1) Cataract operation, posterior capsule rupture
A patient suffered from cataract significantly threatening vision, and it was treated surgically. Before the procedure, the different treatment options were discussed with the patient and surgical treatment was decided on based on the discussion. Following the cataract operation, there was a grey area in the edge of the patient's field of view. A retinal detachment developed in the eye subsequently, and the retina had to be surgically fixed. The patient's eye sight remained poor.
The cataract surgery was challenging because of the dense cataract. The posterior capsule ruptured during the operation. Posterior capsule rupture is a typical complication associated with a cataract surgery, making susceptible to retinal detachment. In most cases, posterior capsule rupture does not result in problems with the eye or eye sight, but in this case the patient had developed retinal detachment possibly caused by the posterior capsule rupture.
The posterior capsule rupture could not be prevented in spite of the completely appropriate implementation of the cataract operation. The retinal detachment resulted in weakened eyesight, even though the fixation of the detachment was also treated appropriately.
Because the complication caused to the patient was not due to insufficient treatment, no compensation was paid under patient insurance.
2) Informing the patient sufficiently prior to LASIK surgery
The patient requested a refractive surgery of the left eye. The operation was indicated and its implementation was appropriate. After the procedure, the patient's vision was good compared to the pre-operative situation. However, the near vision of the eye worsened after the operation because the patient's myopia was changed to almost normal refraction. This was a consequence of the procedure that could not be avoided.
The patient reported not being informed of weakened near vision before the operation. According to the patient, he would not have consented to the operation at all had he been told of the worsening of near vision.
Documents indicated that the patient had been told that he would need reading glasses in the future, even in spite of the operation. The signed agreement on the operation also indicated that the operation has a negative effect on near vision.
It could not be determined based on the investigation that the patient would have refrained from the refractive surgery even if he was aware of the immediate worsening of the near vision of the eye. The patient knew that his near vision would worsen in the future in any case.
The case does not constitute an injury compensable under patient insurance.
3) Informing the patient insufficiently about the adverse effects prior to LASIK surgery
A patient wanted refractive surgery be able to stop wearing glasses. The surgery was performed in a technically appropriate way.
After the operation, one eye was found to be overcorrected, i.e. the patient's near vision had worsened. In addition, he had dry and stinging eyes. Halos occurred in night vision.
The patient had a reoperation of one eye, resulting in his eyesight improving, but the situation was not corrected in other respects. In the notice of injury, the patient reported that he had not been told sufficiently of the risks associated with the operation in advance.
The adverse effects caused by the operation in this case were not common in connection with LASIK surgery. Therefore, it was not usually necessary to inform the patient about them prior to LASIK surgery. However, the patient's age and previous eye disorders increased the probability of adverse effects, and therefore in this case he should have been informed about them prior to performing the operation.
Had the possibility of adverse effects been made known to the patient prior to the operation, he would have probably declined the LASIK procedure, avoiding the adverse effects of the operation.
This was an injury compensable under patient insurance.
4) A LASIK operation did not result in the patient being able to stop wearing glasses
A patient underwent LASIK surgery on both eyes. After the procedure, the patient still needed to use glasses.
The operation was carried out technically in an appropriate way. According to the patient, he did not receive sufficient information before the procedure, and it was only after the procedure that he was told that in case of such short-sightedness, it will not probably be possible to completely get rid of glasses. The physician who performed the procedure reported that he had told the patient of the risks associated with the procedure in advance and also reported having emphasised that the patient’s strong short-sightedness can influence the outcome of the operation. The documents did not include information about any discussions had prior to the procedure.
The patient wanted the operation to get rid of the need to use glasses, but this outcome was not reached with the operation. However, the patient's eyesight improved following the surgery, even though he still needed to use glasses.
Compensation can be paid under patient insurance for personal injury caused to a patient in connection with healthcare or medical care. Personal injury refers to illness, bodily injury or other negative change in health. The need for glasses is not a personal injury and no compensation is paid for it under patient insurance.
Refractory LASIK operations are not absolutely necessary for eyesight. The use of the operation as a treatment method is based on the patient's own choice. Because the procedure is based on non-medical reasons, the significance of appropriate advance information is emphasised. The patient must be given sufficient information about the benefits and risks of the operation before deciding on the operation. The patient must be informed of all significant risks involved in the treatment. However, describing extremely rare risks cannot be required.
With regard to LASIK procedures, it is often a case of contract law. In addition to the notice of injury submitted to the Patient Insurance Centre, the claimant may submit the matter to the Consumer Disputes Board, for example. The Consumer Disputes Board investigates whether the outcome of the operation corresponded with what was agreed upon between the parties from the point of view of contract law.