Exposing the LASIK Scam

OK - Here is the deal.
In 2004, I was 21, and had wavefront surgury. I have 8.5mm pupils, and I had a wavefront laser that had an optical zone of 6.5mm.
Ever since, I have had horrible glare and starbursts day and night. And, a few months after the surgury, I started using Alphagan P and Pilocarpine. I am absolutely certain that the Pilocarpine reduced my pupil size and changed their shape, so now I have 8.25mm pupils with HORRIBLE, BLINDING floaters. My life has been ruined. I went from a great life with a promising future to $60,000 dollars of debt with no possiblity of working since I can not drive or control my anxiety. I have ruined not only my live, but the lives of my parents, and other members of my family.
If there is anyone who can offer me any advice please email me anytime at apizzo667@aol.com or my mom who had to go on medication just to deal with the depression of handeling my aniexty. I know I am crazy for posting my phone number, but after years of dishonest doctors and not being able to find any answers, I found this board and I was hoping to have salvage some form of a life. To make things even worse, I am not able to take any anxiety medicine or depression medicine since all of those medications give me MYDRASIS, which causes an enlargement of the pupil. So when I would take an anti depressent, my pupils enlarge and the starburts and glare become paralzying. I went to doctor after doctor for advice and they all say that I am crazy and that my eyes are perfect. However, any doctor that took a measurement of my pupils and compared it to the optical zone of my orginal surgury, would see that I am right. However, no one can do this, so it is my claim against a doctor. No one believes anything I say. I lost all of my friends and I was hoping to hear from someone. If anyone here lives in the Philadelphia area, please also feel free to call or write me. I need any support and advice. I lost all of my friends and I have nothing but my mother's help left. I am considering complex wavefront retreatment to enlarge my optical zone. I would like to do this with PRK to eliminate any flap risks. Does anyone know if PRK guided wavefront has an optical zone this large? Does conventional wavefront? You might think I am crazy for going under another operation but when I think if I have a life worth living, it is not. So if I go through another unsuccessful surgury, or have no surgury, it will be my time. But if there is any remote change that complex wavefront retreatment will help, well then, its the best and only chance I have left to do. Please, if anyone can reach out to me, I need a friend, I need to cry, I need to vent. Someone please help me. My life is over now. I don't know who I can trust any more. I was in reguluar contact with Glenn Haegle but then I read on your boards that his opinion is biased. Please anyone can someone help me out and maybe, just maybe, CWR could help? Thank you.
I just want some fraction of my life back.

Also, I am very sorry if this sounds like the most selfish posting. I used to be the most caring individual. I used to volunteer and be the most friendly and genuine person. But anymore I can't bring myself to care about anything. I apologize if I made my problems sound any more important than anyone elses. The guilt that I have had ever since my surgury is overwhelming.
Thank you.

Hi APizzo667

I am truly sorry to read about your experience. I, too, have enormous pupils. My pupils are 8mm. I was treated on an old VISX laser with a 6mm optical zone, no blend, and have an effective optical zone of about 5mm. So I understand how devastating this is. That's why I have stayed on the internet for 6 years, trying to warn patients with large pupils. You can't trust LASIK surgeons to tell the truth about this issue.

As far as the floaters go, there's not much you can do about that, short of having a vitrectomy -- that would be the last resort in an extreme case. I experienced a large curtain-like floater in one eye shortly after LASIK. If you haven't had a dilated exam of your retina, you should have one done right away just to ensure no other problems.



No, you're not crazy and your eyes are not perfect, regardless of what line you can read on the Snellen chart. Whoever said that is an idiot.



Oh yes, this can be done. Check out this image of a patient's pupils in the dark with the topography superimposed (to scale) on top of the pupil:



Indisputable proof of the power changes across the pupil diameter, resulting in a degraded retinal image. Let them try to dispute this.



Who advised you to do this? Glenn Hagele? And where is he going to be if that surgery doesn't help, or possibly makes things worse? One word of advise -- NEVER NEVER NEVER TRUST A WOLF IN SHEEP'S CLOTHING!!!

Do not trust Glenn Hagele as far as you can throw him. He gets paid by LASIK surgeons. He downplays complications. He covers up for bad surgeons. He is not a patient advocate. He refers patients to have LASIK to surgeons that pay him a fee.

Complex wavefront retreatments have not been shown to be safe or effective in any controlled clinical trials. They are much more risky than a primary surgery. They can make things much, much worse. They are experimental.



No, it does not. Neither does LASIK wavefront. Besides, PRK on top of a LASIK flap is risky. And they will use a toxic substance on your eye called mitomycin C, or MMC for short.



Never trust someone who gets paid by LASIK surgeons and puts up hate sites about damaged LASIK patients, and who harasses and threatens patients. Stay far, far away from him.

I'll tell you what helped me -- hard contact lenses. Have you tried them? I think they are your best hope. They won't help the floaters, but they will help your vision in dim light if you can tolerate them. I am wearing SynergEyes lenses. They are hard in the center with a soft skirt.

