An ophthalmology expert witness advises on a case involving laser eye surgery that resulted in a man’s vision loss. Prior to obtaining laser eye surgery, the plaintiff underwent testing. The test results were normal, however, the plaintiff had worn contact lenses that day and within the five previous days, which makes the testing inaccurate. A second round of tests showed abnormalities, including anterior float; keratometric; and thickness.
Two years after the surgery, the plaintiff developed corneal ectasia, a progressive thinning, warping and irregular bulging of the cornea, with attendant progressive severe visual problems. Symptoms included monocular diplopia, halo, glare and decreased vision.
The plaintiff sued the defendant doctor for medical malpractice.
Question(s) For Expert Witness
1. Is it generally accepted to perform laser eye surgery when corneal abnormalities are present?
2. Was it medical malpractice?
Expert Witness Response
The corneal topographies performed by the defendants showed that the plaintiff was suffering from corneal disease that is a generally accepted contra-indication to doing LASIK eye surgery, because of the risk, among others, of developing corneal ectasia. Nevertheless, the patient was cleared for, and underwent, bilateral LASIK that same day.
The plaintiff had a good result from the surgery with 20/20 vision. It takes 1 to 2 years before a patient begins to experience symptoms of ectasia.
The patient's symptoms became noticeable around two years after the LASIK, are fully consistent with corneal ectasia, as is the time-frame for these complaints. The testing showed a high degree of irregular corneal astigmatism, with progressively worsening corneal topographies, consistent with the complication of post-LASIK ectasia.
The defendants knew or should have known that the plaintiff was suffering from post-LASIK ectasia based on the combination of the abnormal visual symptoms he was reporting and complaining about; the high degree of irregular astigmatism; and the clearly worsening corneal topographies, but did not tell the patient.
In my opinion, medical malpractice was committed in this matter, in clearing the patient for LASIK, and in performing LASIK on this patient because of the well-known and generally accepted contra-indications to LASIK in his case.
The expert is a board-certified ophthalmologist specializing in anterior segment surgery of the eye including LASIK laser vision correction.
About the author
Kristin Casler
Kristin Casler is a seasoned legal writer and journalist with an extensive background in litigation news coverage. For 17 years, she served as the editor for LexisNexis Mealey’s litigation news monitor, a role that positioned her at the forefront of reporting on pivotal legal developments. Her expertise includes covering cases related to the Supreme Court's expert admissibility ruling in Daubert v. Merrell Dow Pharmaceuticals Inc., a critical area in both civil and criminal litigation concerning the challenges of 'junk science' testimony.
Kristin's work primarily involves reporting on a diverse range of legal subjects, with particular emphasis on cases in asbestos litigation, insurance, personal injury, antitrust, mortgage lending, and testimony issues in conviction cases. Her contributions as a journalist have been instrumental in providing in-depth, informed analysis on the evolving landscape of these complex legal areas. Her ability to dissect and communicate intricate legal proceedings and rulings makes her a valuable resource in the legal journalism field.
