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| Author |
What about the future?
|
|
|
| I'd like to know what people generally feel could go "wrong" in the future
with people who have successful procedures and are happy with their outcomes
now. Besides changes that would have happened anyway (like refractive
changes and presbyopia).
How are the first generation LASIKed eyes doing?
--
~RT
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| |
| serebel 2005-01-28, 8:11 am |
| I'm curious to know also, after all, aren't all post lasiks vested?
SErebel
| |
| sunsweet 2005-01-28, 8:11 am |
|
serebel wrote:
> I'm curious to know also, after all, aren't all post lasiks vested?
> SErebel
My guest would be that other then your vision changing as you age, the
challenge to fit post lasik patient with IOL as the result of cataracts
may not be as successful as those that have not had LASIK, especially
if you are a high correction. I'm sure there are plenty of other
things. This, to me, is the most obvious.
| |
| serebel 2005-01-28, 8:11 am |
|
sunsweet wrote:
>
> My guest would be that other then your vision changing as you age,
the
> challenge to fit post lasik patient with IOL as the result of
cataracts
> may not be as successful as those that have not had LASIK, especially
> if you are a high correction. I'm sure there are plenty of other
> things. This, to me, is the most obvious.
Sunsweet,
I'm pretty sure the technology will exist going forward as far as
fitting IOLs for post refractives considering the number of post
refractives who now exist. Like everything else, time will tell. I
know, it's easy for me to say this now because I figure I won't need
cataract surgery for another thirty years,(I hope).
SErebel
| |
|
| On Fri, 28 Jan 2005 00:07:42 -0500, sunsweet wrote
(in article <1106888862.087075.127340@c13g2000cwb.googlegroups.com> ):
>
> serebel wrote:
>
> My guest would be that other then your vision changing as you age, the
> challenge to fit post lasik patient with IOL as the result of cataracts
> may not be as successful as those that have not had LASIK, especially
> if you are a high correction. I'm sure there are plenty of other
> things. This, to me, is the most obvious.
>
Thanks for your reply. Why do you think it would be harder to fit IOLs?
Also, why no responses from doctors and Glenn? I would think you all would
have some knowledge about this topic to share with us vested post-LASIKs.
--
~RT
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| |
| doctor_my_eye@msn.com 2005-01-31, 11:53 am |
| When a doctor or his technician are computing the power of the IOL that
goes into the eye to replace the human lens, a long mathematical
formula is "crunched" that has certain constant mean values, and
corneal thickness is one of them. There is also a controversy that IOP
measurements are thrown off kilter after LASIK because those formulas
also use a standard constant for corneal thickness.
What are possible future complications? You have opened old wounds
with that question. It has been argued that the suction ring that has
been blamed for causing floaters in so many post-op LASIKS is actually
causing pre-retinal tears, leaving the patient open to a much worse
tear if he were hit by an airbag or had a punch to the eye. The
thinning of the cornea might make the post-op LASIK much more
vulnerable to a blow-out fracture of the eye if he were struck by an
airbag. There may be glaucoma-like damage to every LASIK patient's
optic nerve. When I see a "virgin eye" with an eye pressure of 23,
that patient most likely has glaucoma. When the suction ring is placed
on the cornea to stabilize the microkeratome, the pressure in the eye
goes to numbers greater than 80 mm.
The more you know about LASIK, the less likely you would ever let your
worst enemy (or his dog) have LASIK.
Unfortunately, theories like these are only proven over time. I read
an article 10 years ago about an RK patient who had a retinal tear
after rapid decompression in an airplane. So, in essence, all of this
bad stuff has to happen to people to prove these theories have merit.
| |
| Glenn - USAEyes.org 2005-01-31, 11:53 am |
| I really don't think there is much new information to offer. I guess
I could reference our website where virtually all known limitations
and potential problems are explained, and potential outcomes are
referenced.
The trends are toward wavefront-guided surgery, surface ablation, and
the use of intraocular lenses for those with high refractive errors,
but I've given up on trying to predict the industry. It seems every
year somebody comes up with yet another way to improve refractive
surgery.
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.
| |
| serebel 2005-01-31, 11:53 am |
| Ken,
why did your answer morph into an anti-lasik diatribe? I see that you
are among the backward thinking people who are here to hinder progress.