Let me know if I can answer any more of your questions.

Best of luck to you,
BE

Please read:

The Lone Dog?s pupil primer for casualty prevention

http://www.lasermyeye.org/keratoscoop/c ... y2003.html

Once you read this you will KNOW you are not crazy. Show it to your friends and family, and any doctor you meet. A surgeon who performs corneal refractive surgery on a patient with pupils larger than the area of the full treatment zone planned is reckless, irresponsilble and guilty of malpractice.

Your pupils are too large for corneal refractive surgery. You were a poor candidate, and your doctor should have informed you of this fact.

Go to your original surgeon and request a full copy of your charts including color copies of your scans. If your original surgeon's office gives you ANY trouble with this reasonable request that is your legal right... let us know. Once you have your chart, find your operative reports for each eye - this report contains information on your planned optical zone. Compare the optical zone size your doctor intended for each eye to your maximum pupil size in dim light. Your post-surgical optical zone will be smaller than the planned zone. Your actual post-surgical fully treated area can be measured from your topographies. Subtract the area of your full pupil area from your planned optical zone size. AT LEAST this much area of your entrance pupil is untreated or undertreated. When light enters your pupil through untreated or undertreated areas of your pupil, an unfocused retinal image is the result. No wonder your vision is a mess.

You will need to find a doctor who will perform a wavefront scan at your full pupil size. This will reaveal the amout of higher order aberrations you experience when you are in dim light. A scans at 6, 7, 8, and 8.5mm would be most useful.

You also need to find an expert contact lens fitter ASAP - someone with much experience fitting post-LASIK corneas.

Who was your original surgeon?

We don't typically suggest additional surgeries to patients as they often make a bad situation worse. However, depending on your pre-op prescription and the amount of corneal tissue you have remaining after your initial surgery there may be some hope for improvement with a zone enlargement. Please know that you will lose more corneal tissue in the periphery, which could make you even more likely to develop corneal failure some day. Also... the surgery will damage more corneal nerves. If you have dry eye now it could be much worse.

Your vision may not be improved and could actually, believe it or not, be made worse.

Before you consider more surgery you will need an ARTEMIS scan, which is an ultrasound of your cornea. They have an Artemis scanner at Cornell. There may be one closer to you now. The corneal ultrasound will measure the thickness of all layers of your cornea with a resolution of one micron.

This information will allow better, safer surgical planning.

You should also have an Orbscan.

Antidepressants, from what I have heard, are worse in terms of visual side effects than antianxiety mediations in the benzodiazepine family.

Have you tried benzodiazepines? You would be better off with an antidepressant if there was one you could tolerate, but apparently this has been a problem. You should be seeing a GOOD psychiatrist and considering some antianxiety medications such as ativan.

Stay with us, we want to help you through this difficult period! Many of us on this board are also 'large pupil' LASIK victims and have damaged vision similar to yours.

Ask this post-refractive contact lens fitter if he fits the new SynergEyes lenses:

Dr. Dave Hartzok 71 Brumbaugh Avenue Chambersburg PA 17201 Tel: (717) 264-7225 Fax (717) 264-8637 Email: david@planetcable.net

He had a 6.5 wavefront treatment -- deeper in the periphery and with a blend. No surgeon is going to try to enlarge that under the flap unless he's nuts.

Thank you everyone!
I am trying to read through what everyone wrote so that I can fully understand what was said. I feel like I am becoming a real expert on refractive surgury sometimes.
I can't thank you all enough.
I definatly need to start looking into getting my charts, taking anti anxiety medcine, etc.
I have not used pilocarpine in about a year. It is my belief that if changed the shape of my pupil from a circular shape to more of a football shaped, which makes the the way the light hits the my reflect the any floaters in my eye differently. For example, when I have pilocarpine in my eye, my pupil is very small, and my floaters are extremely apparent. However, when I have my eyes dilated, the floaters are less apparent.
What I am curious about is when I receive my orginal medical charts. Pilocarpine I believe can make pupils permentaly smaller (and thus change their shape). I feel this is what happened in my case. I am just putting this information out there. Please don't feel pressured to respond, you all have helped me so much already. The reson why I wanted to place this information out there is in case anyone had the same experience. Basically, I think my pupil shape went from ) to more of a > shape after using Pilo. Orginally my pupils were about 8.5mm, and now they are 8.25mm. Its my belief that this happend as a result of Pilocarpine. Also, does anyone know how to combat the TIRED, SLEEPY feeling from Alphagan P? Whenever I take it, I need to sleep. I know it is supposed to make you tired, but is their any supplement to combat this?
Thanks!! I want to reply to what everyone wrote earlier so that I can get a fuller understanding of the dynamics of my eye.
Thanks again.
Anthony

