Lasik Eyes Surgery - Surgeons knew about nerve damage and dry eye years ago

Author

Surgeons knew about nerve damage and dry eye years ago

FDAgoldminer

2005-04-14, 8:42 am

But I bet they didn't warn YOU! If MOST PATIENTS
experience dry eye isn't this nerve damage worth a candid chat? PERHAPS?
DOCTORS???

Check out this quote from the FDA transcripts:

Dr. I Howard Fine, Past President of the American Society of Cataract and
Refractive Surgery:

"As we all know, Lasik transects the cornea nerves, therefore inducing dry
eyes in most patients."

http://www.fda.gov/ohrms/dockets/ac...ipts/3806t1.doc

serebel

2005-04-14, 8:42 am

Where did you drag up this old news ? This old news has been bandied
about here long ago.

SErebel

LASIKtruth

2005-04-19, 10:50 am

Strange that the surgery hasn't improved on the dry eye front....with larger
ablation zones surgeons are actually creating more dry eye and more severe
dry eye. Studies have demonstrated chronic, increasing nerve damage over
time. It is time to stop this surgery. The old news should have stopped it
because it should have been made public. The new news is horrifying and no
surgeon who respects his oaths should be performing LASIK now.
"serebel" <serebel@aol.com> wrote in message
news:1113444225.343979.310120@o13g2000cwo.googlegroups.com...
> Where did you drag up this old news ? This old news has been bandied
> about here long ago.
>
> SErebel
>

serebel

2005-04-19, 10:50 am

This surgery has vastly improved on every front, can't argue with the
millions of happy people out there.

SErebel

2005-04-19, 10:50 am

In article <1113530283.867f6df3720e9bcf982365f1791bc3e0@teranews>,
"LASIKtruth" <LASIKtruth@Yahoo_nospam.com> wrote:

> Strange that the surgery hasn't improved on the dry eye front

I have a question about this.

I have noticed that at night, when it used to be my contacts stuck to my
eyeballs, my eyes sting/hurt. I imagine that it is because they are
dry. I had my procedure almost 2 years ago.

If LASIK severs the nerves that tell the brain to produce tears, and if
they don't regenerate completely, why then do dry eyes hurt if there are
fewer nerves?

--
~RT

CatmanX

2005-04-19, 10:50 am

post lasik dry eye stems from incorrectly made tears and poor feedback
from the eye. THe nerves regenerate somewhat, 50%+ after 6 months, but
not fully. THere is still sensation, but not adequate feedback to
produce properly formed tears in some cases.

dr grant

Glenn - USAEyes.org

2005-04-19, 10:51 am

Studies have shown that after two years nerve density returns to
preoperative levels. Corneal nerves do regenerate.

Much of LASIK induced dry eye will depend upon the level of
preoperative dry eye. The vast majority of LASIK patients have only
temporary dry eye problems. Better surgeons are treating the
potential dry eye concerns with a pre=emptive strike of implanting
punctal plugs for the immediate postoperative period and other dry eye
treatment techniques (see
http://www.complicatedeyes.org/dry_eye_treatment.htm) Of course,
preoperative testing is a must for prevention of problems.

LASIK induced transient dry eye is the one problem that continues to
plague LASIK, all others have been significantly reduced with better
evaluations or better treatment. To battle this dry eye problem - and
for other reasons - may doctors are using surface ablation techniques
such as PRK, LASEK, and Epi-LASIK. Unfortunately, the recovery time
for these techniques is longer than LASIK and some people are simply
not good candidates for surface ablation.

If you have dry eye problems and are considering LASIK, get the dry
eye managed first, then make a decision about LASIK.

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

2005-04-19, 10:51 am

Lasik doesn't have anything to do with dry eye.
The temporary dryness in the months after LASIK is not dry eye. The
treatment for dry eye is ineffective for lasik dryness.

Whenever someone says "dry eye" its a red flag that the poster is a
malcontent who is trying to scare people and will resort to misleading
and lying to achieve their goals.

On Thu, 14 Apr 2005 21:58:05 -0400, "LASIKtruth"
<LASIKtruth@Yahoo_nospam.com> wrote:

>Strange that the surgery hasn't improved on the dry eye front....with larger
>ablation zones surgeons are actually creating more dry eye and more severe
>dry eye. Studies have demonstrated chronic, increasing nerve damage over
>time. It is time to stop this surgery. The old news should have stopped it
>because it should have been made public. The new news is horrifying and no
>surgeon who respects his oaths should be performing LASIK now.
>"serebel" <serebel@aol.com> wrote in message
>news:1113444225.343979.310120@o13g2000cwo.googlegroups.com...
>

Ragnar

2005-04-19, 10:51 am

This isn't a direct response to your question.. but it's a good time
to point something out. One difference between soft and rigid lenses
is that soft lenses suck the moisture right off your eyes causing them
to stick. For those that have had their contact lenses stuck to their
eyes like they were superglued on.. you know what a painful problem
this is.
There are some new soft contacts that don't absorb fluid (or lose it)

On Fri, 15 Apr 2005 11:37:06 GMT, RT <RTMD24@NOSPAMyahoo.com> wrote:

>In article <1113530283.867f6df3720e9bcf982365f1791bc3e0@teranews>,
> "LASIKtruth" <LASIKtruth@Yahoo_nospam.com> wrote:
>
>
>I have a question about this.
>
>I have noticed that at night, when it used to be my contacts stuck to my
>eyeballs, my eyes sting/hurt. I imagine that it is because they are
>dry. I had my procedure almost 2 years ago.
>
>If LASIK severs the nerves that tell the brain to produce tears, and if
>they don't regenerate completely, why then do dry eyes hurt if there are
>fewer nerves?

Ragnar

2005-04-19, 10:51 am

oh.. this is interesting...suddenly grant mason is a doctor? he is
not

and once again, he's misleading people by saying dry eye rather than
dryness.

