Radial Keratotomy Surgery Injury: an Overview for Plaintiffs' Counsel
| Publication year | 1989 |
| Pages | 259 |
1989, February, Pg. 259. Radial Keratotomy Surgery Injury: An Overview for Plaintiffs' Counsel
Radial keratotomy ("RK") surgery is an elective surgical procedure designed to correct nearsighted vision by the placement of incisions on the cornea of the eye. The surgery has become popular in recent years. Within limits, the procedure is effective. However, it is as yet somewhat unpredictable.
Some RK patients have experienced injury from the procedure. Complaints include a change in vision to farsightedness in one or both eyes (or a combination of farsightedness in one eye and nearsightedness in the other); difficulty with night vision and depth perceptions; fluctuating vision; excessive glare; double vision; and irregular healing of incisions, causing distortion of the cornea and resulting in multiple image vision.(fn1)
Since most RK patients had vision that was correctable to 20/20 acuity with eyeglasses or contact lenses before RK surgery, complications which affect vision are significant. If the surgery is not totally successful, some patients have had difficulty in correcting their vision to 20/20 acuity with eyeglasses or contact lenses. Some patients have even had to have corneal transplants to replace irreparably damaged corneas.(fn2)
Proof of damages in RK cases is difficult in that vision is subjective. Plaintiffs' counsel must use creatively a combination of experts, the RK client and friends and family of the client to prove damages. This article presents information about RK surgery and the development of an RK case by plaintiffs' counsel, including the bases of claims in RK cases (particularly negligence and informed consent) and expert witnesses.
RK is designed to correct myopia, or nearsightedness, by means of placement of four, six, eight or sixteen symmetrical incisions on the cornea radially around---but never over---the pupil.
The theory of RK surgery is to flatten the height of the cornea by use of surgical incisions. The incisions are placed at a depth of 90 percent of the thickness of the corneal tissue. As they heal, the incisions exert a lateral pressure upon the corneal tissue that reduces the height of the center of the cornea. This reduction in height focuses light closer to the back of the eye at the retina (as eyeglasses and contact lenses do), thereby improving the vision of the patient.
RK is performed on a patient one eye at a time. A minimum of four weeks between the surgeries is usually needed to allow the first eye operated on to "stabilize" post-operatively. The goal of RK surgery is to improve vision to a point where eyeglasses or contact lenses are no longer needed.(fn3)
Specific surgical techniques have been in flux over the past five years. Accepted techniques have changed as literature on various clinical results on RK has been published. Over the last four years, the accepted number of incisions has been reduced and cross-over incisions have been eliminated.(fn4)
Since its introduction to the U.S., hundreds of thousands of Americans have opted for the RK procedure in hopes of shedding their eyeglasses and contact lenses.(fn5) Many people have chosen RK because it has been widely advertised on television, in newspapers and by RK surgeons visiting large employers for employee presentations.(fn6) Results of several medical studies on RK report that some patients have been injured by the procedure(fn7) and that its single greatest drawback is its lack of predictability of outcome.(fn8)
Plaintiffs' counsel have attempted to assert actions against RK surgeons for negligence, misrepresentation, breach of warranty and inadequacy of informed consent. Of the four, negligence and informed consent issues are most prevalent, with informed consent being the single largest issue.
Negligence...
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