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Home > Archive > Lasik Eyes Surgery > September 2005 > Surgeons report problems with Alcon Lasers
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Surgeons report problems with Alcon Lasers
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| Dennis 2005-09-24, 2:38 pm |
| January 2005 - EyeWorld
"Lasers or surgeons: What's really the cause of high retreatment rates?"
Full article
Go here http://www.eyeworld.org/article.php?sid=2267to read the full article
on the January 2005 edition of EyeWorld, on their website.
Excerpts from Dr Sam Omar's comments
Sam Omar, M.D., medical director, Advanced Vision Institute, Longwood, Fla.,
said after he did about 40 cases with LADARVision... he stopped using the
machine due to both a high retreatment rate and poor outcomes....
In order to fix the problem, Dr. Omar said he modified his nomogram three
times and worked with Alcon staff, but the problem remained unresolved.
"LADARVision at times would be spectacular," Dr. Omar said. "Other times,
the result would be a failure...."
Excerpts from Dr Roy Rubinfeld's comments
"While none of the multiple laser platforms I have used since 1996 is
perfect, my experience with LADARVision was particularly troubling," said
Roy S. Rubinfeld, M.D., of Washington Eye Physicians & Surgeons, Chevy
Chase, M.D. "I had several occasions where the thing would just stop
working," said Rubinfelf....
"I had one time where I had to put the flap back with a flashlight because
the illumination light went off so I couldn't figure out where the flap
was," Dr. Rubinfeld said.
Excerpts from Dr Peter Hersh's comments
[These comments are in the context of discussion of a study authored by Dr.
Hersh and which indicated the LADARVision retreatment rates were
approximately double those of the Summit Apex plus. Also note that a
postscript to the article indicates Dr Hersh is a consultant to Alcon.]
While the retreatment rate associated with LADARVision was almost double
that of the Summit Apex Plus in the study, Dr. Hersh concluded that "the
difficulty of the initial procedures performed on the LADARVision laser, for
example, higher degrees of astigmatism correction or mixed astigmatic
corrections, compared with the Apex Plus laser, where more spherical myopic
corrections were treated, may partially account for these findings."
Furthermore, Dr. Hersh concluded that because the LADARVision was the newer
machine in his practice, patient expectations could have been greater with
the platform, causing more desire for enhancement. Later, during an e-mail
exchange, Dr. Hersh said: "We did not at all concentrate on or design our
methodology based on the difference between lasers. Thus, this is the wrong
study from which to draw any conclusions regarding differences in
retreatment rates between different systems."
Excerpts from Dr Doyle Stulting's assertion, vs Alcon's assertion
Alcon receives primary and secondary procedure data from all LADARVision
4000 machines for billing purposes, but surgeons contend it is not something
they can readily retrieve from Alcon.
"Alcon refused to supply their billing information showing retreatment rates
on our LADARVision laser after I requested that they do so," said R. Doyle
Stulting, M.D., Ph.D., professor of ophthalmology, Emory University,
Atlanta.
Officials at Alcon said the information is readily available to individual
surgeons.
Excerpts about data presented in court
According to data presented under oath in a deposition, 27 U.S. surgical
sites enhanced 20% or more primary LADARVision treatments from 2000 to 2002.
That percentage is based on the ratio of all retreatments to all primary
treatments recorded during that time frame. In 2002 alone, the data indicate
that 55 sites had enhancement rates of 20% or greater, although sources
familiar with the data noted that the enhancement rates could be somewhat
off (either larger or smaller) depending upon whether some retreatments
occurred at sites other than the original, occurred after primary treatments
in previous years, or for other reasons.
| |
| Glenn - USAEyes.org 2005-09-24, 2:38 pm |
| Let's talk about Osama "Sam" Omar.
Doctor Omar has been very vocal against the Alcon LADARVision 4000. He
claimed all sorts of bad outcomes with the laser. He claimed an
astronomical retreatment rate. His complaints have been loud and long.
He also failed to mention that he only did a few surgeries and
virtually all of them were very difficult patients that would not be
expected to have outcomes within the norms. I understand that the
specifics of this were disclosed on an ophthalmic newsgroup lately and
his in-your-face attitude was, essentially, turned around on him.
You will find that Dr. Omar has much less to say about the Alcon laser
these days, now that his peers know he misrepresented his experience
with the laser and the type of patients he was treating.
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.
| |
| serebel 2005-09-24, 2:39 pm |
| As long as one doc reports problems (no matter how biased), the loons
here will always try to blow it into "all surgeons report problems".
SErebel
| |
| Glenn - USAEyes.org 2005-09-24, 2:39 pm |
| I don't believe all of the doctors who expressed concern were guilty
of fudging like Dr. Omar. These are respectable doctors.
The most I've been able to get from talking with several of the key
people in all of this is that when Alcon would make major upgrades to
their lasers, the doctor's nomograms were (quite naturally) off and
would need to be adjusted. The big question is if Alcon provided
notification of the upgrades to the doctors. There is nothing wrong
with an upgrade, so long as the doctor knows about it.
Fortunately there is a lot of documentation out there, so the truth
will undoubtedly arise from all the posturing. In the mean time, the
anti-LASIK crowd have something to crow about.
Interestingly, when our organization put out a Patient Advisory about
counterfeit excimer lasers
(http://www.usaeyes.org/counterfeit_lasik_lasers.htm), none of the
zealots had anything to say. Apparently they can only raise their
righteous indignation when they report the problem, not CRSQA.
