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Eye surgery leaves many with problems (The Charlotte Observer)

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Eye surgery leaves many with problems (The Charlotte Observer)

Published: Sun, 30 Sep 2007 12:32:32 GMT

Millions of Americans have undergone laser eye surgery to correct bad vision, and along with the procedure's popularity something else is coming into focus: its hazards. Advertising stresses the surgery's safety, and most procedures are successful. Tiger Woods, who relies on keen eyesight as the world's best golfer, pitches it as a quick and painless way to restore sharp vision. Even the U.S. ...

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another case to be made

for Surface ablation
i support PRK!
 
I like the way Fleming uses this article to bash optometry. He has no problem with an article about BAD SURGICAL OUTCOMES, because he literally blames bad outcomes on co-management. Nice, real nice. :D

BTW: I am sure that his comments are a swipe at TLC which is the largest LASIK co-management network.
 
OMG that article is ridiculous. I did my residency in Laser/Cataract. I'm not having lasik by a guy that does 1-2 per month! I want a guy that does 50-60 per month. One who knows his/her equipment and the nomograms and what to do should any problem arise. Not some guy who does an SLT, a bleph, and a PRK in the same day! And god forbid an OD screw up the post op care, and get paid for it!?! Exactly how do we screw up the post op care? The patient follows the drop schedule of the surgeon. If the flap is off or the pt has bad DLK, send them back!

And the guy that was diagnosed with meibomian gland dysfunction AFTER surgery? How about some WCP, lid massage, AT, restasis anyone? None of these people read or signed an informed consent before the surgery?

No mention of ectasia...which I think in the long run is the biggest potential problem, though there are solutions for that in the works. Some kind of light treatment that hardens the cornea and stops ectasia.
 
[/Quote]No mention of ectasia...which I think in the long run is the biggest potential problem, though there are solutions for that in the works. Some kind of light treatment that hardens the cornea and stops ectasia.[/quote]

I was fascinated by your mentioning of light treatment that hardens the cornea. That could be a big help for keratoconus patients; and over corrected RK patients as well as LASIK ectasias. Do you know of other sources of information on this? I supposed O.D.s will be banned from using this light treatment procedure.
 
No mention of ectasia...which I think in the long run is the biggest potential problem, though there are solutions for that in the works. Some kind of light treatment that hardens the cornea and stops ectasia.[/quote]

I was fascinated by your mentioning of light treatment that hardens the cornea. That could be a big help for keratoconus patients; and over corrected RK patients as well as LASIK ectasias. Do you know of other sources of information on this? I supposed O.D.s will be banned from using this light treatment procedure.[/quote]

http://www.revophth.com/index.asp?page=1_13506.htm

Riboflavin is irradiated with UV light to strengthen the ectatic cornea.
 
That was a very interesting article Dr Wallace. The article said the procedure is not even close to FDA approval in the U.S., but has been approved since December 2006 in Europe. We may see a resurgence of patients running to Canada, TJ, or India to get this procedure. For keratoconus, it would seem that treatment right after identification of the ectasia would be a good idea to prevent visual deterioration. I wonder if it would work on the sclera (for staphylomas?)

I encourage everyone to check out the article Dr. Wallace pointed out from the Review of Ophthalmology.
 
1 MILLION procedures per year with a 2% - 3% defect rate

Equals

30,000 people per year with serious complications.
 
Does a defect mean dryness for a month afterwards? Or DLK requiring a washout?

Anyways, thats why I see it as my job to know which surgeon's chair I want my patient sitting in. Some surgeon might have a 6% complication rate while others have 0.5%. I don't want them to go to the laser-in-a-box factory on their own whim. I'd rather discuss it first and have the pt be informed, as Im sure everyone here would. Get a copy of your surgeon's informed consent to show to pts ahead of time if you want to deter them. After reading that, Im surprised anyone still has LASIK ;) My wife had LASIK 5/2007 at -8.00 with some cyl, and she's been happy ever since. Now she will be able to chase our (yet unborn) rugrats around the house sans correction.

Edit: Oh, and thanks for the reply to the HSA thread Brad ;)
 
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Very interesting article JWAH. There is nothing about the procedure that should keep an OD from doing it per Indiana licensure. Probably be another fight on the horizon, or the uv lamp will be ridiculously expensive.
 
Scott Caughell said:
Very interesting article JWAH. There is nothing about the procedure that should keep an OD from doing it per Indiana licensure. Probably be another fight on the horizon, or the uv lamp will be ridiculously expensive.
Click to expand...
Unless you are going to have 5-10 keratoconics every month, I doubt its cost effective to have the equipment. Look at how many YAG iridotomies or capsulotomies you refer in a month. GIT-R-DUN Scott!
 
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If the light was like $1500 I'd go for it. Regardless I'm sure a large optometric practice or the schools could buy one. For optometry's sake I would much rather refer to an OD than an MD.
 
What about an off label use where patients are fit in a reverse geometry lens till target v.a. is obtained and then are treated with the riboflavin and u.v. light. Refractive surgery without the sugery. With luck it would work for about a year and then need retreatment.;)
 
Jeff Summers said:
What about an off label use where patients are fit in a reverse geometry lens till target v.a. is obtained and then are treated with the riboflavin and u.v. light. Refractive surgery without the sugery. With luck it would work for about a year and then need retreatment.;)
Click to expand...

That would be perfect, the OD answer to birth control, or dental cleanings.
 
here we go yet again!!!!!

the omd in the this very article has the title "Dr" but the OD does not. mistake, I do not think so. there is a post that complains about this very thing.
 
you know john potter

Brad Kardatzke said:
1 MILLION procedures per year with a 2% - 3% defect rate

Equals

30,000 people per year with serious complications.
Click to expand...

john potter and the great folks at TLC have a terrific way of dealing with these. if you don't know how they do it, then you should learn. its not a secret.
Jim
 
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