If you are going to just bash RS at any turn, maybe you should stick to
lecturing the three people who post on your pathetic little website.
Oh, by the way, the world is round, not flat.
SErebel
| |
|
| On Fri, 28 Jan 2005 21:32:39 -0500, serebel wrote
(in article <1106965959.629696.25250@z14g2000cwz.googlegroups.com> ):
> Ken,
> why did your answer morph into an anti-lasik diatribe? I see that you
> are among the backward thinking people who are here to hinder progress.
> If you are going to just bash RS at any turn, maybe you should stick to
> lecturing the three people who post on your pathetic little website.
> Oh, by the way, the world is round, not flat.
>
> SErebel
>
No, I didn't find his answer as an RS bash.
What I would like to know is whether there are any documented cases of the
potential problems Ken lists or are they all hypothetical. Except for the
floaters--which may have happened anyway if the person was a high myope.
--
~RT
________________________________________________
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| |
| serebel 2005-01-31, 11:53 am |
| RT,
What would you call when he wrote "The more you know about lasik,the
less likely you would ever let your worst enemy or his dog have lasik"
?
SErebel
| |
|
| On Fri, 28 Jan 2005 22:56:21 -0500, serebel wrote
(in article <1106970981.266387.44940@z14g2000cwz.googlegroups.com> ):
> RT,
>
> What would you call when he wrote "The more you know about lasik,the less
> likely you would ever let your worst enemy or his dog have lasik"
> ?
I don't know. If what he says is true--ie. provable and documented--then I
do worry that I may have compromised my long term eye health for great vision
now. I truly hope that isn't the case, but I do worry about it. LASIK is
elective after all and hasn't been around that long. So I'd really like to
hear about documented provable cases of what has happened to the earliest
LASIKed eyes.
On the other hand, if there really isn't much to be worried about, I agree
with Ken--I wouldn't want to wish LASIK on my enemies. So far it has been so
amazing that I wouldn't want my enemies to share in the joy of it. I would
want them to continue to suffer with lenses and glasses. And although I love
animals, I've never heard of one that needs refractive correction--but,
really, how do we know how well our pets see or not. Maybe Dr, Ken has a
veterinary optometry business on the side and knows better.
--
~RT
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| |
| serebel 2005-01-31, 11:53 am |
|
RT wrote:
> On Fri, 28 Jan 2005 22:56:21 -0500, serebel wrote
> (in article <1106970981.266387.44940@z14g2000cwz.googlegroups.com> ):
>
lasik,the less[vbcol=seagreen]
>
> I don't know. If what he says is true--ie. provable and
documented--then I
> do worry that I may have compromised my long term eye health for
great vision
> now. I truly hope that isn't the case, but I do worry about it.
LASIK is
> elective after all and hasn't been around that long. So I'd really
like to
> hear about documented provable cases of what has happened to the
earliest
> LASIKed eyes.
>
> On the other hand, if there really isn't much to be worried about, I
agree
> with Ken--I wouldn't want to wish LASIK on my enemies. So far it has
been so
> amazing that I wouldn't want my enemies to share in the joy of it. I
would
> want them to continue to suffer with lenses and glasses. And
although I love
> animals, I've never heard of one that needs refractive
correction--but,
> really, how do we know how well our pets see or not. Maybe Dr, Ken
has a
> veterinary optometry business on the side and knows better.
>
> --
> ~RT
>
Well, as far as what he says is true, you said it yourself many times,
"the truth lies somewhere between ...... and ....".
I too am curious as to how the early lasik people fared. I think it
would give us a pretty good insight as to what to expect. It would be a
lot better than just our opinions which could be debated til the cows
come home.
SErebel
| |
| Ragnar 2005-01-31, 11:53 am |
| it should be added that floaters occur naturally as we age.. and they
are more prevalent in myopic eyes because of the stretched retina and
longer path for the light to travel.
On Sat, 29 Jan 2005 03:16:16 GMT, RT <RTMD24@NOSPAMyahoo.com> wrote:
>On Fri, 28 Jan 2005 21:32:39 -0500, serebel wrote
>(in article <1106965959.629696.25250@z14g2000cwz.googlegroups.com> ):
>
>
>No, I didn't find his answer as an RS bash.
