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The Charade Continues
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|
| gospa68@aol.com 2005-04-05, 6:29 pm |
| It has always been of great interest to see how complication data
and/or inclusion information spills out to the public years after the
surgical community became aware of it but did not act on it in the best
interests of THEIR patients.
Case in point...Brauweiler, Wheler et al in a letter to Ophthalmology,
September 1999, outline the reasons why LASIK should not be done on
patients with more than 8 diopters of myopia. Brauweiler points to the
Barraguer experience which shows that 50% experienced significant
ectasia 20 years after the "thinning of the cornea," with use of the
microkeratome.
Did surgeons stop doing -8+ diopter patients in 1999? No. Was this
seriously looked at with retropsective data? No.
Now comes this just published article in which Michael Lawless, MD, of
Australia states that he does not do -8=3D diopter patients NOW. How many
CRSQA surgeons are performing LASIK above 8 diopters today? Who has
stopped? And when?
WK
LASIK
---------------------------------------------------------------------------=
-----
KUALA LUMPUR, Malaysia - A surgeon who has been using
wavefront-customized LASIK for more than 2 years reviewed some of his
clinical results and patient selection criteria in an interview here.
Michael Lawless, MD, spoke to Ocular Surgery News at the Asia Pacific
Academy of Ophthalmology meeting about his clinic's experience with
customized LASIK.
Dr. Lawless' clinic in Sydney, Australia, began using Alcon's
LADARVision platform about 4 years ago, he said, and began using the
company's wavefront customization options in January 2003. From May
to December 2003, the clinic treated about 2,500 eyes, and about 29% of
those received customized wavefront surgery, he said. He discussed some
of the clinical results in the custom-treated eyes.
"We were getting low to moderate uncorrected visual acuity in the
range of 90% to 95% with 20/20, and about half of those were 20/15,"
he said.
Dr. Lawless also observed that "contrast sensitivity could improve
under low light and photopic conditions" for patients undergoing
customized treatments. And psychometric testing showed that patients
treated with wavefront-guided correction "came up with results that
were better than we could get with conventional LASIK," he said.
Dr. Lawless also spoke about his patient selection criteria for
customized LASIK and for corneal refractive surgery in general.
"The people who didn't get custom were those outside the treatment
range and people with hyperopia," he said. In addition, patients with
thin corneas were at first not selected for the custom program because
early algorithms removed more tissue than current algorithms, he said.
Each new algorithm has been "always better than the previous
version," he said. "They're better at saving tissue, better at
targeting spherical aberration and remain a very good treatment for
coma and other higher-order aberrations."
Not all patients should be candidates for corneal refractive surgery,
Dr. Lawless said.
"Somewhere around -8 D is my limit for corneal refractive
surgery," he said. "Beyond that I don't want to operate on the
cornea because you're doing too much to it."
Dr. Lawless says he prefers to leave a stromal bed at least 300 =B5m
thick. With new algorithms, he said, Alcon's CustomCornea treatment
regimen is "relatively tissue sparing, but it still has
constraints." Faced with a patient whose cornea is too thin, he will
opt to perform another procedure rather than risk thinning the residual
stromal bed to under 300 =B5m, he said.
Ideally, Dr. Lawless said, he would like to see the CustomCornea
treatment range expanded, "not on the myopia or astigmatism side,
because they are maxed out, but on the hyperopic side."
A more complete version of the interview with Dr. Lawless will appear
in an upcoming print edition of Ocular Surgery News.
| |
| Glenn - USAEyes.org 2005-04-05, 6:29 pm |
| Barraquer and others showed ectasia developed in some patients who had
less than 250 microns of healthy cornea remaining untouched after
refractive surgery. Interestingly, ectasia does not occur in all
patients with less than 250 microns of untouched cornea.
This 250 micron minimum has withstood the test of about four decades
of practical experience and multiple studies. It is the standard
adopted by the FDA.
