Exposing the LASIK Scam

Had Wavefront Guided Treatment of High Order Aberrations.
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Author:  zadaw [ Thu Jun 07, 2007 9:34 am ]
Post subject:  Had Wavefront Guided Treatment of High Order Aberrations.

Hello Everybody

I am new to this forum and would like to share my own story with you. Hopefully, it may provide hope and encouragement to those who have the same problems as I had, since many of your stories were similar to mine. I am a qualified doctor myself in Hong Kong and had lasik originally in 2002.

My readings at that time were -9.00 for both eyes. The original procedure was carried out by B&L technolas and used wavefront data. Following the procedure, I made a rocky recovery with a lot of problems with dry eyes. I was left with over 1.00 of induced astigmatism in each eye for which enhancement procedures were carried out in 2003. The procedure for my right eye went successfully but the left eye did not. I started seeing ghosting and double images right after the operation. The main problem was with traffic lights and the brake lights of cars. I could see a thick trail of light shooting towards the one O' clock position. There was also substantial glare and starbursts.

As was probably routine at that time, my surgeon told me that it should improve with time and did not think further surgery was advisable. When the ghosting did not disappear after several months, I decided to seek a second opinion. Measurements by a Ladarvision abberometer revealed extensive high order aberrations in my left eye. However, at that time surgery could not be carried out as the manufacturer would not allow it. In the meantime, the visual symptoms seems to have improved somewhat and I decided that I could live with it. Luckily, the left eye was not my dominant eye. Then last year, it seems that the symptoms started getting worse again.

In March this year, the opthalmologist called me and told me that the manufacturer will now allow the procedure to be carried out. He told me he had treated 20 eyes so far. Of the 20 cases, 15 reported marked improvement, 4 had no improvement and one reported a worsening of symptoms. He said that all severe cases reported substantial improvements. He also told me that my flap can probably be lifted easily even though it is 4 years after the last procedure.

Accordingly, I had wavefront-guided enhancement done on 23rd April. The operation itself was quite terrifying. It took quite a long time to lift the flap. There were a total of two laser sessions, the second one lasted almost two minutes continuously. I made a rapid recovery after that, the ghosting/double images have mostly gone. But I was la but disappointed because I was left with -1.00 myopia (previously it was +0.25). My surgeon explained that he had purposefully made adjustments to the treatment profile in order to prevent the introduction of vast amounts of hyperopia. He told me that I would have to undergo a second treatment in early July.

Then yesterday (June 6th), something incredible seemed to have happened. Suddenly I was seeing pretty clearly with my L eye. Now I am sure that I must be back to 20/20 again. A simple examination by machine revealed that the eye is now +0.25! (this is what it was before the operation). I have heard that custom-effect of wavefront may only appear after 6 weeks but this is so sudden that it completely overwhelmed me!

Although I am really overjoyed at the moment, I know that the story is hardly over. My cornea has hardly stabilized and I don't know what the final readings will be. There must now be a risk towards significant hyperopia. But I hope to avoid a 4th procedure on my left eye as much as possible. Moreover, since much more tissue has been cut away with the wavefront treatment, there may be other adverse effects down the line. I will keep you posted about my progress as it goes.

So for those for you who have got similar problems with high order aberrations as I had, my message would be "do not give up hope, it is possible that something can be done". Believe me, I have gone through the same process of anxiety, depression, and remorse as well and had to seek psychiatric help. My recommendations for those who are having big problems with high order aberrations (night vision problems, glare, halos, ghosting, starbursts, double vision) would be as follows:-

1. Seek the advice of a surgeon who has good experience with treating high order aberrations. In my case, the surgeon's group was the only one who had reported good progress in Hong Kong. For one, this surgery runs the risk of introducing a substantial of low-order aberrations. Also, the flaps are often lifted many years after the original surgery.

2. The machine is all-important. Mine was the Lardarvision 6000 series. I know there had been horror stories about this machine but much more research has been done with this machine than others.

Of course this type of treatment is still quite experimental and rarely carried out. You must think carefully whether you wish to go ahead now or wait another few years for the technology to get more advanced and the data more complete. For example it is still not clear lifting the flap is better than applying the laser onto the flap directly (PRK or Lasek). But my message is that it does work for some people and you should not lose hope.