>
>What I would like to know is whether there are any documented cases of the
>potential problems Ken lists or are they all hypothetical. Except for the
>floaters--which may have happened anyway if the person was a high myope.
| |
|
| On Fri, 28 Jan 2005 23:51:34 -0500, serebel wrote
(in article <1106974294.536875.269560@f14g2000cwb.googlegroups.com> ):
> Well, as far as what he says is true, you said it yourself many times, "the
> truth lies somewhere between ...... and ....". I too am curious as to how the
> early lasik people fared. I think it would give us a pretty good insight as
> to what to expect. It would be a lot better than just our opinions which
> could be debated til the cows come home.
Yes, wouldn't it be wonderful to get some truthful documented information
about real people instead of opinion and insults?
I am interested in keeping my LASIKed eyes as healthy and problem free as
possible. Can we have such an important and mature discussion on this list
or does it have to be only about those who are deciding whether or not to do
it, those who've done in and are happy during their first week, or those who
had a bad outcome and now want to condemn the whole procedure?
Let's talk about positive steps to preserve our good LASIK outcomes and what
situations we should take care to avoid or take extra time to monitor more
claosely,
--
~RT
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| |
| Ragnar 2005-01-31, 11:53 am |
| Heh.. one way of really punishing someone good is to talk them OUT of
having LASIK done. Let them live with their handicap for the rest
of their life.
In a way, it reminds me of elderly deaf people who refuse to get
hearing aids. They prefer to be deaf than to get a solution to the
problem.
On 28 Jan 2005 19:56:21 -0800, "serebel" <serebel@aol.com> wrote:
>RT,
>
>What would you call when he wrote "The more you know about lasik,the
>less likely you would ever let your worst enemy or his dog have lasik"
>?
>
>SErebel
| |
|
| Why are you worrying about this now? Seems like the time to have
thought about the possible consequences of Lasik on aging eyes was
before you had surgery. If something awful is going to happen to your
Lasiked eyes as they get old, you'll be just as SOL worrying or not.
serebel wrote:
> RT wrote:
<1106970981.266387.44940@z14g2000cwz.googlegroups.com> ):[vbcol=seagreen]
> lasik,the less
> documented--then I
> great vision
> LASIK is
> like to
> earliest
I[vbcol=seagreen]
> agree
has[vbcol=seagreen]
> been so
I[vbcol=seagreen]
> would
> although I love
> correction--but,
> has a
> Well, as far as what he says is true, you said it yourself many
times,
> "the truth lies somewhere between ...... and ....".
> I too am curious as to how the early lasik people fared. I think it
> would give us a pretty good insight as to what to expect. It would be
a
> lot better than just our opinions which could be debated til the cows
> come home.
>
> SErebel
| |
|
| On Sat, 29 Jan 2005 00:14:53 -0500, xeno wrote
(in article <1106975693.041668.41630@z14g2000cwz.googlegroups.com> ):
> Why are you worrying about this now? Seems like the time to have thought
> about the possible consequences of Lasik on aging eyes was before you had
> surgery. If something awful is going to happen to your Lasiked eyes as they
> get old, you'll be just as SOL worrying or not.
Frankly, I didn't give it much thought before the procedure, I was much more
focused on the procedure itself and the immediate aftermath 6 month healing
period or so. But now that I'm going on 2 years, my worries have projected
several more years out.
I's not about worrying, but finding out what I can do to reduce proven and
documented complications that arise many years out from the original
procedure. I'm not a person who settles for SOL.
So for example, if the airbag dislodgments are a major problem, then I would
push my seat back as far as is comfortable to drive so the deployed bag
doesn't get me with such force in the face.
--
~RT
________________________________________________
Hogwasher, Premier News and Mail for OS X
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________________________________________________
| |
| doctor_my_eye@msn.com 2005-01-31, 11:53 am |
| Sitting further back from an airbag is good advice to any myope, LASIK
or not. When selecting a new car it is important to look for 2nd or
3rd generation airbags as well. First generation airbags were designed
to catch a 300 pound man and keep his forward motion from going through
a windshield, hence they hit you very hard on deployment. The newer
airbags use sensors in the seat to weigh the individual and depower the
force of the bag. Wearing good sunglasses can also help the shockwave
from an airbag deployment to dissipate the energy of the bag into the
frame and your skull bones and less into your eyeball.
