Patients who undergo vision-correcting laser eye surgery sign a release form with an extensive list of risks, but some researchers and former patients say a potential complication is not mentioned: depression that can lead to suicide.

In response to patient complaints, the Food and Drug Administration plans to convene a large, national study to examine the relationship of lasik complications and quality of life, including psychological problems such as depression.

Malvina Eydelman, an ophthalmologist with the FDA's Center for Devices and Radiological Health, wrote in an e-mail message that the scant clinical data available "failed to suggest significant problems following lasik surgery," but she said the FDA wants a broad and systematic review. She wrote, "We also noted that quality of life issues related to lasik had not been evaluated consistently, and there were few reports of well-designed studies."

Frustration and even sorrow can follow any unsuccessful surgery, but when the procedure leaves a patient with unremitting eye pain or permanently impaired vision, the emotional toll can be particularly severe.

One who could not endure it was Colin Dorrian, 28, a patent lawyer and aspiring medical student from suburban Philadelphia. He committed suicide last summer, 6 1/2 years after lasik surgery left him with lasting visual distortions. The surgery was done at a lasik center in Canada that has since closed.

"If I cannot get my eyes fixed, I'm going to kill myself," he wrote in a note police found on his body. "I just cannot accept the fact that I'm supposed to live like this."

In the note, Dorrian wrote that there had been other instances when he felt down. "I have other problems like most people do. But this is something else," he wrote. "As soon as my eyes went bad, I fell into a deeper depression than I had ever experienced, and I never really came out of it."

Laser eye surgeons who treat patients with complications say they do come across cases of depression, but they don't think lasik complications are the root cause. They say patients who exhibit depression after the procedure were likely depressed or psychologically troubled beforehand.

"There's no cause and effect," said Dr. Steven C. Schallhorn, the former head of the Navy Refractive Surgery Center in San Diego and an expert on permanent visual distortions from lasik.

In September, The News & Observer reported on complications from lasik, a lightly regulated surgical procedure widely promoted as a quick and painless way to eliminate the need for eyeglasses. But patients across the country and in laser eye surgery hot spots such as the Triangle, where 11 laser eye surgery centers operate, say the physical after-effects can cause or aggravate psychological problems.

Martha Walton of Raleigh postponed lasik twice. She had had bouts of depression and anxiety attacks and wasn't sure she was ready for the permanence of eye surgery. She still felt very anxious when she went ahead with it in August. Within a month, Walton, 41, a high school teacher, developed constant, severe pain from eye dryness. She couldn't cope with it and spent six days on suicide watch in a Triangle mental health facility.

"I was in so much pain," Walton said. "Twenty-four hours a day there was no escape. The only relief I could think of was to end my life. At least the pain would be over."

An elaborate regimen of taking supplements, wearing special goggles and switching to preservative-free eye drops has drastically reduced her pain. But her eyes still do not produce enough tears and she continues to take daily anti-anxiety medication.

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