 

Does the story establish the true novelty of the approach?

Not Satisfactory

While the implantable lens is correctly described as newer and less common than other surgical forms of vision correction, it’s not clear whether this particular device and procedure is novel–one of many, the only one of its type, etc.

Clinical trials by the company that markets Visian ICL began in 1994. European approval came in 1997. FDA approval of one form of the lens came in 2005.

What made it news now?  We can’t tell. 

Does the story appear to rely solely or largely on a news release?

Not Applicable

We can’t be sure if the story relied solely or largely on a news release.  As we pointed out, more complete information on potential harms appeared on the company’s website than appeared in the news story!

Total Score: 0 of 9 Satisfactory

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