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Home > Archive > Lasik Eyes Surgery > November 2005 > Hello eye and bill! This is ace! Lets post here
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Hello eye and bill! This is ace! Lets post here
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| You two have alot of informative knowlege about the risks of lasik! I
see you post on "asklasikdocs" alot too. Over here, many people discuss
the risks and cons of lasik so you two will fit in nicely. I will love
to read what you have to say and reply
| |
|
| >ksj said:
>"My perscription is SPH CYL AXISOD -1.00
>-1.00 090OS -0.75 -1.25 075"
>So little to gain... so much to
>lose!!! Refractive surgery isn't all that
>accurate. Your little bit of myopia
>will be a blessing later in
>life.
let me chime in, eye is very correct! Just read the previous threads
and read my thread on "are you less than -2 then forget lasik" What if
you get overcorrected? you wont see well at any distance, especially
near!
I bet you enjoy very
>crisp vision with a thin pair
>of glasses.
you can forgo glasses if they bother you that much. Even without
glasses your vision is crisp enough to do almost anything. My brother
has a very similar pescription to yours and he only wears glasses to
drive or read the lecture if he sits in back of class. His dependancy
on glasses is less than 10%!!!!!!!!
>You may still need glasses AFTER LASIK,
>and you will certainly need glasses
>as you age. We all will.
>So why not preserve your surgically
>untouched eyes?
Hes right. If you end up under/over corrected or with astigmastim you
will have gained nothing. Also youd need reading glasses anyway.
>The lowest aberrations you'll ever have are
>aberrations in your virgin cornea. You'll
>have induced aberrations and nerve damage
>with any corneal refractive procedure.
thats an additional risk
>Although I'd rather see you forgo a
>medically unneccessary procedure on your healthy
>eyes than be proven right (again).
Well the decision is still up to him/her. If that person insists on
doing lasik, do only ONE eye and wait for results. If you get lucky and
end up plano then its up to you to try the other eye and lose the
monovision benefit too. If you had a high pescription and/or lots of
astigmastim then yes lasik would be alot more tempting with less to
lose.
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| VISX fails to report >70% of clinical trial outcomes:
http://www.ncbi.nlm.nih.gov/entrez/...earch&DB=pubmed
Understanding pre-market approval and labeling differences of two
leading customized ablation platforms: a call for reform at the FDA.
Wachler BS, Hiatt JA.
J Refract Surg. 2004 Sep-Oct;20(5):S588-92.
Excerpt from the full text:
VISX reported that 97.7% (84/86) of eyes had UCVA of 20/20 or better at
12 months. These 86 eyes represent only 24.5% of patients.
Accountability is reported to be 95.6%,
despite the fact that 70.7% (248/351) of patients were labeled
“not yet eligible” for analysis at 12 months.
In the VISX trial, 13 eyes were excluded from the data analysis because
they required retreatments (12 within the study, 1 outside the study)
as these 13 eyes had UCVA of 20/32 or worse. Adding these eyes to the
12-month data, UCVA of 20/20 can be recalculated to be 84.8% of eyes
(84/99) at 12 months; this is in contradistinction to the 97.7%
reported with exclusion of these 13 eyes that saw 20/32 or worse
without correction.
The addition of these 13 eyes still only accounts for 28.2% (99/351) of
12-month results from patients enrolled in the clinical trial; the
refractive outcomes for >70% of the study population are not reported.
--------------------------------------------------------------------------------
1. "biased reports"
Posted by ace - wpb, FL on 03:10:51 11/14/2005
Include Original
Message on Reply
A report that only includes the 30% who got 20/20 is a highly biased
one. To be fair, it has to include everyone with good and bad results.
The only conclusion I can make is that 30% were achieving 20/20. The
percentage may be higher but no one knows from the ommitted results.
Not only that but how did the access 20/20? Was he able to read most or
all of the 20/20 line consistly without guessing? Or did he guess and
miss many? How clear did he see 20/20? It also does not measure quality
of vision. Did he see without GASH, ghosting, glare, halos, etc?
Just in case anyone gets mad, I am not bashing lasik, I am bashing
biased incomplete reports. On another forum, someone who works as an
employee at a lasik center told us less than 50% of the patients still
see 20/20 one or more years after lasik. He did say the majority do see
20/20 short term but many regress or develop some astigmastim. Theres
always enhancement which some choose not to go thru, other do without
guarantees and more risks.
