Call it the Lasik indicator. With the weak economy prompting U.S. consumers to cut back on discretionary spending, laser vision-correction surgeries have been falling, as they did during the last recession.

More than 800,000 Americans underwent Lasik surgery in 2007, a slight increase from 2006. But the numbers started slumping along with the economy in the second half of last year. And industry analysts are now predicting a Lasik recession.

“Were forecasting a 17 percent drop for 2008,” said David Harmon, president of Market Scope, an eye surgery market research company.

Harmon said that when first-quarter data became available next month, he expected the numbers to show an even sharper decline in Lasik surgeries than in 2001. That time around, the sour economy triggered a three-year slump in the laser procedures, which are typically not covered by insurance.

Lasik - for laser-assisted in situ keratomileusis - typically costs $800 to $3,000 or more per eye.

Earlier this year, two main companies in the Lasik business - Advanced Medical Optics, a leading maker of laser surgery equipment, and LCA-Vision, which owns a chain of laser surgery centers - warned of a market slowdown.

Besides the economic challenge, the industry is contending with a small but growing number of complaints about the results of Lasik procedures - an issue to be discussed at a federal regulatory hearing on Friday.

Harmons forecast is based on the relatively strong correlation in recent years between Lasik procedures and the Conference Boards index of consumer confidence in the economy.

Doctors and analysts said a wide range of elective medical procedures, including breast implants and skin treatments like Botox injections, are also being affected.

“People are just being a little more conservative about their finances,” said Dr. Robert Cykiert, a New York ophthalmologist who does both eye surgery and Botox injections.

In the case of Botox, for example, Cykierts existing patients are not spacing out their periodic treatments, he said, but some who are interested in Botox have been hesitant to start treatments.

So far, though, Lasik procedures are the most measurably affected.

Advanced Medical Optics, which gets more than one-third of its revenue from laser surgery systems and related gear, cut sales and earnings forecasts for the year in February, saying then that it expected a 10 percent drop in procedures in 2008. Its stock, which closed on Wednesday at $20.16, is down more than 13 percent since the February warning.

The same month, LCA-Vision, the surgery center owner, said it had cut its work force by 16 percent in anticipation of slowing business. Shares of LCA-Vision closed on Wednesday at $12.28, down more than 75 percent since last July. The stock of a competitor, TLC Vision, closed at $1.26, down more than 79 percent from a peak of $6.10 last May.

Lawrence Biegelsen, a medical device analyst for Wachovia Capital Markets, said that Advanced Medical Optics stock could be hit again as complaints by Lasik patients are voiced at the Friday hearing by the Food and Drug Administrations advisory panel on ophthalmic devices.

Federal regulators have received reports about Lasik patients with dry eyes, double vision and distorted night vision, among other problems.

And various Web sites like www.lasik-flap.com and www.lasermyeye.org/forums/index.php carry sobering tales of more serious eye damage or cases where vision improvements seemed to disappear within a few years.

The FDA is asking the panel for advice on ways to get more doctors, patients and hospitals to report problems stemming from laser surgery or lens implants. One goal cited in documents the agency released on Wednesday is to gather more Lasik data through SightNet, an online network of ophthalmologists who are voluntarily linked to the agencys Medical Product Safety Network.

Lasik involves cutting a flap in the surface of the cornea to gain access to the central portion of the eyes natural lens, which is then reshaped by the laser. Lasik can reduce or in many cases eliminate nearsightedness, far-sightedness and astigmatism.

Lasik practitioners say a recent analysis of past studies showed 95 percent satisfaction rates. But with 12 million patients having undergone the procedure in the United States since it was approved in 1995, the sheer number of individuals with unhappy outcomes is growing steadily. And more of their stories are gaining public attention.

“My eyes are damaged beyond repair,” Pamela Barncastle, 62, of Albuquerque, New Mexico, said in a telephone interview. Barncastle said she underwent the surgery in 2001 but now suffers double vision, as well as seeing halos and bursts of blurred light at night that prevent her from driving after sundown.

GLASGOW’S Subway network could be extended from the West End to Celtic Park as part of a 670 million scheme, The Scotsman has learned.

The new line could be built in time for the 2014 Commonwealth Games, which Glasgow hopes to secure. It would replace a previously proposed second Subway circle around the East End. That plan is expected to be shelved because of its price tag of 2.3 billion.

If Glasgow’s Games bid is successful, the opening ceremony will be held at Celtic Park, with an indoor sports arena and velodrome due to be built nearby.

By using disused tunnels, backers say an east-west line would be cheaper than a new circle. It would also use faster tram-type vehicles instead of trains.