The nerves regenerate enough to provide normal tear production. No
cut nerves ever affected tear production as much as contact lenses do.

On 15 Apr 2005 05:11:51 -0700, "CatmanX" <grantm@connexus.net.au>
wrote:

>post lasik dry eye stems from incorrectly made tears and poor feedback
>from the eye. THe nerves regenerate somewhat, 50%+ after 6 months, but
>not fully. THere is still sensation, but not adequate feedback to
>produce properly formed tears in some cases.
>
>dr grant

LASIKtruth

2005-04-19, 10:51 am

LASIK surgery hasn't improved on the dry eye front because it is
fundamentally flawed - it severs corneal nerves that are incapable of full
regeneration. The larger your treatment zone and the deeper your ablation,
the more nerves are FRIED. Eyes dry naturally with age...
what will become of the millions of post-LASIKs who lack corneal nerve
reserves to LASIK???

"RT" <RTMD24@NOSPAMyahoo.com> wrote in message
news:RTMD24-D59979.07370515042005@newssvr14-ext.news.prodigy.com...
> In article <1113530283.867f6df3720e9bcf982365f1791bc3e0@teranews>,
> "LASIKtruth" <LASIKtruth@Yahoo_nospam.com> wrote:
>
>
> I have a question about this.
>
> I have noticed that at night, when it used to be my contacts stuck to my
> eyeballs, my eyes sting/hurt. I imagine that it is because they are
> dry. I had my procedure almost 2 years ago.
>
> If LASIK severs the nerves that tell the brain to produce tears, and if
> they don't regenerate completely, why then do dry eyes hurt if there are
> fewer nerves?
>
> --
> ~RT

LASIKtruth

2005-04-19, 10:51 am

Wrong, wrong, wrong, Glenn. You are completely wrong. Corneal nerves do not
regenerate fully. Didn't you read the Mayo Clinic study? This was a confocal
microscopy study where nerve densities were measured in post-LASIKs.
Decreased even at the 3 year point when the study ended, Glenn. Sorry.

See CatmanX's post about corneal nerve density in this NG.

Preoperatively one's corneal nerves are not sliced and then fried. People
with no dry eye history who are not in high risk groups have ended up with
tragic, debilitating dry eye. Because creating a LASIK flap and severing
nerves, creating an interface that will not heal... is a bad idea.

"Glenn - USAEyes.org" <glenn.hageleSTOPSPAM@USAEyes.org> wrote in message
news:a5gv515tk9ofup117ftuetucurasquck98@4ax.com...
> Studies have shown that after two years nerve density returns to
> preoperative levels. Corneal nerves do regenerate.
>
> Much of LASIK induced dry eye will depend upon the level of
> preoperative dry eye. The vast majority of LASIK patients have only
> temporary dry eye problems. Better surgeons are treating the
> potential dry eye concerns with a pre=emptive strike of implanting
> punctal plugs for the immediate postoperative period and other dry eye
> treatment techniques (see
> http://www.complicatedeyes.org/dry_eye_treatment.htm) Of course,
> preoperative testing is a must for prevention of problems.
>
> LASIK induced transient dry eye is the one problem that continues to
> plague LASIK, all others have been significantly reduced with better
> evaluations or better treatment. To battle this dry eye problem - and
> for other reasons - may doctors are using surface ablation techniques
> such as PRK, LASEK, and Epi-LASIK. Unfortunately, the recovery time
> for these techniques is longer than LASIK and some people are simply
> not good candidates for surface ablation.
>
> If you have dry eye problems and are considering LASIK, get the dry
> eye managed first, then make a decision about LASIK.
>
> 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.

Tabby

2005-04-19, 10:51 am

LASIK and dry eye go hand in hand because corneal nerves are severed. Dry
eye can be permanent, and patients should be better informed about it. You
shouldn't be afraid about patients arming themselves with some actual
knowledge, Ragnar!

"Ragnar" <ragnarsuomi@yahoo.com> wrote in message
news:nsov519gt0a1qale09cbn0qp3st3q5v89n@4ax.com...
> Lasik doesn't have anything to do with dry eye.
> The temporary dryness in the months after LASIK is not dry eye. The
> treatment for dry eye is ineffective for lasik dryness.
>
> Whenever someone says "dry eye" its a red flag that the poster is a
> malcontent who is trying to scare people and will resort to misleading
> and lying to achieve their goals.
>
>
> On Thu, 14 Apr 2005 21:58:05 -0400, "LASIKtruth"
> <LASIKtruth@Yahoo_nospam.com> wrote:
>
>

LASIKtruth

2005-04-19, 10:51 am

Ragnar,

Many post-LASIKs do not have sufficient nerve regeneration to provide
adequate tear production as a result of their surgery. It is a real problem.
I wear plugs and am bothered constantly by dry eye. If you were a bit more
literate, a bit more curious and cared to find out what the facts are you
would learn that LASIK- induced dry eye is fairly common. It's sickening
that this fact is not required to be discussed openly with patients before
surgery.

Cut nerves can debilitate tear production leaving a post-LASIK unable to
hold a job, watch TV, work on the computer, walk outside without goggles.
Nerves cut by LASIK can cause ocular surface disease so severe that patients
seek expensive amniotic membrane transplants in the hope of restoring visual
comfort.

Some people have constant pain for the rest of their lives from the nerve
loss caused by LASIK.

You have no idea what you're talking about and you're an insult to patients
out there who are suffering.