I will agree that around 90% end up with 20/40 uncorrected. Is this
good enough? Will you still want to wear glasses? Its up to you. I was
talking to this lady who had lasik back in the year 2000 and she ended
up 20/30 to 20/40 but she was happy and could read words just a couple
feet less than I could with my BCVA glasses. I have no clue how good
her quality of vision was but her visual accuracy was very nearly as
good as my BCVA. She probably ended up very near plano or plano. She
was -6 to -7 before and blind without her glasses which she hated.
| |
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| >Hi Ace! I have noticed you are
>beginning to 'see through' all the
>marketing claims and are really getting
>a grasp on the problems inherent
>in refractive surgery.
There is alot of marketing and politics surrounding lasik. We have the
freedom of speech to give our opinions of lasik as long as we dont
flame anyone. I can see there are still shortcommings in lasik. However
we are working on them. lasik in the past was much worse than its
today. Lasik in the future very well may further address some
shortcommings.
>Believe it or not, there was an
>FDA hearing discussing the increase in
>HOAs by custom wavefront LASIK and
>how this information should be disclosed
>in the patient labeling to the
>public.
That information was never mentioned to me. I just heard it reduces
HOAs and makes your cornea more perfect and you see better without
glasses. I guess that is true for highly abberated eyes but ive seen
lots of people with high BCVA(better than 20/20) complain about
decrease in quality and even accuracy in vision. To put it short, the
better your BCVA is before lasik, the more you have to lose. The worse
your BCVA is before lasik, the less you lose and you may even gain!
>DR. GRIMMETT: Dr. Bradley stated wavefront-guided LASIK
>does not reduce the level of
>higher-order aberrations of the preoperative eye,
>and he also wrote there's no
>way wavefront-guided LASIK can correct higher-order
>aberrations and render super-normal vision.
I am hearing conflicting reports. Some make the claim you can improve
one or more lines of BCVA. Do you think it was because of glasses
minification? Improper glasses pescription? Improperly made or fitted
glasses/contacts?
If it always increases HOA's then your visual quality and accuracy will
always go down from your true BCVA. My true BCVA is probably 20/25 but
I am not gonna achieve this with -5 glasses. with RGP probably because
they dont minify and also they provide a smooth, percise fit over the
cornea. Unless wavefront lasik can really remove my HOAs and I end up
with less than what I had before lasik, I will see no better than I do
with glasses.
>DR. GRIMMETT: Sure. Wavefront-guided LASIK does not
>reduce the level of higher-order aberrations
>of the preoperative eye.
>DR. WEISS: Would that not be confusing
>to someone? Wouldn't that be confusing?
>
its very confusing, especially to me.
>DR. GRIMMETT: Michael Grimmett.It may suggest somehow
>wording in that wasn't it that
>the higher-order aberrations were 20 percent
>higher than the preop eye in
>the wavefront-guided versus what, 80 percent
>was the number?
>PARTICIPANT: Seventy-seven percent.
question for eye, what was your glasses pescription before and what was
your BCVA? You mentioned in another post you were seeing a blurry 20/15
for a while but not anymore. Were you able to see 20/15 better with
glasses?
>DR. WEISS: In here, is there any
>place saying that LASIK itself increases
>aberrations and that customized corneal ablation
>increases them less than conventional treatment?
>
>DR. GRIMMETT: I think that's the idea.
>
this makes sense. However the word "reduced" is used too liberally. Its
reduced compared to conventional lasik but NOT reduced compared to no
lasik. I think they should start telling everyone that wavefront lasik
will create a reduced amount of extra HOAs vs. conventional instead of
just saying "reduced" they need to explain the meaning of "reduced"
>DR. WEISS: So maybe we could put
>that wavefront-guided ablation ??
>DR. GRIMMETT: Conventional LADARVision LASIK increases higher-order
>aberrations by that figure 77 percent
>while wavefront-guided LASIK increases them by
>whatever, 20 percent, whatever the number
>is, or you can say reduces
>them to a 20-percent level, if
>you want to use the word
>"reduces."
>DR. BULLIMORE: I would avoid the term
>"reducing."