Glenn's comments in this thread are very honest. None of this "bad
stuff" about LASIK is new, and it will continuously be debated in
academic circles. It is still VERY RARE to find an ophthalmologist who
has had LASIK, and I find fewer and fewer primary care physicians that
would ever recommend it to a patient.
When Ragnar and RT discuss their myopia as a "handicap" or "an
affliction" is when they enter into the true mystery why LASIK is so
popular. Creating an analogy where you relate being myopic to being
deaf is like comparing having a rash to having cancer. Most myopes can
wear contact lenses very well (if they are fit well) and glasses are a
simple appliance that puts the eyes at no risk.
LASIK takes a healthy eye and makes it unhealthy. The IOP is raised
from 15 mm of mercury to 80 for as long as an hour, the corneal
structure is permanently weakened, the vitreous humor is often pulled
forward from the retina causing floaters and detachments....(need I go
on?) For those of you who extoll the virtues of LASIK by saying "I can
get up in the morning and see well, and that is why LASIK is perfect to
me."....Well, I hope that you just aren't that shallow about the rest
of the important things in your life. I get up in the morning and put
on my Acuvue Advance contact lenses and see perfectly for 17 hours a
day, and I still have all of my corneal stroma to boot. My IOP will
never be raised to a hundred mm of mercury so that a little go kart can
run across my cornea with a razor blade hanging from between its wheels
and gears.
The anti-LASIK statements made on this board are often made by
individuals who have been seriously injured by LASIK. Some of them
have given up their jobs and are not able to function at work anymore
thanks to the "two minute miracle."
If I could put Ragnar or RT or SErebel in my exam room and have them
sit there silently in a white coat, acting as if they were visiting
doctors...and then I
had a truly mangled post-op LASIK cornea come in..how would they react?
I have had patients whose "two minute miracle" has lead to bilateral
retinal detachments
glaucoma, trigeminal neuralgia, chronic dry eyes, clinical depression,
Bell's Palsy, recurrent corneal erosions, DLK, photophobia...the list
goes on.
RT wrote:
> On Sat, 29 Jan 2005 00:14:53 -0500, xeno wrote
> (in article <1106975693.041668.41630@z14g2000cwz.googlegroups.com> ):
>
thought[vbcol=seagreen]
you had[vbcol=seagreen]
as they[vbcol=seagreen]
>
> Frankly, I didn't give it much thought before the procedure, I was
much more
> focused on the procedure itself and the immediate aftermath 6 month
healing
> period or so. But now that I'm going on 2 years, my worries have
projected
> several more years out.
>
> I's not about worrying, but finding out what I can do to reduce
proven and
> documented complications that arise many years out from the original
> procedure. I'm not a person who settles for SOL.
>
> So for example, if the airbag dislodgments are a major problem, then
I would
> push my seat back as far as is comfortable to drive so the deployed
bag
> doesn't get me with such force in the face.
>
> --
> ~RT
>
> ________________________________________________
>
> Hogwasher, Premier News and Mail for OS X
> http://www.asar.com/cgi-bin/product.../hogwasher.html
> ________________________________________________
| |
|
|
I wouldn't put me in the same group as the staunchly pro-LASIK folks. you
don't need to put me in a room with people with complications. I'm asking
this question because I'm truly concerned about what I have done to my eyes.
> LASIK takes a healthy eye and makes it unhealthy.
This statement is the one that concerns me the most. I am happy with my eyes
and vision now. I sincerely hope I can say that in 20 years.
This statement is not one I considered before I had LASIK, and in retrospect
I wish I had. I probably wouldn't have believed it, but as I do more research
two years out, I'm still wondering to what degree this is true and will be a
factor in the years to come. I was focused on the procedure and the immediate
complications only. It's awful for the people who have been injured during
the LASIK procedure and now have visible and quantifiable visual and corneal
disturbances. Just wondering about folks like me who are happy NOW.
