Lasik Eyes Surgery - back from Iraq for a little R&R

Author

back from Iraq for a little R&R

Simpledog

2005-08-17, 8:57 am

Thought I'd stop in and say hello.

The Opthonix glasses work great outdoors. Crystal clear in the trouble eye.
Reduced distance vision in the 'good' eye for some reason. I can go back to
the doc and he can reshoot and send them back to the lab, which I think I'll
do. I also need some basic glasses with no script on top (I can see ok
20/20 in good light distance) but my up close vision is failing.

Because I'm nearing 40, and they (Opthonix) don't have bifocals yet, I still
rely upon some readers to get some up close reading done. I think Opthonix
is dialing this stuff in.

On another front, is there any movement on 'corrective' wavefront to correct
previously treated patients (I know Alcon was doing something) or are IOL's
or similar being designed with WF built into them? Dr. Wallace said he's
getting good results with the Alegretto machine....but...

Right now, I'm ok with my vision. Not looking for a flap lift and "hope and
pray" fuzzy vision experience anytime soon until the fix is routine.

I head back to Iraq the 4th of Sep. Things are real quiet at Camp
Victory....only 2 rocket attacks...nothing big. Big car bomb outside the
gate before I left.

Regards to all.

CatmanX

2005-08-17, 8:57 am

Glad to hear the glasses are working.

How is your suntan going? You should have added a few shades by now.

grant

crvc@wyoming.com

2005-08-17, 11:55 am

Hi Simple,

We communicated earlier this year when you'd just gotten the glasses.
But I don't remember what vision problems you had. haloes? double
vision?

I found the website and there is now an optometrist within driving
distance who is advertising opthonix glasses.

Glenn - USAEyes.org

2005-08-17, 11:55 am

It's very good to hear from you and learn that all is okay...more or
less.

Only the Visx S4 has received FDA approval to treat hyperopia
(farsighted, longsighted) vision with a wavefront-guided ablation. I
have not seen too many reports on results, so IMO the jury is still
out. I have heard nothing of Complex Wavefront Enhancement (CWR) for
retreatment of myopic (nearsighted, shortsighted) vision patients who
were overcorrected into hyperopia.

I'm glad to hear that those glasses are doing a reasonably good job of
providing corrected vision. As you know, I was rather pessimistic. I'm
glad to change my opinion of them.

As I recall, you live near Bakersfield California. I imagine that at
this time of year, there is not much difference in the weather between
Bakersfield and Iraq. 8^)

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.

crvc@wyoming.com

2005-08-17, 6:02 pm

Just talked to the OD. He says it's brand new equipment that hasn't
arrived yet and no experience with it. But I have an appointment for
an exam in September.

Simpledog

2005-08-17, 10:57 pm

Live between Las Vegas and Los Angeles - think Death Valley weather.

"Glenn - USAEyes.org" <glenn.hageleSTOPSPAM@USAEyes.org> wrote in message
news:70q6g15b65l75jed5lh83o6gu7pl0f2r13@4ax.com...
> It's very good to hear from you and learn that all is okay...more or
> less.
>
> Only the Visx S4 has received FDA approval to treat hyperopia
> (farsighted, longsighted) vision with a wavefront-guided ablation. I
> have not seen too many reports on results, so IMO the jury is still
> out. I have heard nothing of Complex Wavefront Enhancement (CWR) for
> retreatment of myopic (nearsighted, shortsighted) vision patients who
> were overcorrected into hyperopia.
>
> I'm glad to hear that those glasses are doing a reasonably good job of
> providing corrected vision. As you know, I was rather pessimistic. I'm
> glad to change my opinion of them.
>
> As I recall, you live near Bakersfield California. I imagine that at
> this time of year, there is not much difference in the weather between
> Bakersfield and Iraq. 8^)
>
> 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.

Simpledog

2005-08-17, 10:57 pm

I guess it's important to understand the context of my dilemma. I didn't
have a bad outcome - I was just a bad patient. I should have never gotten
lasik, because I want my vision to be spot on. Before I went under the "The
light is your friend" fry, I was a +4.25 -1.00cyl in both eyes. Not exactly
an ideal candidate, although within range of the ladar machine. I was not
counseled adequately as to the probability of my outcome and the increased
risk I took with such an rx. I blame myself, because I'm a smart guy, and I
should have done my homework.

I came out with 20/25 vision in both eyes which took about 9 months to
stabilize. My left eye has a problem getting corrected to what it used to
be able to obtain with glasses. So I went from basically semi-blind to
functional vision, but I traded off about a line of BCVA in my left, and
dominant eye. I have some minor starburts/halos in both eyes at night.
Nothing real bad. Left eye was also drier, but not chronically so. I drop
or two in the morning, and a hot compress, and off I go. Although, with
fluctuating dryness, comes fluctuating vision - regardless of the glasses
you're wearing.

