Lasik Eyes Surgery - UK National Health Service Says LASIK is Too Risky

Author

UK National Health Service Says LASIK is Too Risky

Wizkid

2004-12-16, 9:25 am

Another shoe drops...

The London Times, December 06, 2004

Eye surgery deemed too risky for NHS
By Sam Lister

Watchdog says the chances of damage in treatment do not justify
widespread use

Moves to make laser eye surgery available on the NHS are likely to be
blocked by the Government's clinical watchdog amid growing concerns
over its long-term safety for patients.

A year-long review by the National Institute for Clinical Excellence
(NICE) into the procedure known as Lasik, which is currently available
only at private clinics, has concluded that current evidence on the
treatment's safety does not justify its widespread use on the NHS.

The decision comes after revelations in The Times of two American
lawsuits alleging that a type of laser used by Boots, the high street
chemist, could develop faults leading to blurred vision and damage to
eyesight.

Boots, which was unaware of the concerns before being contacted by The
Times, later announced that it would close its nine laser treatment
centres by the end of the year after failing to win public confidence
in the high-tech procedure.

Bruce Campbell, chairman of NICE's interventional procedures advisory
committee, said that there was very little information about how many
people had been harmed as a result of the Lasik procedure.

A draft of the NICE report, to be published on December 15, has
concluded: "There are concerns about the procedure's safety in the
long term and current evidence does not appear adequate to support its
use without special arrangement for consent (from the NHS)."

Professor Campbell said that questions about the potential damage
caused to some patients had not been answered, leaving the treatment a
cause for concern.

"Lasik offers improvement to people who have mild or moderate trouble
with their vision. This is a problem that can easily be corrected by
spectacles or contact lenses, so any risk of damage to the eye by
Lasik is a real concern," he said.

"Although many people have had Lasik treatment, there is very little
information about how many are harmed as a result. We know that vision
gets worse in a few people after Lasik and eye specialists are also
concerned about the effects of thinning the cornea of the eye in the
long term. We need to know more about these potential problems."

In its draft report, NICE concludes: "current evidence does not appear
adequate to support its use without special arrangements for consent
and for audit and research."

As myopia can be corrected safely with spectacles or contact lenses
NICE says that an alternative treatment "must have excellent safety to
be suitable for use".

Laser surgery, which was introduced in Britain in 1989 in the form of
PRK (photo refractive keratectomy) costs about £2,000 to £3,000 and is
performed on about 100,000 people each year in Britain.

The model Cindy Crawford, the actress Nicole Kidman and the singer
Barry Manilow are among celebrities reported to have undergone the
procedure.

Lasik is the most popular type, where a flap about one third of the
thickness of the cornea is cut, the bed underneath reshaped using the
laser and then the flap is replaced. Last year the medical journal
Ophthalmology said that the failure rate for eye surgery was one in
ten, not the one in a thousand figure widely advertised.

Which?, formerly known as the Consumers' Association, has said that
people having surgery are "gambling with their sight". It found that
some clinics do not highlight possible side-effects until after
patients are signed up for treatment. The Medical Defence Union said
that negligence claims involving laser eye surgery had more than
doubled among its members since 1998.

Minor side-effects that have been reported are dry eyes and night-time
"starbursts". It is estimated that in about 2 to 4 per cent of
patients there will be a measurable decline in the quality of vision.

Glenn - USAEyes.org

2004-12-16, 9:25 am

The back-stories and twisted representations on this could take up an
entire ream of paper.

Glasses and contacts are safer than LASIK, so the UK's national health
system does not want to pay for refractive surgery. No real surprise
there. US federal insurance plans under Medicare and Medicaid don't
pay for LASIK for similar reasons. Private indemnity and managed care
insurance plans don't normally pay for LASIK.

Of course, absolutely nothing is being done to curtail refractive
surgery in UK private clinics where the patients are not relying on
the government to pick up the tab. LASIK is okay in the UK, so long
as the UK isn't paying the bill.

I'd like to know what "Ophthalmology" article they are referring to
that states LASIK has a one in ten "failure" rate, and what the London
Times has decide failure means.

Think about it. If LASIK had a 10% failure rate, then there would be
about 800,000 "failures" out there. That is more than every man,
woman, and child in the entire state of Delaware. It seems like you
would have heard a bit more about all the purported "failures".

BTW, WizKid. Since you have presented yourself here as some sort of
expert proponent of phakic intraocular lenses, did you happen to
attend the CRST Refractive Intraocular Lens convention in Las Vegas
last weekend? If you had, you would have had renowned experts
presenting precisely the same information (and a whole lot more) that
I related in this forum, such information you promptly disputed
without any substantiation whatsoever.

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.

rebeccaNO_SPAM@lasermyeye.org

2004-12-16, 9:25 am

As a practical matter it was never really on the cards that the NHS
would do elective refractive surgery. Hoewver, the report when
published on the 15th is expected to have considerable impact here in
the UK.

I think that the 10% failure rate simply refers back to a report that
came out in summer of 2003, which unfortunately has since often been
referred to in such an imprecise way that it's impossible to tell what
they mean. What WAS meant was failure to achieve the desired refractive
error because of under or overcorrection (which, let's face it, IS a
perfectly legitimate use of the word failure, if the surgery doesn't
accomplish what it was intended to). But to the average reader it might
imply there were other complications.

