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Ectasia is alive and well - Recap of AAO
|
|
| Wizkid 2004-10-29, 10:08 pm |
| Just returned from the AAO. Ectasia, as has been discussed earlier on
this site, is more prevalent than what is being discussed publicly.
Surgeons who are concerned are moving towards PRK for certain "higher
risk" patients. One focus group of twenty surgeons that I sat in with,
were polled on what procedure they would have. All said that they
would have PRK.
Addition Technologies, the manufacturer of INTACS prescription
inserts, is experiencing solid revenue growth due to INTACS for both
the treatment of post-LASIK ectasia, keratoconus, and now low myopia
(its original indication). Addition is a privately held company, but
from what I could gather, INTACS may be the fastest growing refractive
procedure in the US.
From talking to their reps, Post-LASIK ectasia is being experienced
across the board - high and low volume LASIK practices, and without
regard to years of experience. I was reminded of Dr.Michel
Kritzinger's comment, before he was killed, in 2000 when he stated
publicly that Intacs would prove to be the life bouy for LASIK.
Kritzinger was a highly regarded, high volume LASIK surgeon from South
Africa.
Ectasia continues to be the elephant in the room that no one wants to
talk about.
| |
| Ragnar Suomi 2004-10-30, 2:07 am |
| changing the topic here.. but isn't that one of those AAO meetings
that won't let Minarik or Gemoules in?
as for the PRK... of course there are conditions under which PRK is
preferable than LASIK. But if some group of surgeons thought that in
general PRK was preferred... they were a bunch of kooks. I bet they
were all high volume surgeons like LVI has. They LOVE PRK because
they can do a much higher volume with it and not have to be so
careful.
On 29 Oct 2004 17:22:46 -0700, gospa68@aol.com (Wizkid) wrote:
>Just returned from the AAO. Ectasia, as has been discussed earlier on
>this site, is more prevalent than what is being discussed publicly.
>Surgeons who are concerned are moving towards PRK for certain "higher
>risk" patients. One focus group of twenty surgeons that I sat in with,
>were polled on what procedure they would have. All said that they
>would have PRK.
>
>Addition Technologies, the manufacturer of INTACS prescription
>inserts, is experiencing solid revenue growth due to INTACS for both
>the treatment of post-LASIK ectasia, keratoconus, and now low myopia
>(its original indication). Addition is a privately held company, but
>from what I could gather, INTACS may be the fastest growing refractive
>procedure in the US.
>
>From talking to their reps, Post-LASIK ectasia is being experienced
>across the board - high and low volume LASIK practices, and without
>regard to years of experience. I was reminded of Dr.Michel
>Kritzinger's comment, before he was killed, in 2000 when he stated
>publicly that Intacs would prove to be the life bouy for LASIK.
>Kritzinger was a highly regarded, high volume LASIK surgeon from South
>Africa.
>
>Ectasia continues to be the elephant in the room that no one wants to
>talk about.
| |
| Glenn - USAEyes.org 2004-10-30, 2:07 am |
| Ahhh. WizKid. They were talking about it at the AAO.
Of course they are not talking about some unseen someday doomsday
scenario, but there have been many presentations of case studies of
ectasia and...most importantly...how to avoid it.
Glenn Hagele
Executive Director
Council for Refractive Surgery Quality Assurance
Email to glenn dot hagele at usaeyes dot org
http://www.USAEyes.org
http://www.ComplicatedEyes.org
I am not a doctor.
| |
| Rebecca 2004-10-30, 11:08 am |
| Glenn - USAEyes.org <glenn.hageleSTOPSPAM@USAEyes.org> wrote in message news:<o1d6o09ffe0hvrvonoc51okh9kogv5nqqt@4ax.com>...
> Ahhh. WizKid. They were talking about it at the AAO.
I think WizKid meant "...other than peer to peer." It's good that it's
being talked about at the meetings so much (especially in terms of
prevention, which is key) but I would agree that patient education
about ectasia as a specific concern has a long way to go.
