Eye Surgery In Bangkok

[george]

Going abroad for eye surgery: Lower cost, higher risk?

Patients returning here from cheap Lasik surgery in region find they have to fork out more money in order to redress post-op complications

SINGAPORE: -- LURED by low prices, short-sighted Singaporeans are heading to regional countries for Lasik surgery. But some have had to turn to Singapore doctors for help because they developed complications after surgery overseas, six ophthalmologists told The Sunday Times.

Most are minor problems such as mild cornea scarring and dry eye. But some have had problems so severe that they needed corrective surgery in Singapore.

Eye surgeon Jerry Tan said that since 1998, about 50 patients have sought his help after overseas surgery, and about 15 were 'severe cases'.

The Singapore National Eye Centre says its surgeons have seen some patients who developed problems after eye surgery overseas, but declined to give details.

Dr Gerald Chuah, who has a private practice in Mount Elizabeth Medical Centre, said he sees four or five such cases a month. Dr Tony Ho, also at the same centre, sees one or two patients a month.

Regional hospitals in Thailand, China and Malaysia are providing serious competition for Singapore hospitals. Tie-ups between tour agencies representing hospitals and airlines have boosted business for them.

A trip to Thailand for Lasik on both eyes, with a holiday thrown in, costs about $3,000, including budget airfare, hotel stay, breakfast and transfers. In Singapore, patients can expect to pay between $3,500 and $5,000 for the surgery alone.

Post-operation complications, doctors here say, can happen anywhere in the world, and while Lasik surgery is low risk, it is not risk free. Adjunct Associate Professor Au Eong Kah Guan, head of Alexandra Hospital's ophthalmology clinic, and head of research at Tan Tock Seng Hospital's eye clinic, says the rate for post-Lasik complications here is 1 per cent.

If things go wrong overseas, the patient may have little chance of redress, said Singapore Medical Association's Dr Tan Sze Wee. 'If surgery goes wrong in Singapore, the Singapore Medical Council and our ethics committee will investigate and see if it's due to negligence,' he said.

A patient who needed corrective surgery here after Lasik surgery in Bangkok is Mr C. Kelly, 33, a permanent resident here. He had Lasik surgery to correct moderate myopia at Bangkok's private Bumrungrad Hospital on June 18. Four days later, he said, he flew home with bruised and bloodied eyeballs and blurred vision.

In Singapore, Dr Jerry Tan found that there were three wrinkles on the cornea flap in Mr Kelly's right eye, and blood not cleaned off during the operation had congealed under the flap. Vision in the left eye had been over-corrected by 150 degrees, leaving him long-sighted. At night, his vision is reduced and he sees halos around lights.

Dr Tan conducted an emergency operation, re-cutting the 0.16mm flap, sponging up the week-old blood, and smoothing out the wrinkles.

Mr Kelly said that in Bangkok, he had Lasik done on both eyes at the same time and 'my eyes felt like there was acid in them'.

Two days later, he said, the surgeon, Dr Chate Kietrsunthorn, told him he was 'very happy with the surgery'. 'He told me the blood will be absorbed, and the left eye was just 'over-corrected a little',' said Mr Kelly.

Though Dr Tan operated on him, he still is unable to drive at night or look at a computer screen for long. He also has blood spots in his eyes and gets headaches, he said.

It is not that he hadn't done any research. In February, he visited the hospital with his wife and 'asked a million questions, wanted the most senior consultant'. He spent $3,000 in Bangkok, and another $3,000 in Singapore for corrective surgery. And he expects to pay more for future operations.

Another unhappy patient was Ms A.R. Hong, 30, who had dry eyes after surgery in Bangkok.

She sought help from Dr Tan, who prescribed eye drops distilled from her blood. He found a t-shaped wrinkle, which will be operated on if her vision does not further improve.

She said: 'The world was a blur. At one point, I was like, am I going mad?'

--The Straits Times 2004-07-25

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BANGKOK HOSPITAL SAYS IT WILL HELP

WE WILL help in any way we can, said Bumrungrad Hospital, when told of Mr Kelly's case.

Its marketing director Ruben Toral said: 'Our hospital has established protocols to ensure patients are properly informed of treatment risks and outcomes. Established protocols are also in place to investigate and respond to patient complaints. In the event that corrective action is required, then it is taken without reservation to ensure our patient's health, safety and satisfaction.'

When contacted, his doctor, Dr Chate Kietrsunthorn, said Mr Kelly was 'uncooperative' and kept 'moving about during the surgery'. This was why the vision in his left eye was over-corrected.

Mr Kelly disagrees. 'I was tense during the operation... but I didn't fidget.' The blood in Mr Kelly's right eye resulted from a blood vessel cut accidentally, said Dr Chate. 'This happens if the cornea is small,' he said.