Glenn - USAEyes.org

2004-12-16, 9:25 am

Okay, it's Singapore, but I suspect there will be many articles like
this in the near future.

~~~~~~~~~~~~~~~~~
Tuesday December 7, 2:17 AM
Doctors say LASIK is proven safe, only 1% of patients get
complications

SINGAPORE : Eye doctors say laser eye surgery is safe and effective,
with less than 1 percent of patients developing complications.
So the two main public LASIK centres will continue to offer the
surgery to correct short-sightedness.

The reassurance comes after London newspapers had raised concerns over
the long-term safety of laser eye surgery.

In the last 12 months alone, nearly 6,000 Singaporeans had gone to
public hospitals for laser eye surgery to correct myopia and
astigmatism.

Given the rising popularity of LASIK, many were concerned over reports
that UK is putting a 'block on laser eye surgery in Britain'.

But The Eye Institute says no one has called to cancel any surgery,
and that the report is misleading.

Dr Lee Hung Ming, Head of Refractive Surgery at The Eye Institute
(National Healthcare Group), said: "A little bit misleading because it
gives people the impression that the British government is banning
LASIK procedure all over the country.

"If you read into the report, they are trying to block the move to
prevent LASIK from becoming a subsidised item under the healthcare
system."

The report also quoted American Journal of Ophthalmology saying the
failure rate for eye surgery was one in 10, when it is widely known to
be one in a 1,000.

That figure puzzled doctors too.

Associate Professor Donald Tan, Deputy Director of Singapore National
Eye Centre, said: "We have done 18,288 LASIKs since 1998 and that is a
lot of cases.

"We have at present a 100 percent safety record which means no patient
has developed a bad complication and who has gone blind. LASIK is
probably the safest operation that we have."

Dr Lee said: "The long-term safety concern that they mentioned include
the corneal ectesia, which is the progressive thinning of the cornea
that can result in progressive loss of vision for the patients."

Doctors say long-term complications from LASIK, where the cornea gets
progressively thinner, are rare.

But to make sure they do not happen, doctors carry out very stringent
pre-operation screening.

Those with pre-existing corneal problems or thin cornea will not be
operated on.

The centre says it enjoys a success rate of over 98 percent.

And in the four years since it opened, it has carried out more than
5,500 cases, and only one patient so far, has developed complications
such as corneal infection.

Both the Singapore National Eye Centre and the Eye Institute say they
will continue to offer laser eye surgery.

Dr Lee added: "I do not know what is their definition of a failure
rate. But as in all surgical procedures, LASIK does have some side
effects.

"The mild side effects are dry eyes, glare halos at night. But these
are usually short-term and usually persist for three to six months.
But this is mild compared to the new found freedom from the surgery."
- CNA

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

2004-12-16, 9:25 am

Glenn - USAEyes.org <glenn.hageleSTOPSPAM@USAEyes.org> wrote in
news:u7c9r0lm03b3ce8aja0j7cl4hvhllq6pas@4ax.com:

> Okay, it's Singapore, but I suspect there will be many articles like
> this in the near future.
>
> ~~~~~~~~~~~~~~~~~
> Tuesday December 7, 2:17 AM
> Doctors say LASIK is proven safe, only 1% of patients get
> complications
>
> SINGAPORE : Eye doctors say laser eye surgery is safe and effective,
> with less than 1 percent of patients developing complications.
> So the two main public LASIK centres will continue to offer the
> surgery to correct short-sightedness.
>
> The reassurance comes after London newspapers had raised concerns over
> the long-term safety of laser eye surgery.
>
> In the last 12 months alone, nearly 6,000 Singaporeans had gone to
> public hospitals for laser eye surgery to correct myopia and
> astigmatism.
>
> Given the rising popularity of LASIK, many were concerned over reports
> that UK is putting a 'block on laser eye surgery in Britain'.
>
> But The Eye Institute says no one has called to cancel any surgery,
> and that the report is misleading.
>
> Dr Lee Hung Ming, Head of Refractive Surgery at The Eye Institute
> (National Healthcare Group), said: "A little bit misleading because it
> gives people the impression that the British government is banning
> LASIK procedure all over the country.
>
> "If you read into the report, they are trying to block the move to
> prevent LASIK from becoming a subsidised item under the healthcare
> system."
>
> The report also quoted American Journal of Ophthalmology saying the
> failure rate for eye surgery was one in 10, when it is widely known to
> be one in a 1,000.
>
> That figure puzzled doctors too.
>
> Associate Professor Donald Tan, Deputy Director of Singapore National
> Eye Centre, said: "We have done 18,288 LASIKs since 1998 and that is a
> lot of cases.
>
> "We have at present a 100 percent safety record which means no patient
> has developed a bad complication and who has gone blind. LASIK is
> probably the safest operation that we have."
>
> Dr Lee said: "The long-term safety concern that they mentioned include
> the corneal ectesia, which is the progressive thinning of the cornea
> that can result in progressive loss of vision for the patients."
>
> Doctors say long-term complications from LASIK, where the cornea gets
> progressively thinner, are rare.
>
> But to make sure they do not happen, doctors carry out very stringent
> pre-operation screening.
>
> Those with pre-existing corneal problems or thin cornea will not be
> operated on.
>
> The centre says it enjoys a success rate of over 98 percent.
>
> And in the four years since it opened, it has carried out more than
> 5,500 cases, and only one patient so far, has developed complications
> such as corneal infection.
>
> Both the Singapore National Eye Centre and the Eye Institute say they
> will continue to offer laser eye surgery.
>
> Dr Lee added: "I do not know what is their definition of a failure
> rate. But as in all surgical procedures, LASIK does have some side
> effects.
>
> "The mild side effects are dry eyes, glare halos at night. But these
> are usually short-term and usually persist for three to six months.
> But this is mild compared to the new found freedom from the surgery."
> - CNA
>
>
On reading this, I see that the Singapore surgeons "carry out very
stringent pre-operation screening." It would be safe to say that
stringent pre-operative screening is not always observed.

The other point is that Dr. Lee considers all side-effects of LASIK to be
mild and mostly short-term. There are bound to be some disagreements
with this rather benign assessment.

DrG

Glenn - USAEyes.org

2004-12-16, 9:25 am

>The other point is that Dr. Lee considers all side-effects of LASIK to be
>mild and mostly short-term. There are bound to be some disagreements
>with this rather benign assessment.

IMO, this is a huge problem with unsupportable, misrepresentative, and
outlandish claims on both sides of the issue. What inevitably happens
if someone says everything about LASIK is bad, is that someone else
will say everything about LASIK is good. Neither side is correct and
the public just gets confused. Confusion is seldom a good thing when
it comes to medicine.

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

2004-12-16, 9:25 am

Glenn - USAEyes.org <glenn.hageleSTOPSPAM@USAEyes.org> wrote in
news:esi9r0dj9thg6us4gds1hkkknbmq4n83ha@4ax.com:

>
> IMO, this is a huge problem with unsupportable, misrepresentative, and
> outlandish claims on both sides of the issue. What inevitably happens
> if someone says everything about LASIK is bad, is that someone else
> will say everything about LASIK is good. Neither side is correct and
> the public just gets confused. Confusion is seldom a good thing when
> it comes to medicine.
>
> 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.
>

Well, it looks like there are pro-LASIK zealots just as there are anti-
LASIK zealots. Read this:

=========================================================================
..
"We perform 100 per cent audit checks on all cases and the safety data
showed that there has been no vision loss, blindness or severe
complications leading to blindness," said Prof Tan.
..
At the TEI, the Lasik success rate for myopia of up to 600 degrees is 98.3
per cent, as the institute takes stringent precautions to prevent long-term
complications.
..
But even with the good track record, both Dr Lee and Prof Tan cautioned,
there is always a risk, as with any other surgical procedure.
..
At the SNEC, the complication rate is about 0.4 per cent. These are
primarily minor complications like dryness of the eyes and seeing halos at
night.
..
The SNEC, like the TEI, screens patients prior to Lasik surgery. This year,
the SNEC turned away 10 per cent of up to 5,000 cases who were not
suitable, while the TEI turned away five per cent of some 300 cases each
month.
..
"Some of our own Lasik surgeons have had Lasik; we have also performed
Lasik on our children and relatives, so I think that's proof of the pudding
that we believe in it," said Prof Tan.
Report that Britain will prohibit the procedure due to long-term safety
concerns was 'misleading'
===========================================================================

"...minor complications like dryness of the eyes and seeing halos at
night....we have also performed LASIK on our children."

DrG

gospa68@aol.com

2004-12-16, 9:25 am

Glenn,
I was unable to attend due to a death in the family. Sounds like useful
meeting. What does "a whole lot more" refer to. Please share...WK

Glenn - USAEyes.org wrote:
> The back-stories and twisted representations on this could take up an
> entire ream of paper.
>
> Glasses and contacts are safer than LASIK, so the UK's national
health
> system does not want to pay for refractive surgery. No real surprise