Under plans to be unveiled today, the line would run from Yorkhill, near the planned Riverside Museum in the West End, via the Scottish Exhibition and Conference Centre and city centre to Bridgeton and Parkhead. There would be an interchange in the city centre, either with the Subway at St Enoch or at Argyle Street station, just to the east.

Spare or enlarged tunnels could be used from near Yorkhill to Bridgeton, where the line would branch off through a disused mile-long tunnel under London Road to Celtic Park. The tunnel emerges yards from the east end of the stadium, where there was a station between 1897 and 1964.

The new plan for the 110-year-old Subway is seen by the operator Strathclyde Partnership for Transport (SPT) as both more affordable than the previous scheme, and as a possible first step towards further expansion.

SPT is also still considering a 270 million modernisation of the six-mile Subway circle, which would bring its total development costs to about 1 billion.

Alistair Watson, SPT’s chairman, said members visited Toulouse in France last year, where a light rail system using normal rail tracks cost less than 1 billion (672 million).

It is thought the Subway extension could cost a similar amount, which would be more acceptable to ministers than the earlier 2.3 billion scheme.

Mr Watson said: “We believe, with support from the Scottish Government and parliament, it would be possible to begin work on the modernisation and extension project by 2010.”

Ron Culley, SPT’s chief executive, said: “These proposals contain bold visions. What we now need to do is work out how we can make this happen.”

Related topic

- «sport.scotsman.com»
http://sport.scotsman.com/topics.cfm?tid=1589

England will turn to Mike Catt to rescue their World Cup campaign tomorrow after a strained calf forced Andy Farrell to withdraw from their quarter-final against Australia and left the head coach Brian Ashton’s carefully laid midfield plans in disarray.

Farrell pulled his right calf muscle while chasing a kick in training and Olly Barkley is also nursing a dead leg after a collision with his captain, Phil Vickery. Ashton is not due to make an official announcement until lunchtime today but it is understood the 36-year-old Catt will feature in what could be the defining game of England’s tournament.

It is the latest in a chapter of accidents since the defending champions arrived in France over a month ago. Jonny Wilkinson twisted his ankle barely half an hour into the first training session and missed the first two pool games and Barkley, Jason Robinson and Mark Cueto have been unavailable through injury at various times. Moreover Vickery’s two-match suspension for tripping an opponent deprived the squad of their captain against South Africa and Samoa.

Catt, a survivor of England’s 2003 triumph, has not featured since the dismal 36-0 defeat to the Springboks in Paris when he deputised for the injured Wilkinson at No10, with Farrell at inside-centre. He has been giving Ashton tactical assistance behind the scenes but must have feared his 72-cap Test career was over after failing to make the 22-man match-day squad for the past three weeks.

Similar thoughts must now be haunting the 32-year-old Farrell after the latest body blow to his aspirations of becoming a rugby union Test regular. Even if England should overturn the odds and win tomorrow it would seem unlikely he will feature again in this tournament and it is hardly a state secret that England intend to freshen up an ageing squad when they return home.

It also deprives the former Great Britain rugby league captain of the opportunity to silence the critics who have consistently questioned his ability to make a genuine impact at the highest level of the 15-a-side code after years of relentless physical punishment at Wigan. His former league team-mate Robinson suggested this week that Farrell’s biggest problem was having to remove “all the knives out of his back” but rugby-related fitness issues, including back spasms and concussion, have now sidelined the Saracens player from five Tests in the past six months. He has started only six of England’s 15 Tests - including tomorrow’s game - since his debut against Scotland in February.

England, as a result, face yet more disruption in a critical area, particularly as the Wallaby midfield duo of Matt Giteau and Stirling Mortlock are rated among the best combinations in the world at present. Ashton had been looking for Farrell to offer a more direct threat than Barkley provided against Tonga last week, only for both men to limp out of training within five minutes of each other.

Wilkinson described the loss of Farrell as a “disappointment” on the eve of a game of such significance. “It’s not an ideal scenario,” admitted the fly-half, but he added: “I have experience with Mike Catt over the years. He’s someone I’ve respected massively. I’ve always enjoyed his unselfish approach. I’m excited about whatever happens. Whoever comes in, it will be different but there is a system in place. There’s a cohesive feeling about the group. It will be important to get on the wavelength of the person who comes into that slot.”

Barkley was at least fit enough to give the media an update yesterday, insisting the heavy strapping on his right thigh was merely precautionary and, like Farrell’s injury, the result of “freak” circumstances. “I think it’s indicative of our luck at this World Cup,” he sighed. “Faz was just chasing a kick while I got a flying Phil Vickery in the side of my leg.”

He dismissed any suggestion that the recent spate of non-contact injuries during England training sessions might be a result of inadequate warm-up exercises. “If they’d occurred in the first five minutes that might be a possibility but we were both hurt towards the end of the session.”