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Editorial Spotlight | September 2020

Performing Surgery on Family Members

LASIK became a rewarding family affair.

The UK General Medical Council, the Royal College of Surgeons Ireland, and the American Medical Association suggest that doctors should not operate on family members. There is no law against it, but it is regarded as pushing ethical boundaries. In fairness, the criticisms of this practice are usually along the lines of not being able to ascertain a full history—perhaps not being able to ask all the required questions, not having all the required investigations, and not being in a position to deal with possible complications. When one reads any of these guidelines, it becomes apparent that these strictures have to do with medical issues and not necessarily performance issues such as vision correction.

Performing LASIK On My Family

I have treated both my sons and my wife (Figure) with LASIK. I regarded being able to perform these surgeries as an immense privilege and felt competent to deal with the surgeries themselves and with any complication that could arise.

Figure. Dr. Cummings with his family at AECOS Europe in 2019.

Courtesy of Pamela Marans Katz

The sequence of my family’s operations was my older son first, with his LASIK performed at age 18 years and 1 month. That was 13 years ago, and UCVA remains 6/5 OU. The second surgery was on my younger son, 4 years later, also at age 18 years and 1 month. He is now 9 years out and still enjoying brilliant vision with an emmetropic refraction.

I underwent blended vision LASIK in 2011, and when my wife saw how happy I was with my results she proceeded to ask me to perform her blended vision LASIK 1 year later.

For my own LASIK, I asked a friend and colleague in a different country to perform the procedure because I knew he had vast experience and could deal with potential complications. My associate at the time expressly did not want to do my LASIK. “What happens if anything goes wrong, and you’re in the room next to me every day of the working week?” he asked.

I also initially asked my partner in the practice to perform surgery on my children, but he declined, stating that if anything went wrong he would not be able to forgive himself. When I asked my children for their opinions, both said that they would be happier if I did their surgery, especially if something went wrong.

It was precisely this issue, the thought of something potentially going wrong, that led my family members and me to agree that the best scenario would be to have me as their surgeon. LASIK is so well controlled today that, for a properly selected patient who meets all of the requirements, it is extremely safe and effective.

Fortunately, all of these surgeries went well, and none of us has ever looked back.

Lessons Learned

I learned a few important lessons during my experiences operating on family members.

No. 1: It’s a privilege. Not long after my second son underwent LASIK, my partner in the practice asked me to perform his son’s LASIK procedure. Having personally gained such satisfaction from treating my own sons, I encouraged him to treat his own son. There’s a saying that goes, “I opened two gifts this morning. They were my eyes.” Giving the gift of sight to the very people most precious and closest to you is an enormous privilege, and I encourage any ophthalmologist who is comfortable with their own skill set and experience—and whose family member is also comfortable with them—to proceed with doing the surgery. It is an incredible bonding experience.

My partner had the same experience when his son underwent LASIK—both found that the experience was remarkably special.

No 2: Your options are open. If at any stage during the examination or buildup to the surgery either party becomes uncomfortable, simply abort the plan. This is elective surgery, and it can be done at any time.

No. 3: It’s rewarding. My older son is now performing cataract and other ophthalmic surgery as an ophthalmology resident and has an 8-month-old daughter. He can go swimming with her and play with her at home without his glasses getting in the way. My younger son was playing college golf in the United States and is now back in Ireland and enjoying his visual freedom for more than just golf. Knowing that the LASIK procedures that I performed for them has given them the freedom to own their vision and not need prosthetic devices to see well and perform to the best of their abilities is rewarding to the utmost degree.

Sharing the Gift of Sight

The life events that are generally regarded as the most memorable are getting married, buying your first house, the arrival of your first-born and other children, and having your vision corrected. The emotions that go with vision correction are deep and real, and, precisely because of this, it is a wonderful opportunity to share the gift of sight with those whom you love most dearly.

Arthur B. Cummings, MB ChB, FCS(SA), MMed(Ophth), FRCS(Edin)
  • Consultant Ophthalmologist, Wellington Eye Clinic and Beacon Hospital, Dublin, Ireland
  • Associate Chief Medical Editor, CRST Europe
  • Member, CRST International Board
  • abc@wellingtoneyeclinic.com
  • Financial disclosure: None

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