"Ragnar" <ragnarsuomi@yahoo.com> wrote in message
news:uapv51hn8l3vtdfes3vo8ef66r1cga8ljp@4ax.com...
> oh.. this is interesting...suddenly grant mason is a doctor? he is
> not
>
> and once again, he's misleading people by saying dry eye rather than
> dryness.
>
> The nerves regenerate enough to provide normal tear production. No
> cut nerves ever affected tear production as much as contact lenses do.
>
>
> On 15 Apr 2005 05:11:51 -0700, "CatmanX" <grantm@connexus.net.au>
> wrote:
>
>

Glenn - USAEyes.org

2005-04-19, 10:51 am

Anyone interested in chasing Brent's foolishness can visit PubMed and
look up nerve density PRK, nerve density LASIK, and/or view the
multiple articles in the American Journal of Ophthalmology,
Ophthalmology, and Cornea peer-reviewed medical journals.

Furthermore, whether or not nerve density returns to preoperative
levels is not the issue, the issue is whether or not refractive
surgery induced dry eye resolves within the normal six month healing
period. We know from our own patient evaluations and multiple studies
that patients are asymptomatic of ALL refractive induced complications
at six months postop in 97% of the cases. They may not have returned
to postoperative parameters (if they didn't want change, why have
surgery?), but 97% are without complications.

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

2005-04-19, 10:51 am

The temporary dryness during the months following LASIK is not dry eye
and is not related to the condition known as "dry eye".

Those microscopic nerves you mention do regenerate adequately.

On Fri, 15 Apr 2005 21:14:47 -0400, "LASIKtruth"
<LASIKtruth@Yahoo_nospam.com> wrote:

>LASIK surgery hasn't improved on the dry eye front because it is
>fundamentally flawed - it severs corneal nerves that are incapable of full
>regeneration. The larger your treatment zone and the deeper your ablation,
>the more nerves are FRIED. Eyes dry naturally with age...
>what will become of the millions of post-LASIKs who lack corneal nerve
>reserves to LASIK???
>
>
>"RT" <RTMD24@NOSPAMyahoo.com> wrote in message
>news:RTMD24-D59979.07370515042005@newssvr14-ext.news.prodigy.com...
>

Ragnar

2005-04-19, 10:51 am

LasikTruth uses Grant Mason as his source of information. Need I say
more?

On Fri, 15 Apr 2005 22:06:11 -0400, "LASIKtruth"
<LASIKtruth@Yahoo_nospam.com> wrote:

>Wrong, wrong, wrong, Glenn. You are completely wrong. Corneal nerves do not
>regenerate fully. Didn't you read the Mayo Clinic study? This was a confocal
>microscopy study where nerve densities were measured in post-LASIKs.
>Decreased even at the 3 year point when the study ended, Glenn. Sorry.
>
>See CatmanX's post about corneal nerve density in this NG.
>
>Preoperatively one's corneal nerves are not sliced and then fried. People
>with no dry eye history who are not in high risk groups have ended up with
>tragic, debilitating dry eye. Because creating a LASIK flap and severing
>nerves, creating an interface that will not heal... is a bad idea.
>
>
>
>"Glenn - USAEyes.org" <glenn.hageleSTOPSPAM@USAEyes.org> wrote in message
>news:a5gv515tk9ofup117ftuetucurasquck98@4ax.com...
>

Ragnar

2005-04-19, 10:51 am

Severed makes it sound like you are cutting an artery.
Up to 66% of the invisible microscopic nerves are "severed" in LASIK.
This has nothing at all to do with dry eye, is not at all permanent,
and I've had the surgery myself.

Anybody who believes the misinformation you spew would not be a lasik
patient. Anybody who would believe your nonsense should never enter
a medical facility for any reason at all. Just do like Jim Henson of
the Muppets did. Rather than take evil antibiotics which would have
easily cured him within days, he refused treatment and paid the
ultimate price.

On Fri, 15 Apr 2005 22:08:44 -0400, "Tabby" <Tabby@Yahoo_nospam.com>
wrote:

>LASIK and dry eye go hand in hand because corneal nerves are severed. Dry
>eye can be permanent, and patients should be better informed about it. You
>shouldn't be afraid about patients arming themselves with some actual
>knowledge, Ragnar!
>
>"Ragnar" <ragnarsuomi@yahoo.com> wrote in message
>news:nsov519gt0a1qale09cbn0qp3st3q5v89n@4ax.com...
>

Ragnar

2005-04-19, 10:51 am

You are wrong.

On Fri, 15 Apr 2005 22:24:09 -0400, "LASIKtruth"
<LASIKtruth@Yahoo_nospam.com> wrote:

>Ragnar,
>
>Many post-LASIKs do not have sufficient nerve regeneration to provide
>adequate tear production as a result of their surgery. It is a real problem.
>I wear plugs and am bothered constantly by dry eye. If you were a bit more
>literate, a bit more curious and cared to find out what the facts are you
>would learn that LASIK- induced dry eye is fairly common. It's sickening
>that this fact is not required to be discussed openly with patients before
>surgery.
>
>Cut nerves can debilitate tear production leaving a post-LASIK unable to
>hold a job, watch TV, work on the computer, walk outside without goggles.
>Nerves cut by LASIK can cause ocular surface disease so severe that patients
>seek expensive amniotic membrane transplants in the hope of restoring visual
>comfort.
>
>Some people have constant pain for the rest of their lives from the nerve
>loss caused by LASIK.
>
>You have no idea what you're talking about and you're an insult to patients
>out there who are suffering.
>
>
>"Ragnar" <ragnarsuomi@yahoo.com> wrote in message
>news:uapv51hn8l3vtdfes3vo8ef66r1cga8ljp@4ax.com...
>

2005-04-19, 10:51 am

In article <jvd261lenbq9921ie37mmjctgrbm944te0@4ax.com>,
Ragnar <ragnarsuomi@yahoo.com> wrote:

> You are wrong.

Gosh Rags, you can't even admit that this HAS happened to some people
(even people who give their personal accounts) and CAN happen?

Extremism on either side is basically blindness and ultimately ignorance.