He couldn't remember if this was the case for Mr Kelly, he said, but added that it was not a major issue and 'the blood would have been absorbed into his eyes, if he had waited'.

However, he conceded both problems were 'uncommon'.

He said the wrinkles in Mr Kelly's right cornea flap were not present during the post-surgery consultation.

'He must have squeezed his eyes when he was sleeping, which will wrinkle the flap.'

But Mr Kelly disputes this, saying he was aware he was not to rub his eyes, and that he had his eye shields on at night.

Some 3,300 Singaporeans sought treatment at the hospital last year for all kinds of ailments.

[john b good]

I have always felt a bit twitchy about getting something like eye surgery carried out in Thailand.

One should not (IMO) be a cheap charlie when it comes to ones eyes

[Axel]

Regional hospitals in Thailand, China and Malaysia are providing serious competition for Singapore hospitals....

Perhaps this article is a little bit biased and the part I quoted seems to confirm this.

Bumrungrad Hospital as well as an eye-clinic on Bangkok's Asok (coming from Petchaburi-Rd. on the left sight traveling towards Sukhumvit) do have very good reputation. Any surgery has it's risks but why should an experienced MD in Bangkok be worse than somewhere else?

An alternative would be Manila, I know one person having had correctional surgery and was very happy with it.

[camerata]

Actually, this type of thing happens in Western countries too. And I've read that the oft-quoted 1% rate of complications is lower than it really is (halos is a common problem). Also, according to the UK Daily Telegraph, the first Lasik operation fails to correct vision in one out of 10 of all cases.

But I think it is pretty shabby to blame problems on the patient being "uncooperative."

[john b good]

Regional hospitals in Thailand, China and Malaysia are providing serious competition for Singapore hospitals....

Perhaps this article is a little bit biased and the part I quoted seems to confirm this.

Bumrungrad Hospital as well as an eye-clinic on Bangkok's Asok (coming from Petchaburi-Rd. on the left sight traveling towards Sukhumvit) do have very good reputation. Any surgery has it's risks but why should an experienced MD in Bangkok be worse than somewhere else?

An alternative would be Manila, I know one person having had correctional surgery and was very happy with it.

but why should an experienced MD in Bangkok be worse than somewhere else?

This is a fair enough question.

But lets face it (and let me say that this is not an anti Thai rant or anti Thai bashing) all universities in Thailand are not considered equal in terms of what they produce.

NOT all universities in the world are considered equal in what they produce.

A degree from Chulalongkon, or Ramkhamhaeng, or Kasetsart etc., (spelling might be a bit off) would be held more highly than from say Rajaphat, Payap, Maejo or the likes.

A degree from Yale, Harvard, Oxford, Cambridge etc are held more highly than many others.

So OK, a doctor, specialist, physician etc., from one of the more respected universities would you might say be better able (better qualified) to perform operations with better and more successful outcomes.

Thailand does not to my knowledge have an eye surgeon who has gained the world wide respect of his/her peers than say Fred Hollows or Feyderov.

Both of these guy's are household names throught the world.

Is there a Thai who claim the same worldwide respect?

The answer, plain and simple is "NO" there is not.

And that is not my opinion, "it is a FACT"

[Axel]

john b good, I fully agree to what you said, but this does not mean that Singapore has got internationally accepted experts.

I have no personal experience with eye-problems but minor surgeries in other fields. Most MDs I met here have been US-trained at least in Rama 9 and BKK General Hosp.

I been for 1 night in Mount Elizabeth in Singapore and fixed the problem (ENT) finally in BKK with a 2-hour operation and 3 days in hospital. No complain from my side. Except, that I did visit the same hospital in BKK once 2:00 am in the morning and the reglar Dr. 11:00 am, he was shocked about the 'wrong' treatment I got in ER, until I told him that it was his 'young' colleague on nightshift.

Can happen all over the world, so for any treatment I would not travel back home or to any place else, unless there is somewhere an expert I really know and need.

But the whole issue here seems to be a competition between Singpore and Bangkok.

[TRIPxCORE]

I had both my eyes done in BKK and am very happy with the results.

[Speedy]

......as well as an eye-clinic on Bangkok's Asok (coming from Petchaburi-Rd. on the left sight traveling towards Sukhumvit) do have very good reputation.