One of the factors I would like to see change in this regard is
promotional videos with graphical representations of the surgery. Many
that I have seen give an erroneous sense of proportion (flap to total
cornea - often the flap is rendered is something quite superficial
when in fact it may be 25% or more of the total cornea) and structural
implications (the flap lies down and any sign of incision or interface
magically disappears, vs the reality of the permanent flap interface).
| |
| Wizkid 2004-10-30, 11:08 am |
| You are correct. There were several sessions in which ectasia was
center stage and was discussed. Presenters were talking about how to
avoid it and how to fix it. There is still much confusion on both.
These sessions were well attended... some completely full.
But the talk on ectasia's incidence and prevalence is not center stage
but left to hallway conversations. As I stated, the elephant is in
the room but still, from a patient's right to know about its
existance, is being ignored. WK
Glenn - USAEyes.org <glenn.hageleSTOPSPAM@USAEyes.org> wrote in message news:<o1d6o09ffe0hvrvonoc51okh9kogv5nqqt@4ax.com>...
> Ahhh. WizKid. They were talking about it at the AAO.
>
> Of course they are not talking about some unseen someday doomsday
> scenario, but there have been many presentations of case studies of
> ectasia and...most importantly...how to avoid it.
>
> Glenn Hagele
> Executive Director
> Council for Refractive Surgery Quality Assurance
>
> Email to glenn dot hagele at usaeyes dot org
>
> http://www.USAEyes.org
> http://www.ComplicatedEyes.org
>
> I am not a doctor.
| |
| Ragnar Suomi 2004-10-30, 11:08 am |
| It would be wonderful if there were a way to find out which surgeons
have complications such as infextions and ecstasia. For instance,
last year, one LVI surgeon in one day had 19 of his 24 patients get
eye infections. Even that was too much for LVI and they fired him.
Another local surgeon commented that he has done over 20,000 LASIK
procedures and not had a single infection. It's a no-brainer who the
surgeon to go to is. Of course, the no-infection surgeon charges
more than twice as much as the discount surgeon.
On 30 Oct 2004 07:38:53 -0700, gospa68@aol.com (Wizkid) wrote:
[vbcol=seagreen]
>You are correct. There were several sessions in which ectasia was
>center stage and was discussed. Presenters were talking about how to
>avoid it and how to fix it. There is still much confusion on both.
>These sessions were well attended... some completely full.
>
>But the talk on ectasia's incidence and prevalence is not center stage
>but left to hallway conversations. As I stated, the elephant is in
>the room but still, from a patient's right to know about its
>existance, is being ignored. WK
>
>Glenn - USAEyes.org <glenn.hageleSTOPSPAM@USAEyes.org> wrote in message news:<o1d6o09ffe0hvrvonoc51okh9kogv5nqqt@4ax.com>...
| |
| Dr. Leukoma 2004-10-30, 7:09 pm |
| Ragnar Suomi <ragnarsuomi@yahoo.com> wrote in
news:o656o01gn29n7c8lu784d1ej3ktrvoh04m@4ax.com:
> changing the topic here.. but isn't that one of those AAO meetings
> that won't let Minarik or Gemoules in?
>
Since the AAO has barred optometrists from attending, I guess you are
correct.
Since I have never attended an AAO convention, it is moot.
What is your problem?
DrG
| |
| Dr. Leukoma 2004-10-30, 7:09 pm |
| Are you saying that LVI surgeons have a higher incidence or ectasia?
I hope you have proof of that.
DrG
Ragnar Suomi <ragnarsuomi@yahoo.com> wrote in
news:ome7o0lu2bcr1hotui2d30cfqlrglj3oun@4ax.com:
> It would be wonderful if there were a way to find out which surgeons
> have complications such as infextions and ecstasia. For instance,
> last year, one LVI surgeon in one day had 19 of his 24 patients get
> eye infections. Even that was too much for LVI and they fired him.
> Another local surgeon commented that he has done over 20,000 LASIK
> procedures and not had a single infection. It's a no-brainer who the
> surgeon to go to is. Of course, the no-infection surgeon charges
> more than twice as much as the discount surgeon.
>
> On 30 Oct 2004 07:38:53 -0700, gospa68@aol.com (Wizkid) wrote:
>
>
>
| |
|
| Ragnar Suomi <ragnarsuomi@yahoo.com> wrote in message news:<o656o01gn29n7c8lu784d1ej3ktrvoh04m@4ax.com>...