Its just so confusing! It reduces HOA's but not in the way many people
believe. We should say "increases less"
>DR. WEISS: I would say each of
>them increases it because basically whether
>or not you're treating the preexistent
>or what's induced, the bottom line
>is you still have more aberrations
>than you did when you started
>off.
>DR. GRIMMETT: Well, the intent is telling
>the traffic cop that you're speeding
>less than the other speeders.------------------------------------------------
>Go to FDA.gov and look up the
>approvals for wavefront guided treatements. You
>will see that the FDA states
>that HOAs are NOT reduced.
>You quoted Jack Holliday - here is
>something he said in the current
>issue of the Journal of Refractive
>Surgery:
>" Ablations based on refractive wavefront aberrometry
>alone, without detailed knoweledge of the
>patient's current corneal topography WILL NEVER
>attain the best visual results and
>is the reason wavefront-guided ablations have
>lost much of their luster".
>Unless you have an EXTREMELY aberrated cornea
>it is unlikely that your HOAs
>will be decreased by wavefront treatment.
>We are still searching for ONE
>patient who had normal virgin eyes...
>who experienced a decrease in HOAs
>after wavefront treatment.
There are topographies of people before and after lasik. Some of them
are obviously worse but others appear to be better but then I am not an
expert at interpreting topographies.
>Ace - you've hit the nail on
>the head! What is really upsettig
>to me is that doctors will
>perform LASIK on patients like you,
>who do not have 'visual quality
>reserve' to play around with.
He just said "we can get you to 20/25"
When he gave me a manual refraction I was kinda just guessing the 20/25
line. I had said "too small, cant see those" then he said try your best
so I did. I guess I can partially blame my -5 glasses for minification
and making the 20/25 line too small. If I end up plano with lasik then
his 20/25 claims are reasonable.
The fact
>that you are not correctable to
>20/20 now may or may not
>be due to HOA's (you should
>go for a thorough exam and
>find out).
I can show you my topographies here:
http://www.asklasikdocs.com/forum/main/3371.html
Feel free to interpret them. I have been told I have irregular
astigmastim which cant really be corrected by glasses. Notice the
orange colors, this is the steeper, uneven part.
Refractive surgery is riskier
>for you because refractive surgery does
>reduce visual quality and your baseline
>of visual quality is nothigh.
If I have highly abberated eyes, I may not end up worse but it still
wont guarantee overcorrection, dry eyes, regression, GASH, etc or still
needing glasses anyway.
>My hope is that getting the word
>out will protect the 'visual reserves'
>of patients like you.
What do you think of intacs then? Perhaps I am better suited for those?
| |
| Glenn - USAEyes.org 2005-11-14, 11:02 am |
| As if "Eye/Bill" is not posting here already.
Glenn Hagele
Executive Director
USAEyes.org
"Consider and Choose With Confidence"
Email to glenn dot hagele at usaeyes dot org
http://www.USAEyes.org
http://www.ComplicatedEyes.org
I am not a doctor.
| |
|
| I havent seen eye post here and bill posted a while back. They also
post on asklasikdocs but that forum isnt really the right one for what
topics they post. Someone linked me to this forum and says this is a
much better place to discuss the pros and cons of lasik freely.
| |
| Glenn - USAEyes.org 2005-11-14, 5:58 pm |
| An advantage/disadvantage of the Internet is that one person can
create many aliases. While you may not have seen the "Eye" and "Bill"
aliases in this newsgroup, this person has most assuredly posted here
under different aliases.
Glenn Hagele
Executive Director
USAEyes.org
"Consider and Choose With Confidence"
Email to glenn dot hagele at usaeyes dot org
http://www.USAEyes.org
http://www.ComplicatedEyes.org
I am not a doctor.
| |
| Ragnar 2005-11-14, 5:58 pm |
| The FDA is a very poor source of information unfortunately. Their
goal is more like to be a controlling agency like a mafia godfather
rather than an organization to promote excellent health care.
If you stay up late at night, watch one of the infomercials with that
infomercial nut Kevin Trudeau. He's making millions off of his book
exposing the true nature of the FDA. Trudeau's an opportunist nut
himself, but by targeting the FDA, he's found a goldmine.
On 14 Nov 2005 05:01:43 -0800, "Ace" <acemanvx@yahoo.com> wrote:
>
>There is alot of marketing and politics surrounding lasik. We have the
>freedom of speech to give our opinions of lasik as long as we dont
>flame anyone. I can see there are still shortcommings in lasik. However
>we are working on them. lasik in the past was much worse than its
>today. Lasik in the future very well may further address some
>shortcommings.