> there. US federal insurance plans under Medicare and Medicaid don't
> pay for LASIK for similar reasons. Private indemnity and managed
care
> insurance plans don't normally pay for LASIK.
>
> Of course, absolutely nothing is being done to curtail refractive
> surgery in UK private clinics where the patients are not relying on
> the government to pick up the tab. LASIK is okay in the UK, so long
> as the UK isn't paying the bill.
>
> I'd like to know what "Ophthalmology" article they are referring to
> that states LASIK has a one in ten "failure" rate, and what the
London
> Times has decide failure means.
>
> Think about it. If LASIK had a 10% failure rate, then there would be
> about 800,000 "failures" out there. That is more than every man,
> woman, and child in the entire state of Delaware. It seems like you
> would have heard a bit more about all the purported "failures".
>
> BTW, WizKid. Since you have presented yourself here as some sort of
> expert proponent of phakic intraocular lenses, did you happen to
> attend the CRST Refractive Intraocular Lens convention in Las Vegas
> last weekend? If you had, you would have had renowned experts
> presenting precisely the same information (and a whole lot more) that
> I related in this forum, such information you promptly disputed
> without any substantiation whatsoever.
>
> 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.

gospa68@aol.com

2004-12-16, 9:25 am

gospa68@aol.com

2004-12-16, 9:25 am

gospa68@aol.com

2004-12-16, 9:25 am

In article <Xns95B7CCFB53E2Cdrgleukomacom@204.127.204.17>,
"Dr. Leukoma" <drgNOSPAM@leukoma.com> wrote:

> "...minor complications like dryness of the eyes and seeing halos at
> night....we have also performed LASIK on our children."
>
> DrG

Please explain what is so terrible about these statements? Most dry eye
resolves within a few months, as do halos. I think most people would
consider these minor complications, a temporary nuisance with a payoff
of great vision after a few months. Yes, there are a few cases of
severe dry eye post-LASIK, but from all that I can tell, this usually
occurs in patients who are pre-disposed due to a medical condition and
who are not caught b/c of poor prescreening.

I'm glad they perform LASIK on their children and relatives (and
themselves). I think it shows they do trust the technology.

Oh, you probably thought "children" meant while they are young.
Unlikely, their children are probably adults.

Nice try.

Glenn - USAEyes.org

2004-12-16, 9:25 am

Sorry to hear of the family loss.

The majority of the attendees were cataract surgeons thinking about
getting into refractive surgery by way of lens-based surgery. All the
manufacturers - Alcon, Eyeonics, Zeiss, Staar, Oasis, B&L - presented
information regarding their products and where they are in
development. Faculty included many of the well known, Arturo Chayet,
Stephen Brint, Warren Hill, John Doane, John Vukich, Lee Nordan, and
on and on.

The program was narrowly focused on refractive lens procedures, their
relative advantages and relative disadvantages. Stop by
http://www.crstoday.com/vegas/agenda.html

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

2004-12-16, 9:25 am

RT <RTMD24@NOSPAMyahoo.com> wrote in news:RTMD24-
5EDDC6.22503806122004@newssvr14-ext.news.prodigy.com:

>
> Please explain what is so terrible about these statements? Most dry eye
> resolves within a few months, as do halos. I think most people would
> consider these minor complications, a temporary nuisance with a payoff
> of great vision after a few months. Yes, there are a few cases of
> severe dry eye post-LASIK, but from all that I can tell, this usually
> occurs in patients who are pre-disposed due to a medical condition and
> who are not caught b/c of poor prescreening.
>
> I'm glad they perform LASIK on their children and relatives (and
> themselves). I think it shows they do trust the technology.
>
> Oh, you probably thought "children" meant while they are young.
> Unlikely, their children are probably adults.
>
> Nice try.
>

RT,

Even to an objective person, the article seems to show a bias. It is clear
that the authors consider as a complicaton only those that would lead to
blindness. Everything else -- such as dry eye and halos -- are but minor
nuisances to them. I know quite a few people who do not consider those
symptoms minor nuisances, even years after surgery.

Sorry, but I infer the meaning of words as they are commonly used, and the
dictionary defines "child" as somewhere between infancy and youth.

Nice try, Ragnar, but I don't think we'll be reading the results of their
study in the Lancet any time soon.

DrG

2004-12-16, 9:25 am

In article <Xns95B848E663AFEdrgleukomacom@216.148.227.77>,
"Dr. Leukoma" <drgNOSPAM@leukoma.com> wrote:

> RT,
>
> Even to an objective person, the article seems to show a bias. It is clear
> that the authors consider as a complicaton only those that would lead to
> blindness.

What is the definition of blindness? Apparently I was functionally
blind before LASIK as -4.50. If that's the case, then I suppose one
could consider debilitating starbursts as "blindness." That would be a
complication of "blindness."

If it resolves with healing, like most dry eyes and halos, is that a
complication? or a side effect of healing? Could it be that the
definition of "complication" is the issue? Are side effects and
complications different things? What do you think?

>Everything else -- such as dry eye and halos -- are but minor
> nuisances to them. I know quite a few people who do not consider those
> symptoms minor nuisances, even years after surgery.
>
> Sorry, but I infer the meaning of words as they are commonly used, and the
> dictionary defines "child" as somewhere between infancy and youth.

I just find the "spin" everyone puts on things so very interesting and
illuminating. I was responding to the quote you highlighted from the
article, which showed *your* particular bias. I didn't read that their
children are "youths" but rather to show that they are willing to
perform LASIK on their nearest and dearest.

> Nice try, Ragnar, but I don't think we'll be reading the results of their
> study in the Lancet any time soon.

Please! I'm not Ragnar. I'm sorry he came up with the RM name. That
seems to be causing some confusion.

~RT

PS: Everything has a bias. "Studies" have a bias. Remember, for
everything that is included, something has been left out. Even
"objective" Glenn has a bias 8^)

Glenn - USAEyes.org

2004-12-16, 9:25 am

>What is the definition of blindness? Apparently I was functionally
>blind before LASIK as -4.50.

The last I heard it was 20/200 or worse, best corrected vision. I
assume that some government agencies and some disability insurance
companies may have a slightly different definition, but all would be
pretty close to this.

At -4.50, you would be legally blind without glasses, however I'm sure
that corrective lenses brought you to 20/20, so you are not legally
blind.

>If it resolves with healing, like most dry eyes and halos, is that a
>complication? or a side effect of healing? Could it be that the
>definition of "complication" is the issue? Are side effects and
>complications different things? What do you think?

The definition of a complication is very much an issue, and when it is
defined is also an issue. A patient at one month postop may have
debilitating complications, but at six months have none. If you
evaluate at one month, you get a very different statistic than if you
evaluate at six months.

Subjective complications are difficult for some clinicians if they
cannot be objectively observed or measured. Before wavefront, a lot
of doctors deep down thought their patients were nuts because they
could see Snellen 20/20 but complained that their vision was "not
right". Fortunately, quality of vision has become much better
understood (and measurable).

What constitutes a complication for one person may be a
inconsequential nuisance to another. By subjective measurement, I
have more night vision halos than some people who have had LASIK and
complain of their halos. I have not had surgery. By that
measurement, I have a complication, but it is perfectly natural for
me.

We have seen in this forum many people complain bitterly about issues
that others have remarked are no big deal. Try telling the complainer
that they don't have a complication.

>PS: Everything has a bias. "Studies" have a bias. Remember, for
>everything that is included, something has been left out. Even
>"objective" Glenn has a bias 8^)

My bias is objectivity. 8^)

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

2004-12-16, 9:25 am

RT <RTMD24@NOSPAMyahoo.com> wrote in
news:RTMD24-8DA64D.11453707122004@newssvr14-ext.news.prodigy.com:

> In article <Xns95B848E663AFEdrgleukomacom@216.148.227.77>,
> "Dr. Leukoma" <drgNOSPAM@leukoma.com> wrote:
>
>
> What is the definition of blindness? Apparently I was functionally
> blind before LASIK as -4.50. If that's the case, then I suppose one
> could consider debilitating starbursts as "blindness." That would be a
> complication of "blindness."

The legal definition is 20/200 or worse with correction in the better
seeing eye, or a visual field of 20 degrees or less. Debilitating
starbursts are not in any definition of blindness.
>
> If it resolves with healing, like most dry eyes and halos, is that a
> complication? or a side effect of healing? Could it be that the
> definition of "complication" is the issue? Are side effects and
> complications different things? What do you think?

I believe that commonly occurring symptoms that resolve could justly be
termed side-effects. If they are visually degrading or cause discomfort,
are long-term, then they are complications. The only thing I left out
was the patient's perception. Are they only complications if the patient
thinks they are? I have patients who don't really meet the DPS
requirements for driving, yet they don't appear particularly "bothered"