If anyone of you are in Hong Kong and wishes to get more advice, do not hesitate to pm me. Right now I am still savoring the moment which I thought I would never see, and I am beginning to believe in miracles again! I just pray it stays this way.

Bless You


Author:  Scientist [ Fri Jun 08, 2007 7:01 pm ]
Post subject:  Had Wavefront Guided Treatment of High Order Aberrations

Hi zadaw (Derek)!

Thanks for sharing your story. Often stories of retreatments to fix a previous bad LASIK are not so happy. Please let us know how your healing progresses and if you experience any further problems with your retreatment! Can you tell us your pre and post-op higher order aberrations (please use same scan size as pre-op for comparison)? It would be interesting to know which higher order aberrations were reduced to achieve your results, and how much they were reduced. Was your optical zone enlarged? How much residual stromal thickness do you have after your last surgery?

The machine is all-important. Mine was the Lardarvision 6000 series. I know there had been horror stories about this machine but much more research has been done with this machine than others.

Ironically, the laser used for your wavefront retreatment has been recalled for myopic wavefront treatments!

Read the report elsewhere on this forum:

Author:  zadaw [ Sat Jun 09, 2007 4:53 pm ]
Post subject: 

My pupil size is 6mm and the treatment zone was enlarged during treatment. My cornea thickness was 4.98mm. If possible, I will get some readings and scans and post it here.

On a subjective basis, this is the outcome after 6 weeks of surgery

1. Trail of light from a light source e.g. traffic lights, brake lights - 80% improvement. This was by far my most irritating symptom
2. Glare - 80% improvement
3. Starbursts - 95-100% improvement
4. Blurred vision on opening eye widely - 90% improvement
5. Ghosting of high contrast targets - this is very erratic at the moment. In fact initially this was worse but is now better. I will be watching this carefully.

The overall image quality is not that great yet but this may be due to oedema rather than unresloved HOA problems. Incidentally, I was told that there is quite a lot of HOA in my R eye as well. However, the only symptom I am getting is starbursts. But normally this does not affect my night vision and night driving because the streets are well-illuminated in Hong Kong. That means that my pupils are normally small enough not to see starbursts.

One thing I learned out this affair is not to be too greedy. I do not want to risk my dominant messed up in order to get rid of a few starbursts.


Author:  zadaw [ Sat Jun 09, 2007 5:22 pm ]
Post subject: 

I am not 100% sure whether it was an ALCON 6000 or an upgraded Alcon 4000. I am told that the algorithm for wavefront measurements and the operation itself had just been upgraded. Export versions of ALCON machines have more restrictions than those in the US. The reason why my operation could not be performed until now because the machine would shut down immediately if my wavefront profile was imported. This means was that many patients in the US acted as guinea pigs during these past few years. Therefore I am not surprised to hear that the results were not good or predictable. But ALCON has updated their algorithm and it will become clearer with time what type of patient will benefit and what type will not. I was told that the results from B&L and other machines have not been that good in Hong Kong and the surgeons would not discuss it openly.

At present, the main problem with using wavefront technology to correct HOA is the risk of introducing large amounts of low-order aberrations, espcially farsightedness. Given my experience, I would probably be well over 1.00 D now if my surgeon had not adjusted my profile. Obviously, there is still a big risk that I may overshoot by a large margin since losing -1.25D in 4 weeks in quite dramatic.


Author:  Eye [ Wed Jun 13, 2007 1:30 am ]
Post subject:  All corneal refractive surgery patients are guinea pigs

Hi zadaw. The fact that your wavefront treatment plan was outside the allowable parameters for your laser until very recently is a concern!

I think there are 'problem outcomes' with every laser and that surgeons who are looking for a 'beter laser' are hurting people. Removing corneal tissue to correct for overall refractive error in the eye is not and never will be a good idea.

Mother nature has given us enough corneal tissue to allow most of us to hold back the forces of intraocular pressure of the eye (barring some disease of the cornea) and a cornea thin enough to provide good vision. We just don't have enough tissue to 'spare' for safe corneal refractive surgery, and these surgeries can't be done without damaging corneal neves vital for the comfortable wetting of the eye.