--
~RT
The truth lies somewhere between Ragnar and LASIKtruth
Two sides of the same coin

--
~RT

gospa68@aol.com

2005-04-19, 10:51 am

Tsk, tsk.. it is well known that Glenn is very selective when it comes
to reading and quoting studies....WK

Glenn - USAEyes.org

2005-04-19, 10:51 am

I just recommended that interested persons do their own search on
PubMed where virtually all relevant articles are available, and come
to their own conclusion. Tell us how that is "selective", WizKid.

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.

Andrew Chew

2005-04-19, 10:51 am

"Glenn - USAEyes.org" <glenn.hageleSTOPSPAM@USAEyes.org> wrote in message
news:k9c3611kp376ls52hegfe45ph0shv2e5pn@4ax.com...
>I just recommended that interested persons do their own search on
> PubMed where virtually all relevant articles are available, and come
> to their own conclusion. Tell us how that is "selective", WizKid.

What I found on pubmed

http://www.ncbi.nlm.nih.gov/entrez/...t_uids=15505047
CONCLUSIONS: Both subbasal and stromal corneal nerves in LASIK flaps recover
slowly and do not return to preoperative densities by 3 years after LASIK.
The numbers of subbasal nerves appear to decrease between 2 and 3 years
after LASIK. The orientation of the regenerated subbasal nerves remains
predominantly vertical.

http://www.ncbi.nlm.nih.gov/entrez/...t_uids=12454033
CONCLUSIONS: In the corneal flap, the number of subbasal and stromal nerve
fiber bundles decreases by 90% immediately after LASIK. During the first
year after LASIK, subbasal nerve fiber bundles gradually return, although by
1 year their number remains less than half of that before LASIK.

gospa68@aol.com

2005-04-19, 10:51 am

Glenn, people come to this site seeking information. Most are not well
skilled in medical literature research as you and me. You want us to
believe that you speak from a position of authority representing the
CRSQA, which would imply certain responsibilities. However, as we have
learned and contrary to the responsible image you try to portray, the
CRSQA is a front for LASIK surgeons and is not a patient advocacy
organization at all. Your response that they should go to PubMed and
all is well is what I would expect from you and the CRSQA.

Basically, you are saying "we'll tell you what we want you to know. You
go do the rest of the work if you want the full truth." ....incomplete
patient informed consent, which is what you stand for.
WK

LASIKtruth

2005-04-19, 10:51 am

Nobody who is truly informed about LASIK would elect to have the surgery
these days. If the facts about what LASIK really does to the eye became
public knowledge....well...there goes Glenn's livilihood!

<gospa68@aol.com> wrote in message
news:1113747298.068387.322590@f14g2000cwb.googlegroups.com...
> Glenn, people come to this site seeking information. Most are not well
> skilled in medical literature research as you and me. You want us to
> believe that you speak from a position of authority representing the
> CRSQA, which would imply certain responsibilities. However, as we have
> learned and contrary to the responsible image you try to portray, the
> CRSQA is a front for LASIK surgeons and is not a patient advocacy
> organization at all. Your response that they should go to PubMed and
> all is well is what I would expect from you and the CRSQA.
>
> Basically, you are saying "we'll tell you what we want you to know. You
> go do the rest of the work if you want the full truth." ....incomplete
> patient informed consent, which is what you stand for.
> WK
>

LASIKtruth

2005-04-19, 10:51 am

Thanks to Andrew for posting those studies with links so that others can
verify them. Eat those studies, Glenn! LASIK causes some serious, lasting
nerve damage. It is unethical to damage healthy eyes (first do no harm,
doctors) - especially without informing patients that nerve damage is a
certainty before surgery.

LASIK surgeons, the LASIK industry and those who promote LASIK will all look
like schmucks very soon because it's impossible that those responsible for
continuing the practice of LASIK are unaware of these studies. Nerve damage
is only part of the story.... visual quality suffers after LASIK and some
surgeons are beginning to speak openly about this.

"Andrew Chew" <andrew@nospam.alumni.nus.edu.sg> wrote in message
news:1113708907.22069.0@lotis.uk.clara.net...
>
> "Glenn - USAEyes.org" <glenn.hageleSTOPSPAM@USAEyes.org> wrote in message
> news:k9c3611kp376ls52hegfe45ph0shv2e5pn@4ax.com...
>
> What I found on pubmed
>
> http://www.ncbi.nlm.nih.gov/entrez/...t_uids=15505047
> CONCLUSIONS: Both subbasal and stromal corneal nerves in LASIK flaps
> recover slowly and do not return to preoperative densities by 3 years
> after LASIK. The numbers of subbasal nerves appear to decrease between 2
> and 3 years after LASIK. The orientation of the regenerated subbasal
> nerves remains predominantly vertical.
>
> http://www.ncbi.nlm.nih.gov/entrez/...t_uids=12454033
> CONCLUSIONS: In the corneal flap, the number of subbasal and stromal nerve
> fiber bundles decreases by 90% immediately after LASIK. During the first
> year after LASIK, subbasal nerve fiber bundles gradually return, although
> by 1 year their number remains less than half of that before LASIK.
>
>
>
>
>

Ragnar

2005-04-19, 10:51 am

Some people do get dry eye. Having LASIK done has nothing to do with
it.
Some people will get murdered, have heart attacks, strokes, glaucoma,
etc. LASIK is not the cause of it.

On Sat, 16 Apr 2005 19:20:33 GMT, RT <RTMD24@NOSPAMyahoo.com> wrote:

>In article <jvd261lenbq9921ie37mmjctgrbm944te0@4ax.com>,
> Ragnar <ragnarsuomi@yahoo.com> wrote:
>
>
>Gosh Rags, you can't even admit that this HAS happened to some people
>(even people who give their personal accounts) and CAN happen?
>
>Extremism on either side is basically blindness and ultimately ignorance.
>
>--
>~RT
>The truth lies somewhere between Ragnar and LASIKtruth
>Two sides of the same coin

Ragnar

2005-04-19, 10:51 am

Your post is incorrect.