--
~RT
________________________________________________
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| |
| Ragnar 2005-01-31, 11:53 am |
| Minarik tries to rationalize his own irrational thinking by bending
the facts. Anway...
I see you have called LASIK the "Two Minute Miracle". Boy doesn't
that sound scandalous. No LASIK procedure was ever done in 2 minutes.
The old marketing term was a 15 minute miracle. A very crude timeline
of the procedure on each eye would be 5 minutes to prepare the eye
(drops, tape back eyelashes, etc) and make the flap, 90 seconds of
ablation, 1 minute of "rinsing" the eye and folding back the flap, and
5 minutes of waiting for the flap to settle down enough so that it
stays in place. Obviously if a surgeon has 9 patents to do in a few
hours and has a plane to catch that night, they are going to push
their patient into PRK which involves no flap to save a lot of time.
Assuming someone had a mangled cornea, they need to go to an
ophthalmologist, not an optometrist. If you were doing your job, you
would be referring these patients to an ophthalmologist. Frankly, I'm
surprised you haven't been sued for treating patients that you had no
business treating. I certainly hope that you are informing these
surgeons about the patients that are coming to you. You need to get
their medical history - especially related to the surgery they had.
You also need to let the surgeon know about the problem so they don't
repeat the same mistake. I know you don't let the surgeon know you
have "acquired" patients.
On 28 Jan 2005 22:37:34 -0800, doctor_my_eye@msn.com wrote:
>The anti-LASIK statements made on this board are often made by
>individuals who have been seriously injured by LASIK. Some of them
>have given up their jobs and are not able to function at work anymore
>thanks to the "two minute miracle."
>If I could put Ragnar or RT or SErebel in my exam room and have them
>sit there silently in a white coat, acting as if they were visiting
>doctors...and then I
>had a truly mangled post-op LASIK cornea come in..how would they react?
>I have had patients whose "two minute miracle" has lead to bilateral
>retinal detachments
>glaucoma, trigeminal neuralgia, chronic dry eyes, clinical depression,
>Bell's Palsy, recurrent corneal erosions, DLK, photophobia...the list
>goes on.
>
| |
| Glenn - USAEyes.org 2005-01-31, 11:53 am |
| Ken, you are absolutely wrong about it being rare to find an
ophthalmologist who has had refractive surgery. As an entire group,
refractive surgery is slightly more prevalent with ophthalmologists
than in the population on the whole. With refractive surgeons, the
ratio is about four to one more surgeons having refractive surgery
than the general population. This is according to polls taken by the
American Society of Cataract and Refractive Surgery.
Analogies aside, being myopic IS a handicap. Just try getting through
a day without corrective lenses. Yes, it is a handicap that is
relatively easily accommodated and one that is so common as to not be
much noticed, (Bon Jovi won't be putting on a Glasses-Aid concert
anytime soon) but a person who has refractive error is handicapped
without correction.
I do not agree with your blanket contention that LASIK makes the
cornea unhealthy. It is permanently altered and will never be exactly
as it was before surgery, but suggesting that the cornea is unhealthy
is simply wrong. With (fortunately) rare exception, the cornea after
LASIK is healthy enough to function properly throughout the patient's
lifetime.
Yes, the anti-LASIK statements here and elsewhere tend to be from
those who have had a poor outcome, but you seem to be condemning the
procedure and the 97% who do not have problems because of the 3% who
do have a problem,the 0.5% who have a serious problem, and the hand
full who post here again and again and again and again. To keep up
that logic, you would need to condemn just about all elective surgery,
automobiles, backyard swimming pools, and just about everything else
in life.
LASIK has risk, that is for sure. It also is based upon the
combination of one procedure that has been around for about five
decades and another that has been around for about 15 years now.
Millions have successfully had LASIK and other excimer laser assisted
refractive surgery without harmful effect and with significant
positive effect. Just because it is not for everybody and not
everybody gets the outcome they want does not make LASIK the devil
some like to make it appear to be.
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 2005-01-31, 11:53 am |
| I have seen staunchly pro-lasik people, but not in this newsgroup.
Who are you referring to?
