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Home > Archive > Lasik Eyes Surgery > October 2006 > Known Risk Factors for Ectasia by William B. Trattler, MD
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Known Risk Factors for Ectasia by William B. Trattler, MD
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| http://www.crstoday.com/PDF%20Artic...3_Trattler.html
Important excerpts:
By 2005, most LASIK surgeons have either seen one of their own patients
develop ectasia or have examined patients who underwent LASIK elsewhere
and have now developed ectasia. The number of post-LASIK ectasia cases
continues to increase since this condition was first reported in 1998.
(my comment: Ectasia is alot more common than procontents like to
imagine)
normal eyes that were left with thin residual stromal beds after LASIK
surgery.
(my comment: This is why at least 300+ microns must be left!)
Because LASIK flaps can be easily lifted years after the original LASIK
procedure, one wonders about the strength of its adherence to the
underlying stroma. This information is important to know both for
advising patients on their risks of flap dislocations with blunt trauma
and understanding the extent to which the flap contributes to the
overall strength of the cornea.
(my comment: Some surgeons have abandoned lasik and moved to PRK)
The actual reduction in corneal strength due to LASIK was recently
determined in a study of 21 cadaver eyes at Emory university in
Atlanta.4 The researchers found that the adhesive strength of the LASIK
flap was only 2.4% (=B11.2%) compared with the normal interlamellar
strength of a virgin cornea. In other words, the strength of the wound
between the flap and the underlying stromal bed is reduced by 97.6%
suggesting that the LASIK flap contributes little to the overall
strength of the cornea after LASIK.
(my comment: A flap is a bad idea!)
It is not surprising that a solid number of patients who developed
ectasia after LASIK first underwent a LASIK enhancement. Higher-risk
eyes that do become ectatic drift toward more myopia and astigmatism,
which may be interpreted as an undercorrection or regression instead of
increasing myopic astigmatism due to ectasia. These patients are more
likely to present for an enhancement, because their refractive results
typically do not remain stable.
(my comment: Enhancements further thin and weaken the cornea!)
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| Ragnar 2006-10-20, 4:30 pm |
| This is actually a good find by Ace.. even though it is wrong.
In this case, the article below is written by a surgeon who tries to
justify doing PRK instead of LASIK because he doesn't like flaps. That
surgeon did a flap once that resulted in a real disaster and since
then he has been beating the drums of surface ablation with no flap.
It's really disgusting that he tries to drum up PRK business by
scaring people from having lasik done. There is noting wrong with
PRK, but LASIK is better. If he has issues with LASIK, I would
suggest he stop doing both lasik AND prk.
Dr. Trattler should also inform people that his opinion about lasik is
his alone and does not represent the opionion of his peers. There is
one other surgeon in England that pulls a similar stunt, only in his
case he tries to scare people from having LASIK and having LASEK
instead.
What Ace failed to mention below is that Dr. Trattler is a big
advocate of having PRK done. Ace is only interested in the negative
comments of Trattler and ignores the fact that Dr. Trattler does PRK
successfully all the time.
On 19 Oct 2006 22:49:46 -0700, "Ace" <acemanvx@yahoo.com> wrote:
>http://www.crstoday.com/PDF%20Artic...3_Trattler.html
>
>
>Important excerpts:
>
>
>By 2005, most LASIK surgeons have either seen one of their own patients
>develop ectasia or have examined patients who underwent LASIK elsewhere
>and have now developed ectasia. The number of post-LASIK ectasia cases
>continues to increase since this condition was first reported in 1998.
>(my comment: Ectasia is alot more common than procontents like to
>imagine)
>
>
>normal eyes that were left with thin residual stromal beds after LASIK
>surgery.
>(my comment: This is why at least 300+ microns must be left!)
>
>
>Because LASIK flaps can be easily lifted years after the original LASIK
>procedure, one wonders about the strength of its adherence to the
>underlying stroma. This information is important to know both for
>advising patients on their risks of flap dislocations with blunt trauma
>and understanding the extent to which the flap contributes to the
>overall strength of the cornea.
>(my comment: Some surgeons have abandoned lasik and moved to PRK)
>
>
>The actual reduction in corneal strength due to LASIK was recently
>determined in a study of 21 cadaver eyes at Emory university in
>Atlanta.4 The researchers found that the adhesive strength of the LASIK
>flap was only 2.4% (±1.2%) compared with the normal interlamellar
>strength of a virgin cornea. In other words, the strength of the wound
>between the flap and the underlying stromal bed is reduced by 97.6%
>suggesting that the LASIK flap contributes little to the overall
>strength of the cornea after LASIK.
>(my comment: A flap is a bad idea!)
>
>
>
>It is not surprising that a solid number of patients who developed
>ectasia after LASIK first underwent a LASIK enhancement. Higher-risk
>eyes that do become ectatic drift toward more myopia and astigmatism,
>which may be interpreted as an undercorrection or regression instead of
>increasing myopic astigmatism due to ectasia. These patients are more
>likely to present for an enhancement, because their refractive results
>typically do not remain stable.
>(my comment: Enhancements further thin and weaken the cornea!)