> changing the topic here.. but isn't that one of those AAO meetings
> that won't let Minarik or Gemoules in?
>
Why wouldn't they? They let patients like me in.
| |
|
| Are you LVI's defender now? If you read my post, I was discussing
LVI's infections which are indefensible and outrageous and publically
documented. You are trying to infer that I said ectasia? Didn't say
that although it wouldn't surprise me. They do have a 20% enhancement
rate which is just about twice the rate of any other provider.
It's almost as if you are defending the facilities that refer you the
most patients either directory or indirectly. It reminds me of the
classic Charlie Chaplin movie "The Kid" in which Charlie is profitting
by replacing broken windows - and the kid is the one breaking the
windows in the first place. (triva note: The Kid went on to be
Uncle Fester in the Addams Familiy - Jackie Coogan).
On Sat, 30 Oct 2004 23:02:46 GMT, "Dr. Leukoma"
<drgNOSPAM@leukoma.com> wrote:
[vbcol=seagreen]
>Are you saying that LVI surgeons have a higher incidence or ectasia?
>
>I hope you have proof of that.
>
>
>DrG
>
>
>Ragnar Suomi <ragnarsuomi@yahoo.com> wrote in
>news:ome7o0lu2bcr1hotui2d30cfqlrglj3oun@4ax.com:
>
| |
|
| Good question! Maybe you should ask Dr. Gemoules about that.
He could put on a fake mustache and funny glasses with a big nose and
maybe nobody would recognize him and he would get in.
It's obvious that they want to keep the vultures out.
On 31 Oct 2004 01:22:38 -0800, sandy@savvysneaks.com (Sandy) wrote:
>Ragnar Suomi <ragnarsuomi@yahoo.com> wrote in message news:<o656o01gn29n7c8lu784d1ej3ktrvoh04m@4ax.com>...
>
>Why wouldn't they? They let patients like me in.
| |
| Rebecca 2004-10-31, 11:09 am |
| RM <rm@yahoo.com> wrote in message news:<0ae9o0p3408bhsc306rmoocioh51192g47@4ax.com>...
> They do have a 20% enhancement
> rate which is just about twice the rate of any other provider.
20% is unacceptable and I believe it substantially exceeds the
labelling (specified in FDA approval documents) indications of
retreatment rates for myopia or myopia with astigmatism on any
excimer.
| |
|
| On 31 Oct 2004 08:48:59 -0800, rebeccaNO_SPAM@lasermyeye.org (Rebecca)
wrote:
>RM <rm@yahoo.com> wrote in message news:<0ae9o0p3408bhsc306rmoocioh51192g47@4ax.com>...
>
>
>20% is unacceptable and I believe it substantially exceeds the
>labelling (specified in FDA approval documents) indications of
>retreatment rates for myopia or myopia with astigmatism on any
>excimer.
This came up before, and the maximum enhancement rate was legally
something like 30%. I have a feeling that these things don't get
enforced though.
It would be nice if the malcontent people would concentrate their
efforts on going after the centers and surgeons who are flagrantly
operating in an unacceptable way. No matter what anybody thinks of
the LASIK procedure, attacking it is futile and absurd.
Interestingly, when the local news covered the LVI story last year in
which roughly 20 people got eye infections in one day at their Tampa
center, Ron Link was part of the story. Basically, he was saying it
wasn't unusual for that to happen!!!!!!! By boldy making his
incredibly false assertions which attacked LASIK, he exonerated LVI
from blame. Thanks a lot Ron! With friends like him, who needs
enemas. Oddly, although Ron lives within walking distance of LVI, he
has never made any effort to go after them. Could it be that he's
trying to bend people's opinions to make it seem that problems are
part of the procedure even when done properly - and therefore taking
the blame off of centers that have bad results? Now why would
someone do that? $$$
| |
| Glenn - USAEyes.org 2004-10-31, 7:11 pm |
|
>This came up before, and the maximum enhancement rate was legally
>something like 30%.
