Lasik Eyes Surgery - Update on Keratoconus

Author

Update on Keratoconus

gospa68@aol.com

2005-01-31, 11:54 am

LASIK weakens the cornea much like Keratoconus. Keratoconus is a
disease whose origin and mechanism of action is still not understood.
We know much more about LASIK as the weakening stems from the cutting
of a flap, whether it is done by a microkeratome or Intralase. Intacs
appears to be suitable for treating both in some, but certainly not all
cases.

Keratoconus: a new breakthrough in treatment

(Nashville, Tennessee, August 6, 2004). Tens of thousands of patients
who suffer from a congenital corneal blinding condition called
keratoconus can now have a chance of sight restoration from a new
breakthrough in eye surgery technology: Intacs corneal surgery,
approved by FDA for Humanitarian Device Exemption on August 4 and was
performed for the first time in the state using femtosecond laser by
Dr. Ming Wang of Nashville, Tennessee, this new eye surgery is bringing
hope of vision to these patients who up to now have been told that they
have no chance of visual restoration if diseases progresses except
risky corneal transplantation and potential life-long risk of graft
rejection.

"We are so excited to be at the forefront of research and technology
development of another breakthrough in eye technology in being able to
bring this revolutionary eye technology to the state to enable our
keratoconus patients to have a chance of vision restoration", Dr. Wang
said, who is a director of Wang vision Institute and staff surgeon at
Saint Thomas Hospital in Nashville, Tennessee.

Mr. Steve Howell, a 45 year old man from Sparks TN, has vision loss in
both eyes and suffers from a congenital corneal weakening condition
called pellucid marginal denegation, a disease similar to keratoconus.
He had been under the care of many eye doctors over the years and has
tried everything and failed. He was told by the doctors from major
hospital and medical centers that there was no way to slow down or stop
his disease progression and his vision would most likely get worse and
worse until the "death sentence of the cornea", i.e., replacement of
the entire cornea with a cornea from another person. Since the corneal
transplantation is a risky procedure that can cause blindness due to
infection or trauma and has a life-long risk of graft rejection
afterwards, Steve has been living in fear and worry all of his life
knowing that this devastating disease is relentlessly progressing and
he will continue to lose vision.

Steve Howell became the first patient in the state to have the
breakthrough eye surgery for keratoconus, femtosecond laser - Intacs
procedure, at Wang Vision Institute in Nashville, Tennessee. The
surgery went beautifully and Steve's vision has since improved. Most
importantly, his disease progression was halted and he no longer lives
in the fear of losing his vision due to a relentless and unstoppable
disease progression.

"For the first time ever, we have a treatment that treats the root
cause of the keratoconus disease. This breakthrough new technology
brings exciting new hope of vision restoration for the hundreds of
thousands of patients who suffer from this genetic corneal blinding
condition which is one of the most common causes for 50,000 corneal
transplantations in the US each year", Dr. Wang added.

Intacs are intracorneal ring segments manufactured by Addition
Technology, Inc (Des Plaines, IL). The ring segments are placed in the
corneal stromal to "tend" the cornea up to increase its strength.
Intacs received FDA HDE approval for the treatment of keratoconus on
August 4, 2004.

Combining Intacs technology with another high tech laser technology
Intralase femtosecond laser represents a new approach to the treatment
of keratoconus with Intacs, according to Dr. Wang. Femtosecond laser
has been developed to perform elective eye surgery such as LASIK.
However, its safety and precision in corneal tissue separation makes it
an ideal tool for creating intra-corneal channels for Intacs ring
segment placement. "We have been involved in research in the
management of keratoconus for many years and are pleased to be the
first in the state to offer this new eye surgery, femtosecond laser
with Intacs, to our keratoconus patients", Dr. Wang added.

Dr. Wang received his M.D. from Harvard Medical School (magna cum
laude) and is one of the few LASIK surgeons in the world today who
holds a doctorate degree in laser physics. Wang Vision Institute is the
site where many of the new eye surgery technologies are brought to the
state, including bladeless LASIK, customVue wavefront surgery and CK
radio wave for over-40 eyes. Dr. Wang is also a corneal specialist and
has been at forefront of development of novel eye surgery research and
technology to restore vision in terminally corneal blind patients. He
recently performed the world's first combined procedure of
laser-artificial cornea surgery and restored vision in a man who had
been blind for 40 years. Dr. Wang's patients come from around the
world to Nashville to have these new eye surgeries to have a chance to
see again. He established a sight restoration foundation, The Wang
Foundation for Sight Restoration, to help these patients pay for their
travel and care while continue waiving his professional fees

Glenn - USAEyes.org

2005-01-31, 11:54 am

LASIK will weaken the corneal structure of the cornea, however if the
cornea is healthy and at least 250 microns of cornea remains
untouched, the cornea remains stable. There are decades of studies
that affirm this and millions of patients that prove this fact.