by this fact. I think Glenn would say a complication is defined by the
patient.....food for thought.
>
>
> I just find the "spin" everyone puts on things so very interesting and
> illuminating. I was responding to the quote you highlighted from the
> article, which showed *your* particular bias. I didn't read that
> their children are "youths" but rather to show that they are willing
> to perform LASIK on their nearest and dearest.

My bias is that LASIK should be performed only on consenting adults. I
particularly abhor the thought of having it performed on someone who is
not of the age of consent. My only "bias" was in thinking that the term
"child" meant a minor. I think that the authors' bias is self-evident.
They are just biased in a way you approve -- in favor of LASIK for
everybody who qualifies, the 4 or 10 percent who are turned away
notwithstanding (seems like it should be more than that).
>
>
> Please! I'm not Ragnar. I'm sorry he came up with the RM name. That
> seems to be causing some confusion.
>
> ~RT
>
> PS: Everything has a bias. "Studies" have a bias. Remember, for
> everything that is included, something has been left out. Even
> "objective" Glenn has a bias 8^)
>
Not sure I agree with you on that. Science is supposed to be objective.
I am sure that you have read some studies in your field that were so well
designed and executed that you would agree with the results even if you
didn't like them. If we could all agree on the definition of a
complication vs. side-effect, and then conduct a large scale population
study, we might be able to put some of these questions to bed.

DrG

Glenn - USAEyes.org

2004-12-16, 9:25 am

> Science is supposed to be objective.
>I am sure that you have read some studies in your field that were so well
>designed and executed that you would agree with the results even if you
>didn't like them.

After more than 20 years of reviewing "objective" scientific studies,
I have come to the conclusion that the numbers almost never lie, but
bias is shown in the analysis.

When someone with a vested interest looks at raw data, that person
will often attribute benefits to his or her device or technique, even
if the data does not empirically support that position. It's not the
study or the data that is biased, but the analysis often is.

That is just a part of human nature. When your kid hits one out of
the park, it must be because of all those hours of you training with
him/her.

I've learned to wait until people without a direct interest publish
results, and until something gets out to the rank and file. Then you
can reasonably rely on the analysis.

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.

2004-12-16, 9:25 am

In article <Xns95B87B079ECCCDrLeukoma@207.217.125.201>,
"Dr. Leukoma" <drg@leukoma.com> wrote:

> They are just biased in a way you approve -- in favor of LASIK for
> everybody who qualifies, the 4 or 10 percent who are turned away
> notwithstanding (seems like it should be more than that).

Well, yes I agree if you want to categorize me. I do believe that
someone should be able to have LASIK if they qualify. What should those
qualifications be? I don't know, I'm not an opthalmologist. Do I think
pre-screening is stringent enough and free from advertising hype? No.
Do I think people get operated on even when they have
contra-indications? Yes. Do they know the risks and proceed anyway?
Yes and no. Sometimes doctors gloss over the risks so they don't really
know the true risk of what they are doing given their individual
circumstances, and sometimes I think some people want it so bad they
will lie or gloss over their own risk factors and gamble that all will
work out in the end.

So yes, I do think LASIK should be available as an option for someone
who qualifies for it. I do not think LASIK should be performed on
people who don't qualify for it.

Again, my response was a criticism on the hype and bias. It is easy for
you to see where the bias lies in others, but not so easy in your own
comments and the "way" in which you, Dr. G, read certain articles.
> Not sure I agree with you on that. Science is supposed to be objective.

Supposed to be, but all "facts" are open to interpretation. In fact,
people have been known to use the "facts" to support contesting sides of
an issue. Think about the "facts" of a criminal case. Furthermore,
"reality" is not even constant. Scientists are constantly discovering
new scientific laws and redefining old ones. Otherwise, we'd still be
in a world where the sun revolves around the earth.

> I am sure that you have read some studies in your field that were so well
> designed and executed that you would agree with the results even if you
> didn't like them.

No, my field is all about subjective interpretation. I may be a doctor,
but not a medical one. I'm a PhD. I'm all about treating philosophical
ills

>If we could all agree on the definition of a
> complication vs. side-effect, and then conduct a large scale population
> study, we might be able to put some of these questions to bed.

I'm beginning to think that it is all in the matter of definition, not
only of subjective experience, like visual disturbance from
complications or side effects, but medical ethics. Why does the
government regulate medication differently than medical devices?

~RT

2004-12-16, 9:25 am

In article <g1sbr0d9gnk6fc6a0f5icji5vmeq30p7lu@4ax.com>,
Glenn - USAEyes.org <glenn.hageleSTOPSPAM@USAEyes.org> wrote:

>
> After more than 20 years of reviewing "objective" scientific studies,
> I have come to the conclusion that the numbers almost never lie, but
> bias is shown in the analysis.

> When someone with a vested interest looks at raw data, that person
> will often attribute benefits to his or her device or technique, even
> if the data does not empirically support that position. It's not the
> study or the data that is biased, but the analysis often is.

Exactly my point.
everyone has a bias, even you Glenn

You cannot be entirely objective either. For every "fact" or data you
include or choose to respond to, you have left something else out.

That's scientific: Two objects cannot occupy the same space at the same
time. One of them has to be pushed aside. Therein lies the bias which
makes all presentations of that "object" inherently subjective. for
every utterance, something remains unuttered.

Dr. Leukoma

2004-12-16, 9:25 am

RT <RTMD24@NOSPAMyahoo.com> wrote in news:RTMD24-8F6DF6.15322907122004
@newssvr14-ext.news.prodigy.com:

> In article <g1sbr0d9gnk6fc6a0f5icji5vmeq30p7lu@4ax.com>,
> Glenn - USAEyes.org <glenn.hageleSTOPSPAM@USAEyes.org> wrote:
>
>
>
> Exactly my point.
> everyone has a bias, even you Glenn

>
> You cannot be entirely objective either. For every "fact" or data you
> include or choose to respond to, you have left something else out.
>
> That's scientific: Two objects cannot occupy the same space at the same
> time. One of them has to be pushed aside. Therein lies the bias which
> makes all presentations of that "object" inherently subjective. for
> every utterance, something remains unuttered.
>

Which of the following statements make sense? Which ones reflect a clear
bias of the author?

"In Dallas today, the high temperature was 60 degrees under sunny skies."

"Ten percent of LASIK patients require a re-operation."

"XX percent of LASIK patients experience dry eyes following their
surgery."

"In Singapore, LASIK surgeons have performed LASIK on their own
children."

"RT thinks that every statement is biased if it is not exhaustive."

DrG

gospa68@aol.com

2004-12-16, 9:25 am

In response to Glenn Hagele's comment, "After more than 20 years of
reviewing "objective" scientific studies,I have come to the conclusion
that the numbers almost never lie, but bias is shown in the analysis."

There is a big difference in how clinical studies are done. This is
well known within all surgical communities. FDA studies require that
surgery and eye exams (in ophthalmology) be separated to eliminate
surgeon bias. They also require multi-site studies to highlight
variations between centers, surgeon abitliy, and to surface any
irregularities. Additionally, the FDA will audit a site to insure that
all tests and all protocols are followed explicitly.

Non-FDA studies are generally not controlled, do not involve multiple
sites, and are not audited. Most pubished and/or presented studies lack
the rigor of an FDA study. As such, many of these studies are viewed
with skepticism unless the audience believes fully in the credibility
of the presenter/surgeon.

The bottom line is that numbers can lie and all in medicine are aware
of that.
WK

Dr. Leukoma

2004-12-16, 9:25 am

RT <RTMD24@NOSPAMyahoo.com> wrote in
news:RTMD24-EAF798.15273307122004@newssvr14-ext.news.prodigy.com:

> In article <Xns95B87B079ECCCDrLeukoma@207.217.125.201>,
> "Dr. Leukoma" <drg@leukoma.com> wrote:
>
>
> Well, yes I agree if you want to categorize me. I do believe that
> someone should be able to have LASIK if they qualify. What should
> those qualifications be? I don't know, I'm not an opthalmologist. Do
> I think pre-screening is stringent enough and free from advertising
> hype? No. Do I think people get operated on even when they have
> contra-indications? Yes. Do they know the risks and proceed anyway?
> Yes and no. Sometimes doctors gloss over the risks so they don't
> really know the true risk of what they are doing given their
> individual circumstances, and sometimes I think some people want it so
> bad they will lie or gloss over their own risk factors and gamble that
> all will work out in the end.
>
> So yes, I do think LASIK should be available as an option for someone
> who qualifies for it. I do not think LASIK should be performed on
> people who don't qualify for it.
>
> Again, my response was a criticism on the hype and bias. It is easy
> for you to see where the bias lies in others, but not so easy in your
> own comments and the "way" in which you, Dr. G, read certain articles.

I see that some are keen to see bias where none exists.

