Depression often follows failed laser eye surgery

For some, the pain becomes unbearable.

RALEIGH NEWS & OBSERVER

Patients who undergo vision-correcting laser eye surgery sign a release form with an extensive list of risks, but some researchers and former patients say a potential complication is not mentioned: depression that can lead to suicide.

In response to patient complaints, the Food and Drug Administration plans to convene a large, national study to examine the relationship of lasik complications and quality of life, including psychological problems such as depression.

Malvina Eydelman, an ophthalmologist with the FDA’s Center for Devices and Radiological Health, wrote in an e-mail message that the scant clinical data available “failed to suggest significant problems following lasik surgery,” but she said the FDA wants a broad and systematic review. She wrote, “We also noted that quality of life issues related to lasik had not been evaluated consistently, and there were few reports of well-designed studies.”

Frustration and even sorrow can follow any unsuccessful surgery, but when the procedure leaves a patient with unremitting eye pain or permanently impaired vision, the emotional toll can be particularly severe.

One who could not endure it was Colin Dorrian, 28, a patent lawyer and aspiring medical student from suburban Philadelphia. He committed suicide last summer, 61⁄2 years after lasik surgery left him with lasting visual distortions. The surgery was done at a lasik center in Canada that has since closed.

Laser eye surgeons who treat patients with complications say they do come across cases of depression, but they don’t think lasik complications are the root cause. They say patients who exhibit depression after the procedure were likely depressed or psychologically troubled beforehand.

“There’s no cause and effect,” said Dr. Steven C. Schallhorn, the former head of the Navy Refractive Surgery Center in San Diego and an expert on permanent visual distortions from lasik.

Martha Walton of Raleigh, N.C., postponed lasik twice. She had had bouts of depression and anxiety attacks and wasn’t sure she was ready for the permanence of eye surgery. She still felt anxious when she went ahead with it in August. Within a month, Walton, 41, a high school teacher, developed constant, severe pain from eye dryness. She couldn’t cope with it and spent six days on suicide watch in a mental health facility.

“I was in so much pain,” Walton said. “Twenty-four hours a day there was no escape. The only relief I could think of was to end my life. At least the pain would be over.”

An elaborate regimen of taking supplements, wearing special goggles and switching to preservative-free eye drops has drastically reduced her pain. But her eyes still do not produce enough tears and she continues to take anti-anxiety medication.

Christine Sindt, an optometrist and associate professor of clinical ophthalmology at the University of Iowa in Iowa City, Iowa, has encountered the psychological effects that patients experience when they have trouble seeing.

“Depression is a problem for any patient with a chronic vision problem,” she said. But in the case of post-lasik patients, she said, the depression is compounded by remorse.

Since the mid-1990s, numerous studies have shown that the surgery known as laser-assisted in-situ keratomileusis, or lasik, is safe and successful in most cases and has become more so with the introduction of new technology. Most of the 1.3 million Americans who undergo the surgery every year are happy with the results. The American Society of Cataract and Refractive Surgery, which represents about 9,000 ophthalmologists specializing in laser eye surgery, suggests that 2 percent to 3 percent of lasik patients experience complications.

In Cleveland, Tenn., Kim Hybarger, 44, a nurse, developed debilitating visual distortions after lasik surgery Dec. 21, 2006. She tried to walk into traffic, cut her throat and starve herself.

“I was filled with anger,” she said. “I felt so hopeless and helpless. I just wanted to die. The way I saw was so frightening.”

Hybarger said she had never had problems with depression before her lasik surgery. Afterward she felt so bad, she said, she told her husband to “load a gun with a bullet and give it to me. I’m not going to live the rest of my life like this.”