Exposing the LASIK Scam

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 Post subject: 2-3 moons after Intralase
PostPosted: Wed Feb 15, 2006 6:28 pm 
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Joined: Wed Dec 07, 2005 5:09 am
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Ever since I had Intralase close to 6 months ago, i've noticed that the moon isn't round anymore. It is shaped more like a horizontal football, most noticable during a bright full moon. Last night I could look at the moon and see a second and third ghost alongside it. If I look at the ground a second and look back up, the problem is worse and then seems to settle down to just a distorted shape with one ghost. What does this sound like?
I should add that i recently had another appointment and she put me back on steroids which I've taken off and on for almost 6 months.


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 Post subject:
PostPosted: Thu Feb 16, 2006 2:54 am 
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First question -- what is your current refraction? Do you have any astigmatism? Astigmatism can cause ghosted images. Higher order aberrations also can cause them. Second question -- have you had a wavefront scan taken at your maximum dark-adapted pupil diameter?

The reason the problem is worse after you look at the ground for a second and then back at the moon is because when you look down, your pupils are dilating. Then when you look at the moon directly again, for a second the image of the moon is passing through a larger pupil. HOAs are pupil-size dependent.

When I look at the moon I see several ghost images and a huge ugly smeared-halo around it. If I shine a flashlight toward my eyes while looking at the moon, the aberrations go away. If the moon is very bright, just the light from the moon itself will make the aberrations go from massive to much smaller after just a split second -- exactly what you are experiencing. This is all about pupil size.

Is your surgeon keeping a close watch on your IOP while you are on steriods? Is your surgeon aware of falsely low IOP measurements due to the flap or edema? Has your surgeon talked to you about the possible risks of long-term steriods use?

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"The price good men pay for indifference to public affairs is to be ruled by evil men." Plato


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 Post subject:
PostPosted: Thu Feb 16, 2006 4:02 am 
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Hi BE,
I do have astigmatism after surgery but still have ghosting and starbursting even wearing corrective lenses. One eye doesn't have astigmatism but still has ghosting identical to the bad eye.
My surgeon told me that my dilated pupil size is only 4.1 and 4.2. Doesn't this seem very small or are these BS numbers?
My surgeon says steroid eye pressure is not a worry but I only remember her checking it once. I have gone about 2 months on steroids before an appointment. She says there are no flap wrinkles or DLK. They are telling me my presription is 20/20 with astigmatism in one eye. I can't remember the number.


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 Post subject: 2nd opinion?
PostPosted: Thu Feb 16, 2006 4:52 am 
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Hi Jons,

One good trick to get an honest 2nd opinion is to tell the new doctor that you had your surgery done in Canada to save money. This way they 'may' be more honest about your complications. Doctors don't want to make negative comments about another local doctor's work because his unhappy patients may go to THEM. Get it?

Your doctor should be checking your intraocular pressure regularly if you are on steroids. Ask for it to be checked and express your concern. Ask why you have been placed on steroids, and why you have been on steroids so long. Steroids are for inflammation, but where is it?

Recall with Intralase they burned a path through your cornea with a laser to make the flap instead of cutting it cleanly with a microkeratome. It may take longer to recover from tissue damage from intralase? Perhaps a longer period of corneal swelling?

Have you requested a full copy of your charts? You should. With COLOR copies of your scans. The contents of your chart may be very illuminating.
At least the scans can't lie.

Sometimes people regress quite a bit and end up going through several pairs of glasses after surgery - if your current prescription needs to be changed this could add to your night vision problems. You should get a copy of your pre-lasik prescription, and most recent prescription and go to an Optometrist - not your Ophthalmologist... to have a good 'current' refraction and take a copy of your new prescription home with you for your records.

When you compare your pre and post-op prescriptions it would be useful to know how much astigmatism you have now, and if it is residual (yours but uncorrected) or induced by the surgery. Has the astigmatism gone up or down? Has the AXIS changed? Is your prescription stable since your last refraction? If not, how much has it changed?

Your stated pupil measurements sound unusually small. You may consider asking your 2nd opinion doctor to measure your dark-adapted pupil size. This means you need to be in a very dark room and have time to be adapted. You shouldn't be looking into a light source such as an eye chart that has been left on when the measurement is taken.

If you have a recent point spread function from a wavescan take a look at the shape of the blob. Most patients report that the blob on their point spread function resembles the aberrations they see. Does yours?

It would also be great to know your total higher order aberrations, and your values for spherical aberration, coma and trefoil. Could you post those for each eye?


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 Post subject:
PostPosted: Thu Feb 16, 2006 12:59 pm 
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jons wrote:
Hi BE,
I do have astigmatism after surgery but still have ghosting and starbursting even wearing corrective lenses. One eye doesn't have astigmatism but still has ghosting identical to the bad eye.
My surgeon told me that my dilated pupil size is only 4.1 and 4.2. Doesn't this seem very small or are these BS numbers?
My surgeon says steroid eye pressure is not a worry but I only remember her checking it once. I have gone about 2 months on steroids before an appointment. She says there are no flap wrinkles or DLK. They are telling me my presription is 20/20 with astigmatism in one eye. I can't remember the number.


Based on what you're telling me, it sounds like your problem is irregular astigmatism, also known as higher order aberrations. It would interesting to see your color topographies and wavefront scans (be sure the wavefront scan is taken at your max dark-adapted pupil size).

If your pupils are really that small in the dark, and you are having the problems you're having (aberrations changing with pupil size), you must have a very small effective optical zone. This really doesn't sound right to me. I would get that pupil measurement done again if I were you.

Your doctor is worrying me with her attitude about long-term steriod use and IOP.

Find out your exact refraction. That's important. If you are going around with uncorrected refractive error, that could be the source of some of your problem.

Ask your doctor point-blank if you have corneal edema. We still haven't ruled that out as a source of some of your issues.

Boy, I'd love to be able to go with you to see your eye doctor. I'd pin her butt to the wall.

_________________
Broken Eyes

"The price good men pay for indifference to public affairs is to be ruled by evil men." Plato


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