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.
| |
| Ragnar 2005-09-24, 2:39 pm |
| I'm no fan of LADARVision nor Nidek systems. They are primarily used
by cut-rate LASIK mills and should be avoided. In the case of Nidek,
the provider can lower the cost of the procedure by about $200 per eye
because they don't have to pay a royalty to the manufacturer (which is
used to finance their research and development of the technology).
These surgeons whining about their Alcons are too cheap to go buy a
good laser system and want discounts, rebates, and upgrades for free
from Alcon.
The line about Dr. Omar modifying his nomogram shows how uninformed
the author of the article is. A nomogram must constantly be modified.
It is associated with one specific laser unit in one office - and even
that system changes constantly as the laser is used. No two lasers on
the planet should be using the exact same nomogram, nor should any
nomogram remain constant for any individual laser.
On Mon, 29 Aug 2005 19:35:34 -0400, "Dennis" <Dennis@nospam.com>
wrote:
>January 2005 - EyeWorld
>"Lasers or surgeons: What's really the cause of high retreatment rates?"
>
>Full article
>
>Go here http://www.eyeworld.org/article.php?sid=2267to read the full article
>on the January 2005 edition of EyeWorld, on their website.
>
>Excerpts from Dr Sam Omar's comments
>
>Sam Omar, M.D., medical director, Advanced Vision Institute, Longwood, Fla.,
>said after he did about 40 cases with LADARVision... he stopped using the
>machine due to both a high retreatment rate and poor outcomes....
>
>In order to fix the problem, Dr. Omar said he modified his nomogram three
>times and worked with Alcon staff, but the problem remained unresolved.
>"LADARVision at times would be spectacular," Dr. Omar said. "Other times,
>the result would be a failure...."
>
>Excerpts from Dr Roy Rubinfeld's comments
>
>"While none of the multiple laser platforms I have used since 1996 is
>perfect, my experience with LADARVision was particularly troubling," said
>Roy S. Rubinfeld, M.D., of Washington Eye Physicians & Surgeons, Chevy
>Chase, M.D. "I had several occasions where the thing would just stop
>working," said Rubinfelf....
>
>
>"I had one time where I had to put the flap back with a flashlight because
>the illumination light went off so I couldn't figure out where the flap
> was," Dr. Rubinfeld said.
>
>Excerpts from Dr Peter Hersh's comments
>
>[These comments are in the context of discussion of a study authored by Dr.
>Hersh and which indicated the LADARVision retreatment rates were
>approximately double those of the Summit Apex plus. Also note that a
>postscript to the article indicates Dr Hersh is a consultant to Alcon.]
>
>While the retreatment rate associated with LADARVision was almost double
>that of the Summit Apex Plus in the study, Dr. Hersh concluded that "the
>difficulty of the initial procedures performed on the LADARVision laser, for
>example, higher degrees of astigmatism correction or mixed astigmatic
>corrections, compared with the Apex Plus laser, where more spherical myopic
>corrections were treated, may partially account for these findings."
>
>
>Furthermore, Dr. Hersh concluded that because the LADARVision was the newer
>machine in his practice, patient expectations could have been greater with
>the platform, causing more desire for enhancement. Later, during an e-mail
>exchange, Dr. Hersh said: "We did not at all concentrate on or design our
>methodology based on the difference between lasers. Thus, this is the wrong
>study from which to draw any conclusions regarding differences in
>retreatment rates between different systems."
>
>Excerpts from Dr Doyle Stulting's assertion, vs Alcon's assertion
>
>Alcon receives primary and secondary procedure data from all LADARVision
>4000 machines for billing purposes, but surgeons contend it is not something
>they can readily retrieve from Alcon.
>
>
>"Alcon refused to supply their billing information showing retreatment rates
>on our LADARVision laser after I requested that they do so," said R. Doyle
>Stulting, M.D., Ph.D., professor of ophthalmology, Emory University,
>Atlanta.
>
>
>Officials at Alcon said the information is readily available to individual
>surgeons.
>
>Excerpts about data presented in court
>
>According to data presented under oath in a deposition, 27 U.S. surgical
>sites enhanced 20% or more primary LADARVision treatments from 2000 to 2002.
>That percentage is based on the ratio of all retreatments to all primary
>treatments recorded during that time frame. In 2002 alone, the data indicate
>that 55 sites had enhancement rates of 20% or greater, although sources
>familiar with the data noted that the enhancement rates could be somewhat
>off (either larger or smaller) depending upon whether some retreatments
>occurred at sites other than the original, occurred after primary treatments
>in previous years, or for other reasons.
>
>
>
| |
| Ragnar 2005-09-24, 2:39 pm |
| And it's interesting that Dr. Omar is one of the disgraceful docs who
allow their names to be used on SE.
On Tue, 30 Aug 2005 02:07:01 GMT, Glenn - USAEyes.org
<glenn.hageleSTOPSPAM@USAEyes.org> wrote:
>Let's talk about Osama "Sam" Omar.
>
>Doctor Omar has been very vocal against the Alcon LADARVision 4000. He
>claimed all sorts of bad outcomes with the laser. He claimed an
>astronomical retreatment rate. His complaints have been loud and long.
>
>He also failed to mention that he only did a few surgeries and
>virtually all of them were very difficult patients that would not be
>expected to have outcomes within the norms. I understand that the
>specifics of this were disclosed on an ophthalmic newsgroup lately and
>his in-your-face attitude was, essentially, turned around on him.
>
>You will find that Dr. Omar has much less to say about the Alcon laser
>these days, now that his peers know he misrepresented his experience
>with the laser and the type of patients he was treating.
>
>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.
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