>
>
>
>
>That information was never mentioned to me. I just heard it reduces
>HOAs and makes your cornea more perfect and you see better without
>glasses. I guess that is true for highly abberated eyes but ive seen
>lots of people with high BCVA(better than 20/20) complain about
>decrease in quality and even accuracy in vision. To put it short, the
>better your BCVA is before lasik, the more you have to lose. The worse
>your BCVA is before lasik, the less you lose and you may even gain!
>
>
>
>I am hearing conflicting reports. Some make the claim you can improve
>one or more lines of BCVA. Do you think it was because of glasses
>minification? Improper glasses pescription? Improperly made or fitted
>glasses/contacts?
>If it always increases HOA's then your visual quality and accuracy will
>always go down from your true BCVA. My true BCVA is probably 20/25 but
>I am not gonna achieve this with -5 glasses. with RGP probably because
>they dont minify and also they provide a smooth, percise fit over the
>cornea. Unless wavefront lasik can really remove my HOAs and I end up
>with less than what I had before lasik, I will see no better than I do
>with glasses.
>
>
>
>
>its very confusing, especially to me.
>
>
>
>
>
>question for eye, what was your glasses pescription before and what was
>your BCVA? You mentioned in another post you were seeing a blurry 20/15
>for a while but not anymore. Were you able to see 20/15 better with
>glasses?
>
>
>
>
>
>this makes sense. However the word "reduced" is used too liberally. Its
>reduced compared to conventional lasik but NOT reduced compared to no
>lasik. I think they should start telling everyone that wavefront lasik
>will create a reduced amount of extra HOAs vs. conventional instead of
>just saying "reduced" they need to explain the meaning of "reduced"
>
>
>
>
>
>
>Its just so confusing! It reduces HOA's but not in the way many people
>believe. We should say "increases less"
>
>
>
>
>
>
>
>
>
>There are topographies of people before and after lasik. Some of them
>are obviously worse but others appear to be better but then I am not an
>expert at interpreting topographies.
>
>
>
>
>He just said "we can get you to 20/25"
>When he gave me a manual refraction I was kinda just guessing the 20/25
>line. I had said "too small, cant see those" then he said try your best
>so I did. I guess I can partially blame my -5 glasses for minification
>and making the 20/25 line too small. If I end up plano with lasik then
>his 20/25 claims are reasonable.
>
>
>The fact
>
>
>I can show you my topographies here:
>
>http://www.asklasikdocs.com/forum/main/3371.html
>
>Feel free to interpret them. I have been told I have irregular
>astigmastim which cant really be corrected by glasses. Notice the
>orange colors, this is the steeper, uneven part.
>
>
>Refractive surgery is riskier
>
>
>If I have highly abberated eyes, I may not end up worse but it still
>wont guarantee overcorrection, dry eyes, regression, GASH, etc or still
>needing glasses anyway.
>
>
>
>
>What do you think of intacs then? Perhaps I am better suited for those?
| |
|
| Bill and eye have repeately said they are not the same person, although
they talk alike. Two anti-lasik guys perhaps? as for the FDA, arent
they supposed to be protecting us by making sure products are safe
before approving them to the general public?
| |
| Glenn - USAEyes.org 2005-11-15, 12:55 pm |
| >...as for the FDA, arent
>they supposed to be protecting us by making sure products are safe
>before approving them to the general public?
They do, but many people do not understand the purpose of the FDA.
The FDA only evaluates and approves pharmaceuticals and medical
devices. It does not control every aspect of how those devices are
used. That is up to the doctor, who is under the review of the state
medical board. The FDA cannot stop a doctor from making a poor
decision on how to use an approved medical device.
I'm a pretty big critic of the bloated bureaucracy that is the FDA,
but overall they do what they are sanctioned to do.
Glenn Hagele
Executive Director
USAEyes.org
"Consider and Choose With Confidence"
Email to glenn dot hagele at usaeyes dot org
http://www.USAEyes.org
http://www.ComplicatedEyes.org
I am not a doctor.
| |
| Ragnar 2005-11-15, 5:59 pm |
| Well.. they take way too long to do what they do... and they don't do
a very good job of doing it.