Residual corneal thickness can be a concern for those with thin
corneas and/or high refractive error who are considering a refractive
surgery technique that removes tissue. Calculations and evaluations
are able to be performed before surgery to determine if the patient
would be in danger of an unstable cornea. If the margin of safety is
too close, it may be that a surface ablation technique such as PRK or
its cousins LASEK and Epi-LASIK would be an option. In some cases, a
phakic intraocular lens (P-IOL) or Refractive Lens Exchange (RLE) may
be appropriate.

For details, see http://www.usaeyes.org/faq/subjects/thickness.htm

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.

Sandy - LASIKdisaster.com - LASIKmemorial.com

2005-01-31, 11:54 am

Glenn - USAEyes.org wrote:
> LASIK will weaken the corneal structure of the cornea, however if the
> cornea is healthy and at least 250 microns of cornea remains
> untouched, the cornea remains stable. There are decades of studies
> that affirm this and millions of patients that prove this fact.

Hagele, you are a dangerous person and anyone who believes that you are
a patient advocate is just as misinformed as I was when I trusted my
optometrist to refer me to the best surgeon, not realizing that he had
a financial interest influencing his referral.

250 microns of residual stromal bed is NOT a guarantee that ectasia
(bowing forward of the weakened cornea which could lead to a cornea
transplant) will be avoided.

Glenn - USAEyes.org

2005-01-31, 11:54 am

Here yet again we have Keller telling us all that five decades of
studies and millions of patients are wrong because she thinks so.

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

2005-02-01, 2:46 pm

Glenn,
You are the one who is wrong and misinformed. There have been plenty of
presentations and publications that show that 250 microns is no
guarantee that ectasia will be avoided...and there have numerous case
reports presented and published that underscore this truth. There are
few if any surgeons (or optometrists) who would make the statement you
made.

I suggest that you control your knee jerk reactions to Sandy, reflect,
do your homework, then report to us on what your findings are. Being a
"patient advocate" requires responsibility, homework, and integrity.
WK

Glenn - USAEyes.org

2005-02-01, 2:46 pm

As to the point of guarantee, there are no guarantees in surgery. No
doctor can guarantee that a patient's cornea will not become diseased.
No doctor can guarantee a specific surgical outcome. What one can do
is look at the long history and accumulated knowledge about a
particular procedure and come to reasonable conclusions.

Since you love disputing virtually everything I say, perhaps you
should review the abstracts of the last three major ophthalmic
meetings and see how many studies refer to the accepted 250 micron
minimum. Better yet, go over to the website for the National Library
of Medicine and do a search on "250 micron". You will find over 700
citations that all affirm the same thing: 250 microns of untouched
corneal tissue is the minimum required to maintain stability of a
healthy cornea, and more is always better.

A question for you WizKid: Why do you continue to post statements
that I am easily able to refute with multiple studies of fact? You
simply look like a fool while wasting my time and yours.

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

2005-02-01, 2:46 pm

On 31 Jan 2005 06:40:10 -0800, "Sandy - LASIKdisaster.com -
LASIKmemorial.com" <sandy@savvysneaks.com> wrote:

>
>Glenn - USAEyes.org wrote:
>
>Hagele, you are a dangerous person and anyone who believes that you are
>a patient advocate is just as misinformed as I was when I trusted my
>optometrist to refer me to the best surgeon, not realizing that he had
>a financial interest influencing his referral.
>
>250 microns of residual stromal bed is NOT a guarantee that ectasia
>(bowing forward of the weakened cornea which could lead to a cornea
>transplant) will be avoided.

Neither is a completely untouched cornea on an eye that never had
LASIK done.

serebel

2005-02-01, 2:46 pm

Bear in mind folks, Sandy says lasik is bad for you even though she had
NINE surgeries!!

SANDY KELLER IS A FRAUD. HER WEBSITE IS CHOCK FULL OF LIES!! SHE SEES
20/20 AND READILY ADMITS THIS.

SErebel