Exposing the LASIK Scam

One Surgeon at a Time
It is currently Tue Feb 20, 2018 12:11 am

All times are UTC




Post new topic Reply to topic  [ 32 posts ]  Go to page Previous  1, 2, 3  Next
Author Message
 Post subject:
PostPosted: Sat Feb 16, 2008 8:10 pm 
Offline
 Profile

Joined: Sat Nov 26, 2005 1:23 pm
Posts: 2080
This is to answer your question about the difference between custom and conventional:

http://www.osnsupersite.com/view.asp?rID=6057

OCULAR SURGERY NEWS U.S. EDITION October 1, 2005

Modern excimer improvements due to more than wavefront technology, optics expert says

A better understanding of the radial compensation function and other optical concepts has helped to improve LASIK outcomes.

By Tim Donald, ELS

Excerpt:
Quote:
Dr. Holladay noted that when the three main U.S. ophthalmic excimer laser manufacturers, Visx, Bausch & Lomb and Alcon, introduced their wavefront-guided systems, they reported improvements in visual acuity outcomes over their older, conventional excimer refractive systems.

?And in fact we did get better outcomes when wavefront came along,? he said. ?But as I explained in my Barraquer Lecture last year, the three factors that resulted in the biggest improvement for wavefront had little to do with wavefront.?

Delivering the Barraquer Lecture at the American Academy of Ophthalmology meeting last year, Dr. Holladay outlined the three reasons he believes that modern wavefront-guided lasers achieve better refractive results than conventional treatments.

One reason is that the U.S. manufacturers have now taken the radial compensation function into account and included it in their ablation profiles.

The second is that the manufacturers have been required by the Food and Drug Administration to specify the minor axis of astigmatism as the size of the optical zone in astigmatic treatments, which are oval.
Dr. Holladay explained: ?With the previous standard systems, if you wanted to do a plano -4.00 X90 treatment, when you specified a 6-mm optical zone on the laser, you?d actually get a 4.5-mm-by-6-mm optical zone. But the 4.5-mm axis was the one that was critical. A few years ago I pointed out to the FDA that the smaller dimension was the one that was critical, and they began to require subsequent software to consider the smallest dimension as the effective optical zone. So previously when you did a plano -4 X90 with a standard treatment you got a 4.5-by-6-mm optical zone. But when you do it with wavefront now you get a 6-by-7.5-mm optical zone, and that?s not a fair comparison between the two types of treatment.?

The third reason is that the manufacturers have learned how to create a smoother central cornea and avoid the central islands that older systems sometimes induced, he said.

?All three of those things were included in the new wavefront treatment protocols, so there?s no question that the wavefront-guided treatments were better, but it had little to do with the wavefront measurements on the patients,? Dr. Holladay said.

_________________
Broken Eyes

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


Top
 
 Post subject:
PostPosted: Tue Feb 19, 2008 8:13 pm 
Offline
 Profile

Joined: Wed Jul 11, 2007 11:33 am
Posts: 14
Location: Iowa
Broken Eyes wrote:


I called and talked to one of the technicians. Her name and voice were familiar; I must have talked with her before. Anyway, I don't know how many more ways I could have asked for more information regarding the exact laser I was treated with. She said it is the Star S4 US IR and gave me the part number. I asked her if she could find any numbers that started with P9300 and she said that she could not. Any ideas? Do I need to ask for another tech or a surgeon?

_________________
Didn't think it could happen to me.


Top
 
 Post subject:
PostPosted: Tue Feb 19, 2008 8:16 pm 
Offline
 Profile

Joined: Wed Jul 11, 2007 11:33 am
Posts: 14
Location: Iowa
Broken Eyes wrote:


I see now that the FDA description for the last two lasers listed above (20 and 21) include the IR moniker that the tech described to me over the phone. Without better information, I would have to say that the laser used in my surgery was one of those.

_________________
Didn't think it could happen to me.


Top
 
 Post subject:
PostPosted: Tue Feb 19, 2008 8:52 pm 
Offline
 Profile

Joined: Sat Nov 26, 2005 1:23 pm
Posts: 2080
Supplements 20 and 21 were for wavefront-guided LASIK. From what I've read so far of your records, I would agree with the 2nd opinion doctors -- it does not appear that you had a wavefront-guided treatment. Didn't you say you paid for wavefront?...

To pick back up where we left off in our emails...

Yes, I see where it's noted in your records that you have significant debris under the free cap. There's also mention of a "reaction" around the debris material.

Did you not return for follow-up between your one day post-op on 1/6/07 and the next appointment I see on 2/19/07? Maybe it's in here and I just haven't gotten to it yet.