Yes , the name of this place is RUTNIK EYE CLINIC. I have been there myself more then 8 times over the last two months in order to remove a foreign body (metal) that got into my eye while driving my motorbike in Bkk. I have not done LASIK, although they do offer it there as well, but as far as the removal of the foreign body concerns, I must recommend the RUTNIN EYE CLINIC. They are very clean, professional, have high end equipment and the Doctor that I visited was to my experinece professional and experienced. But again, i didn t do the LASIK since it scares me off a litlte too much. I prefer to stick to a pair of old fashioned glasses, for now.

xx

[joinme2leave]

any experience(s) how much Bkk hospitals do ask for LASIK service ???

thx

[bkkbound04]

kinda off topic but along the lines of john b goods post

i visted my local nurse last week for my booster jabs for my thai visit

after reading reports on thaivisa about medical treatment in los and cost of treatment i was encouraged by these reports and had a lot of faith in thai hospitals

i was under the impression that the standard of treatment would be on par with treatment in western countries

so my jaw dropped with suprise and shock when i was advised by an insistent nurse that i should take my own sterile needles/syringe in case i needed any type of jab

i told the nurse that i wouldn't attend any backstreet hospital if i needed any treatment and would attend a decent hospital in bangkok or pattaya..this made no difference and she still insisted that i bring my own sterile equipment

i was told that it wasn't common practise to use new needles and many hospitals opted to re-use "washed" needles

i find this unbelievable in this day and age with all the knowledge of hiv/aids, hep etc

i don't feel too comfortable having any treatment in los after being told this....i don't even feel that trusting in dental treatment now

i hope some peeps can tell me this a load of bull and put my mind at ease, it's just when u are advised the above by a medical proffesional in your home country it doesn't inspire too much confidence :no:

[ka12345]

so my jaw dropped with suprise and shock when i was advised by an insistent nurse that i should take my own sterile needles/syringe in case i needed any type of jab

i told the nurse that i wouldn't attend any backstreet hospital if i needed any treatment and would attend a decent hospital in bangkok or pattaya..this made no difference and she still insisted that i bring my own sterile equipment

i was told that it wasn't common practise to use new needles and many hospitals opted to re-use "washed" needles

i find this unbelievable in this day and age with all the knowledge of hiv/aids, hep etc

That is a load of bull. Take some photos and send as postcards to that nurse from Bumrungrad or any other private hospital in BKK. That should make her jaws drop...

[camerata]

i hope some peeps can tell me this a load of bull and put my mind at ease, it's just when u are advised the above by a medical proffesional in your home country it doesn't inspire too much confidence :no:

That nurse is misinformed. Thailand got its act together in the late 80s when HIV/AIDS was big news and threatened to scare off some of the tourists. Any hospital or clinic you're likely to visit in LOS will follow the "Universal Precautions" that Western hospitals use, including using new needles with each patient. Sometimes you'll see the nurse take the needle out of its sealed packet.

[haha]

4 of my friends had LASIK done on their eyes at the TRSC institute here in bangkok with happy results. the place is located at the HSBC bank building near the dusit thani hotel. I think they have a website too. but don't know the url offhand.

incidentally, I personally had LASIK done on my eyes in san francisco back in 1997. as I recall, the LASIK procedure had just been approved 3 months earlier.

what are my eyes like now, you ask? ..my left eye is still 20/20. my right eye is about 20/30 now.

considering that I was legally blind before the operation in 1997, I have no complaints. my eyes were so bad, I couldn't see the big E on the eye chart. when I woke up in the morning, many times I couldn't locate my glasses even if they were placed near my head.

ahhhh! LASIK!

[cobra]

Two things you don't skip on: a Lawyer and a Cutter,

An associate shopped around for the cheapest surgeon to address a spinal issue, needless to say he nicked a nerve and now this guy has to use a catheter to urinate,

Most often You get what you pay,

[Dradam]

Is there a Thai who claim the same worldwide respect?

The answer, plain and simple is "NO" there is not.

And that is not my opinion, "it is a FACT"

The First Surgeon to perform LASIK in Asia is a Thai surgeon named Dr. Ekktet Chansue. He studied laser refractive surgery in the US in 1991, the first year that US FDA trials began. He first performed LASIK in Thailand in 1994, before US surgeons were approved to perform the procedure. To date, he has performed 16,000+ procedures. He is the Medical Director at TRSC International LASIK Center.

Doctors in Singapore have suggested that if you have LASIK in Thailand, he is the one to go to. He is highly respected by Surgeons throughout Europe and Asia as well.

He performed LASIK on my eyes and I see better than 20/20.

Before picking Dr. Ekktet Chansue, I had other doctors in Thailand at other hospitals perform the necessary measurements on my eyes, including the Head LASIK Surgeon at Bumrungrad. I was disappointed by their inaccuracy and their explanations.

[Dradam]

4 of my friends had LASIK done on their eyes at the TRSC institute here in bangkok with happy results. the place is located at the HSBC bank building near the dusit thani hotel. I think they have a website too. but don't know the url offhand.

the url is http://www.lasikthai.com

[sukumvitsteve]

any experience(s) how much Bkk hospitals do ask for LASIK service ???