On Sat, 29 Jan 2005 14:13:52 GMT, RT <RTMD24@NOSPAMyahoo.com> wrote:
>
>I wouldn't put me in the same group as the staunchly pro-LASIK folks. you
>don't need to put me in a room with people with complications. I'm asking
>this question because I'm truly concerned about what I have done to my eyes.
>
>
>This statement is the one that concerns me the most. I am happy with my eyes
>and vision now. I sincerely hope I can say that in 20 years.
>
>This statement is not one I considered before I had LASIK, and in retrospect
>I wish I had. I probably wouldn't have believed it, but as I do more research
>two years out, I'm still wondering to what degree this is true and will be a
>factor in the years to come. I was focused on the procedure and the immediate
>complications only. It's awful for the people who have been injured during
>the LASIK procedure and now have visible and quantifiable visual and corneal
>disturbances. Just wondering about folks like me who are happy NOW.
| |
| doctor_my_eye@msn.com 2005-01-31, 11:53 am |
| I know that there are times that Ragnar says things that are so
blatantly stupid or ignorant that I know that he knows better. But,
there are times I can't tell if he is actually ignorant or just playing
with me. So, I'll give him the benefit of the doubt and play this one
close to the vest.
It seems as though Ragnar has only defined optometrists as those
individuals he has seen working in a shopping mall next to
Lenscrafters. The reality of today's healthcare marketplace is that
the primary care optometrist is the "gatekeeper" or entry point of all
eye care. In my practice I see about 120 patients a week, and many of
them are actually physicians themselves. A licensed optometrist who is
trained in therapeutics can prescribe topical antibiotics and steroids,
and can treat glaucoma and other eye diseases. I am listed as a
primary eyecare provider on no less than 161 health plans, and I freely
exchange information with primary care physicians on a daily basis as
they send me their diabetic patients for their dilated fundus
examinations and retinal photography. When a post op LASIK patient
sees me he is getting a level of care he might not ever find at a
surgeon's office. Many ophthalmologists have no interest in fitting
contact lenses and have no experience doing so. Geometrical optics and
physiological optics are taught much more intensely during an
optometrist's four years of grad school than during an
ophthalmologist's two-year residency. Another way to look at this
"debate" is to note that an ophthalmologist is an MD who is a doctor
first but an eye specialist secondarily, with a heavy emphasis on
surgery and the eye. An optometrist goes to college for 7 or 8 years
and does not aspire to be an MD, he just wants to be an "eye guy". We
are taught much more heavily the psychology of vision and the role of
the brain in the visual process. Vision therapy and eye exercises are
rarely touched during an ophthalmology residency, but they become an
important part of how an optometrist sees the patients eyes.
As an aside, my wife's OB-GYN retired last year, and was replaced with
a much younger physician. This new physician employes a highly
qualified nurse practitioner, and this nurse practitioner does all of
the normal routine gynocological visits and pap smears, etc. in the
place of the surgeon doing all that work. At first my wife was
concerned that such important work was being done by an RN. But,
within 6 months and a couple of visits it became very obvious that the
nurse practitioner spent more time with each patient, took a more
thorough history and performed a much more detailed physical
examination than my wife's old "real doctor" ever did. Take a look at
this week's USNews and World Report and you'll see a nurse practitioner
on the cover. The future of health care is that the primary level of
care will be at the level of the nurse practitioner, optometrist,
pharmacist, chiropractor, and so on. Then, when a patient at that
level of care needs to be referred up to "secondary care" will the MD
be involved.
Ragnar wrote:
> Minarik tries to rationalize his own irrational thinking by bending
> the facts. Anway...
>
> I see you have called LASIK the "Two Minute Miracle". Boy doesn't
> that sound scandalous. No LASIK procedure was ever done in 2
minutes.
> The old marketing term was a 15 minute miracle. A very crude
timeline
> of the procedure on each eye would be 5 minutes to prepare the eye
> (drops, tape back eyelashes, etc) and make the flap, 90 seconds of
> ablation, 1 minute of "rinsing" the eye and folding back the flap,
and
> 5 minutes of waiting for the flap to settle down enough so that it
> stays in place. Obviously if a surgeon has 9 patents to do in a few
> hours and has a plane to catch that night, they are going to push
> their patient into PRK which involves no flap to save a lot of time.