DrG
>
>
> Supposed to be, but all "facts" are open to interpretation. In fact,
> people have been known to use the "facts" to support contesting sides
> of an issue. Think about the "facts" of a criminal case. Furthermore,
> "reality" is not even constant. Scientists are constantly discovering
> new scientific laws and redefining old ones. Otherwise, we'd still be
> in a world where the sun revolves around the earth.

"It is 60 degrees in Dallas right now." "Ten percent of LASIK patients
require a re-operation." "XX percent of LASIK patients suffer from dry
eye symptoms." How are those "facts" open to interpretation?
>
>
> No, my field is all about subjective interpretation. I may be a
> doctor, but not a medical one. I'm a PhD. I'm all about treating
> philosophical ills

Then you do not have an M.D.? If you are a philosopher, then you should
be able to clarify your own thoughts and language.

>
>
> I'm beginning to think that it is all in the matter of definition, not
> only of subjective experience, like visual disturbance from
> complications or side effects, but medical ethics. Why does the
> government regulate medication differently than medical devices?
>
> ~RT

It does help to agree on definitions and the meaning of words, now
doesn't it?

DrG

2004-12-16, 9:25 am

In article <Xns95B897EB55E50DrLeukoma@207.217.125.201>,
"Dr. Leukoma" <drg@leukoma.com> wrote:

> Which of the following statements make sense? Which ones reflect a clear
> bias of the author?

To take this to an absurd level now:
>
> "In Dallas today, the high temperature was 60 degrees under sunny skies."

this statement makes sense, as long as you know what/where Dallas is.
The bias of this author is that he/she makes an assumption that the
reader will know that degrees are in Fahrenheit, otherwise 60 degrees is
absurdly hot. Why not mention the low? Or the fact there were no
clouds?
>
> "Ten percent of LASIK patients require a re-operation."

This statement makes sense, but the author shows a certain bias by not
stating: 80% of LASIK patients do not require a re-operation. Same
"fact;" different way of stating it.
>
> "XX percent of LASIK patients experience dry eyes following their
> surgery."

Same here, XX percent of LASIK patients do not require a re-operation.
>
> "In Singapore, LASIK surgeons have performed LASIK on their own
> children."

Makes sense, but is open to interpretation as we saw, whether or not
this refers to young children or their offspring. My bias in reading it
stems on the fact that LASIK is currently contraindicated for children
under the age of 18, and the words "their own" are included, indicating
the stress is on the familial connection rather than age. If the author
had written, "In Singapore, LASIK surgeons have performed LASIK on
children" omitting "their own" then I think the bias for interpretation
would fall on their performing LASIK on young people who are considered
children (under the age of 18).

Whether the author has a bias in this sentence is not clear. the reader
(in case you or I) clearly did/does have bias in our respective
interpretations. More context is needed to determine the author's bias.

> "RT thinks that every statement is biased if it is not exhaustive."

Does not make sense because that is not what I believe. First of all, I
never said every statement is biased. I did say no one can be
completely objective in their presentation or interpretation of facts or
issues because they are coming from their own personal bias. Being
"exhaustive" is not the issue. Being reflexive is.

For example, there is a difference between these two ways of stating a
"fact."

In Dallas today it was sunny.
In Dallas today it was not cloudy.

Both statements are "true" (supposedly--I'm in NYC where it poured all
day

), but each implies a different bias (kind of like if you see the
glass half full or half empty).

Word choice and placement, even in the scientific community, says a lot
about the bias of the author. Think subtext. Language is not purely the
domain of poetry and literature.

And now back to biased opinions of LASIK....

~RT

Dr. Leukoma

2004-12-16, 9:25 am

RT <RTMD24@NOSPAMyahoo.com> wrote in
news:RTMD24-BB7729.17222607122004@newssvr14-ext.news.prodigy.com:

> In article <Xns95B897EB55E50DrLeukoma@207.217.125.201>,
> "Dr. Leukoma" <drg@leukoma.com> wrote:
>
>
> To take this to an absurd level now:
>
> this statement makes sense, as long as you know what/where Dallas is.
> The bias of this author is that he/she makes an assumption that the
> reader will know that degrees are in Fahrenheit, otherwise 60 degrees
> is absurdly hot. Why not mention the low? Or the fact there were no
> clouds?

My point was that a factual statement could be made without bias. In
order to communicate a fact, it is not necessary to clutter it up with
all sorts of sub-propositions. Bias, BTW, means prejudice. The
statement may have been imprecise, but it certainly was not biased.

>
> This statement makes sense, but the author shows a certain bias by not
> stating: 80% of LASIK patients do not require a re-operation. Same
> "fact;" different way of stating it.

This is nothing but a logical tautology. 100-20 = 80. If a patient was
interested in having LASIK, they may want to know what their chances are
of having a re-operation.

>
> Same here, XX percent of LASIK patients do not require a re-operation.
>
> Makes sense, but is open to interpretation as we saw, whether or not
> this refers to young children or their offspring. My bias in reading
> it stems on the fact that LASIK is currently contraindicated for
> children under the age of 18, and the words "their own" are included,
> indicating the stress is on the familial connection rather than age.
> If the author had written, "In Singapore, LASIK surgeons have
> performed LASIK on children" omitting "their own" then I think the
> bias for interpretation would fall on their performing LASIK on young
> people who are considered children (under the age of 18).

I do not know what the law is in Singapore. Perhaps the legal age of
consent is less than 18 years. There have indeed been published results
of LASIK having been performed on "young children," notably in India, for
amblyopia.
>
> Whether the author has a bias in this sentence is not clear. the
> reader (in case you or I) clearly did/does have bias in our respective
> interpretations. More context is needed to determine the author's
> bias.
>
>
> Does not make sense because that is not what I believe. First of all,
> I never said every statement is biased. I did say no one can be
> completely objective in their presentation or interpretation of facts
> or issues because they are coming from their own personal bias. Being
> "exhaustive" is not the issue. Being reflexive is.

I disagree. I believe that it is possible to be completely objective.
Unfortunately, most patients do not want their doctor to be completely
objective. They want a "recommendation," or an "opinion," and often in
the absence of an adequate -- I won't say complete -- knowledge of the
facts.
>
> For example, there is a difference between these two ways of stating a
> "fact."
>
> In Dallas today it was sunny.
> In Dallas today it was not cloudy.

Same thing. Each statement may conjure up a different mental image, but
the meaning is the same.
>
> Both statements are "true" (supposedly--I'm in NYC where it poured all
> day

), but each implies a different bias (kind of like if you see
> the glass half full or half empty).
>
> Word choice and placement, even in the scientific community, says a
> lot about the bias of the author. Think subtext. Language is not
> purely the domain of poetry and literature.

These variations do not reflect bias, just different ways of expressing
the same state-of-affairs.
>
> And now back to biased opinions of LASIK....
>
.....which is the real purpose of this NG.

DrG

Glenn - USAEyes.org

2004-12-16, 9:25 am

>Exactly my point.
>everyone has a bias, even you Glenn

Sure, but I do endeavor to present both sides of a story as best I
can, and more importantly, present enough information about myself and
the organization I represent so others can make up their own minds
about why or what bias I may demonstrate, whether it be conscious or
subconscious.

I guess the biggest difference between me and some others around this
newsgroup is that I desire to not present a bias. Some others go out
of their way to distort things to fit their bias.

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.

2004-12-16, 9:25 am

In article <Xns95B8AC3EDE617DrLeukoma@207.217.125.201>,
"Dr. Leukoma" <drg@leukoma.com> wrote:

> I believe that it is possible to be completely objective.

You "believe" or you "know"? Can "belief" be objective? How does
belief work in science? Isn't belief the sister of faith?

Doctors have to "believe" they are objective, otherwise how could they
treat a patient without taking into consideration his/her whole
being--like his/her emotional state, nutrition, sleep patterns, stress
levels, and the patients' faith in medicine--not just empirical
measurements? Right?

No more on this subject--either you get my point or you don't. I
"believe" that you don't.

Dr. Leukoma

2004-12-16, 9:25 am

RT <RTMD24@NOSPAMyahoo.com> wrote in news:RTMD24-
8A4EA6.18050907122004@newssvr14-ext.news.prodigy.com:

> In article <Xns95B8AC3EDE617DrLeukoma@207.217.125.201>,
> "Dr. Leukoma" <drg@leukoma.com> wrote:
>
>
> You "believe" or you "know"? Can "belief" be objective? How does
> belief work in science? Isn't belief the sister of faith?
>
> Doctors have to "believe" they are objective, otherwise how could they
> treat a patient without taking into consideration his/her whole
> being--like his/her emotional state, nutrition, sleep patterns, stress
> levels, and the patients' faith in medicine--not just empirical
> measurements? Right?
>
> No more on this subject--either you get my point or you don't. I
> "believe" that you don't.

