Board Accuses Eye Doctor of Negligence, Incompetence : Medicine: Burbank practitioner Akim F. Czmus botched cataract surgery and misdiagnosed glaucoma, the state agency charges.

State medical officials have accused a Burbank eye doctor of botching cataract surgery on one elderly patient who later went blind and of giving an excessive number of laser “shots” to another who was left with almost no vision in the treated eye.

Dr. Akim F. Czmus also misdiagnosed a 15-year-old girl as having glaucoma, an increase in eyeball pressure that can lead to blindness, despite normal pressure readings and the rarity of the condition among teen-agers, officials said.

According to state records, Czmus has been on probation since 1987 for falsely telling a Glendale hospital where he was seeking a job that he was certified by the American Board of Ophthalmology.

Czmus, 39, who is in private practice, was charged with negligent and incompetent treatment of six patients in a recent complaint filed by the California Medical Board, which disciplines state-licensed health practitioners. He faces loss of his medical license if found guilty of the charges, which are expected to be heard by an administrative law judge next spring.

Czmus obtained his medical degree at Brown University and was a resident in ophthalmology at Kings County Hospital Center in New York from 1978 to 1980, a medical board spokeswoman said.

A man who identified himself as Czmus’ office administrator said the doctor had no comment on the charges and referred calls to Czmus’ lawyer, Ronald S. Marks, who could not be reached for comment.

The state complaint said Czmus improperly treated one elderly patient identified only as William P.

Czmus operated to remove a cataract on the man’s left eye in 1987 and again the next year to remove one from his right eye. After each surgery, the doctor reported no complications, the complaint said. A cataract is the gradual clouding of an eye lens or its capsule, leaving victims totally or partially blind.

Czmus subsequently performed a series of laser treatments on both of William P.’s eyes. The man later suffered a detached retina in his right eye and severe uveitis, an inner-eye inflammation, in his left eye, according to the state complaint.

After the patient underwent additional surgery by another doctor, it was discovered that his left eye still contained damaged lens material supposedly removed by Czmus. By August, 1988, “the patient was essentially blind in both eyes,” the complaint said.

State officials alleged that Czmus should have removed the damaged lens material and should have seen problems developing in the man’s eyes.

Czmus was also charged in connection with his treatment of another elderly patient, identified in the complaint as Rafaela P.

Czmus performed cataract surgery on her left eye in 1987, noting no complications in his postoperative report, the complaint said.

After the surgery, Czmus gave the woman 333 laser “shots” to punch holes in an eye membrane that sometimes clouds over in a cataract-like manner.

But state officials said that number of shots was far too high and that Czmus used too high a power setting for many of them.

“If he needs that many shots, that’s crazy,” said state Deputy Atty. Gen. Mark Roohk, who is handling the complaint against Czmus.

“One doesn’t do that number of shots at that level of power on one patient and one eye.”

Roohk said laser treatments are normally used when there are complications after a cataract removal, an indication that the surgery was done incorrectly.

By April, 1988, Rafaela P. had developed a detached retina and had lost much of her vision in the eye, Roohk said.

“Once that retinal detachment happens, you’re talking about a pretty minute amount of vision left,” he said.

The medical board complaint further alleged that Czmus subjected the 15-year-old girl, Emily P., to excessive treatment after misdiagnosing her with glaucoma.

The girl initially registered high pressure readings in both eyes, but they later dropped to normal, the complaint said. In the meantime, Czmus gave her a laser treatment and put her on anti-glaucoma medication and a monthly schedule of office visits.

Eye doctors who later treated Emily P. found no evidence of glaucoma, the complaint said. Czmus diagnosed glaucoma despite the rarity of the condition in teen-agers and the absence of any physical evidence that the girl had it, the complaint said.

According to the complaint, Czmus in 1985 falsely told officials at Verdugo Hills Hospital in Glendale, where he was seeking appointment to the medical staff, that he was board-certified in ophthalmology.

Czmus later agreed to be placed on probation for five years and take a course in medical ethics to settle state charges in that matter.