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Dirziness, Headaches
Plague Her Every Day

One woman's nightmare serves as a warning for the
vision-impaired.

RUTH LITTMANN STAFF WRITER

L

ynn Rosenthal, whose eyes
always watered and turned
red with contact lenses, be-
lieved surgery would elim-
inate her need to wear glasses
while playing tennis. Instead, the
surgery all but wiped out her
game.
"This has been the worst ex-
perience of my entire life," she
says.
Ms. Rosenthal, at 32, suffers
from fatigue, dizzy spells,
headaches and blurry vision. She
feels off-balance and can no
longer drive at night.
She blames it on a botched-up
procedure that left one of her eyes
permanently damaged.
"That little cut," she reflects.
"It's been a nightmare."
Ms. Rosenthal filed a lawsuit
against the doctor who performed
the surgery and last month set-
tled the case out of court. Now,
she's warning other candidates
for the surgery to wise up before
they sign on.
Sick of spectacles, Ms. Rosen-
thal in 1992 decided to undergo
the increasingly popular "radial
keratotomy," better known as
RK A co-worker had the surgery
and loved the outcome.
Because Ms. Rosenthal has an
astigmatism (an irregular cornea
that blurs her vision), she un-
derwent a variant of RK called
AK, or astigmatic keratotomy.
Like RK, the AK procedure
changes the shape of the cornea's
curvature over the pupil of the
eye. Doctors use a diamond knife
to make incisions into the cornea.
The process generally takes less
than 30 minutes.

In 1994, nearly half a million
such surgeries were performed,
up from 50,000 in 1990. The
American Academy of Ophthal-
mology reports that the vision of
90 percent of RK patients im-
proved to 20-40, sufficient for
passing a driver's license exam.
"RK and AK are popular for
good reason," says Dr. William
Fishkind, director of the
Fishkind-Bakewell Eye Care and
Surgery Center in Tucson, Ariz.
"However, like any other surgery,
these surgeries are indicated only
for people who fit within certain
parameters."
Ms. Rosenthal did not fit with-
in the proper parameters. Un-
fortunately, prior to her surgery,
no one knew she was a bad can-
didate because, according to her
lawsuit, it seems as though Ms.
Rosenthal had been inadequate-
ly screened for the procedure.
First, she claims her ophthal-
mologist never performed a
topography, which is a comput-
erized analysis of corneal curva-
ture. Topography enables doctors
to determine how much to correct
a patient's vision.
It also helps the doctor diag-
nose certain diseases that might
make RK and AK too risky.
Three of those diseases include
"map dot fingerprint dystrophy,"
"Fuchs dystrophy" and `Twin
frest keratoconus," which is char-
acterized by weakness in the
front surface of the cornea. All
three conditions cause patients
to respond poorly to RK and AK
As it happened, Ms. Rosenthal
may suffer from form frest kera-
toconus.
"If I would have had that
one little (topography) test,
I wouldn't have had the
surgery," she says.
She argues that some-
thing else ran amok. The
doctor, she claims, over-cor-
rected her vision by misus-
ing a nomogram, a graph
that helps doctors deter-
mine the size and number
of incisions to make.
Dr. Fishkind, who also
serves as a spokesperson
for the American Academy
of Ophthalmology, warns
candidates for eye surgery
to be very certain about

Lynn Rosenthal still works full
time, but must seek rides at
night.

their decisions. On the one hand,
RK and AK can drastically im-
prove one's quality of life. On the
flip side, he says, "there's no eras-
er at the end of a scalpel."
Five to 15 percent of RK and
AK patients must deal with over-
corrections, which only serve to
worsen their vision. Until this
summer, there was no way to re-
verse an over-correction.
'With a brand-new procedure,
out only three months ago, a su-
ture is placed around the outer
part of the cornea to bring it back
to a more normal shape to re-
move the surgically induced far-
sightedness," Dr. Fishkind says.
Before opting for eye surgery,
the doctor advises people to pick
a board-certified ophthalmologist
who belongs to the American
Academy of Ophthalmology. The
practitioner should have special
RK and AK training, and ought
to perform the procedures on a
regular basis.
Get references from other pa-
tients, and don't neglect to de-
mand a thorough eye
examination prior to surgery, in-
cluding topography.
The surgery should be carried
out in a sterile operating room,
which might be in the doctor's of-
fice or in an outpatient facility of
a hospital. Make sure the oph-
thalmologist is using modern
equipment, Dr. Fishkind says.
RK surgery has existed since the
late 1970s, and technology has
improved over time.
People with corneal disease,
diabetes, cataracts, glaucoma and
some other health problems
should think twice.
Ms. Rosenthal, a legal secre-
tary, continues to work full time.
Her boss makes enlargements of
documents he needs typed, and
with glasses, Ms. Rosenthal can
get tasks done.
But evenings generally find
her exhausted by 7:30. In her life,
tennis has waned from a com-
petitive pastime to a spectator
sport — barely.
"If it weren't for my parents
and good friends, I don't know if
I would have made it this far. It's
frustrating, but what's done is
done. I have to live with it. I have
no choice," she says. "However, if
I can prevent even half of what
I'm going through from happen-
ing to someone else, it'll
help." 11