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| Tom Lucas 2006-10-20, 4:30 pm |
| "Ace" <acemanvx@yahoo.com> wrote in message
news:1161323385.992625.204010@i42g2000cwa.googlegroups.com...
http://www.crstoday.com/PDF%20Artic...3_Trattler.html
It is not surprising that a solid number of patients who developed
ectasia after LASIK first underwent a LASIK enhancement. Higher-risk
eyes that do become ectatic drift toward more myopia and astigmatism,
which may be interpreted as an undercorrection or regression instead of
increasing myopic astigmatism due to ectasia. These patients are more
likely to present for an enhancement, because their refractive results
typically do not remain stable.
(my comment: Enhancements further thin and weaken the cornea!)
You've missed the point there but he is being a bit round-the-houses
with it. What he means is that the patients mistake the ecstasia as
regression or undercorrection and _then_ have an enhancement. In these
cases the enhancement is not the cause of the ecstasia, but probably
doesn't help once it has been done.
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| southeasteyecare@hotmail.com 2006-10-20, 9:30 pm |
| There is no way LASIK is better. Just cutting a LASIK flap with NO
lasering induces higher order aberrations. The flap itself is a fragile
mutilation of a patients' cornea that will never heal. LASIK should
never have been approved by the FDA. If the CRS study had turned in all
of its clinical outcomes instead of less than 30%...and turned in the
loss of contrast sensitivity which was UNIVERSAL with LASIK... then it
would NOT have been approved. Only a coverup allowed LASIK to be
approved. It is a bad surgery, and malpractice by all who perform this
surgery today.
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| southeasteyecare@hotmail.com 2006-10-20, 9:30 pm |
|
Looks like Dr. Trattler does his literature reviews on the FLAP.
http://lasikflap.com/forum
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| that may or may not have been true for the approval process with the FDA.
what about Health Canada and every other country that has approval processes and
approved Lasik/PRK?
don't tell me every single one of them was fooled.
how exactly do you explain a 8 year (11 years in Canada) ongoing cover up since
approval?
"and support your assertion with some documentation"
<southeasteyecare@hotmail.com> wrote in message
news:1161392093.903539.166140@b28g2000cwb.googlegroups.com...
> There is no way LASIK is better. Just cutting a LASIK flap with NO
> lasering induces higher order aberrations. The flap itself is a fragile
> mutilation of a patients' cornea that will never heal. LASIK should
> never have been approved by the FDA. If the CRS study had turned in all
> of its clinical outcomes instead of less than 30%...and turned in the
> loss of contrast sensitivity which was UNIVERSAL with LASIK... then it
> would NOT have been approved. Only a coverup allowed LASIK to be
> approved. It is a bad surgery, and malpractice by all who perform this
> surgery today.
>
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| Ragnar 2006-10-21, 2:29 am |
| Everyone is entitled to their opinion.. no matter how stupid it is. In
some countries you would be imprisioned or shot, but here, you are
free to make an XXX of yourself.
Your opinion is 1 vote against. There are 10,000,000 for...
I can't think of anything other than lasik that so many people like
and so few people dislike. The only exception might be Sara Lee
pastries.
I suspect that your problem isn't that your eyes are bad... your
problem is that you are fundamentally a miserable person to begin
with. The expression "you can't make a silk purse out of a sow's ear"
comes to mind. Hopefully the only life you will make miserable is
your own.
On 20 Oct 2006 17:54:53 -0700, southeasteyecare@hotmail.com wrote:
>There is no way LASIK is better. Just cutting a LASIK flap with NO
>lasering induces higher order aberrations. The flap itself is a fragile
>mutilation of a patients' cornea that will never heal. LASIK should
>never have been approved by the FDA. If the CRS study had turned in all
>of its clinical outcomes instead of less than 30%...and turned in the
>loss of contrast sensitivity which was UNIVERSAL with LASIK... then it
>would NOT have been approved. Only a coverup allowed LASIK to be
>approved. It is a bad surgery, and malpractice by all who perform this
>surgery today.
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| Ragnar 2006-10-21, 2:30 am |
| Trattler was and probably still is one of the nut doctors at SE.
Dr. Trattler is the prince of PRK... so I assume that you recommend
that people have PRK done. That's fine with me. Lasik is better,
but if someone wants PRK I would say "fine.. your end results will be
almost identical anyway".
On 20 Oct 2006 17:55:47 -0700, southeasteyecare@hotmail.com wrote:
>
>
>Looks like Dr. Trattler does his literature reviews on the FLAP.
>
>http://lasikflap.com/forum
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| Ragnar 2006-10-21, 2:30 am |
| Excellent point Scott...
The FDA is generally considered to be a bureaucratic bunch of boobs..
however, every other country has given the thumbs up to lasik also.
Oct 2006 02:18:54 GMT, "Scott" <moe__green@msn.com> wrote:
>that may or may not have been true for the approval process with the FDA.
>what about Health Canada and every other country that has approval processes and
>approved Lasik/PRK?
>don't tell me every single one of them was fooled.
>how exactly do you explain a 8 year (11 years in Canada) ongoing cover up since
>approval?
>"and support your assertion with some documentation"
>
><southeasteyecare@hotmail.com> wrote in message
>news:1161392093.903539.166140@b28g2000cwb.googlegroups.com...
>
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