A simple pass of a microkeratome is not going to be enough to cause
ectasia on a healthy cornea of normal thickness. I believe the letter
to which you refer appears to reference thinning the cornea with
Automated Lamellar Keratectomy (ALK), which involves multiple passes
of the microkeratome to shave off corneal tissue, not today's
significantly more accurate excimer laser ablation under a flap of
corneal tissue that was created with a single partial pass of a
microkeratome.
The thickness of the cornea can be measured prior to surgery and
calculations can be made (within a margin of error) to determine if
the patient will have the requisite 250 micron minimum remaining
untouched after surgery.
The FDA has approved excimer lasers to perform refractive surgery on
patients with greater than 8.00 diopters of myopia. All surgeons are
able to provide care within the approval parameters of the FDA,
including CRSQA Certified Refractive Surgeons.
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 2005-04-05, 6:29 pm |
| There goes Wizzer spinning the truth again. He waited a long time to
come up with his latest distortion.
SErebel
| |
|
| Glen, how can you be so glaringly uniformed? Patients with 300 microns of
residual stroma
under the bed have developed ectasia, and 300 microns is becoming the
emerging standard
for safety. But even 300 microns isn't safe. Why don't you ask Gail Keziah
how many
patients she has in her database with ectasia and at least 300 microns under
the flap?
See the findings of the peer-reviewed studies in one of the top RS jounals
below. In the
bottom study it was observed that 350 microns of residual bed was associated
with
lack forward shift of the cornea. Hey Ragnar, your eyes are bulging.
J Cataract Refract Surg. 2004 May;30(5):1067-72. Related Articles,
Links
Comment in:
a.. J Cataract Refract Surg. 2004 Nov;30(11):2251; author reply 2251-2.
Residual bed thickness and corneal forward shift after laser in situ
keratomileusis.
Miyata K, Tokunaga T, Nakahara M, Ohtani S, Nejima R, Kiuchi T, Kaji Y,
Oshika T.
Miyata Eye Hospital, Miyasaki, Japan.
PURPOSE: To prospectively assess the forward shift of the cornea after laser
in situ keratomileusis (LASIK)
in relation to the residual corneal bed thickness.
SETTING: Miyata Eye Hospital, Miyazaki, Japan.
METHODS: Laser in situ keratomileusis was performed in 164 eyes of 85
patients with a mean
myopic refractive error of -5.6 diopters (D) +/- 2.8 (SD) (range -1.25
to -14.5 D). Corneal
topography of the posterior corneal surface was obtained using a
scanning-slit topography
system before and 1 month after surgery. Similar measurements were performed
in 20 eyes of 10
normal subjects at an interval of 1 month. The amount of anteroposterior
movement of the posterior
corneal surface was determined. Multiple regression analysis was used to
assess the factors that
affected the forward shift of the corneal back surface.
RESULTS: The mean residual corneal bed thickness after laser ablation was
388.0 +/- 35.9 microm
(range 308 to 489 microm). After surgery, the posterior corneal surface
showed a mean forward
shift of 46.4 +/- 27.9 microm,
which was significantly larger than the absolute difference of 2
measurements obtained in normal
subjects, 2.6 +/- 5.7 microm (P<.0001, Student t test). Variables relevant
to the forward shift
of the corneal posterior surface were, in order of magnitude of influence,
the amount of laser
ablation (partial regression coefficient B = 0.736, P<.0001) and the
preoperative corneal thickness
(B = -0.198, P<.0001). The residual corneal bed thickness was not relevant
to the forward shift
of the cornea. CONCLUSIONS: Even if a residual corneal bed of 300 microm or
thicker is
preserved, anterior bulging of the cornea after LASIK can occur. Eyes with
thin corneas and
high myopia requiring greater laser ablation are more predisposed to an
anterior shift of the cornea.
---------------------------------------------------------------------------------------------------
J Cataract Refract Surg. 2003 Apr;29(4):778-84. Related Articles,
Links
Comment in:
a.. J Cataract Refract Surg. 2004 Mar;30(3):533-4.
Early spatial changes in the posterior corneal surface after laser in situ
keratomileusis.