>
> Assuming someone had a mangled cornea, they need to go to an
> ophthalmologist, not an optometrist. If you were doing your job, you
> would be referring these patients to an ophthalmologist. Frankly,
I'm[vbcol=seagreen]
> surprised you haven't been sued for treating patients that you had no
> business treating. I certainly hope that you are informing these
> surgeons about the patients that are coming to you. You need to get
> their medical history - especially related to the surgery they had.
> You also need to let the surgeon know about the problem so they don't
> repeat the same mistake. I know you don't let the surgeon know you
> have "acquired" patients.
>
>
>
>
> On 28 Jan 2005 22:37:34 -0800, doctor_my_eye@msn.com wrote:
>
>
anymore[vbcol=seagreen]
react?[vbcol=seagreen]
depression,[vbcol=seagreen]
list[vbcol=seagreen]
| |
| serebel 2005-01-31, 11:53 am |
|
Glenn - USAEyes.org wrote:
> Ken, you are absolutely wrong about it being rare to find an
> ophthalmologist who has had refractive surgery. As an entire group,
> refractive surgery is slightly more prevalent with ophthalmologists
> than in the population on the whole. With refractive surgeons, the
> ratio is about four to one more surgeons having refractive surgery
> than the general population. This is according to polls taken by the
> American Society of Cataract and Refractive Surgery.
>
> Analogies aside, being myopic IS a handicap. Just try getting
through
> a day without corrective lenses. Yes, it is a handicap that is
> relatively easily accommodated and one that is so common as to not be
> much noticed, (Bon Jovi won't be putting on a Glasses-Aid concert
> anytime soon) but a person who has refractive error is handicapped
> without correction.
>
> I do not agree with your blanket contention that LASIK makes the
> cornea unhealthy. It is permanently altered and will never be
exactly
> as it was before surgery, but suggesting that the cornea is unhealthy
> is simply wrong. With (fortunately) rare exception, the cornea after
> LASIK is healthy enough to function properly throughout the patient's
> lifetime.
>
> Yes, the anti-LASIK statements here and elsewhere tend to be from
> those who have had a poor outcome, but you seem to be condemning the
> procedure and the 97% who do not have problems because of the 3% who
> do have a problem,the 0.5% who have a serious problem, and the hand
> full who post here again and again and again and again. To keep up
> that logic, you would need to condemn just about all elective
surgery,
> automobiles, backyard swimming pools, and just about everything else
> in life.
>
> LASIK has risk, that is for sure. It also is based upon the
> combination of one procedure that has been around for about five
> decades and another that has been around for about 15 years now.
> Millions have successfully had LASIK and other excimer laser assisted
> refractive surgery without harmful effect and with significant
> positive effect. Just because it is not for everybody and not
> everybody gets the outcome they want does not make LASIK the devil
> some like to make it appear to be.
>
>
Thanks Glenn, you saved me a whole lot of typing time for answering
Ken's post. I would like to add, that lasik does not cause as many
detachments as Ken says, very few indeed.
If I were observing in his office an RS mangled cornea, I would just do
the job at hand to alleviate the problem as opposed to trashing RS in
general. After all , what's done is done.
SErebel
| |
| sunsweet 2005-01-31, 11:54 am |
|
RT wrote:
> On Fri, 28 Jan 2005 00:07:42 -0500, sunsweet wrote
> (in article <1106888862.087075.127340@c13g2000cwb.googlegroups.com> ):
>
vested?[vbcol=seagreen]
the[vbcol=seagreen]
cataracts[vbcol=seagreen]
especially[vbcol=seagreen]
>
> Thanks for your reply. Why do you think it would be harder to fit
IOLs?
>
> Also, why no responses from doctors and Glenn? I would think you all
would
> have some knowledge about this topic to share with us vested
post-LASIKs.
>
> --
> ~RT
>
>Thanks for your reply. Why do you think it would be harder to fit
IOLs?
Because I was told so by my LASIK Surgeon. In fact, he warn me that
cataract surgeons would not be familiar with the prescription that
would be require for someone with complication with RS. My problem is
irregular astigmatism.