With the WF glasses, the glare at night is reduced by about 40 to 50%. I've
gained my vision back in my left eye, but ONLY during the day or in good
lighting. I attribute this to much of what Glenn speaks of. The glasses
cannot compensate for all the mechanics of the eye, they can't 'bend' light
perfectly because of the inherent deficiencies of a mechanical response to a
non fixed biological function (vision). As your pupil constricts, your eyes
are a bit drier.etc...so go the 'fixed' properties of your vision. So, I
guess what I'm saying is.....if you REALLY want to get great vision, have
them make a set of WF glasses for you after you sit in a very dark room for
about 10 min, then, somehow, someway, have them do it for you in great
lighting.

So what I have done is to pop out the right lens, and replace it with just
glass. I can almost seen 20/22 with that eye, unaided, but I DON'T want it
to be stronger than my left. Now with my left, I'm a solid 20/20 with the
wf lenses. However, I'm not that crisp 20/15 as I was prior to lasik, and
dark rooms still cause contrast problems. In short, Opthonix technology is
the aspirin of lasik - at least for me. It will help, but it will not fix
your problems. I think as time goes on, they'll improve the lens and the
technology.

<crvc@wyoming.com> wrote in message
news:1124299558.795971.189730@f14g2000cwb.googlegroups.com...
> Just talked to the OD. He says it's brand new equipment that hasn't
> arrived yet and no experience with it. But I have an appointment for
> an exam in September.
>

Glenn - USAEyes.org

2005-08-17, 10:57 pm

Ah, the other direction. I guess you would acclimate rather quickly.

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.

Simpledog

2005-08-18, 8:59 am

It's about 5 degrees hotter there, than here. It was 116 the day I left.
It's still 110 or so....and only 100 in Barstow.

But it's very similar.

Here is a web site a girl put up, sorta shows where I am at.

http://www.armychic256bde.com/id44.html

Not much of a war zone now...at least where I am at.....there are car bombs
outside Camp Victory....sporadic mortar fire which usually misses. I'll
here the rat ta ta ta of AK47 fire at night....way off in the distance.

Headed back 4 Sep till early March.

We work 12x6 now, with one day off, but usually average 14 hour days after
all is said and done. Not much to do other than work, eat, run 3 miles,
read a bit, sleep, rinse and repeat. I'll keep going back 6 months a year,
as long as the WIAS (Army Speak for Work tasking) is out there. Only thing
that limits me from staying full time is the limit on the amount you can
make in one year working for the Feds (not contractor - they are tax free
and the sky is the limit).

There are lasik centers in Baghdad, I kid you not. I don't venture out, but
should things calm down, I wouldn't be able to resist heading to one for a
free consult! NOT!

lol

So Glenn........what's up man, when are they going to start applying WF
surgery to fix prior surgical problems, as an FDA approved procedure?
Howabout IOLs?

"Glenn - USAEyes.org" <glenn.hageleSTOPSPAM@USAEyes.org> wrote in message
news:u418g1l4aqq10tni69risf7tsq1ifv6ijb@4ax.com...
> Ah, the other direction. I guess you would acclimate rather quickly.
>
> 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.

Glenn - USAEyes.org

2005-08-18, 5:56 pm

Interesting website and update on your Iraq adventures. Insult to
injury: you have to eat Burger King and use AT&T. 8^)

Docs are using Complex Wavefront Retreatment (CWR), but it is all
off-label. I really will be surprised if any laser manufacturer will
go through the trouble and expense of getting full FDA approval for
retreatment. There are too many issues that just don't make sense from
the manufacturer's point of view.

) It is not necessary. Off label use of the laser is within the scope
of practice rules.

)Not much of a market. There is a rather small number of people who
need specialized retreatment.

)Pointing out refractive surgery limitations. Requesting FDA approval
for retreatment would be acknowledging the need for retreatment. It is
one thing to know it is needed, it is another to say they need it.

)Mediocre results. Because they are starting with aberrated eyes,
retreatment outcomes would not be very impressive. Improved, yes,
impressive, no.

)Cost. It costs hundreds of thousands of dollars to get full FDA
approval for a medical device.

If they do anything at all, my bet is that they would seek a
Humanitarian Device Exemption (HDE) for up to 5,000 patients per year.
That is less expensive, easier to attain, and would cover the need.

IOLs that custom correct wavefront have a big problem in that IOLs
move. It takes very little rotation for the wavefront to be screwed
up. Using wavefront data to create an IOL (wavefront optimized) may
make an IOL that has better optics, but custom is not likely in the
near future. In fact, I predict that until Calhoun gets their Light
Adjusted IOL approved, nobody is going to pay more than lip service to
wavefront IOLs.