Lee DH, Seo S, Jeong KW, Shin SC, Vukich JA.
Department of Ophthalmology, Ilsan Paik Hospsital, Inje university Medical
College, South Korea. dhlee@ilsanpaik.ac.kr
PURPOSE: To evaluate the forward shift of the posterior corneal
surface after myopic laser in situ keratomileusis
(LASIK) relative to the residual stromal bed thickness and the ablation
percentage of the total
corneal thickness.
SETTING: Department of Ophthalmology, Ilsan Paik Hospital, Inje University,
Ilsan, Korea.
METHODS: Three hundred sixty-three eyes of 182 consecutive patients who had
LASIK were examined retrospectively. The range of the refractive errors
was -1.5 to -12.0 diopters.
Corneal topography using Orbscan II (Bausch & Lomb) and pachymetry were
obtained preoperatively
and 1 week and 1, 2, and 3 months postoperatively. The patients were divided
into 4 groups based on
the residual stromal bed thickness: Group 1, 145 eyes with less than 250
microm; Group 2, 129 eyes
with 250 to 300 microm; Group 3, 76 eyes with 300 to 350 microm; and Group
4, 13 eyes with more
than 350 microm. They were also grouped by the ablation percentage per total
corneal thickness:
Group A, 16 eyes with less than 10%; Group B, 166 eyes with 10% to 20%;
Group C, 146 eyes
with 20% to 30%; and Group D, 35 eyes with more than 30%. RESULTS: The
increase in the forward
shift of the posterior corneal surface postoperatively correlated with the
residual corneal bed thickness
and the ablation ratio per total corneal thickness. There were no
statistically significant changes in the
postsurgical forward shift of the posterior corneal surface if the residual
corneal thickness remained greater
than 350 microm or the ablation percentage was less than 10%.
CONCLUSIONS: Increased forward shift of the posterior corneal surface is
common after myopic LASIK
and correlates with the residual corneal thickness and the ablation
percentage per total corneal thickness.
An excessively thin residual corneal bed or a large ablation percentage may
increase the risk of iatrogenic
complications.
-----------------------------------------------------------------------------------------------------------------------------------------------------------
"Glenn - USAEyes.org" <glenn.hageleSTOPSPAM@USAEyes.org> wrote in message
news:1dn3515j523e9uj17jq4nvsnc84b6ql5lr@4ax.com...
> Barraquer and others showed ectasia developed in some patients who had
> less than 250 microns of healthy cornea remaining untouched after
> refractive surgery. Interestingly, ectasia does not occur in all
> patients with less than 250 microns of untouched cornea.
>
> This 250 micron minimum has withstood the test of about four decades
> of practical experience and multiple studies. It is the standard
> adopted by the FDA.
>
> A simple pass of a microkeratome is not going to be enough to cause
> ectasia on a healthy cornea of normal thickness. I believe the letter
> to which you refer appears to reference thinning the cornea with
> Automated Lamellar Keratectomy (ALK), which involves multiple passes
> of the microkeratome to shave off corneal tissue, not today's
> significantly more accurate excimer laser ablation under a flap of
> corneal tissue that was created with a single partial pass of a
> microkeratome.
>
> The thickness of the cornea can be measured prior to surgery and
> calculations can be made (within a margin of error) to determine if
> the patient will have the requisite 250 micron minimum remaining
> untouched after surgery.
>
> The FDA has approved excimer lasers to perform refractive surgery on
> patients with greater than 8.00 diopters of myopia. All surgeons are
> able to provide care within the approval parameters of the FDA,
> including CRSQA Certified Refractive Surgeons.
>
> 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 2005-04-05, 6:29 pm |
|
Tabby wrote:
> Why don't you ask Gail Keziah
> how many
> patients she has in her database with ectasia and at least 300
microns under
> the flap?
>
How would Gail's database compare with the MILLIONS of lasik surgeries
that don't result in ectasia?
