Replies to LegCo questions

LCQ15: Laser vision correction surgeries

Following is a question by the Hon Chiang Lai-wan and a written reply by the Secretary for Food and Health, Dr Ko Wing-man, in the Legislative Council today (March 27):

Question:

It has been reported that an authoritative ophthalmologist in Taiwan had publicly stated last year that the eyesight of quite a number of people who had undergone laser vision correction surgeries in earlier years had one after another deteriorated evidently more than a decade after their surgeries. A patient even suffered, two decades after the surgery, from severe deterioration of eyesight which could not be corrected. It was suspected that the deterioration was related to the inflammation of the corneal flap after the surgery. In addition, the United States Food and Drug Administration (FDA) pointed out in 2008 that as approximately 5% of those who had undergone laser surgeries developed after-effects such as dry eyes, reduced night vision and seeing glare, etc., it would conduct a national study to re-assess whether risk warnings issued for such surgeries were sufficient. Some members of the public have expressed concern about the risks of laser vision correction surgeries. In this connection, will the Government inform this Council:

(a) whether it knows the current number of people in Hong Kong who have undergone laser vision correction surgeries, broken down by the age group (each covering five years) to which they belong;

(b) of the total number of complaints about laser vision correction surgeries received by the authorities in the past 10 years, together with a breakdown by the content of the complaints;

(c) whether it has sufficient information at present to indicate that the deterioration of the eyesight of some of those who have undergone laser vision correction surgeries is related to such surgeries;

(d) as it has been reported that according to the standard adopted in the United Kingdom and the United States, circumstances such as the development of presbyopia or inflammation of the keratoconus two to three or more years after laser vision correction surgeries will all be classified as surgery failure, whether it knows if the medical institutions in Hong Kong currently adopt the same standard; if they adopt the same standard, of the details; if not, the reasons for that;

(e) whether it has looked into the results of the aforesaid study conducted by FDA; whether it will consider conducting a territory-wide longitudinal study in Hong Kong to assess the potential risks of laser vision correction surgeries; if it will, of the details; if not, the reasons for that; and

(f) as some medical professionals have pointed out that laser vision correction surgeries have only been introduced for less than three decades, with their pros and cons all along being disputable, and that the medical regulatory authorities in a number of countries have expressly required medical institutions to ensure that people who intend to undergo such surgeries fully understand the potential risks of such surgeries, of the guidelines that have been put in place in Hong Kong in this respect (including whether medical institutions are required to provide free annual optometric assessment for people who have undergone laser surgeries)?

Reply:

President,

My consolidated reply to the six parts of Hon Chiang's question is set out as follows:

Laser vision correction surgeries in Hong Kong are mainly performed in private hospitals or by private medical practitioners. The Hospital Authority (HA) does not provide such service and hence we do not have any statistical information on the laser vision correction surgeries carried out in public hospitals. According to our information, there are currently four private hospitals that provide laser vision correction surgeries in Hong Kong and a total of 5 847 surgeries were performed in 2012; in addition, a department of a medical school also provides such service to the public.

In the past three years (i.e. 2010 to 2012), the Medical Council of Hong Kong (MCHK) have received six complaints regarding laser vision correction surgeries, all of which focuses on the outcomes of the surgery. Two of the six complaints are considered not justified because there was insufficient evidence; one of the complaints has been passed to the MCHK Preliminary Investigation Committee for consideration; while the remaining three complaints are still under investigation. During the same period, the Department of Health (DH) has received one complaint about the outcome of laser vision correction surgery carried out in private hospital. Investigation results showed that the hospital concerned had not violated the requirements of the Code of Practice for Private Hospitals, Nursing Homes and Maternity Homes (COP).

Laser vision correction surgeries have to be performed by registered medical practitioners. Professional conduct of all registered medical practitioners is regulated by MCHK. According to the Professional Code and Conduct for the Guidance of Registered Medical Practitioners promulgated by MCHK, medical practitioners must act in the patient's best interest when performing a medical procedure or treatment. Before any treatment is offered, the medical practitioner should properly explain to the patient the nature, effect and risks of the proposed treatment and seek his/her consent. Members of the public may lodge a complaint about the professional conduct of a registered medical practitioner with the MCHK which will deal with the case in accordance with the Medical Registration Ordinance and its subsidiary legislation.

Besides, DH registers private hospitals subject to their conditions relating to accommodation, staffing and equipment in accordance with the Hospitals, Nursing Homes and Maternity Homes Registration Ordinance (Cap. 165). In addition, it issues COP which sets out the standards of good practice for private hospitals to adopt. According to COP, private hospitals providing operating theatre services are required to have properly trained and qualified registered medical practitioners and healthcare professionals in charge of each and every procedure, so as to ensure the safety of patients. Private hospitals should also respect the rights of patients. The attending doctor should explain clearly to the patient the procedures and risks involved before the surgery. The surgery will only be performed with the signed consent of the patient.

Like all medical procedures, laser vision correction surgeries carry some degree of risk. Before receiving the treatment, patients should have a thorough understanding of the procedures and potential risks, etc. They should consult their doctors in order to decide on the procedures that best suit their conditions.


Ends/Wednesday, March 27, 2013
Issued at HKT 17:03

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