Ever since I was 12, I wanted lasik eye surgury. But I waited for years to have the surgury done. I was 21 when I had it. I waited until it was "safe" enough to have it. So when I was 21, I had the new and "safe" wavefront surgury. But its my belieft now its the wavefront that screwed me over. I think, correct my if I am wrong, that wavefront lasers all have optical zones smaller than convential lasik. I am not saying that convential lasik would have been better, but at least the optical zone would have been larger. I orginally had -2.25 diopters in each eye (forgive me I stated that wrong), with 1 diopter of astigmatism. Now I have about 1 diopter of mixed astigmatism. Also, I believe I had about 55% of HOA. I hope what I wrote is clear about my eye sight. I am still learnign how to properly classify my conditions and such. All that I wrote I had to learn on my eye without any help. But I hope this information helps anyone who could potential find it useful. Thanks again,
Anthony

Wrong. Prior to wavefront the optical zones commonly used for conventional LASIK were 5.5 - 6.5mm. Older technologies used even smaller optical zones. Wavefront with a 6.5 optical zone, plus a blend zone, is as large as it gets with LASIK. And the additional benefit of wavefront is that it ablates deeper in the periphery, which is important when you have large pupils. Maybe the total ablation zone which includes the blend zone is where you are getting confused.




Plus irregular astigmatism induced by LASIK. This is not correctable with glasses and therefore not reflected in your refraction. It can only be measured with a wavefront aberrometer, and the scan diameter should be as large as your pupils in the dark. Not all aberrometers can measure large pupils.

VISX aberrometers are the worst offenders for hiding high higher order aberrations in large pupil patients. VISX historically had fixed diameter scans at 6mm, but I think they may now do 6.5mm scan... I'll have to check.

But VISX aberrometers will not measure a scan diamter larger than 6.5mm. VISX lasers will certainly generate aberrations well outside of 6mm that devastate visual quality, but VISX won't permit these induced distortions to be measured on a VISX device. Likely VISX doesn't want patients to know that the aberrations past 6-6.5mm are there. If VISX wanted to measure aberrations out to a patients full scotopic (dark-adapted) pupil size their aberrometer would be capable of scanning at these diameters.

Broken Eyes said:


Hey B.E., I thought all surgeons were nuts. This patient would need a surface ablation, careful choice of surgeon and laser, he would need to accept the fact that he would have mitomycin C used in his eyes and could STILL have haze even with MMC, AND he would have to accept that he could be made worse.

All this is assuming the Artemis showed sufficient tissue - if his flaps were cut thick prior to the wavefront treatment, he could be pretty thin in the periphery even with the low pre-op prescription.

LASIK surgeons do enormous damage to healthy eyes - they damage all eyes they touch. Some patients escape with less damage, and others are severely damaged from day one. Some patients manifest symptoms of complications years after LASIK surgery. All are harmed.

Eye was advising having an Artemis scan done for surgical planning purposes. The primary reason for having an Artemis scan for surgical planning is to determine the RST under the flap. That's why I replied to the flap lift comment.

I feel like the biggest idiot sometimes. I was just on Brett Hansons website and another doctor that I emailed a few times for help was on there.
I tried emailing Dr. Probst out of Chicago several times with advice on CWR. I was looking for doctors on the internet who were "experts" on large pupil sizes but it seems that I don't know who I can trust!

When it comes to large pupils, there aren't many LASIK surgeons you can trust. The scientific literature contains hundreds of articles going back for over a decade that discuss the issue of pupils dilating beyond the effective optical zone. Then there are a small handful of poorly designed studies that say pupil size doesn't matter. The methodology used in these "size doesn't count" studies is so flawed I like to call them Swiss Cheese Studies, because they are full of holes. But LASIK surgeons will quote them instead of the mountain of studies to the contrary because it serves their purpose, to cover up the problems. There have been some pupil size lawsuits -- surgeons like Stephen Slade testify against patients with large pupils. Do not trust anyone who says that "pupil size is a poor predictor of night vision disturbances" like Glenn Hagele. Basically don't trust anyone in the LASIK industry unless he is very clear that pupil size is extremely important. Surgeons like Salz, Trattler, and Holladay are proponents of the importance of pupil size.

I wanted to plan a visit to my orginal wavefront surgeon. He would also be the one to do my CWR if I deciede it offers me the possibility of reducing some of my nighttime problems.
I used to "Questions to ask" topic for the base of my questions. Aside from those questions, here are some additional questions I wanted to ask my surgeon which are particular to my case:

1. Where can I get an Artemis scan? Artemis scan will tell the thickness of my cornea.
2. What are my exact pupil sizes for each eye?
3. What was my original ablation zone since for my first surgery? What was my original blend zone size? Are blend zones necessary is the ablation zone can cover the whole pupil size? Will optical zone ever be as large as my eye for future wavefront lasers?
4. What laser was my original surgery on? What laser do you plan on using for my next surgery? What is my planned optical zone and planned blend zone?
5. Is my surgery called complex wavefront retreament?
6. How harmful is MMC?
7. Was my original optical zone a circle or oval? Does an oval shape make any enhancement more difficult?

When I do plan this appointment, which is making me incredible sick thinking about, I would like to post the responses and maybe see what some of you think about the answers and hopefully I can make a life decision from there.