SErebel
| |
| Glenn - USAEyes.org 2005-04-05, 6:29 pm |
| Forward corneal shift that stabilizes during the normal healing period
is called regression. It happens with virtually all patients who have
more than 6 diopters of correction, no matter how much residual bed
remains. It appears that you desire to change the definition of
ectasia to meet your anti-LASIK agenda.
There are many reports and studies that show patients with more than
250 microns of untouched cornea that develop true ectasia. One by one
each is being finally determined to be an unhealthy cornea, such as
pre-existing undiagnosed keratoconus, or that the actual stromal bed
was not what was previously assumed. There are about six cases that I
know exist where there is no current underlying cause of the ectasia.
That is out of how many millions?
If you want guarantees, don't have surgery of any kind. There are no
guarantees in medicine; there are only reasonable probabilities. It
is based upon those reasonable probabilities that the FDA has
determined the 250 micron minimum to be adequate. It is by practical
use of those probabilities that doctors are able to reasonably
reliably predict when problems are going to occur. Yes, after a few
million patients there will be some who have improbable results. That
is why there are no guarantees in 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.
| |
| CatmanX 2005-04-05, 6:29 pm |
| But Gail's list shows that some do develop ectasia. We don't fully
understand why these people do, especially those in the 250-300 micron
range, who, by convention, should not be developing ectasia.
This is an area that requires some more research. Is it weaker collagen
fibrils? Has the collagen been adversely affected by the laser?????
grant
| |
|
|
| Ragnar 2005-04-06, 8:49 am |
| Yes.. and of course when some bozo such as yourself doesn't understand
something, they automatically blame LASIK.
Basically, some people wind up with ecstasia, even moreso if they have
myopic eyes. LASIK certainly doesn't prevent the incidence of
ecstastia, but then again, neither has it been shown to induce
ecstasia.
People need to remember that most eyes on which LASIK is peformed are
mishapen, elongated, stretched, and otherwise problematic before
surgery, so it's obvious that there are going to be some problems
after surgery as well. People don't get perfect eyes after having
LASIK done, they do get a dramatic improvement though.
On 5 Apr 2005 14:38:38 -0700, "CatmanX" <grantm@connexus.net.au>
wrote:
>But Gail's list shows that some do develop ectasia. We don't fully
>understand why these people do, especially those in the 250-300 micron
>range, who, by convention, should not be developing ectasia.
>
>This is an area that requires some more research. Is it weaker collagen
>fibrils? Has the collagen been adversely affected by the laser?????
>
>grant
| |
| Tabby 2005-04-08, 10:25 pm |
| Ragnar,
LASIK most certainly is responsible for causing ectasia. It thins the
cornea! Also myopic eyes are not necessarily unhealthy eyes - in the vast
majority of cases, myopia is due to to an overall oblong shape of the eye,
not to thinness of the cornea. All eyes lose some degree of visual quality
after LASIK. Some people experience a devastating loss of visual quality and
loss of the ability to function in certain situations, for example in dim
lighting. Some experience chronic pain after LASIK.
It's a bad surgery. If you read more [read, if you read at all] you would
know something about this.
"Ragnar" <ragnarsuomi@yahoo.com> wrote in message
news:7gl651lepverahup8tra6pu6g93rhfgq5h@4ax.com...
> Yes.. and of course when some bozo such as yourself doesn't understand
> something, they automatically blame LASIK.
> Basically, some people wind up with ecstasia, even moreso if they have
> myopic eyes. LASIK certainly doesn't prevent the incidence of
> ecstastia, but then again, neither has it been shown to induce
> ecstasia.
>
> People need to remember that most eyes on which LASIK is peformed are
> mishapen, elongated, stretched, and otherwise problematic before
> surgery, so it's obvious that there are going to be some problems
> after surgery as well. People don't get perfect eyes after having
> LASIK done, they do get a dramatic improvement though.