On Tue, 15 Nov 2005 17:08:57 GMT, Glenn - USAEyes.org
<glenn.hageleSTOPSPAM@USAEyes.org> wrote:
>
>They do, but many people do not understand the purpose of the FDA.
>
>The FDA only evaluates and approves pharmaceuticals and medical
>devices. It does not control every aspect of how those devices are
>used. That is up to the doctor, who is under the review of the state
>medical board. The FDA cannot stop a doctor from making a poor
>decision on how to use an approved medical device.
>
>I'm a pretty big critic of the bloated bureaucracy that is the FDA,
>but overall they do what they are sanctioned to do.
>
>Glenn Hagele
>Executive Director
>USAEyes.org
>
>"Consider and Choose With Confidence"
>
>Email to glenn dot hagele at usaeyes dot org
>
>http://www.USAEyes.org
>http://www.ComplicatedEyes.org
>
>I am not a doctor.
| |
| eyetooamdamaged@yahoo.com 2005-11-16, 12:59 am |
| Ace, what bothers me is VISX claims almost everybody was 20/20 at 12
months after surgery and they hid the bad data to do this. People can't
make a good choice for themselves if they don't have the correcte
information!
| |
| eyetooamdamaged@yahoo.com 2005-11-16, 12:59 am |
| ACE said:
To put it short, the
better your BCVA is before lasik, the more you have to lose. The worse
your BCVA is before lasik, the less you lose and you may even gain!
Eye replied:
Depends on the reason your BCVA isn't good before LASIK. If your BCVA
isn't good because you have unusual higher order aberrations that are
explained by your cornea than MAYBE your HOAs will go down after
refractive surgery. Hovever, if your abberations are partly lenticular
(from the lens) or if you have other problems with your optical path,
then the typical increase in HOAs you end up with after refractive
surgery, ADDED to your other visual problems may leave you fairly
miserable and impaired.
| |
|
| Ace, Bill will return soon, he's traveling and will be pretty tired for
a while. I called him and told him you asked about him.
Eye
| |
|
| Ace, we received and e-mail to go to http://lasikflap.com/forum/
,which is brand new and under construction. It has a lot of interesting
headings, can't wait till it's fully loaded.
All my best,
Eye
| |
|
| youve linked me and I replied at asklasikdocs. Here is the reply again:
A report that only includes the 30% who got 20/20 is a highly biased
one. To be fair, it has to include everyone with good and bad results.
The only conclusion I can make is that 30% were achieving 20/20. The
percentage may be higher but no one knows from the ommitted results.
Not only that but how did the access 20/20? Was he able to read most or
all of the 20/20 line consistly without guessing? Or did he guess and
miss many? How clear did he see 20/20? It also does not measure quality
of vision. Did he see without GASH, ghosting, glare, halos, etc?
Just in case anyone gets mad, I am not bashing lasik, I am bashing
biased incomplete reports. On another forum, someone who works as an
employee at a lasik center told us less than 50% of the patients still
see 20/20 one or more years after lasik. He did say the majority do see
20/20 short term but many regress or develop some astigmastim. Theres
always enhancement which some choose not to go thru, other do without
guarantees and more risks.
I will agree that around 90% end up with 20/40 uncorrected. Is this
good enough? Will you still want to wear glasses? Its up to you. I was
talking to this lady who had lasik back in the year 2000 and she ended
up 20/30 to 20/40 but she was happy and could read words just a couple
feet less than I could with my BCVA glasses. I have no clue how good
her quality of vision was but her visual accuracy was very nearly as
good as my BCVA. She probably ended up very near plano or plano. She
was -6 to -7 before and blind without her glasses which she hated.
Depends on the reason your BCVA isn't good before LASIK. If your BCVA
isn't good because you have unusual higher order aberrations that are
explained by your cornea than MAYBE your HOAs will go down after
refractive surgery."
I can show you my topographies. I believe they are on my cornea. You
are right about the maybe. I do have a better chance of not getting
more HOA's than someone who has few HOAs to start off with. You
mentioned on average HOAs go up 20% in the day and 30-fold at night! I
might experience 0% increased HOAs in the day but this doesnt mean my
night vision will be good, especially with my huge pupils, could be
anywhere from 8-10mm, need to get them measured. Daytime vision isnt
something to worry but nighttime is, especially with large pupils.
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