And corneal tissue doesn't exactly lend itself to laser treatments as it doesn't heal well and tends to develop haze under conditions of excessive inflammation.

Most patients would likely benefit from avoiding laser corneal refractive surgery entirely.

Losing a diopter and a quarter in 4 weeks is quite dramatic. Do you have access in any clinic near you to a Bausch and Lomb Orbscan device? Serial Orbscans may help you determine if your myopic regression is due to forward movement of your cornea (check the posterior float) or is more likely epithelial thickening and/or healing changes at the front of the cornea.

Nine diopters is a lot of myopia and having a wavefront enhancement on top of that correction means you lost a fair amount of corneal tissue... and with the wavefront algorithm, more tissue in the periphery than with standard LASIK.

Author:  zadaw [ Wed Jun 13, 2007 12:24 pm ]
Post subject: 

Eye, I completely understand and appreciate your comments. It was a very difficult decision to make and I asked a lot of questions. I was very scared leading up to, during, and after the surgery. Ultimately, it was a personal decision that I have made and I would have to live with it. Be it should I suffer complications from a thinned cornea later on. John (Dean Andrew Kantis of www.LifeAfterLasik.com) made the same decision to have further surgery and I am that his case was more complicated than mine.

Having refractive surgery in the first place for correcting myopia was completely elective and there are good medical alternatives available (glasses and contact lenses) However, in the case of HOA that had been introduced as a result of LASIK, I feel that risk equation is entirely different. For one, this is an illness that had been introduced for which spectacles and contact lenses are not really great options. Prolong use of contact lenses carry substantial risks in themselve, in either damaging the flap or introducing a severe infection, both of which may lead to blindness.

This procedure was not approved for emetropic or eyes with hyperopia until recently. The reason was the propensity of the procudure to introduce around +2.00 hyperopia into the eye. For this reason, my surgeon purposefully adjusted my profile so some myopia would be introduced into my eye initially, hoping that it will fade away as it seems to happened in my case. Therefore, the skill and experience of the surgeon is of utmost importance with this procedure. I am due to have a full check-up in two weeks' time and I will let you know how it goes. Right at this moment, it seems that and I pray that I will not need any further surgery.

Incidentally, my surgeon was one of the first opthalmologists in my city to have LASIK. He is not charging me any operation fees except those due to the operating theatre, and he was not the surgeon who operated on me originally.

Author:  Scientist [ Sun Jun 17, 2007 6:17 pm ]
Post subject:  Contact lenses much safer than surgery

Hi zadaw,
The patients on this board decided to have LASIK too - you are NOT alone and this was not poor judgement on your part! None of us had access to the information we needed to make an informed decision. Failure of informed consent is the problem.

I know of no case where a patient was damaged by contact lenses. In almost every case of surgical retreatment for complications, however, the patient either had no improvement or was further damaged. We were all worried sick about Dean - so far he is no worse off and he may see some improvement from his retreatment with healing.

We do have the concern that any benefits from a retreatment may be outweighed by additional nerve damage and increased risk of ectasia.

We just don't trust corneal refractive surgeons... I think you can understand that! We are all keeping our fingers crossed for you!

Author:  zadaw [ Thu Aug 16, 2007 3:43 pm ]
Post subject:  4 month post-op follow-up

I just want to post the results of my 4 months post-op follow up of the complex wavefront treatment for HOAs in my left eye. At 2 weeks post-op. I was -1.00F with 0.5D astigamatism. My vision at that time was 20/60. Then at 6 weeks post-op, my vision suddenly became clear overnight. Now at 4 months, the results are as follows

0.0 D, 0.25D astigmatism.

Coma was reduced from 1.18 to 0.34 RMS
Spherical aberration from 1.00 to 0.27 RMS
Other aberrations from 0.75 to 0.35 RMS

There is a substantial increase in contrast sensitivity. Most of the HOA effects have disappeared. The only slight concern is that my vision in that eye is 20/25 compared to 20/15 on my R eye. However, I am cautiously optimistic that it will reach 20/20 eventually as it took years for my R eye to reach this level of acuity after surgery.

My surgeon told me that my treatment zone was 6.5mm and therefore not particularly enlarged. He said mine was among the best results that he has ever achieved. He suggested that I should also consider surgery on my R. eye but I thanked him and politely declined. Although there was substantial measurable HOAs on my R. eye, the only manifestation is starbursts under pretty dark conditions. However, in Hong Kong the streets are usually well-lit at night so I hardly ever see them.