>
>
> On 5 Apr 2005 14:38:38 -0700, "CatmanX" <grantm@connexus.net.au>
> wrote:
>
>
| |
| serebel 2005-04-08, 10:25 pm |
|
Tabby wrote:
> Ragnar,
>
> LASIK most certainly is responsible for causing ectasia. It thins the
> cornea! Also myopic eyes are not necessarily unhealthy eyes - in the
vast
> majority of cases, myopia is due to to an overall oblong shape of
the eye,
> not to thinness of the cornea. All eyes lose some degree of visual
quality
> after LASIK. Some people experience a devastating loss of visual
quality and
> loss of the ability to function in certain situations, for example in
dim
> lighting. Some experience chronic pain after LASIK.
> It's a bad surgery. If you read more [read, if you read at all] you
would
> know something about this.
>
>
You pretty much summed it up for yourself, SOME people(out of
millions)experience loss after lasik. Lasik is not a bad surgery.
Tabby, Mermaid, or Tabby's mommy , what ever you call yourself these
days is just another SE lunatic.
SErebel
| |
| Ragnar 2005-04-08, 10:25 pm |
| Tabby, we should all be grateful that there are not more malcontent
nuts such as yourself infecting the world with your poisonous
misinformation.
Anybody familiar with this newsgroup knows who you are. With your
reputation, I don't blame you for changing your alias.
I would expand on that, but by changing your alias, you are now even
more insignificant than you were before.
It's also interesting to see that you have been reading my posts about
myopia. The bad thing is that you have pulled your classic trick of
changing certian key facts amongst the other facts to twist reality.
This one can be covered easily. Myopic eyes are not necessarily
unhealthy? That is completely wrong. The myopic eye is elongated and
susceptible to a greater incidence of most eye problems including
detached retinas, floaters, macular degeneration, color distortion,
etc. The visual receptors at the back of the eye are stretched due to
the shape. There is no way to make a myopic eye non-myopic. The
primary problem with a myopic eye is that the light entering the eye
is focusing at a point in front of rather than ON the retina. To get
around this, LASIK flattens the center of the cornea by about the
thickness of one sheet of typing paper. This reduces the curve of the
cornea slightly so the light focuses on the retina instead of in front
of it. This has the added benefit of greatly reducing any astigmatism
(irregular curve which everybody has to some degree).
No other surgery provides more benefits with such a miniscule risk.
For the vast majority of myopic people, LASIK is their best option.
The rest of the people are not LASIK candidates and a competent
surgeon will not do the procedure on them. Just because your surgeon
was an idiot doesn't mean that LASIK is bad. You were told many times
by many doctors over the period of many years not to have refractive
surgery. You finally found a surgeon who would do the surgery on you.
You didn't like the results, you continued to shop around for more
surgery.. there is no surgery you have even turned down.. You just had
your 10th surgery on your right eye as I recall.
Your misinformation is criminal.
On Wed, 6 Apr 2005 19:30:13 -0400, "Tabby" <Tabby@Yahoo_nospam.com>
wrote:
>Ragnar,
>
>LASIK most certainly is responsible for causing ectasia. It thins the
>cornea! Also myopic eyes are not necessarily unhealthy eyes - in the vast
>majority of cases, myopia is due to to an overall oblong shape of the eye,
>not to thinness of the cornea. All eyes lose some degree of visual quality
>after LASIK. Some people experience a devastating loss of visual quality and
>loss of the ability to function in certain situations, for example in dim
>lighting. Some experience chronic pain after LASIK.
>It's a bad surgery. If you read more [read, if you read at all] you would
>know something about this.
>
>
>"Ragnar" <ragnarsuomi@yahoo.com> wrote in message
>news:7gl651lepverahup8tra6pu6g93rhfgq5h@4ax.com...
>
| |
| CatmanX 2005-04-08, 10:25 pm |
| Here we go again clown.
1) If you expect problems to occur, why are you advising people to go
ahead with RS?? There is no logic here.
2) The stretching that has occurred is in the stroma of the globe
causing axial elongation. All studies show there is NO corneal effect
from axial myopia. Again, your arguement has no credence.
