|
Home > Archive > Lasik Eyes Surgery > December 2005 > Dr. Charles Casebeer testifies in deposition that all LASIK patients' eyes are bulging
You are viewing an archived Text-only version of the thread.
To view this thread in it's original format and/or if you want to reply to
this thread please [click here]
| Author |
Dr. Charles Casebeer testifies in deposition that all LASIK patients' eyes are bulging
|
|
|
| >From the deposition of J Charles Casebeer, M.D. p.69/70 3/12/04
Q, If you assume for me on the posterior float on that Orbscan that
there is red, a red spot, what is that indicative of?
Casebeer: That red spot that occurs on the posterior surface occurs in
all patients after LASIK on Orbscan.
Q. Does it indicate a thinning of the cornea?
Casebeer: Not necessarily. We thought originally that it did, but it
turns out thatthere are some people where the correlation is there, but
it doesn't mean that.
Q. And could it mean bulging of the cornea?
Casebeer: Well, that's what it's called. And in fact that word was
given to it by me. It's called "bulging" because we didn't know what to
call it to imply that there's a forward bulging, if you would, of the
back side of the cornea, but it's known to occur now in all LASIK
patients.
Q. Does that indicate that there's a thinnning of the cornea? Is that
why --
Casebeer: Well, it's certainly resultant from the LASIK and LASIK thins
the cornea, so I guess you could make the reasonable assumption that it
is caused by that...
p. 71/72
Q. In your training and experience, have patients with 250 microns,
have they developed ectasia?
Casebeer: I don't think I've ever seen that but I have heard of it.
I've seen it reported in journals and things that people with even
250 have developed corneal ectasia.
Q. What is ectasia?
Casebeer: The word "ectasia" means bulging and thinning and what it
is, it occurs in a system that's positive pressure where the outside
resistance is inadequate to contain the inside pressure, and it's
kind of like developing a blow-out in a car, not quite so dramatic, but
it's thinning and forward bowing of the cornea or other organs that
can be ecstatic.
Q. Can that be dangerous to a patient?
Casebeer: Indeed. It's one of the most feared complications of LASIK.
Q. And why is that?
Casebeer: Well, the reason being is that probably the only treatment
for it, although there's some new stuff that may help, is to have a
corneal transplant.
Q. And you indicated to me earlier that all LASIK patients have
bulging, what we've described as the red spot on the Orbscan at the
posterior, correct?
Casebeer: To the best of my knowledge, yes.
| |
|
| so basically you say all lasik causes ectasia and many end up needing a
cornea transplant?
| |
|
| Ace, all LASIK corneas bulge. This phenomenon was probably factored in
when surgeons initially set up nomograms for correction. A bulging
fudge factor was likely included. What's really scary is that bulging
can cause apparent 'regression'. Without an artemis scan there is no
way to tell if your myopic regression is from epithelial thickening or
from bulging. So imagine that the surgeon thins the cornea so much it
becomes weak and bulges over time. The patient loses their correction
and returns for an 'enhancement' which removes even more tissue. See
the problem? That's absolutely the worst thing to do!
I have heard of people who have had 3 enhancements for regression. Mark
Saxenmeyer of Fox news Chicago, for example. I worry about him in terms
of future ectasia.
Patients even with the supposedly 'safe limit' of 300 microns of tissue
under the bed have developed ectasia. No refractive surgery patient is
safe from ectasia. Thinning the cornea is always a risk.
Ace, don't let anyone mess with your corneas!
| |
| serebel 2005-12-05, 12:59 am |
| Who's the straight man here for this comedy act? "eye" lies and "ace"
swears to it.
| |
| Ragnar 2005-12-05, 12:59 am |
| Whoopee...bulging and thinning. Bulging and thinning are not the
same as ecstasia. Of course it's thinning. If you are ablating 25%
of the cornea, you sure aren't going to have a thicker cornea
afterwards.
Also, for those that actually read the entire post, they will see
this:
Q. In your training and experience, have patients with 250 microns,
have they developed ectasia?
Casebeer: I don't think I've ever seen that but I have heard of it.
Out of 10 million procedures, I would imagine that just about
everything has been heard of... and once again.. some LASIK patents do
get ecstasia... so do NON-LASIK people. Oddly, the incidence of
ectasia in LASIK patients is LOWER than non-LASIK people because the
LASIK patients have been screened.
I have more bad news using the logic below. 100% of LASIK patients
will die. It may take up to 90 years, but they will die. I guess
nobody should have LASIK done. LASIK patients also get cancer, get
hit by cars, go deaf, go bald, get cataracts, have their teeth fall
out. and their pets die. Darn that LASIK anyway.
On 4 Dec 2005 13:20:58 -0800, "Eye" <eyetooamdamaged@yahoo.com> wrote:
>
>Q, If you assume for me on the posterior float on that Orbscan that
>there is red, a red spot, what is that indicative of?
>Casebeer: That red spot that occurs on the posterior surface occurs in
>all patients after LASIK on Orbscan.
>Q. Does it indicate a thinning of the cornea?
