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Surgery pioneer drops support for LASIK

The China Post--Ray Tsai (蔡瑞芳), one of Taiwan's pioneers in laser eye surgery, said yesterday that he will no longer perform the procedure because it violates his medical ethics.

Twenty years ago, Tsai led a 500-case clinical trial of laser eye surgery — known as LASIK — as head of ophthalmology at Linkou's Chang Geng Memorial Hospital (長庚醫院). His research and later promotion of the LASIK helped popularize the technique as an alternative for vision correction.

Sudden Vision Loss

In an unlikely twist, Tsai told local press yesterday that he will cease performing the LASIK procedure as it goes against his medical ethics.

He has observed situations in which visual acuity worsens suddenly and rapidly long after the LASIK procedure itself.

Such vision loss deals a huge blow to patients' careers and daily lives.

Tsai cited the case of a 45-year old woman who, ten years after receiving surgery, experienced such drastic vision loss that she is now unable to drive her children to school.

Tsai believes the loss is linked to post-surgery corneal inflammation.

He continued, recently he received some ten other cases of patients who have found their post-operative complications so intolerable that they have returned for more treatment. These are typically patients between the ages of 40 and 50, he said.

Stands by 'Bombshell': Tsai

Tsai said he is aware that his "bombshell" against LASIK may affect Taiwan's LASIK industry and potentially even draw a hostile response.

"I still insist," he said yesterday, citing his "duty as a medical professional."

In LASIK surgery, a surgeon uses a precision blade to cut thin flaps into the cornea and correct its curvature with an excimer laser. The flap is then smoothed over the modified cornea and bonded.

Possible complications of LASIK treatment include dry eye syndrome, infection, light sensitivity, night glare, and loss of visual acuity.

In a standard procedure, a surgeon evaluates a patient to decide if he is a safe candidate for LASIK treatment.

No Alteration to Policy: DOH

LASIK is a legal procedure sanctioned by the Executive Yuan's Department of Health (DOH, 衛生署).

The DOH will not alter its policy based on one medical practitioner's views, said Dr. Chung-Liang Shih (石崇良), director of the DOH's Bureau of Medical Affairs (醫事處).

Said Shih, published research and other scholarly reports indicate that the LASIK technique has matured.

Whether an individual patient is happy with the results is a matter that should be discussed before the surgeon picks up the blade, he said.

Since 1993, more than ten thousand patients in Taiwan have received vision correction through LASIK. There are currently more than 100 clinics that perform the procedure, according to the Ophthalmological Society of Taiwan (眼科醫學會).

June 10, 2013    prof.shahid.femto.lasik@
Glad to read this post and associated comments, as a senior Professor of Ophthalmology I would like to say that proper diagnosis + consultation is the key for any eye disease/issue.
Best Regards,
Prof. Shahid Azim Mirza
Fellow American Academy of Ophthalmology and
The American Society of Cataract and Refractive Surgery
December 15, 2014    herb_low@
Is Dr. Ray Tsai the only honest lasik practitioner in the field? My respect and regards to him as he prepared himself to be attacked by his former colleagues.
December 15, 2014    miller.henry641@
I do hope this action maintains interest. It is, IMO, a very important topic.
I first became aware of corrective eye surgery way back in the early '80s in South America. It was a very hot topic then.
Later I followed its progress in southern California and now I see it is still among the chief electives here in Taiwan.

As a near-sighted, 60+ yr old with diagnosed cataracts (in one eye thankfully) and astigmatism, I have considered this corrective option.

I hope to read more on this from those with up to date knowledge and information.
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