My point was that in time many LASIK patients will probably require
cataract surgery. If you had a good result, you will likely assume
that cataract surgery will be a "no brainer", when in actuallity it
will be more complicated as the result of the RS surgery. My guess is
that most cataract surgeons have no clue what addition measurement need
to be perform, since this is still very new. I'm not sure I want to be
on their learning curve. But I think that's what will happen.
How many cataract surgeons do RS? It is a separate field.
________________________________________________
>
> Hogwasher, Premier News and Mail for OS X
> http://www.asar.com/cgi-bin/product.../hogwasher.html
> ________________________________________________
| |
| serebel 2005-01-31, 11:54 am |
| Sunsweet,
Many cataract surgeons do RS, in fact they do RS because of medicare
cut backs.
Do you really think that going forward, that the IOL problems won't be
solved?
SErebel
| |
|
| On Sun, 30 Jan 2005 22:01:02 -0500, sunsweet wrote
(in article <1107140462.808841.64420@z14g2000cwz.googlegroups.com> ):
> My guess is that most cataract surgeons have no clue what addition
> measurement need to be perform, since this is still very new. I'm not sure I
> want to be on their learning curve. But I think that's what will happen.
Are you close to cataracts? I'm 39, so I'm hoping that I have many years
before the onset of cataracts. I imagine there will have been thousands, if
not millions of people with LASIK needing cataract surgery before me.
Hopefully a few cataract surgeons will have figured something out by then.
Maybe someone on this list who has had LASIK and cataract surgery can speak
to this.
BTW, my LASIK surgeon is a corneal specialist who also performs cataract
surgery.
--
~RT
________________________________________________
Hogwasher, Premier News and Mail for OS X
http://www.asar.com/cgi-bin/product.../hogwasher.html
________________________________________________
| |
| Glenn - USAEyes.org 2005-01-31, 11:54 am |
| Calculating the correct power of the replacement intraocular lens
(IOL) for implantation after cataract surgery is more challenging when
the patient has had previous refractive surgery, but certainly not
impossible and is being done every day.
One of the leaders in IOL calculations is Jack Holladay, MD. Shortly
before PRK started through clinical trials in the US, Dr. Holladay
began adjusting his already widely used calculation system to
accommodate the cornea after refractive surgery. Continued refinement
had placed the technique nearly to the level of success as with a
virgin eye. Others have developed similar methods to calculate the
correct IOL power for a patient who has had refractive surgery.
What is preferable is for the patient to have the evaluation for
intraocular lens calculations completed prior to refractive surgery.
Then the process is simply subtracting the achieved refractive error
from the previous refractive error. The doctor may keep this
information in the patient's file, the patient may keep a copy, or
both.
Starting in the late 1950s, there have been millions of patients
throughout the world who have had refractive surgery of one form or
another. IOL calculations for these patients is not a new
consideration, nor is it unique with LASIK. It is a challenge, but it
is a challenge that in most cases is readily overcome.
There are much greater difficulties in IOL calculation than refractive
surgery.
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.
| |
|
| On Sun, 30 Jan 2005 22:18:48 -0500, Glenn - USAEyes.org wrote
(in article <u98rv0d51oeb18sqkmi4b480958dndnd73@4ax.com> ):
> What is preferable is for the patient to have the evaluation for intraocular
> lens calculations completed prior to refractive surgery. Then the process is
> simply subtracting the achieved refractive error from the previous refractive
> error. The doctor may keep this information in the patient's file, the
> patient may keep a copy, or both.
Is this something the Dr. might do without the patient asking or knowing
about it? Is it likely my Dr. has this info based on my scans etc.?
--
~RT
________________________________________________
Hogwasher, Premier News and Mail for OS X
http://www.asar.com/cgi-bin/product.../hogwasher.html
________________________________________________
| |
| Glenn - USAEyes.org 2005-01-31, 11:54 am |
| It is becoming very common for refractive surgeons to preoperatively
acquire and chart the information necessary for IOL calculations. It
is not something that is necessarily discussed with the patient, nor
is it something that would stand out all that much.
I suggest you ask your doctor's staff to check to determine if the
calculations for IOL power are in your medical chart.
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.
| |
| serebel 2005-01-31, 11:54 am |
| I'm pretty sure the way to achieve this is to get all the previous
measurements from your lasik surgeon.
SErebel
|
| |
|
|