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.

Simpledog

2005-08-19, 9:02 am

So are you saying that we're at wits end for wf applications for previously
treated eyes? As a hyperope, I'm limited to the Visx machine in the states.
However, I've heard that the Allegreto machine, even without customized wf,
does a better job on farsighted patients...

Who out there is doing the best work on retreatments now?

"Glenn - USAEyes.org" <glenn.hageleSTOPSPAM@USAEyes.org> wrote in message
news:i0k9g15lshi9au23hh2av1bikt3atfrjva@4ax.com...
> Interesting website and update on your Iraq adventures. Insult to
> injury: you have to eat Burger King and use AT&T. 8^)
>
> Docs are using Complex Wavefront Retreatment (CWR), but it is all
> off-label. I really will be surprised if any laser manufacturer will
> go through the trouble and expense of getting full FDA approval for
> retreatment. There are too many issues that just don't make sense from
> the manufacturer's point of view.
>
> ) It is not necessary. Off label use of the laser is within the scope
> of practice rules.
>
> )Not much of a market. There is a rather small number of people who
> need specialized retreatment.
>
> )Pointing out refractive surgery limitations. Requesting FDA approval
> for retreatment would be acknowledging the need for retreatment. It is
> one thing to know it is needed, it is another to say they need it.
>
> )Mediocre results. Because they are starting with aberrated eyes,
> retreatment outcomes would not be very impressive. Improved, yes,
> impressive, no.
>
> )Cost. It costs hundreds of thousands of dollars to get full FDA
> approval for a medical device.
>
> If they do anything at all, my bet is that they would seek a
> Humanitarian Device Exemption (HDE) for up to 5,000 patients per year.
> That is less expensive, easier to attain, and would cover the need.
>
> IOLs that custom correct wavefront have a big problem in that IOLs
> move. It takes very little rotation for the wavefront to be screwed
> up. Using wavefront data to create an IOL (wavefront optimized) may
> make an IOL that has better optics, but custom is not likely in the
> near future. In fact, I predict that until Calhoun gets their Light
> Adjusted IOL approved, nobody is going to pay more than lip service to
> wavefront IOLs.
>
> 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.

Glenn - USAEyes.org

2005-08-19, 9:02 am

The "best work" on retreats is a bit of a loaded question. The Visx S4
is a fine machine, but I'd like to see what the flying spot lasers are
able to do before making any kind of recommendation. You already know
and have been seen by a couple of the best. They will be the ones to
approach.

Since you are on the other side of the world half the year, you might
consider taking an extended vacation in Europe or Britain for
retreatment there. They have more advanced equipment than available in
the US. Normally I would not suggest considering a long-distance
surgery, but due to your unique circumstances it may work well for
you. Plus you could R&R in Belgium rather than Barstow.

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.

Simpledog

2005-08-19, 9:02 am

Yeah, I've considered that. The problem I have with the docs here, is that
the best always have different answers. Meaning, Rabinowitz is ready to
shoot me tomorrow with the Visx machine. I mean, boom, start taking the
drops, and schedule the surgery. Boxer-Wachler says to hold off, but a year
ago was very interested in doing an off-label Ladar shot. Nordan doesn't
practice any more, and when I saw him 2 years ago, wasn't really a WF
promoter. Haven't seen Assil. Haven't seen Maloney, and I'm not going to
wait 3 months to do so either.

I guess I could go see Durrie in Kansas, but he's a Ladar guy, and they
aren't doing hyperopic wf yet.

hmm......

Who in Belgium then? I certainly can afford it now.

"Glenn - USAEyes.org" <glenn.hageleSTOPSPAM@USAEyes.org> wrote in message
news:drnag1dlpe8asbquolbl3aidvqom2uos4f@4ax.com...
> The "best work" on retreats is a bit of a loaded question. The Visx S4
> is a fine machine, but I'd like to see what the flying spot lasers are
> able to do before making any kind of recommendation. You already know
> and have been seen by a couple of the best. They will be the ones to
> approach.
>
> Since you are on the other side of the world half the year, you might
> consider taking an extended vacation in Europe or Britain for
> retreatment there. They have more advanced equipment than available in
> the US. Normally I would not suggest considering a long-distance
> surgery, but due to your unique circumstances it may work well for
> you. Plus you could R&R in Belgium rather than Barstow.
>
> 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.

Glenn - USAEyes.org

2005-08-19, 11:52 am

SimpleDog,

I've sent you an email with some ideas on how to locate a surgeon for
you in Europe.

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.