_________________
Broken Eyes

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


Top
 
 Post subject:
PostPosted: Tue Feb 19, 2008 9:13 pm 
Offline
 Profile

Joined: Sat Nov 26, 2005 1:23 pm
Posts: 2080
Did you see this?

Image

http://www.fda.gov/cdrh/pdf/p930016S016a.pdf

_________________
Broken Eyes

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


Top
 
 Post subject:
PostPosted: Tue Feb 19, 2008 9:52 pm 
Offline
 Profile

Joined: Wed Jul 11, 2007 11:33 am
Posts: 14
Location: Iowa
Broken Eyes wrote:
Supplements 20 and 21 were for wavefront-guided LASIK. From what I've read so far of your records, I would agree with the 2nd opinion doctors -- it does not appear that you had a wavefront-guided treatment. Didn't you say you paid for wavefront?...

To pick back up where we left off in our emails...

Yes, I see where it's noted in your records that you have significant debris under the free cap. There's also mention of a "reaction" around the debris material.

Did you not return for follow-up between your one day post-op on 1/6/07 and the next appointment I see on 2/19/07? Maybe it's in here and I just haven't gotten to it yet.


Yes, I paid for the wavefront treatment. LVI refers to it as "Custom." At the time (and maybe even today), it was the highest end surgery they sold. Again, I was told that I needed it because of my prescription. Other LASIK evalutations I received (not with this company) all happened to use the VISX technology, and all agreed that I would require the Custom treatment.

The situation surrounding my pre- and post-operative appointments is just one more complication surrounding my whole situation. I had my eyes ruined in Chicago. However, I live 6 hours from Chicago. So, I had my before and after appointments at a "branch location" closer to me. Any notes taken pre- and post- would be there. I hadn't previously requested those files. I am doing that as we speak.

_________________
Didn't think it could happen to me.


Last edited by TheEyesHaveIt on Tue Feb 19, 2008 9:57 pm, edited 1 time in total.

Top
 
 Post subject:
PostPosted: Tue Feb 19, 2008 9:53 pm 
Offline
 Profile

Joined: Wed Jul 11, 2007 11:33 am
Posts: 14
Location: Iowa
Broken Eyes wrote:


No, I hadn't seen that. Does it really mean anything? Is this grounds for litigation by itself? All I was provided was the consent form. At no time did I receive any type of documentation regarding wavefront or the laser or anything.

_________________
Didn't think it could happen to me.


Top
 
 Post subject:
PostPosted: Tue Feb 19, 2008 10:43 pm 
Offline
 Profile

Joined: Sat Nov 26, 2005 1:23 pm
Posts: 2080
TheEyesHaveIt wrote:
Yes, I paid for the wavefront treatment. LVI refers to it as "Custom." At the time (and maybe even today), it was the highest end surgery they sold. Again, I was told that I needed it because of my prescription. Other LASIK evalutations I received (not with this company) all happened to use the VISX technology, and all agreed that I would require the Custom treatment.


Custom LASIK (in the United States) means wavefront-guided. I have reviewed a good portion of your records. I am stumped why anyone would tell you that you *needed* a custom treatment. Conventional VISX was approved to treat your refractive error (I've reviewed your pre-op records). Two possibilties come to mind. 1- They just wanted to charge you more for custom (lost likely case, in my opinion), or 2- they really had your best interest in mind and thought you would benefit from the improvements of wavefront-guided over conventional. I'm not really buying scenario #2 and here's why: Did you notice on your pre-op exam sheet it said your pupils are 4mm in dim light and 4mm in bright light in both eyes?! It wasn't until your 2nd opinion (after surgery) that I see pupil measurements of 6.1 and 6.3. Now, I don't know about you, but I've never seen a live person whose pupils are frozen in diameter. I'm trying not to jump to conclusions, but it looks at first glance TO ME like your pupils were mismeasured, and if that's true, let me say "WELCOME TO THE CLUB!" I cannot tell you what this does to my blood pressure...

Another thing I noticed is that you had border-line flat corneas. Flat corneas are associated with an increased risk of a free cap.

I think you said in the first part of this post that you had very thick corneas preoperatively but I found that not to be the case. The pre-op surgical planning form says your R eye was 531, which is about average. Left eye was recorded as 597 - which is thick. But it doesn't add up because at your 2nd opinion, your left eye was recorded at 485, 486, 491. It looks TO ME like an error was made. BUT OF COURSE I COULD BE WRONG! :roll: The operative report shows the laser ablated 56 microns on your left eye. Now if you started with 597, and they ablated 56... You do the math.

TheEyesHaveIt wrote:
The situation surrounding my pre- and post-operative appointments is just one more complication surrounding my whole situation. I had my eyes ruined in Chicago. However, I live 6 hours from Chicago. So, I had my before and after appointments at a "branch location" closer to me. Any notes taken pre- and post- would be there. I hadn't previously requested those files. I am doing that as we speak.


