<- Home <- Arhive <- Vol. 22, Issue 2, June 2014

Rom J Leg Med22(2)121-126(2014)
© Romanian Society of Legal Medicine

Extended use of LASIK procedure – possible medical error? Ethical and forensic case assessment

C. Corbu, R. Moisescu, R. Iancu, C. Nicula, M. Marinescu

Abstract: Excimer laser in situ keratomileusis (LASIK) is a relatively new surgical procedure that can be used to correct refractive errors of the eye, such as myopia. Since the 90’s, many patients have experienced the benefits of this technique and LASIK has become a frequent practice among ophthalmologists, who used it to correct high myopia. By experiencing a series of postoperative complications, surgeons became aware of the fundamental importance of establishing the limitations of the procedure in order to accurately advise and select patients.
We present the case of a young female with a history of bilateral refractive surgery (LASIK) for high myopia, which developed unilateral corneal ectasia 11 years after the procedure. All of the inclusion criteria valid at the time she underwent surgery were followed, although they are no longer applicable in present. Corneal ectasia in this case is an iatrogenic complication of LASIK and was successfully treated using corneal collagen cross-linking.
After an evaluation of both forensic and ethical issues generated by this case, we concluded that performing LASIK on this patient was not a medical error at that time, but that the late postoperative complications that may occur are an indication of the importance of establishing the right inclusion criteria, as well as the possible medico-legal consequences of criteria changing over time.
Keywords: Laser in-situ keratomileusis, myopia, corneal ectasia, medical error, inclusion criteria, forensic assessment, ethical issues.

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