On Sun, 17 Apr 2005 11:19:57 -0400, "LASIKtruth"
<LASIKtruth@Yahoo_nospam.com> wrote:

>Thanks to Andrew for posting those studies with links so that others can
>verify them. Eat those studies, Glenn! LASIK causes some serious, lasting
>nerve damage. It is unethical to damage healthy eyes (first do no harm,
>doctors) - especially without informing patients that nerve damage is a
>certainty before surgery.
>
>LASIK surgeons, the LASIK industry and those who promote LASIK will all look
>like schmucks very soon because it's impossible that those responsible for
>continuing the practice of LASIK are unaware of these studies. Nerve damage
>is only part of the story.... visual quality suffers after LASIK and some
>surgeons are beginning to speak openly about this.
>
>"Andrew Chew" <andrew@nospam.alumni.nus.edu.sg> wrote in message
>news:1113708907.22069.0@lotis.uk.clara.net...
>

Ragnar

2005-04-19, 10:51 am

That's not the case. In fact, the incidence of complications is
dropping as the surgery gets more and more precise with even better
equipment.

On Sun, 17 Apr 2005 11:12:56 -0400, "LASIKtruth"
<LASIKtruth@Yahoo_nospam.com> wrote:

>Nobody who is truly informed about LASIK would elect to have the surgery
>these days. If the facts about what LASIK really does to the eye became
>public knowledge....well...there goes Glenn's livilihood!
>
>
>
>
>
><gospa68@aol.com> wrote in message
>news:1113747298.068387.322590@f14g2000cwb.googlegroups.com...
>

Glenn - USAEyes.org

2005-04-19, 10:51 am

Keep looking and you will find the studies showing nerve mass at
preoperative levels at two years, but I would tend to agree that it is
much more likely mass returns later rather than earlier. The question
is, are we talking about nerve mass, or LASIK induced dry eye. They
are not necessarily the same.

Many patients have LASIK and develop not dry eye. None. If dry eye
was just an issue of corneal nerve fiber quantity, then every patient
would suffer from dry eyes, but they don't.

Equally, patients at 3, 4, 5, and even 6 years postop still have dry
eyes. Under all studies the nerve mass would have returned to
preoperative levels so all patients with LASIK induced dry eye should
not have dry eye at that time, but some do.

LASIK induced dry eye is not just about severing nerves, or nerve
mass, or corneal shape, or depth of ablation, or type of excimer
energy beam used, etc. LASIK induced dry eye is about ALL of these
issues, and more. To point to one and say "that's why" or "it won't
be better until nerves are at this level" indicates a very poor
understanding of what causes LASIK induced dry eye. An understanding
even poorer than that which medicine currently possesses.

Certainly loss of nerve mass and severing of nerves contribute somehow
to LASIK induced dry eyes, but not always and correction of these
issues alone is not always the answer.

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.

Glenn - USAEyes.org

2005-04-19, 10:51 am

"Andrew Chew" did fine, and if you are so good, bring your own
citations to this newsgroup. I'm just not going to spend all my time
going back to study after study that I've already reviewed because
Brent is having an attention tantrum.

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.

Glenn - USAEyes.org

2005-04-19, 10:51 am

The incidence of serious unresolved complications is dropping
dramatically, however due to persistent LASIK induced dry eye, the
overall rate of any unresolved complication at six months postop stays
about the same at 3%.

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.

Andrew Chew

2005-04-19, 10:51 am

"Glenn - USAEyes.org" <glenn.hageleSTOPSPAM@USAEyes.org> wrote in message
news:hup561pk7k9rctik1rsnp1fbr2eik3b1q4@4ax.com...
> Keep looking and you will find the studies showing nerve mass at
> preoperative levels at two years, but I would tend to agree that it is
> much more likely mass returns later rather than earlier. The question
> is, are we talking about nerve mass, or LASIK induced dry eye. They
> are not necessarily the same.

Please post the studies like I did. Thanks.
>
> Many patients have LASIK and develop not dry eye. None. If dry eye
> was just an issue of corneal nerve fiber quantity, then every patient
> would suffer from dry eyes, but they don't.

Every patient has a different response to nerve severage. Some people turn
out better, some don't.
>
> Equally, patients at 3, 4, 5, and even 6 years postop still have dry
> eyes. Under all studies the nerve mass would have returned to
> preoperative levels so all patients with LASIK induced dry eye should
> not have dry eye at that time, but some do.

Where did you read this? According to the study I posted, even at 3 years,
the nerve mass has not returned to preoperative levels. Please post several
studies corroborating what you say.
>
> LASIK induced dry eye is not just about severing nerves, or nerve
> mass, or corneal shape, or depth of ablation, or type of excimer
> energy beam used, etc. LASIK induced dry eye is about ALL of these
> issues, and more. To point to one and say "that's why" or "it won't
> be better until nerves are at this level" indicates a very poor
> understanding of what causes LASIK induced dry eye. An understanding
> even poorer than that which medicine currently possesses.
>
> Certainly loss of nerve mass and severing of nerves contribute somehow
> to LASIK induced dry eyes, but not always and correction of these
> issues alone is not always the answer.

It depends on patient response possibly.

Andrew Chew

2005-04-19, 10:51 am

"Glenn - USAEyes.org" <glenn.hageleSTOPSPAM@USAEyes.org> wrote in message
news:4eq561prs656s6mc4dfu0bs4f2rsrgnlku@4ax.com...
> "Andrew Chew" did fine, and if you are so good, bring your own
> citations to this newsgroup. I'm just not going to spend all my time
> going back to study after study that I've already reviewed because
> Brent is having an attention tantrum.