I presented several unbiased statements, such as a simple description of
the weather, none of which satisfied you. Therefore, you did not get my
point, and that you do not believe that language can be purely descriptive
and objective.

I get your point, which is that nobody is "unbiased," and that no unbiased
presentation of fact is possible, in medicine or in science, and to that I
say you are wrong and I disagree.

The practice of medicine is hardly an exact science, but that has little or
nothing to do with the idea that the results of a treatment can be
described objectively.

I wonder about the agenda of someone who so vigorously obfuscates on this
point, as if to discourage meaningful dialogue.

DrG

Dr. Leukoma

2004-12-16, 9:25 am

On Wed, 08 Dec 2004 03:22:15 GMT, "Dr. Leukoma"
<drgNOSPAM@leukoma.com> wrote:

>RT <RTMD24@NOSPAMyahoo.com> wrote in news:RTMD24-
>8A4EA6.18050907122004@newssvr14-ext.news.prodigy.com:
>
>
>I presented several unbiased statements, such as a simple description of
>the weather, none of which satisfied you. Therefore, you did not get my
>point, and that you do not believe that language can be purely descriptive
>and objective.
>
>I get your point, which is that nobody is "unbiased," and that no unbiased
>presentation of fact is possible, in medicine or in science, and to that I
>say you are wrong and I disagree.
>
>The practice of medicine is hardly an exact science, but that has little or
>nothing to do with the idea that the results of a treatment can be
>described objectively.
>
>I wonder about the agenda of someone who so vigorously obfuscates on this
>point, as if to discourage meaningful dialogue.
>
>DrG

RT... what is going on here is some classic Dr. Gemoules tap-dancing
through reality. Notice what he said above - "I presented several
unbiased statements". On occassion, Dr. Gemoules tries to disguise
his true agenda by posting seemingly unbiased statements. BUT just
because he posts some unbiased messages, never forget that he is
completely biased. To illustrate my meaning, a serial killer doesn't
walk around advertising the fact that they are a serial killer.
Serial killers such as John Wayne Gacy often present themselves as the
nicest people around... in order to lure in their victims... then they
wind up sticking their pal's head in the freezer and torso in a pit
covered by concrete.
In short, be wary of people who try to deceive you. That is why I
mentioned in an earlier e-mail that at least Mason doesn't disguise
what his agenda is.

2004-12-16, 9:25 am

In article <83rer0h3alv1488bumcng11np175s1586f@4ax.com>,
RM <rm@yahoo.com> wrote:

> RT... what is going on here is some classic Dr. Gemoules tap-dancing
> through reality. Notice what he said above - "I presented several
> unbiased statements". On occassion, Dr. Gemoules tries to disguise
> his true agenda by posting seemingly unbiased statements. BUT just
> because he posts some unbiased messages, never forget that he is
> completely biased.

I must be honest and say that I was willing to give him the benefit of
the doubt for a while, but I'm afraid that Dr. G truly BELIEVES he is
unbiased, so much in fact that even in statements that have nothing to
do with RS, such as "In Dallas today it was 60 degrees" he cannot see
his American bias by not indicating what system of measurement he is
using. So, he really cannot see his bias where the facts are more open
to interpretation.

Facts may be facts, but their meaning lies within the ways they are
presented. I thought he understood that, I thought I could engage him
in some intellectual debate, but it is clear that he cannot see it after
I've tried 3 times (the tennis player, this past Singapore children
issue, and one other--I forget). Three strikes...

He may be a good contact lens fitter, but his bias against LASIK (which
he believes he's presenting objectively) isn't helping people coming
here looking for information or those who've had LASIK and need some
post-procedure support.

I think he would be more effective (as you point out) if he quit trying
to disguise his true agenda. He could really help a lot of people that
way. As it is, I wonder what else he is hiding.

--
~RT

Dr. Leukoma

2004-12-16, 9:25 am

RT <RTMD24@NOSPAMyahoo.com> wrote in news:RTMD24-
673719.17031008122004@newssvr14-ext.news.prodigy.com:

> In article <83rer0h3alv1488bumcng11np175s1586f@4ax.com>,
> RM <rm@yahoo.com> wrote:
>
>
> I must be honest and say that I was willing to give him the benefit of
> the doubt for a while, but I'm afraid that Dr. G truly BELIEVES he is
> unbiased, so much in fact that even in statements that have nothing to
> do with RS, such as "In Dallas today it was 60 degrees" he cannot see
> his American bias by not indicating what system of measurement he is
> using. So, he really cannot see his bias where the facts are more open
> to interpretation.
>
> Facts may be facts, but their meaning lies within the ways they are
> presented. I thought he understood that, I thought I could engage him
> in some intellectual debate, but it is clear that he cannot see it after
> I've tried 3 times (the tennis player, this past Singapore children
> issue, and one other--I forget). Three strikes...
>
> He may be a good contact lens fitter, but his bias against LASIK (which
> he believes he's presenting objectively) isn't helping people coming
> here looking for information or those who've had LASIK and need some
> post-procedure support.
>
> I think he would be more effective (as you point out) if he quit trying
> to disguise his true agenda. He could really help a lot of people that
> way. As it is, I wonder what else he is hiding.
>

The problem within this newsgroup AT PRESENT is that measured against the
rabidly pro-LASIK agenda of RT=RM=(Glenn, say it isn't so), any attempt at
objectivity seems totally distorted.

Glenn, when I was interviewed for yet another publication, I did reference
your organization. Unfortunately, my reference did not make it to the
final draft. I did try, but to no avail.

DrG

2004-12-16, 9:25 am

In article <Xns95B9C3530154Bdrgleukomacom@216.148.227.77>,
"Dr. Leukoma" <drgNOSPAM@leukoma.com> wrote:

> The problem within this newsgroup AT PRESENT is that measured against the
> rabidly pro-LASIK agenda of RT=RM=(Glenn, say it isn't so),

I really don't see how I'm "rabidly" pro-LASIK. Is it because I'm
trying to get you to see how biased and un-objective you are when you
read articles and news stories and then post them in this NG?

I know I'm not objective. I speak from my experience. I don't dispense
advice about LASIK because I'm not in the field. I can make comments on
my experience of going through the procedure as a consumer.

I read and post on this NG because I'm interested about the LASIK
procedure. I'm both fascinated and appalled by the advertising, hype
and anti-hype. I'm curious about new advances in the technology. I've
come to the understanding that there doesn't exist an OBJECTIVE truth
about LASIK surgery. There are too many variables to say it is bad for
everybody or it is good for everybody. Why do some people have bad
outcomes even when they have been "properly"screened? Is it the
screening process, the doctors, the optics of the eye, the machinery,
the software, lifestyle or environment, or ??? What can be done to
increase the safety and effectiveness of the procedure? What can be
done to protect consumers throughout the process, recovery and beyond?
And on a purely personal level, what does the future hold for a LASIKed
eye? I really want to know that since I have 2 of them.

>any attempt at objectivity seems totally distorted.

YES! Exactly, your attempts at objectivity are distorted by your bias.
Instead of trying to capitalize on people's fears (oooh, in Singapore
(which happens to be one of the most technologically advanced and
civilized places on earth) they perform LASIK on children), why don't
you concentrate on positive constructive solutions to some of the
perceived problems surrounding LASIK, both informational and technical
like Rebecca and Glenn?

--
~RT

Dr. Leukoma

2004-12-16, 9:25 am

RT <RTMD24@NOSPAMyahoo.com> wrote in
news:RTMD24-1426FA.20462908122004@newssvr14-ext.news.prodigy.com:

> In article <Xns95B9C3530154Bdrgleukomacom@216.148.227.77>,
> "Dr. Leukoma" <drgNOSPAM@leukoma.com> wrote:
>
>
> I really don't see how I'm "rabidly" pro-LASIK. Is it because I'm
> trying to get you to see how biased and un-objective you are when you
> read articles and news stories and then post them in this NG?
>
> I know I'm not objective. I speak from my experience. I don't
> dispense advice about LASIK because I'm not in the field. I can make
> comments on my experience of going through the procedure as a
> consumer.
>
> I read and post on this NG because I'm interested about the LASIK
> procedure. I'm both fascinated and appalled by the advertising, hype
> and anti-hype. I'm curious about new advances in the technology. I've
> come to the understanding that there doesn't exist an OBJECTIVE truth
> about LASIK surgery. There are too many variables to say it is bad
> for everybody or it is good for everybody. Why do some people have
> bad outcomes even when they have been "properly"screened? Is it the
> screening process, the doctors, the optics of the eye, the machinery,
> the software, lifestyle or environment, or ??? What can be done to
> increase the safety and effectiveness of the procedure? What can be
> done to protect consumers throughout the process, recovery and beyond?
> And on a purely personal level, what does the future hold for a
> LASIKed eye? I really want to know that since I have 2 of them.
>
>
> YES! Exactly, your attempts at objectivity are distorted by your bias.
> Instead of trying to capitalize on people's fears (oooh, in Singapore
> (which happens to be one of the most technologically advanced and
> civilized places on earth) they perform LASIK on children), why don't
> you concentrate on positive constructive solutions to some of the
> perceived problems surrounding LASIK, both informational and technical
