The commercialisation of Ireland's booming laser eye surgery sector is putting patients at risk, according to a number of leading ophthalmologists.
The past six months have seen major growth in the number of clinics offering laser eye procedures throughout the State. There are now more than 20 clinics specialising in laser eye surgery in Ireland, compared with four just five years ago. One large UK chain, Optical Express, has entered the market and now has three outlets in the Republic.
Concerns have been raised about the use of doctors imported from the UK and elsewhere to carry out the surgery, often being flown in and out of the State in a 24-hour period.
"As such they can't offer continuity of care and this is not a healthy set-up," said Dr Arthur Cummings, consultant ophthalmologist at the Wellington Eye Clinic in Dublin.
Describing the sector as a "minefield", Prof Michael O'Keeffe, consultant ophthalmologist at the Mater Private Hospital, said the huge growth in the area in recent months was a result of SSIA windfalls.
Prof O'Keeffe warned against commercial clinics that "sell surgery like a commodity" and said that some clinics failed to give their patients independent assessments and lacked proper follow-up care.
These clinics were being set up by business people who see the sector as "a place to make a buck", he said.
While laser eye surgery is very safe, it does have risks and when things go wrong patients can end up with "significant problems", he said.
"Laser eye surgery is real surgery with real potential risks. People are treating the procedure like getting their hair done or a fake tan," he said.
Weng Lee, consultant ophthalmologist at Dublin's Eye and Ear Hospital, told The Irish Times he had seen three patients with "very nasty eye infections" as a result of laser eye treatment in the past 12 months.
Mr Lee has also treated a further five Irish patients who had presented with complications following laser eye surgery abroad in places such as Romania and Tehran.
While eye infections could usually be remedied, patients could suffer scarring of the eye and have permanent reduced vision, he said. The worst possible scenario was the loss of an eye, he said.
Mr Lee said some business-led clinics were failing to offer patients proper follow-on care and independent assessments.
"Business-led clinics are under pressure to convert assessments into surgery and the normal check points may not be as stringent as they could be," he said.
Competition to offer the lowest prices means that clinics are flying surgeons in and out of the State to keep costs down. Some of the surgeons are not on the specialist register and may not have the appropriate training, according to Mr Lee.
In Ireland, just as in Britain, any registered medical doctor can carry out a laser treatment and need not have eye training, he said.
It was good medical practice for the eye surgeon to carry out the assessment, surgery and post-surgery check-up, but this was not possible when the surgeon was not resident in the country, he said.
The Irish College of Ophthalmologists needs to take the lead and tighten up the sector, according to Mr Lee. There were plans in the UK to establish a register of accredited laser eye surgeons, and a similar move should be made in Ireland, he said.
The Irish Consumer Association (ICA) has also expressed concern about the advertising practices in the sector. Risks and side effects associated with laser surgery "are so clearly and determinedly played down" in many newspaper advertisements, according to Dermott Jewell, chief executive of the ICA.
"Stronger warnings to indicate the risks associated with the treatment are needed. Warnings are not something for the small print."
Warnings that the procedure may not suit everybody was "not sufficient", he said.