I went through all the articles under my search criteria and posted the
links to the 2 most salient ones.

The latest studies do seem to indicate nerve bundles do not regenerate to
their pre-operative state 3 years after LASIK. It is possible what you
reviewed could have been outdated.

Glenn - USAEyes.org

2005-04-19, 10:51 am

It wouldn't be the first time newer information contradicted older
information. I'll ask some of the researchers here at the ASCRS
convention to see what is the current consensus. I'm glad to correct
this if I'm wrong.

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.

Glenn - USAEyes.org

2005-04-19, 10:51 am

Here is the latest on subnasal nerve density from the ASCRS meeting.

In a yet unpublished poster presented by Jay Erie, MD of the Mayo
Clinic (author of the previous study I quoted) we find the five year
follow-up on nerve density.

At 1 year postop, PRK patients have 59% of their nerve density return,
while LASIK patients have 51%.

At 2 years postop, PRK density is essentially the same as preoperative
levels and stays at normal level for the five years of the study.

At 5 years postop, LASIK patients first present nerve density recovery
at preoperative levels, however both PRK and LASIK patients have about
20% lower density at five years postop, apparently attributed to norms
of patients without surgery.

So I was wrong about LASIK nerve levels returning at 2 years. This
happens with PRK, but does not occur with LASIK until 5 years postop.

A very clear question this poster raises is what would be the nerve
density of a similar population without surgery. A control group was
not used for this study. That would indicate if the extrapolation of
levels meeting the norm is accurate.

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

2005-04-19, 10:51 am

Funny Glenn, how do you figure 20% less than pre-op is normal???

If I took 20% OF THE CYLINDERS OUT OF YOUR CAR, WOULD YOU CONSIDER IT
TO BE RUNNING NORMALLY??? (sorry, hit the caps lock button, I am not
yelling)

This is part of the crap that has to be acknowledged before the
industry can move forward. 20% less is NOT normal, it is essentially a
pathological condition (I'll take 20% of your heart function away too).
Ways to regenerate, or prevent nerve damage are critical for the long
term efficacy of Lasik and patient care (sorry to bring patients into
this).

I still feel we are heading for a dry eye explosion in 10-20 years from
Lasik and this research does nothing to quell that fear.

dr grant

serebel

2005-04-19, 10:51 am

If you took away 50% of your kidneys, could you lead a normal life?
Your car and heart analogy is kind of comparing apples to oranges.

SErebel

LASIKtruth

2005-04-19, 10:51 am

You know, there are very few examples of a 50% change in a biological
parameter that does not have serious consequences. Didn't think you were
bright enough to think of one.

If you doubled or halved your blood pressure you would die.

Standard LASIK, on average, doubles your higher order aberrations
(distortions which are induced in the cornea by surgery but cannot be
corrected with glasses). Wavefront increases them, too - just 20% or so less
than standard LASIK.

This is why people see visual trash. Some more than others. Those who see
less are just lucky. Most post-LASIKs have some issue with their LASIK
surgery if you know the right questions to ask, and all are potential
ticking time bombs for real tragedy.

"serebel" <serebel@aol.com> wrote in message
news:1113873819.011181.206200@l41g2000cwc.googlegroups.com...
> If you took away 50% of your kidneys, could you lead a normal life?
> Your car and heart analogy is kind of comparing apples to oranges.
>
> SErebel
>

serebel

2005-04-19, 10:51 am

That's a whole lot of lucky millions out there. Strange, I saw more
haloing around street lights before I HAD LASIK.

SErebel

Glenn - USAEyes.org

2005-04-19, 10:51 am

Believe me Grant, I don't think 20% less after five years is normal.
I'm just reporting what is on the poster. I intend to meet with the
doctor tomorrow, if at all possible. I believe he will be at the
poster in the afternoon. I'd like that question answered too.

Grant, most of the summertime I drive a British car. I'm quite
pleased if only 20% of the cylinders not working. 8^)

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.

Glenn - USAEyes.org

2005-04-19, 10:51 am

I actually laughed out loud at that one. Standard LASIK doubling HOA?
Maybe years ago with the first generation lasers, but not today.
Maybe one or two individual Zernike representations of higher order
aberration, but not all.

Fortunately for most, wavefront-guided ablations are available. They
induce significantly less HOA overall and often (although not
predictably enough) reduce coma, secondary astigmatism, spherical
aberration, and trefoil; these being the HOA most critical to vision
quality.

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.

Todd Rich

2005-04-19, 10:51 am

serebel <serebel@aol.com> wrote:
> That's a whole lot of lucky millions out there. Strange, I saw more
> haloing around street lights before I HAD LASIK.

> SErebel

<aol>Me too</aol>

Todd

P.S. 3 month follow up visit is tomorrow. I'll post the results.

Ragnar

2005-04-19, 10:59 pm

I guess your aticles aren't all that salient.
Why do you keep harping on this issue that is not a relevant issue?

I'll give you something to chew on. There are 3 nerve bundles on the
cornea. To make the flap, either 1 or 2 of those bundles is severed
depending on which direction the flap is made. If you are so
concerned about nerves, I suggest you tell people to ask their surgeon
to make a flap which only severs 33% of the nerves instead of 66%.
They do regenerate sufficiently to perform their function, but you
don't seem to want to accept that.

Here's something else for you. Did you know the liver can be 83%
damaged, removed, or otherwise non-functional and still perform its
function with no problem at all? The body is not a collection of
binary on/off switches. There are vast tolerances in anatomy.

There are plenty of procedures which completely sever ALL the corneal
nerves, and you don't hear about any major problems resulting from
that.

Find a new topic to dwell upon.