RM, do you know where the language for this is located. I can't find
an "approved" rate in any of the laser approvals. I must be looking
in the wrong place.
I remember that Tampa newspaper article and the quote of SurgicalEye's
Ron Link too. Yes, by trying to shoot LASIK as a whole, he shot
himself in the foot and made LVI look "normal". This is not all that
different from when he endorsed the ASCRS LASIK guidelines even though
they said the complication rate was only 1%. As you said, with
friends like him...
On a related note, SurgicalEyes is all but gone. A few of the
remaining stalwarts are trying to create a new organization with a new
name. Apparently this is to get out from under SE's building debt and
declining reputation. There is even a rumor (unsubstantiated but from
many sources) that Link is washing out of law school and trying to
take back SE. Talk about a battle for a sinking ship.
To get an idea of what to expect from the new organization, their
projected board includes the optometrist currently running
SurgicalEyes and their patient representative is reported to be
Keller's good buddy Paula Cofer, who has recently been identified in
this group as Ron Link's current or former girlfriend, "Broken Eyes"
who frequents SE's bulletin board, and "Scientist" who dominates the
LaserMyEye bulletin board.
Isn't the definition of insanity doing the same thing again and again
but expecting a different result each time?
Glenn Hagele
Executive Director
Council for Refractive Surgery Quality Assurance
Email to glenn dot hagele at usaeyes dot org
http://www.USAEyes.org
http://www.ComplicatedEyes.org
I am not a doctor.
| |
| Wizkid 2004-10-31, 7:11 pm |
| Thanks for clarifying what I intended. Your point on the video
graphics is excellent. Few, if any, patients understand the
significance of the flap. Many providers of LASIK like to discuss the
space age accuracy of the laser - removes tissue to the one micron
range - with total disregard of the dimensional error introduced by
the flap. WK
rebeccaNO_SPAM@lasermyeye.org (Rebecca) wrote in message news:<120ffab4.0410300518.eae301b@posting.google.com>...
> Glenn - USAEyes.org <glenn.hageleSTOPSPAM@USAEyes.org> wrote in message news:<o1d6o09ffe0hvrvonoc51okh9kogv5nqqt@4ax.com>...
>
>
> I think WizKid meant "...other than peer to peer." It's good that it's
> being talked about at the meetings so much (especially in terms of
> prevention, which is key) but I would agree that patient education
> about ectasia as a specific concern has a long way to go.
>
> One of the factors I would like to see change in this regard is
> promotional videos with graphical representations of the surgery. Many
> that I have seen give an erroneous sense of proportion (flap to total
> cornea - often the flap is rendered is something quite superficial
> when in fact it may be 25% or more of the total cornea) and structural
> implications (the flap lies down and any sign of incision or interface
> magically disappears, vs the reality of the permanent flap interface).
| |
| Glenn - USAEyes.org 2004-10-31, 7:11 pm |
| >Thanks for clarifying what I intended. Your point on the video
>graphics is excellent. Few, if any, patients understand the
>significance of the flap. Many providers of LASIK like to discuss the
>space age accuracy of the laser - removes tissue to the one micron
>range - with total disregard of the dimensional error introduced by
>the flap. WK
WizKid, you think femtosecond created LASIK flaps are introducing
"dimensional error"?
Glenn Hagele
Executive Director
Council for Refractive Surgery Quality Assurance
Email to glenn dot hagele at usaeyes dot org
http://www.USAEyes.org
http://www.ComplicatedEyes.org
I am not a doctor.
| |
| Dr. Leukoma 2004-10-31, 7:11 pm |
| Now, why on earth would I be LVI's defender? Have you gone totally nuts?
However, you must be held to the same standards to which I hold myself, and
be willing to substantiate your claims of malfeasance. Otherwise, you are
liable to a defamation lawsuit. You cannot demand that some of us be
accountable to standards that you are not.
I hope I have made myself clear.
DrG
RM <rm@yahoo.com> wrote in news:0ae9o0p3408bhsc306rmoocioh51192g47@4ax.com:
> Are you LVI's defender now? If you read my post, I was discussing
> LVI's infections which are indefensible and outrageous and publically
> documented. You are trying to infer that I said ectasia? Didn't say
> that although it wouldn't surprise me. They do have a 20% enhancement
> rate which is just about twice the rate of any other provider.