>Casebeer: Not necessarily. We thought originally that it did, but it
>turns out thatthere are some people where the correlation is there, but
>it doesn't mean that.
>Q. And could it mean bulging of the cornea?
>Casebeer: Well, that's what it's called. And in fact that word was
>given to it by me. It's called "bulging" because we didn't know what to
>call it to imply that there's a forward bulging, if you would, of the
>back side of the cornea, but it's known to occur now in all LASIK
>patients.
>Q. Does that indicate that there's a thinnning of the cornea? Is that
>why --
>Casebeer: Well, it's certainly resultant from the LASIK and LASIK thins
>the cornea, so I guess you could make the reasonable assumption that it
>is caused by that...
>
>p. 71/72
>Q. In your training and experience, have patients with 250 microns,
>have they developed ectasia?
>Casebeer: I don't think I've ever seen that but I have heard of it.
>I've seen it reported in journals and things that people with even
>250 have developed corneal ectasia.
>Q. What is ectasia?
>Casebeer: The word "ectasia" means bulging and thinning and what it
>is, it occurs in a system that's positive pressure where the outside
>resistance is inadequate to contain the inside pressure, and it's
>kind of like developing a blow-out in a car, not quite so dramatic, but
>it's thinning and forward bowing of the cornea or other organs that
>can be ecstatic.
>Q. Can that be dangerous to a patient?
>Casebeer: Indeed. It's one of the most feared complications of LASIK.
>Q. And why is that?
>Casebeer: Well, the reason being is that probably the only treatment
>for it, although there's some new stuff that may help, is to have a
>corneal transplant.
>Q. And you indicated to me earlier that all LASIK patients have
>bulging, what we've described as the red spot on the Orbscan at the
>posterior, correct?
>Casebeer: To the best of my knowledge, yes.
| |
| Ragnar 2005-12-05, 12:59 am |
| Ace.. if you don't want poo, don't go fishing in the toilet... in
other words... don't waste your time corresponding with Eye.
On 4 Dec 2005 16:21:10 -0800, "Eye" <eyetooamdamaged@yahoo.com> wrote:
>Ace, all LASIK corneas bulge. This phenomenon was probably factored in
>when surgeons initially set up nomograms for correction. A bulging
>fudge factor was likely included. What's really scary is that bulging
>can cause apparent 'regression'. Without an artemis scan there is no
>way to tell if your myopic regression is from epithelial thickening or
>from bulging. So imagine that the surgeon thins the cornea so much it
>becomes weak and bulges over time. The patient loses their correction
>and returns for an 'enhancement' which removes even more tissue. See
>the problem? That's absolutely the worst thing to do!
>
>I have heard of people who have had 3 enhancements for regression. Mark
>Saxenmeyer of Fox news Chicago, for example. I worry about him in terms
>of future ectasia.
>
>Patients even with the supposedly 'safe limit' of 300 microns of tissue
>under the bed have developed ectasia. No refractive surgery patient is
>safe from ectasia. Thinning the cornea is always a risk.
>
>Ace, don't let anyone mess with your corneas!
| |
| Glenn - USAEyes.org 2005-12-20, 12:55 pm |
| "Eye", you are a cross between Chicken Little and the five blind men
who each touch a different part of an elephant and each come up with a
different description of what is an elephant. Like you, the blind men
don't get the full picture and come to inaccurate conclusions.
Yes, there is a posterior forward shift of the cornea after refractive
surgery. This shift is reasonably predictable and is considered as a
part of the algorithm created for the excimer laser, along with many
other biomechanical changes that occur during LASIK. Because all these
predictable calculations are made, LASIK has a relatively high rate of
predictable outcomes.
Yes, the posterior forward shift can, and does, regress back toward
its original position. This is a part of the healing process and it
too is reasonably predictable. In fact, a recent paper
(Ophthalmologica 2006;220:37-42) provides additional details of this
shift and the difference between the shift in LASIK and LASEK. It is
because of detailed studies like this that LASIK can be as predictable
as it is.
You conclusions that an enhancement surgery is "absolutely the worst
thing to do" is simplistic, at best, and idiotic, at worst. The sky is
not falling because a patient may need an enhancement after the
healing period has ended. Sure, everyone would like the full
correction to be made with only one surgery, but only in the instance
of an extremely thin cornea would an enhancement be overly
problematic. Corneal thickness measurements are performed before
surgery so this too would have been predictable. The patient and
doctor are able to be made fully aware that the possibility of an
enhancement (if needed) would be low.
It is true that a relatively small number of patients who were thought
to have had more than 300 microns of untouched corneal tissue have
developed ectasia, but nearly all have been determined to have
diseased corneas (such as keratoconus) or the untouched bed was in
fact less than the 250 microns necessary for stability in a healthy
cornea. There are a handful of outliers, but a handful out of millions
is to be expected.
There are also patients who have LESS than 250 microns of untouched
cornea and have NOT developed ectasia. These too are outliers and a
handful out of millions is to be expected.
About the only difference between you and the five blind men touching
the elephant is that they cannot see the whole picture. In my opinion,
you choose not to see.
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.
|
| |
|
|