> like Rebecca and Glenn?
>

Well, then, I bid you adieu, and leave you in the capable hands of Glenn,
Rebecca, Brent, Sandy, et. al. Good luck.

DrG

2004-12-16, 9:25 am

On Wed, 08 Dec 2004 22:03:10 GMT, RT <RTMD24@NOSPAMyahoo.com> wrote:

>In article <83rer0h3alv1488bumcng11np175s1586f@4ax.com>,
> RM <rm@yahoo.com> wrote:
>
>
>I must be honest and say that I was willing to give him the benefit of
>the doubt for a while, but I'm afraid that Dr. G truly BELIEVES he is
>unbiased, so much in fact that even in statements that have nothing to
>do with RS, such as "In Dallas today it was 60 degrees" he cannot see
>his American bias by not indicating what system of measurement he is
>using. So, he really cannot see his bias where the facts are more open
>to interpretation.
>
>Facts may be facts, but their meaning lies within the ways they are
>presented. I thought he understood that, I thought I could engage him
>in some intellectual debate, but it is clear that he cannot see it after
>I've tried 3 times (the tennis player, this past Singapore children
>issue, and one other--I forget). Three strikes...
>
>He may be a good contact lens fitter, but his bias against LASIK (which
>he believes he's presenting objectively) isn't helping people coming
>here looking for information or those who've had LASIK and need some
>post-procedure support.
>
>I think he would be more effective (as you point out) if he quit trying
>to disguise his true agenda. He could really help a lot of people that
>way. As it is, I wonder what else he is hiding.

I have no doubt that he believes that he is unbiased. One very common
problem that doctors have is t that they become so confident of
themselves that they lack any sense of objectivity. I think the
reason some of them post here is to bolster their own confidence.

2004-12-16, 9:25 am

According to the malcontents, anybody who isn't espousing gloom and
doom is pro lasik.
I have seen pro-laisk people.. thank god there are none here. I will
give an example... this lady was telling everyone to have lasik
without even knowing their eye condition.. she assured them that they
would love their results and everything would go perfectly and that
the doctors were the best in the field. What a load of crap. She
lasted 2 weeks at her job. She was so blatantly biased that she had
zero credibility.

On Thu, 09 Dec 2004 01:46:30 GMT, RT <RTMD24@NOSPAMyahoo.com> wrote:

>In article <Xns95B9C3530154Bdrgleukomacom@216.148.227.77>,
> "Dr. Leukoma" <drgNOSPAM@leukoma.com> wrote:
>
>
>I really don't see how I'm "rabidly" pro-LASIK. Is it because I'm
>trying to get you to see how biased and un-objective you are when you
>read articles and news stories and then post them in this NG?
>
>I know I'm not objective. I speak from my experience. I don't dispense
>advice about LASIK because I'm not in the field. I can make comments on
>my experience of going through the procedure as a consumer.
>
>I read and post on this NG because I'm interested about the LASIK
>procedure. I'm both fascinated and appalled by the advertising, hype
>and anti-hype. I'm curious about new advances in the technology. I've
>come to the understanding that there doesn't exist an OBJECTIVE truth
>about LASIK surgery. There are too many variables to say it is bad for
>everybody or it is good for everybody. Why do some people have bad
>outcomes even when they have been "properly"screened? Is it the
>screening process, the doctors, the optics of the eye, the machinery,
>the software, lifestyle or environment, or ??? What can be done to
>increase the safety and effectiveness of the procedure? What can be
>done to protect consumers throughout the process, recovery and beyond?
>And on a purely personal level, what does the future hold for a LASIKed
>eye? I really want to know that since I have 2 of them.
>
>
>YES! Exactly, your attempts at objectivity are distorted by your bias.
>Instead of trying to capitalize on people's fears (oooh, in Singapore
>(which happens to be one of the most technologically advanced and
>civilized places on earth) they perform LASIK on children), why don't
>you concentrate on positive constructive solutions to some of the
>perceived problems surrounding LASIK, both informational and technical
>like Rebecca and Glenn?

2004-12-16, 9:25 am

In article <Xns95B9D0D6B17FCdrgleukomacom@204.127.204.17>,
"Dr. Leukoma" <drgNOSPAM@leukoma.com> wrote:

> Well, then, I bid you adieu, and leave you in the capable hands of Glenn,
> Rebecca, Brent, Sandy, et. al. Good luck.
>
> DrG

Oh how dramatic. When challenged to be pro-active and constructive,
rather than underhandedly and covertly bashing LASIK, he exits.

Does that tell us something about his true agenda?

What a shame, because based on his contact lens experience he could
really help (and has helped) people with post-LASIK complications who
come to this board.

--
~RT

Dr. Leukoma

2004-12-16, 9:25 am

RT <RTMD24@NOSPAMyahoo.com> wrote in
news:RTMD24-C5B438.08563409122004@newssvr14-ext.news.prodigy.com:

> In article <Xns95B9D0D6B17FCdrgleukomacom@204.127.204.17>,
> "Dr. Leukoma" <drgNOSPAM@leukoma.com> wrote:
>
>
> Oh how dramatic. When challenged to be pro-active and constructive,
> rather than underhandedly and covertly bashing LASIK, he exits.
>
> Does that tell us something about his true agenda?
>
> What a shame, because based on his contact lens experience he could
> really help (and has helped) people with post-LASIK complications who
> come to this board.
>

I guess this is going to have to be one of those painfully long, and
protracted "adieus."

Getting lectured by you and Ragnar on objectivity is like getting a
lecture on STD's by a couple of whores. What on earth did you study to
get your Ph.D.?

What a shame you cannot keep your arguments straight. In the first
place, nobody except Glenn has claimed total objectivity. What I argued
is that it is possible to be unbiased, and to make unbiased statements.
However, in your strange and twisted use of logic, you found bias in a
simple description of the weather. I made it clear that your use of the
word "bias" is rather quaint.

I have stated my agenda here many, many times. I have a website. Read
it if you want, but that shouldn't be necessary. I believe that
refractive surgery is being over-hyped and over-sold, that too many
surgeons are not doing sufficient screening and are willing to perform
surgery on patients who are not ideal candidates. Instead of erring on
the side of caution, we see too many examples here of patients who were
not good candidates. As examples, a professional tennis player with a
pterygium, a patient with amblyopia, and mentally unstable people like
RM.

Refractive surgery has its place, but it is not to replace eyeglasses and
contact lenses for the majority of people. The public health
consequences of doing so at this point in time are not sufficiently
known. Unfortunately, the refractive surgery industry isn't willing to
fund their own study, similar to the PERK study, and similar to other
studies that are ongoing or have been done on contact lenses. The issues
are far too serious to be left in the hands of a few "guardians" of
objectivity and statistics.

Now, be nice.

DrG

2004-12-16, 9:25 am

In article <Xns95BA5F7581DB7DrLeukoma@207.217.125.201>,
"Dr. Leukoma" <drg@leukoma.com> wrote:

> Now, be nice.

Nice post. Thank you for being straightforward. We obviously agree on
most points, accept for some that we will have to agree to disagree

BTW, I'm not into these name calling and analogies you, Ragnar, SErebel
and even Glenn engage in (I usually snip them even when I'm quoting to
reply), but who would know better about STDs than whores?

--
~RT

Dr. Leukoma

2004-12-16, 9:25 am

RT <RTMD24@NOSPAMyahoo.com> wrote in news:RTMD24-083DA3.11460109122004
@newssvr14-ext.news.prodigy.com:

> In article <Xns95BA5F7581DB7DrLeukoma@207.217.125.201>,
> "Dr. Leukoma" <drg@leukoma.com> wrote:
>
>
> Nice post. Thank you for being straightforward. We obviously agree on
> most points, accept for some that we will have to agree to disagree

>
> BTW, I'm not into these name calling and analogies you, Ragnar, SErebel
> and even Glenn engage in (I usually snip them even when I'm quoting to
> reply), but who would know better about STDs than whores?
>

Not only do whores know about STDs, but they spread them.

Well, you seemed to be in total agreement with me being compared to John
Wayne Gacy, which kind of makes you a name-caller by proxy. Thanks for
your assistance in helping Ragnar paint me black through outright lies
and distortions. Does that make you feel good, "doctor"? It certainly
doesn't make you look good.

I still haven't told you my agenda. I only gave you my position on
refractive surgery. My agenda, if there is one, is to take part in
discussions about LASIK and LASIK problems in a manner that is hopefully
thoughtful and rational. Sometimes that is impossible to do in a place
where the resident lunatic and his aliases has facilitators like you.

Who cares about my "agenda" anyway? I just call them like I see them,
which includes pointing out that some surgeons who do LASIK for a living,
who don't see any problems in their patients except a little temporary
dryness and a few minor halos at night, and who have done LASIK on their
families may just might be a little zealous.

DrG

2004-12-16, 9:25 am

I played nice and you come back with insults.

I do not support Ragnar, refuse to have anything to do with him, and
most importantly, I refuse to engage in name calling. Period. I have
pointed out the ugliness of his tactics to him on several occasions. I
wish he practiced the art of the delete button more often.

BTW, I have never insulted your profession, practice, or your knowledge.
I admit you are at somewhat of a disadvantage since you don't know who I
am or what I do. So I'll let that go.

I still think you distort "the facts" to tell your own biased story of
LASIK. If someone doesn't agree with your biased reading or