> It's almost as if you are defending the facilities that refer you the
> most patients either directory or indirectly. It reminds me of the
> classic Charlie Chaplin movie "The Kid" in which Charlie is profitting
> by replacing broken windows - and the kid is the one breaking the
> windows in the first place. (triva note: The Kid went on to be
> Uncle Fester in the Addams Familiy - Jackie Coogan).
>
>
>
>
> On Sat, 30 Oct 2004 23:02:46 GMT, "Dr. Leukoma"
> <drgNOSPAM@leukoma.com> wrote:
>
>
| |
| Dr. Leukoma 2004-10-31, 7:11 pm |
| RM <rm@yahoo.com> wrote in
news:ove9o0595kp9ufhbqfijbufh896m8f9431@4ax.com:
> Good question! Maybe you should ask Dr. Gemoules about that.
> He could put on a fake mustache and funny glasses with a big nose and
> maybe nobody would recognize him and he would get in.
>
You haven't supplied a reason for me to attend. As an optometrist, it
would never have occurred to me to attend an OMD meeting.
Are you an OMD wannabee? Of course you are.
DrG
>
> On 31 Oct 2004 01:22:38 -0800, sandy@savvysneaks.com (Sandy) wrote:
>
>
>
| |
| Rebecca 2004-10-31, 10:08 pm |
| Glenn - USAEyes.org <glenn.hageleSTOPSPAM@USAEyes.org> wrote in message news:<v3dao01kjd7kk6f2qod43lciem8fl2umfg@4ax.com>...
> To get an idea of what to expect from the new organization, their
> projected board includes the optometrist currently running
> SurgicalEyes and their patient representative is reported to be
> Keller's good buddy Paula Cofer, who has recently been identified in
> this group as Ron Link's current or former girlfriend, "Broken Eyes"
> who frequents SE's bulletin board, and "Scientist" who dominates the
> LaserMyEye bulletin board.
OK, now, everybody, repeat after me so I don't have to keep giving this lesson:
"Scientist" is not Paula.
Rebecca
| |
| Ragnar Suomi 2004-11-01, 2:09 am |
| If I remember right.. it was Christine that told me what the legal
limit was on enhancments. But that is not the point.. I don't really
care what the legal limit is. When a top surgeon has a 3% or less
enhancement rate, everyone else has an 11% rate, and LVI has a 20%
rate, it doesn't take a genius to spot the problem.
As for Ron, he would do or say anything that would line his pockets
with money. I wouldn't be surprised if he is washing out of law
school. It's very expensive and there are so many people wanting to
be lawyers that its very competitive. Only the most aggressive people
who are also good actors and have enough sense to know how far they
can go without losing their credibility, succeed as lawyers. Sadly,
it's just about impossible to be a successful lawyer and not be a
slimeball. Ron lacks the good sense that a lawyer must have to create
an image of integrity. He reminds me of Joe Pesci in "My Cousin
Vinnie" - "dese too yutes"... "What is a YUTE?"
On Sun, 31 Oct 2004 19:11:38 GMT, Glenn - USAEyes.org
<glenn.hageleSTOPSPAM@USAEyes.org> wrote:
>
>
>RM, do you know where the language for this is located. I can't find
>an "approved" rate in any of the laser approvals. I must be looking
>in the wrong place.
>
>I remember that Tampa newspaper article and the quote of SurgicalEye's
>Ron Link too. Yes, by trying to shoot LASIK as a whole, he shot
>himself in the foot and made LVI look "normal". This is not all that
>different from when he endorsed the ASCRS LASIK guidelines even though
>they said the complication rate was only 1%. As you said, with
>friends like him...
>
>On a related note, SurgicalEyes is all but gone. A few of the
>remaining stalwarts are trying to create a new organization with a new
>name. Apparently this is to get out from under SE's building debt and
>declining reputation. There is even a rumor (unsubstantiated but from
>many sources) that Link is washing out of law school and trying to
>take back SE. Talk about a battle for a sinking ship.