On Mon, 18 Apr 2005 20:16:29 +0800, "Andrew Chew"
<andrew@nospam.alumni.nus.edu.sg> wrote:

>
>"Glenn - USAEyes.org" <glenn.hageleSTOPSPAM@USAEyes.org> wrote in message
>news:4eq561prs656s6mc4dfu0bs4f2rsrgnlku@4ax.com...
>
>I went through all the articles under my search criteria and posted the
>links to the 2 most salient ones.
>
>The latest studies do seem to indicate nerve bundles do not regenerate to
>their pre-operative state 3 years after LASIK. It is possible what you
>reviewed could have been outdated.
>

CatmanX

2005-04-19, 10:59 pm

Loss of nerve fibres affects afferent feedback, which affects tear film
quality, not quantity.

Contact lenses do not affect tear production in any way, they increase
dehydration.

Please get your facts right cliffy.

dr grant

LASIKtruth

2005-04-19, 10:59 pm

Having no liver function is fatal, you idiot. All procedures which sever
corneal nerves cause problems. You're just uniformed and uneducated. Perhaps
you should be quiet until you learn something useful.

"Ragnar" <ragnarsuomi@yahoo.com> wrote in message
news:ucpa61lhae1v8a9ptp4gcv71ue90hbeh9u@4ax.com...
>I guess your aticles aren't all that salient.
> Why do you keep harping on this issue that is not a relevant issue?
>
> I'll give you something to chew on. There are 3 nerve bundles on the
> cornea. To make the flap, either 1 or 2 of those bundles is severed
> depending on which direction the flap is made. If you are so
> concerned about nerves, I suggest you tell people to ask their surgeon
> to make a flap which only severs 33% of the nerves instead of 66%.
> They do regenerate sufficiently to perform their function, but you
> don't seem to want to accept that.
>
> Here's something else for you. Did you know the liver can be 83%
> damaged, removed, or otherwise non-functional and still perform its
> function with no problem at all? The body is not a collection of
> binary on/off switches. There are vast tolerances in anatomy.
>
> There are plenty of procedures which completely sever ALL the corneal
> nerves, and you don't hear about any major problems resulting from
> that.
>
> Find a new topic to dwell upon.
>
>
> On Mon, 18 Apr 2005 20:16:29 +0800, "Andrew Chew"
> <andrew@nospam.alumni.nus.edu.sg> wrote:
>
>

Ragnar

2005-04-19, 10:59 pm

Those figures don't take into account that usually 2 of the 3 nerve
branches are severed. If someone is concerned about nerve density,
have them do the flap so only 1 of the 3 branches is severed.
The whole topic is somewhat irrelevant since it's not a problem.

What is a problem is having mis-shapen eyes that result in not being
able to see more than 2 inches in front of one's face. Good thing
there is LASIK!

On Mon, 18 Apr 2005 14:31:29 GMT, Glenn - USAEyes.org
<glenn.hageleSTOPSPAM@USAEyes.org> wrote:

>Here is the latest on subnasal nerve density from the ASCRS meeting.
>
>In a yet unpublished poster presented by Jay Erie, MD of the Mayo
>Clinic (author of the previous study I quoted) we find the five year
>follow-up on nerve density.
>
>At 1 year postop, PRK patients have 59% of their nerve density return,
>while LASIK patients have 51%.
>
>At 2 years postop, PRK density is essentially the same as preoperative
>levels and stays at normal level for the five years of the study.
>
>At 5 years postop, LASIK patients first present nerve density recovery
>at preoperative levels, however both PRK and LASIK patients have about
>20% lower density at five years postop, apparently attributed to norms
>of patients without surgery.
>
>So I was wrong about LASIK nerve levels returning at 2 years. This
>happens with PRK, but does not occur with LASIK until 5 years postop.
>
>A very clear question this poster raises is what would be the nerve
>density of a similar population without surgery. A control group was
>not used for this study. That would indicate if the extrapolation of
>levels meeting the norm is accurate.
>
>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

2005-04-19, 10:59 pm

I'm sounding like a broken record here.. but once again.. here we go:
LASIK has nothing to do with dry eye. There is often a few months of
dryness after lasik as the flap heals. This is easily taken care of
with cheap eyedrops or not-so-cheap plugs.

And again, grant is not a dr.

On 18 Apr 2005 15:35:52 -0700, "CatmanX" <grantm@connexus.net.au>
wrote:

>Funny Glenn, how do you figure 20% less than pre-op is normal???
>
>If I took 20% OF THE CYLINDERS OUT OF YOUR CAR, WOULD YOU CONSIDER IT
>TO BE RUNNING NORMALLY??? (sorry, hit the caps lock button, I am not
>yelling)
>
>This is part of the crap that has to be acknowledged before the
>industry can move forward. 20% less is NOT normal, it is essentially a
>pathological condition (I'll take 20% of your heart function away too).
>Ways to regenerate, or prevent nerve damage are critical for the long
>term efficacy of Lasik and patient care (sorry to bring patients into
>this).
>
>I still feel we are heading for a dry eye explosion in 10-20 years from
>Lasik and this research does nothing to quell that fear.
>
>dr grant

Ragnar

2005-04-19, 10:59 pm

That's a great point! People willingly donate one kidney all the
time.. only 1 of 2 of them is needed.. hence 50%...

In the other spare parts department.. people get along with just one
lung, 2 of 4 heart chambers, no gall bladder, no stomach and all
functions just fine.
Lance Armstrong had one of two special organs removed and he went on
to win 6 (and going for 7) Tour de Frances. Maybe the secret to
stamina is to have one nut removed. I do think that Barnard went too
far having both removed though.

On 18 Apr 2005 18:23:39 -0700, "serebel" <serebel@aol.com> wrote:

>If you took away 50% of your kidneys, could you lead a normal life?
>Your car and heart analogy is kind of comparing apples to oranges.
>
>SErebel

Ragnar

2005-04-19, 10:59 pm

You are so full of it that nobody with any intelligence at all would
pay any attention to you.
Anyone who would pay attention to you should not have surgery of any
kind, ever. If they get a cut, they shouldn't even put a band-aid on
it.