Shit happens and we don't fully understand it. I am simply pointing out
that we don't know why some people who should not develop ectasia under
our current understanding do in fact go on to develop it.
| |
| CatmanX 2005-04-08, 10:25 pm |
| SErebel, is it not the issue that it does happen in some and the reason
sould be addressed. Yes, most RS recipients are getting good results
and are happy, but it does not mean we need to ignore those who don't
get perfect results.
As an example, take many of the problems from 5-10 years ago, most were
due to small ablation zones and small blends, now we see fewer problems
as ablation zone size has increased and blends are much larger. These
patients were told they were perfectly corrected and had 20/20 vision,
it is only recently we have fully understood why these people were
complaining.
| |
| Tabby 2005-04-08, 10:25 pm |
| Christopher, everyone knows that the malcontent nut is you.
"Ragnar" <ragnarsuomi@yahoo.com> wrote in message
news:fj8a519t23tall5jn3bqor83gepv71rl06@4ax.com...
> Tabby, we should all be grateful that there are not more malcontent
> nuts such as yourself infecting the world with your poisonous
> misinformation.
> Anybody familiar with this newsgroup knows who you are. With your
> reputation, I don't blame you for changing your alias.
> I would expand on that, but by changing your alias, you are now even
> more insignificant than you were before.
>
> It's also interesting to see that you have been reading my posts about
> myopia. The bad thing is that you have pulled your classic trick of
> changing certian key facts amongst the other facts to twist reality.
>
> This one can be covered easily. Myopic eyes are not necessarily
> unhealthy? That is completely wrong. The myopic eye is elongated and
> susceptible to a greater incidence of most eye problems including
> detached retinas, floaters, macular degeneration, color distortion,
> etc. The visual receptors at the back of the eye are stretched due to
> the shape. There is no way to make a myopic eye non-myopic. The
> primary problem with a myopic eye is that the light entering the eye
> is focusing at a point in front of rather than ON the retina. To get
> around this, LASIK flattens the center of the cornea by about the
> thickness of one sheet of typing paper. This reduces the curve of the
> cornea slightly so the light focuses on the retina instead of in front
> of it. This has the added benefit of greatly reducing any astigmatism
> (irregular curve which everybody has to some degree).
> No other surgery provides more benefits with such a miniscule risk.
>
> For the vast majority of myopic people, LASIK is their best option.
> The rest of the people are not LASIK candidates and a competent
> surgeon will not do the procedure on them. Just because your surgeon
> was an idiot doesn't mean that LASIK is bad. You were told many times
> by many doctors over the period of many years not to have refractive
> surgery. You finally found a surgeon who would do the surgery on you.
> You didn't like the results, you continued to shop around for more
> surgery.. there is no surgery you have even turned down.. You just had
> your 10th surgery on your right eye as I recall.
>
> Your misinformation is criminal.
>
>
> On Wed, 6 Apr 2005 19:30:13 -0400, "Tabby" <Tabby@Yahoo_nospam.com>
> wrote:
>
>
| |
| Tabby 2005-04-08, 10:25 pm |
| You have no idea who I am. I had a single surgery on each eye, and was never
told I was a bad candidate for LASIK even though that was clearly the case.
LASIK reduces the mechanical strength of the cornea by about 1/3because the
LASIK flap does not heal with the underlying stroma. LASIK patients always
have an interface, or split cornea - for life.
Myopic patients may have floaters, but the suction ring used during LASIK
often pulls up more and can also damage the retina and optic nerve.
Since LASIK leaves the cornea flattened and lumpy instead of smooth and
round, it is harder for post-LASIKs to keep the ocular surface comfortably
wet. This leads to ocular surface disease, poor vision and pain in many
patients.
Doctors don't bother to tell LASIK patients that their corneal shape will be
so flatttened and irregular that it may be difficult to be fitted for
contact lenses should they need them. And the decrease in corneal nerve
density caused by LASIK may render the eyes too dry to tolerate lenses.
The thought that doctors do this surgery to healthy eyes without informing
patients of these facts makes me physically sick.
Since LASIK damages every eye (reduces optical quality of the eye, causes
permanent nerve damage and predisposes patients to ectasia) it is not a good
surgery for anyone.
