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The dark side of eye surgery

Rating

2 Star

The dark side of eye surgery

Our Review Summary

This brief segment reports on an FDA advisory committee recommendation that patients should receive clearer warnings about the side effects of Lasik vision correction surgery.

It sketches the scope of the problem and the risks.

But the segment falls short of best practices in several important ways:

  • It fails to make clear that the Lasik procedure is elective and expensive–and that the "treatments" of glasses and contacts are used by a large majority of people who need vision correction. 
  • It uses two diametrically opposed medical sources–one a strong advocate of the procedure, one a strong detractor. The public would be better served by hearing from one or more dispassionate, knowledgeable sources who can thoughtfully compare risks vs. benefits, provide more detail about the side effects, etc.
  • It fails to cite facts regarding what may be the most important measure of surgical success/patient satisfaction: The ability to see well without glasses. 
  • It fails to include any patient takeaway: Given the advisory committee’s recommendation, what should someone considering getting Lasik surgery know and do? The reference at the end to what doctors should do is, for patients, beside the point.

A viewer of this story is likely to come away frightened of the surgery and uncertain about what to do. That is not a good outcome.

Criteria

Does the story adequately discuss the costs of the intervention?

Not Satisfactory

The segment fails to mention the price of Lasik surgery, which is considerable–$4,000 and up. The omission is particularly unfortunate because the story is essentially about benefits vs. risks of a voluntary surgery. 

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

Not Satisfactory

The report cites the estimate of a 95 percent patient satisfaction rate. The source for this is not given.  The reason why many people get this procedure is to be able to stop wearing glasses.  The story should have told viewers what proportion achieve that goal.  

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

Not Satisfactory

The report focuses largely on the potential harms.

But the segment fails to describe which of these side effects is permanent, and what proportion are disabling. That figure is far less than the 5 percent who report being unsatisfied with the results. Many of these are dissatisfied because their vision is short of 20/20 or because they still need to wear glasses.

This is a key omission which results in an exaggerated sense of visual disability.

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

Not Satisfactory

The segment is based on an FDA advisory committee’s recommendation that patients should receive better warnings about Lasik. While the action itself is not evidence, the committee’s recommendation is based on an assessment of evidence.

The report cites "studies" that show a 95 percent patient satisfaction rating. This is not enough detail to help a viewer determine the quality of this evidence. There is also no source provided for that figure, or any sense for how it was derived. 

The story states: "the FDA has received only 140 complaints from 1998 to 2006. But even if only 5 percent of patients are dissatisfied, with 700,000 Americans getting Lasik every year, it could mean thousands of unhappy patients. "  Wait a minute:  140 out of 700,000 is not 5 percent!!!

Does the story commit disease-mongering?

Satisfactory

The piece does not exaggerate the risks of surgery. At the same time it is not clear where the "5%" complication rate comes from.  Certainly NOT from the number of complaints that the FDA has reported which is well under the 5% level.  The report would be stronger if this information was included. 

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

Not Satisfactory

The segment quotes one doctor who is an advocate of the procedure and one who is absolutely opposed. But the public would be better served by hearing from one or more dispassionate, knowledgeable sources who can thoughtfully compare risks vs. benefits, provide more detail about the side effects, etc.

Does the story compare the new approach with existing alternatives?

Not Satisfactory

The story fails to emphasize that this surgery is elective, and that contact lenses and glasses correct vision with virtually no risk of side effects.

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

Satisfactory

The segment makes clear that Lasik eye surgery is widely available.

Does the story establish the true novelty of the approach?

Satisfactory

It’s clear from the story that this procedure has been around for years and is in widespread use.

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

Not Applicable

Because two different physician sources were quoted – one advocating the procedure and one opposing – we assume it did not rely on a news release.

Total Score: 3 of 9 Satisfactory

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