On Mon, 18 Apr 2005 22:08:08 -0400, "LASIKtruth"
<LASIKtruth@Yahoo_nospam.com> wrote:

>You know, there are very few examples of a 50% change in a biological
>parameter that does not have serious consequences. Didn't think you were
>bright enough to think of one.
>
>If you doubled or halved your blood pressure you would die.
>
>Standard LASIK, on average, doubles your higher order aberrations
>(distortions which are induced in the cornea by surgery but cannot be
>corrected with glasses). Wavefront increases them, too - just 20% or so less
>than standard LASIK.
>
>This is why people see visual trash. Some more than others. Those who see
>less are just lucky. Most post-LASIKs have some issue with their LASIK
>surgery if you know the right questions to ask, and all are potential
>ticking time bombs for real tragedy.
>
>
>"serebel" <serebel@aol.com> wrote in message
>news:1113873819.011181.206200@l41g2000cwc.googlegroups.com...
>

Ragnar

2005-04-19, 11:00 pm

Before lasik.. streetlights looked like a blurry blob to me.

On 18 Apr 2005 19:42:09 -0700, "serebel" <serebel@aol.com> wrote:

>That's a whole lot of lucky millions out there. Strange, I saw more
>haloing around street lights before I HAD LASIK.
>
>SErebel

CatmanX

2005-04-20, 8:54 am

LOL!!!

I agree with that one. My dad had a Jag a number of years back that
blew a head gasket the day after servicing. Seeint the head was alloy,
that got wrecked too!!

Go poms....

dr grant

Glenn - USAEyes.org

2005-04-20, 8:54 am

Off Subject:

I have a Jag and a Triumph Spitfire. My cousin restores Jags. I am
all too familiar with British engineering...daily.

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.

Glenn - USAEyes.org

2005-04-20, 8:54 am

Not quite true. All procedures that severe corneal nerves have the
potential of causing problems, but the actual occurrence of the
problem is significantly less and the occurrence of a long-term life
disruptive problem is even lower. At six months postop, 3% of
refractive surgery patients have an unresolved problem of ANY kind,
including anything that would relate to corneal innervation.

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

2005-04-20, 5:56 pm

I don't know how many times we have to go over this, but again, you
are wrong.
Furthermore, why are you identifying yourself as a doctor when you are
not a doctor?

On 19 Apr 2005 13:33:48 -0700, "CatmanX" <grantm@connexus.net.au>
wrote:

>Loss of nerve fibres affects afferent feedback, which affects tear film
>quality, not quantity.
>
>Contact lenses do not affect tear production in any way, they increase
>dehydration.
>
>Please get your facts right cliffy.
>
>dr grant

Ragnar

2005-04-20, 5:56 pm

I don't think you know how to read. One's liver can be 83% gone or
dead and still perform it's function perfectly.
Did I or anyone say no liver function?

You are just plain wrong.
Please post more to further establish that you have no credibility.

On Tue, 19 Apr 2005 18:47:16 -0400, "LASIKtruth"
<LASIKtruth@Yahoo_nospam.com> wrote:

>Having no liver function is fatal, you idiot. All procedures which sever
>corneal nerves cause problems. You're just uniformed and uneducated. Perhaps
>you should be quiet until you learn something useful.
>
>
>"Ragnar" <ragnarsuomi@yahoo.com> wrote in message
>news:ucpa61lhae1v8a9ptp4gcv71ue90hbeh9u@4ax.com...
>

CatmanX

2005-04-20, 5:56 pm

No, 3% have unresolved complications that the surgeon acknowledges to
be a complication. There is a difference between the 2 perspectives.

dr grant

Ragnar

2005-04-20, 10:52 pm

Unresolved at 6 months post op. at 12 months post op, the unresolved
approaches 0%. At 1 day post-op, the rate is about 99% unresolved.

Meanwhile, the neverending complication rate of contact lenses
throughout the entire lifetime of the patient is 5%. And increases
over time, not descreases.

On 20 Apr 2005 15:02:11 -0700, "CatmanX" <grantm@connexus.net.au>
wrote:

>No, 3% have unresolved complications that the surgeon acknowledges to
>be a complication. There is a difference between the 2 perspectives.
>
>dr grant

CatmanX

2005-04-21, 8:54 am

where are the reports for this cliffy????

stop prattling on like the wanker you are and give some evidence of 0%.

dr grant

Ragnar

2005-04-21, 5:53 pm

Keep beating your drum and making a fool of yourself.

But quit trying to deceive people by calling yourself a dr, which you
are not.. Your last name isn't even grant, that is your first name,
your last name is Mason. - Grant Mason

On 21 Apr 2005 05:03:33 -0700, "CatmanX" <grantm@connexus.net.au>
wrote:

>where are the reports for this cliffy????
>
>stop prattling on like the wanker you are and give some evidence of 0%.
>
>dr grant

Glenn - USAEyes.org

2005-04-21, 5:53 pm

I'm as good a cynic as the next guy, but we have completed a lot of
evaluations, communicated with thousands of patients, and there have
been many studies by many people with many axes to grind for and
against refractive surgery. There may be some room for
interpretation, but 3% really is the number.

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.

Glenn - USAEyes.org

2005-04-21, 5:53 pm

Or you could say at ten years the rate is 0.000001%, but people
thinking about having refractive surgery are not buying a 10 year
healing plan. They are expecting the 20-Minute Miracle. Pushing the
end point out is really just cheating. Six months is the end of the
normal recovery period.

Although some of the complications that are not resolved at six months
postop may improve with time, most are going to need maintenance or
intervention for resolution. Some (thankfully a very small number)
are never going to be fully resolved. It is the nature of 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.