interpretation, they are a "problem." As you say, you "call them like
you see them" which was (and is my point). It's "how" you see it that
is not a universal undeniable truth--it's your interpretation. You say
it in one breath and deny it in another, which makes it impossible to
have a decent debate with you.

Plus, you keep changing your story. First you are appalled that
Singaporeans perform surgery on (young) children (your reading of that
article) and now you argue that those "who have done LASIK on their
families may just might be a little zealous." First you blame that eye
disease the tennis player had on LASIK, and then you are appalled that a
surgeon would do LASIK on a person with that eye disease. Which is it?

And I concede on the subject of whores and STDs. Sounds like you know
what you are talking about ;)

--
~RT

Dr. Leukoma

2004-12-16, 9:25 am

RT <RTMD24@NOSPAMyahoo.com> wrote in
news:RTMD24-AA409B.17074009122004@newssvr14-ext.news.prodigy.com:

If you want me to be nice, then apologize.
>
> I still think you distort "the facts" to tell your own biased story of
> LASIK. If someone doesn't agree with your biased reading or
> interpretation, they are a "problem." As you say, you "call them like
> you see them" which was (and is my point). It's "how" you see it that
> is not a universal undeniable truth--it's your interpretation. You say
> it in one breath and deny it in another, which makes it impossible to
> have a decent debate with you.

Excuse me: Say what in one breath, and say what in another? If you are
painting me as inconsistent, then at least tell me what I am inconsistent
about. You are simply making this up out of whole cloth because I have
never said such a thing in this NG. BTW, I don't tell any story about
LASIK. I leave that up to the patients and to Glenn.
>
> Plus, you keep changing your story. First you are appalled that
> Singaporeans perform surgery on (young) children (your reading of that
> article) and now you argue that those "who have done LASIK on their
> families may just might be a little zealous." First you blame that
> eye disease the tennis player had on LASIK, and then you are appalled
> that a surgeon would do LASIK on a person with that eye disease.
> Which is it?

Isn't this what the article said? Children? I don't care if the
children are their own, I still don't think it is right. What I said was
that surgeons who (and now this will require you to pay attention)
dismiss complications as minor temporary dryness or night vision
disturbances AND who do LASIK on their own families just might be
considered a little zealous and therefore we can probably take their
statement with a grain of salt.

Again, please tell me where I blamed a particular eye disease on LASIK.
What I said was either the pterygium was present before LASIK, or LASIK
caused it. As an eye doctor, I rather think that it was present before
LASIK. Pterygiums, by the way, are thought to be caused by dryness. We
won't even fit contact lenses on them. Are you willing to get your Ph.D.
trained mind around this concept?
>
> And I concede on the subject of whores and STDs. Sounds like you know
> what you are talking about ;)
>
I am no longer at a disadvantage, because I know who you are: Ragnar's
twin.

DrG

2004-12-16, 9:25 am

In article <Xns95BAAA4D64245DrLeukoma@207.217.125.201>,
"Dr. Leukoma" <drg@leukoma.com> wrote:

> RT <RTMD24@NOSPAMyahoo.com> wrote in
> news:RTMD24-AA409B.17074009122004@newssvr14-ext.news.prodigy.com:
>
> If you want me to be nice, then apologize.

For what? Calling it like I see it? Are you the only one allowed to do
that with impunity?

>
> Excuse me: Say what in one breath, and say what in another? If you are
> painting me as inconsistent, then at least tell me what I am inconsistent
> about. You are simply making this up out of whole cloth because I have
> never said such a thing in this NG.

Pay attention: In one breath you say you "call them like
you see them" and then in the next breath you say your interpretations
of articles are unbiased. I'm not saying you are inconsistent, but
completely unaware of how you distort and misread certain articles to
support a certain agenda.

> BTW, I don't tell any story about
> LASIK. I leave that up to the patients and to Glenn.

What, you are now denying you have an opinion about LASIK???? I'm
confused.

> Isn't this what the article said? Children?

Even you, Dr. G, are someone's child. Read into that what you will.

> Again, please tell me where I blamed a particular eye disease on LASIK.
> What I said was either the pterygium was present before LASIK, or LASIK
> caused it.

You just said it again "LASIK caused it."

>As an eye doctor, I rather think that it was present before
> LASIK. Pterygiums, by the way, are thought to be caused by dryness.

You "rather" think? Decisions, decisions...

>We
> won't even fit contact lenses on them. Are you willing to get your Ph.D.
> trained mind around this concept?

Good. People shouldn't perform LASIK on them either. What do you
propose the industry should do to prevent that from happening to someone
in the future? How can you, with your knowledge on this subject, help
someone coming to this board make sure s/he is not a risk for pterygiums
or at risk for having LASIK performed despite having a pterygium?

> I am no longer at a disadvantage, because I know who you are: Ragnar's
> twin.
>
LOL! That's a good one. Still reverting to name calling.

BTW: I would never accuse you of being inconsistent. In fact, you are
reassuringly consistent.

--
~RT

gospa68@aol.com

2004-12-16, 9:25 am

It will be interesting to see what this report covers and how it is
presented. I agree that it was probably not in the cards for NHS to
endorse (and reimburse) such a procedure. Nevertheless, the fact that
they are making a public statement on LASIK is in itself unusual as
they make many negative coverage decisions each year. WK

gospa68@aol.com

2004-12-16, 9:25 am

gospa68@aol.com

2004-12-16, 9:25 am

gospa68@aol.com

2004-12-16, 9:25 am

2004-12-16, 9:26 am

On Thu, 09 Dec 2004 13:56:36 GMT, RT <RTMD24@NOSPAMyahoo.com> wrote:

>In article <Xns95B9D0D6B17FCdrgleukomacom@204.127.204.17>,
> "Dr. Leukoma" <drgNOSPAM@leukoma.com> wrote:
>
>
>Oh how dramatic. When challenged to be pro-active and constructive,
>rather than underhandedly and covertly bashing LASIK, he exits.
>
>Does that tell us something about his true agenda?
>
>What a shame, because based on his contact lens experience he could
>really help (and has helped) people with post-LASIK complications who
>come to this board.

RT... Dr. Gemoules isn't going anywhere. This newsgroup is half his
life.

2004-12-16, 9:26 am

On Thu, 09 Dec 2004 22:36:17 GMT, "Dr. Leukoma" <drg@leukoma.com>
wrote:

>RT <RTMD24@NOSPAMyahoo.com> wrote in
>news:RTMD24-AA409B.17074009122004@newssvr14-ext.news.prodigy.com:
>
>If you want me to be nice, then apologize.
>
>Excuse me: Say what in one breath, and say what in another? If you are
>painting me as inconsistent, then at least tell me what I am inconsistent
>about. You are simply making this up out of whole cloth because I have
>never said such a thing in this NG. BTW, I don't tell any story about
>LASIK. I leave that up to the patients and to Glenn.
>
>Isn't this what the article said? Children? I don't care if the
>children are their own, I still don't think it is right. What I said was
>that surgeons who (and now this will require you to pay attention)
>dismiss complications as minor temporary dryness or night vision
>disturbances AND who do LASIK on their own families just might be
>considered a little zealous and therefore we can probably take their
>statement with a grain of salt.
>
>Again, please tell me where I blamed a particular eye disease on LASIK.
>What I said was either the pterygium was present before LASIK, or LASIK
>caused it. As an eye doctor, I rather think that it was present before
>LASIK. Pterygiums, by the way, are thought to be caused by dryness. We
>won't even fit contact lenses on them. Are you willing to get your Ph.D.
>trained mind around this concept?
>I am no longer at a disadvantage, because I know who you are: Ragnar's
>twin.
>
>DrG

Ragnar's twin? That shows how mentally out of tune you are. Anybody
who doesn't eat up your line of bull is lumped into one category.
I really don't think RT and I are very similar.

2004-12-16, 9:26 am

RT... I realize you are trying to be rational with Dr. Gemoules.. but
realize that you are fighing a hopeless battle. Dr. Gemoules has
posted hundreds of thousands of messages and his mind is closed to
anybody else's input.
You will just wear out your keyboard and get arthritis trying to make
nice with him.

On Thu, 09 Dec 2004 23:15:21 GMT, RT <RTMD24@NOSPAMyahoo.com> wrote:

>In article <Xns95BAAA4D64245DrLeukoma@207.217.125.201>,
> "Dr. Leukoma" <drg@leukoma.com> wrote:
>
>
>For what? Calling it like I see it? Are you the only one allowed to do
>that with impunity?
>
>
>Pay attention: In one breath you say you "call them like
>you see them" and then in the next breath you say your interpretations
>of articles are unbiased. I'm not saying you are inconsistent, but
>completely unaware of how you distort and misread certain articles to
>support a certain agenda.
>
>
>What, you are now denying you have an opinion about LASIK???? I'm
>confused.
>
>
>Even you, Dr. G, are someone's child. Read into that what you will.
>
>
>You just said it again "LASIK caused it."
>
>
>You "rather" think? Decisions, decisions...
>
>
>Good. People shouldn't perform LASIK on them either. What do you
>propose the industry should do to prevent that from happening to someone
>in the future? How can you, with your knowledge on this subject, help
>someone coming to this board make sure s/he is not a risk for pterygiums
>or at risk for having LASIK performed despite having a pterygium?
>
>LOL! That's a good one. Still reverting to name calling.
>
>BTW: I would never accuse you of being inconsistent. In fact, you are
>reassuringly consistent.