Anyway, I hope that this will provide some encouragement to those who are in a similar situation. Obviously no two patients are the same and it is an extremely major decision to undergo further surgery.

God Bless


Author:  Regrets [ Thu Aug 16, 2007 4:46 pm ]
Post subject: 

hhhmmmm...I wonder if retreatment could help me out. Although...maybe I don't to want fix my under correction, since I learned from someone on this board (Eye or Broken Eyes...can't remember) that my under correction will save me from needing reading glasses in the future. I think I can live around -1.00 where I'm at now...to save the annoyance of needing TWO pairs of glasses in the future (1 pair for far and dim lighting, and also a pair for reading). Would be nice to get rid of this friggin astigmatism though...SO ANNOYING!!!! (plus....I trust LASIK surgeons just about as far as I can throw them...and I don't have a very good pitching arm)

Author:  APizzo667 [ Wed Oct 03, 2007 12:55 am ]
Post subject: 

I met some people today who had RK and then PRK on top of it. Tommororw I will be able to see the images of what their cornea looks like, but those people are at serious risk of ectacsia, or may already have it.
I used to think ectacsia was something that happened to senior citizens who smoked and never saw an eye doctors, you know, just like people with general health risks and never looked after themselves properly.

But while I am here in Miami, I got to see this police officer come in today to visit Dr. Boshnick. This guy was a body builder and the picture of health. Turns out that guy went in for lasik one day and before he knew it, he had ectacsia, and after only one surgery!!!!!!!!

I was shocked. I could not believe it. And here he was fighting his insurance company to get coverage for contacts he needed to see (glasses can't help his case) all from ectascia.

God bless Dr. Boshnick and anyone else out there not promoting refractive surgery and going about things the natural way.

Author:  surgieyes [ Fri Oct 05, 2007 9:29 pm ]
Post subject: 

APizzo667 wrote:
I met some people today who had RK and then PRK on top of it. Tommororw I will be able to see the images of what their cornea looks like, but those people are at serious risk of ectacsia, or may already have it.


Not surprising. RK has weakened the cornea so much, PRK would make it worse by further thinning of the cornea. I?d like to know the long-term results of these patients.

RK is a flawed surgery. A pointed light source would look like a STARBURST at night. All RK patients would experience that.

APizzo667 wrote:
But while I am here in Miami, I got to see this police officer come in today to visit Dr. Boshnick. This guy was a body builder and the picture of health. Turns out that guy went in for lasik one day and before he knew it, he had ectacsia, and after only one surgery!!!!!!!!

Just like water and oil, police officers and LASIK don?t mix. LASIK flap never heals and can be dislodged or lifted many years after surgery. Police officers or people who do contact sports should avoid LASIK like the plaque.

Author:  Eye [ Sun Oct 07, 2007 10:39 pm ]
Post subject:  All corneal refractive surgeries are flawed!

surgieyes said:
RK is a flawed surgery

PRK is a flawed surgery.

Then LASIK became the next flawed surgery. 'Bladeless' LASIK and wavefront LASIK were even more flawed than standard LASIK.

So surgeons began to return to PRK, which is still flawed. They give surgeries based largely on old technologies fancy new names like 'Epi-LASIK' in the hope that patients won't recognize them as the same old recycled flawed surgeries that permanently injured many.

Author:  surgieyes [ Mon Oct 08, 2007 10:10 pm ]
Post subject:  Re: All corneal refractive surgeries are flawed!

PRK is a flawed surgery.

PRK removes Bowman's layer which is regarded as a natural barrier to disease.

Conjunctival Biopsy - Nevi, Primary Acquired Melanosis, and Melanoma
Surgical Approach - In General
* These lesions often cross the limbus onto the cornea. When they do involve the cornea, they usually involve only the corneal epithelium.
* Do not perform lamellar dissections into the cornea to remove lesions that straddle the limbus. Bowman's layer is a natural barrier to the penetration of malignancies into the stroma and if the lesion recurs after Bowman's layer has been violated surgically, the recurrent lesion has unimpeded access to the stroma.

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