Informed consent in refractive eye surgery: learning from patients and the courts

Refractive eye laser surgery involves ablation of the cornea using excimer laser to correct short or long sightedness and thus negate the need for glasses and/or contact lenses. With the doctrine of informed consent often central to claims of medical negligence in this area, we examine the attitudes, understanding and recall of patients to consent for refractive surgery and outline the relevant law. 102 patients undergoing first time refractive surgery were analysed to examine their understanding and recall of the consenting process. Only 2 patients remembered all 5 risks outlined preoperatively, while 11 remembered no risks at all. 65% of patients consulted the internet to learn more about the operation. Our study demonstrates that patient understanding and recall remains poor. A signed consent form is not, of itself a full defence to allegations of uninformed consent, and the consent process must be comprehensive.