>
>To get an idea of what to expect from the new organization, their
>projected board includes the optometrist currently running
>SurgicalEyes and their patient representative is reported to be
>Keller's good buddy Paula Cofer, who has recently been identified in
>this group as Ron Link's current or former girlfriend, "Broken Eyes"
>who frequents SE's bulletin board, and "Scientist" who dominates the
>LaserMyEye bulletin board.
>
>Isn't the definition of insanity doing the same thing again and again
>but expecting a different result each time?
>
>Glenn Hagele
>Executive Director
>Council for Refractive Surgery Quality Assurance
>
>Email to glenn dot hagele at usaeyes dot org
>
>http://www.USAEyes.org
>http://www.ComplicatedEyes.org
>
>I am not a doctor.
| |
| Ragnar Suomi 2004-11-01, 2:09 am |
| Now you are starting to sound like Hanson with his threats of
lawsuits.
Here.. I'll play your game. "My dad is bigger than your dad and he's
going to come over and kick your XXX.. nyeah nyeah.. "
As far as LVI surgeons and lawsuits, the one surgeon in particular was
encouraged to sue me by someone known to this newsgroup. She actively
collected correspondence and sent it to him and contacted a lawyer.
The end result? That surgeon wound up setitng a world record for eye
infections and even LVI couldn't stand him and fired him.. he's now in
Las Vegas. That same surgeon lost his license to practice for nearly
2 years. I never did find out why he lost his license.
On Mon, 01 Nov 2004 00:09:07 GMT, "Dr. Leukoma"
<drgNOSPAM@leukoma.com> wrote:
[vbcol=seagreen]
>Now, why on earth would I be LVI's defender? Have you gone totally nuts?
>
>However, you must be held to the same standards to which I hold myself, and
>be willing to substantiate your claims of malfeasance. Otherwise, you are
>liable to a defamation lawsuit. You cannot demand that some of us be
>accountable to standards that you are not.
>
>I hope I have made myself clear.
>
>DrG
>
>
>RM <rm@yahoo.com> wrote in news:0ae9o0p3408bhsc306rmoocioh51192g47@4ax.com:
>
| |
| Ragnar Suomi 2004-11-01, 2:09 am |
| There must be another Dr. Leukoma posting here then. The other Dr.
Leukoma was complaining that he was banned from AAO meetings.
on, 01 Nov 2004 00:13:41 GMT, "Dr. Leukoma" <drgNOSPAM@leukoma.com>
wrote:
[vbcol=seagreen]
>RM <rm@yahoo.com> wrote in
>news:ove9o0595kp9ufhbqfijbufh896m8f9431@4ax.com:
>
>
>You haven't supplied a reason for me to attend. As an optometrist, it
>would never have occurred to me to attend an OMD meeting.
>
>Are you an OMD wannabee? Of course you are.
>
>
>DrG
>
>
| |
| Ragnar Suomi 2004-11-01, 2:09 am |
| Who really cares who Scientist is? The fact is that Scientist is a
total nutcase and has hurt your website severely by flooding it with
garbage. You would be wise to part ways with that nut.
Of course you won't, but cest la vie.. it's your website that suffers
the most from it.
On 31 Oct 2004 17:33:23 -0800, rebeccaNO_SPAM@lasermyeye.org (Rebecca)
wrote:
>Glenn - USAEyes.org <glenn.hageleSTOPSPAM@USAEyes.org> wrote in message news:<v3dao01kjd7kk6f2qod43lciem8fl2umfg@4ax.com>...
>
>
>OK, now, everybody, repeat after me so I don't have to keep giving this lesson:
>
>"Scientist" is not Paula.
>
>Rebecca
| |
| Glenn - USAEyes.org 2004-11-01, 2:10 am |
|
Thanks Rebecca. I had not seen any direct contradiction or
acknowledged so I couched my statement by saying Cofer had "been
identified in this group" as Scientist, but the state and profession
didn't match up, so I too was skeptical.
Glenn Hagele
Executive Director
Council for Refractive Surgery Quality Assurance
Email to glenn dot hagele at usaeyes dot org
http://www.USAEyes.org
http://www.ComplicatedEyes.org
I am not a doctor.
|
| |
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