Prominent refractive surgeons including Marguerite McDonald and Bill
Trattler have given up LASIK completely because of problems inherent in the
LASIK flap and the poor visual results obtained with LASIK as compared with
surface ablations.
It is possible for LASIK to reduce some astigmatism but it can also induce
astigmatism in patients. LASIK almost always induces some irregular
astigmatism (the kind that cannot be corrected with glasses). Who wants to
have permanent distortions created in their corneas???
A wise doctor once told me that the most un-aberrated eyes you will ever
have are your virgin (pre-op) eyes. Only in the most unusual circumstances
(when something went very awry with a previous surgery or the pre-op eye had
very high aberrations) will LASIK reduce the higher order aberrations in the
eye. LASIK typically increases these distortions, even wavefront LASIK.
Who am I, Ragnar? Take a stab at it ... go ahead.
"Tabby" <Tabbyr@Yahoo_nospam.com> wrote in message
news:1112921951.0274be9b103c5790a678bf32268e0540@teranews...
> Christopher, everyone knows that the malcontent nut is you.
>
> "Ragnar" <ragnarsuomi@yahoo.com> wrote in message
> news:fj8a519t23tall5jn3bqor83gepv71rl06@4ax.com...
>
>
| |
| serebel 2005-04-08, 10:25 pm |
|
CatmanX wrote:
> SErebel, is it not the issue that it does happen in some and the
reason
> sould be addressed. Yes, most RS recipients are getting good results
> and are happy, but it does not mean we need to ignore those who don't
> get perfect results.
>
> As an example, take many of the problems from 5-10 years ago, most
were
> due to small ablation zones and small blends, now we see fewer
problems
> as ablation zone size has increased and blends are much larger. These
> patients were told they were perfectly corrected and had 20/20
vision,
> it is only recently we have fully understood why these people were
> complaining.
These people from 5-10 years ago still state that todays lasik is the
same as theirs. It's a distortion. Every type of surgery evolves,
including lasik. Being stuck in a time warp helps no one.
SErebel
| |
| Ragnar 2005-04-08, 10:25 pm |
| You have completely misrepresented my post... which is evident in that
you didn't include the post you are referring to in your message.
If there is anybody who is buying Catman Grant's garbage, let me know.
I don't think anybody here is that stupid.
If nobody is being deceived by him then I don't need to point out his
incompetence so often.
Notice Mr. Mason's fascination with feces below. He can't post a
message without referring to poo poo.
On 7 Apr 2005 15:03:47 -0700, "CatmanX" <grantm@connexus.net.au>
wrote:
>Here we go again clown.
>
>1) If you expect problems to occur, why are you advising people to go
>ahead with RS?? There is no logic here.
>
>2) The stretching that has occurred is in the stroma of the globe
>causing axial elongation. All studies show there is NO corneal effect
>from axial myopia. Again, your arguement has no credence.
>
>Shit happens and we don't fully understand it. I am simply pointing out
>that we don't know why some people who should not develop ectasia under
>our current understanding do in fact go on to develop it.
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| Ragnar 2005-04-08, 10:25 pm |
| You really insult the intelligence of everyone here - we all know who
you are. You are hopeless.
On Thu, 7 Apr 2005 20:59:13 -0400, "Tabby" <Tabbyr@Yahoo_nospam.com>
wrote:
>Christopher, everyone knows that the malcontent nut is you.
>
>"Ragnar" <ragnarsuomi@yahoo.com> wrote in message
>news:fj8a519t23tall5jn3bqor83gepv71rl06@4ax.com...
>
| |
|
| OK, genius. I accept your challenge. Name me.
"Ragnar" <ragnarsuomi@yahoo.com> wrote in message
news:aolc519pptk9lvjoob7g2ais6crfupvbtr@4ax.com...
> You really insult the intelligence of everyone here - we all know who
> you are. You are hopeless.
>
> On Thu, 7 Apr 2005 20:59:13 -0400, "Tabby" <Tabbyr@Yahoo_nospam.com>
> wrote:
>
>
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