Prices for LASIK are all reasonable here in Thailand. In the US and Europe, they are between $1,500 and $2,500 per eye unless you go to an inexperienced surgeon or a clinic which is striving to compete solely on price and volume. I just read an article suggesting 3 clinics for expats.

TRSC - 60,000 to 80,000 Baht for both eyes (although you get a discount if you say you know someone who had it done there).

Rutnin - 55,000 to 79,000 Baht for both eyes

Bumrungrad - 48,000 Baht for both eyes (although they certainly aren't well known for LASIK. I have a friend who works there and he went elsewhere to have LASIK done)

TRSC seems to be the most popular. It probably isn't a bad idea to visit all three to find out which one is the best. Talk to the staff and see what they know.

I wouldn't pick based on the price unless you have an extremely small budget and are a risk-taker.

[ThaiDiamond]

I too had LASIK by Dr. Ekktet Chansue at TRSC in March of 2003.

I had been researching the procedure on and off for the past 4 years or so, i.e. laser manufacturers, procedures, etc. etc. And that included consultations with my eye doctor in San Diego who is highly respected in southern California for LASIK operations.

I followed that up in early 2003 with a lot of local research –usually with a visit to each facility – on what was available here in Siam. Dr. Chansue was very familiar with the latest research, and as Radam mentioned in his post, my finds found that he is clearly the most experienced and most recommended doctor in Thailand.

I started wearing glasses when I was eight and had been wearing hard contacts for over some 35 years when I first consulted with Dr. Chansue. Moreover, I wanted a modified LASIK operation called “monovision.”

Monovision is one remedy for presbyopia – or the “reading glasses” condition that hits almost everybody in the 40’s. They still don’t know exactly what causes it and it typically comes on very suddenly. And while it very easy to correct – just go out a buy a pair of reading glasses – it is very inconvenient in that one tends to forget to have their glasses when the restaurant menu is handed to them or their checking labels and the supermarket.

In monovision, by correcting one eye to focus in the distance and one eye to focus for near, the vision part of our brain tends to suppress or filter out the image from the eye that is not in clear focus. After an initial adjustment period, some 3 to 6 weeks, you’re not bothered by the eye that is not in focus, the brain adjusts and when viewing far objects or when viewing close up objects like whatever your reading or viewing this computer monitor.

I should note that if you're younger, you would normally have both your eyes fully corrected and should (hopefully) see at 20:20 or so. But just like a normal person born with perfect vision, you would almost certainly experience presbyopia later in life and have to wear reading glasses regardless of having correctly your eyes by LASIK years earlier!

And my results? (drum roll, please...)

TRSC corrected my dominant eye to a bit better than 20:16 (I could actually read some chart letters at 20:12.5 but not consistently). My “reading eye” was only corrected to about 20:40 – again, as per design.

Today I’m quite happy as I can go around see most everything quite clearly both far and near. I never use reading classes when I read or when I spend 5 hours of more at a daily computer session.

But as Dr. Chansue (and my San Diego doctor) advised, monovision is not for everyone. It is a tradeoff. If I had to quantify this, I would estimate my vision is some 93% to 95% corrected as I can sometimes detect a slight bi-polar effect at distant objects. And, as the light fades, this bi-polar effect increases as monovision works least well at night or under dim lighting conditions. I have, however, simply bought a special pair of glasses that has a prescription lens for only the under-corrected eye for nighttime situations. However, for the great majority of the time I forget that I even have a monovision prescription and I can even adjust somewhat at night.

Importantly, it has not affected my tennis game!

And monovision is reversible in that I can always go back and fully correct my reading eye, but then I would always (again) have to have a pair of reading glasses at hand.

One final note on TRSC: I did their so called “wave front” technique which was not then FDA approved in March of 2003, even though this Bausch and Lomb procedure used that company’s approved laser and was considered as the next generation of their initial procedure did have American approval.

Wavefront had already been used in over 25,000 operations world wide outside the U.S. – with Dr. Chansue have done some 1,500 of those. The key difference wavefront is that it employs a customized reading and measurement of the eye to determine your eye’s exact deficiencies as opposed the then current method of assigning the same laser parameters to the same prescription. In essence, it added a greater amount of individual characteristic shape of the eye, which affects the amount of near sightedness and (in my case) high astigmatism. It was recommended for me and my research had found that many patients doing wavefront were seeing better than 20:20 with this revised method.

I should also note that while TRSC is inexpensive by international standards, they are the most expensive option in Thailand. You can easily save 20 or 30 thousand baht going elsewhere.