Good to know. So there are more pre-op records that I haven't seen.

_________________
Broken Eyes

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


Last edited by Broken Eyes on Tue Feb 19, 2008 10:48 pm, edited 1 time in total.

Top
 
 Post subject:
PostPosted: Tue Feb 19, 2008 10:45 pm 
Offline
 Profile

Joined: Sat Nov 26, 2005 1:23 pm
Posts: 2080
TheEyesHaveIt wrote:
No, I hadn't seen that. Does it really mean anything? Is this grounds for litigation by itself? All I was provided was the consent form. At no time did I receive any type of documentation regarding wavefront or the laser or anything.


No, I guess it doesn't mean anything that those jerks keep violating FDA rules. No, it's not grounds for a lawsuit unless it's standard of care to give the booklet. If they all violate FDA rules, then that's the standard of care. :shock: If they all stick a pencil in your eye, that's standard of care! :roll:

_________________
Broken Eyes

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


Top
 
 Post subject:
PostPosted: Tue Feb 19, 2008 11:42 pm 
Offline
 Profile

Joined: Sat Nov 26, 2005 1:23 pm
Posts: 2080
So far I haven't found a consensus on whether to proceed or abort when a free cap occurs.

Standard of care in LASIK is "how low can you go?"...

_________________
Broken Eyes

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


Top
 
 Post subject:
PostPosted: Wed Feb 20, 2008 2:12 pm 
Offline
 Profile

Joined: Wed Jul 11, 2007 11:33 am
Posts: 14
Location: Iowa
I requested the records from the branch office that I visited pre and post-op. They couldn't fax them to me because that violates some internal security policy that they have. They can mail them to me, but the mail has to be routed through their corporate office for approval so it can take up to 2 weeks to receive. So, I should see them in two weeks. I will scan them and provide them at that time.

_________________
Didn't think it could happen to me.


Top
 
 Post subject:
PostPosted: Wed Feb 20, 2008 2:20 pm 
Offline
 Profile

Joined: Wed Jul 11, 2007 11:33 am
Posts: 14
Location: Iowa
Broken Eyes wrote:
Custom LASIK (in the United States) means wavefront-guided. I have reviewed a good portion of your records. I am stumped why anyone would tell you that you *needed* a custom treatment. Conventional VISX was approved to treat your refractive error (I've reviewed your pre-op records). Two possibilties come to mind. 1- They just wanted to charge you more for custom (lost likely case, in my opinion), or 2- they really had your best interest in mind and thought you would benefit from the improvements of wavefront-guided over conventional. I'm not really buying scenario #2 and here's why: Did you notice on your pre-op exam sheet it said your pupils are 4mm in dim light and 4mm in bright light in both eyes?! It wasn't until your 2nd opinion (after surgery) that I see pupil measurements of 6.1 and 6.3. Now, I don't know about you, but I've never seen a live person whose pupils are frozen in diameter. I'm trying not to jump to conclusions, but it looks at first glance TO ME like your pupils were mismeasured, and if that's true, let me say "WELCOME TO THE CLUB!" I cannot tell you what this does to my blood pressure...


No, I didn't notice that my pupils were grossly mismeasured prior to the surgery. There were a lot of things, in retrospect, that I did not notice or chose not to notice for fear that my "dream" would be shattered. :roll: Now my vision is shattered instead. :shock: Holy cow. :evil: I hate to keep sounding like all I am looking for is something to sue these jerks on, but that has to be prosecutable. A 33% mis-measurement in pupils is a medical error, plain and simple. Just because it is an elective procedure doesn't give them the right to make gross errors.

Broken Eyes wrote:
Another thing I noticed is that you had border-line flat corneas. Flat corneas are associated with an increased risk of a free cap.

I think you said in the first part of this post that you had very thick corneas preoperatively but I found that not to be the case. The pre-op surgical planning form says your R eye was 531, which is about average. Left eye was recorded as 597 - which is thick. But it doesn't add up because at your 2nd opinion, your left eye was recorded at 485, 486, 491. It looks TO ME like an error was made. BUT OF COURSE I COULD BE WRONG! :roll: The operative report shows the laser ablated 56 microns on your left eye. Now if you started with 597, and they ablated 56... You do the math.


I have also read about flat corneas in relationship to the risk of free cap. I just didn't know that I had flat corneas. Another thing that I should have been warned about. :roll:

Does the mismeasurement in corneal thickness have any contribution to my side effects? Is it used in some of the calculations?

_________________
Didn't think it could happen to me.


Top
 
 Post subject:
PostPosted: Wed Feb 20, 2008 2:28 pm 
Offline
 Profile

Joined: Wed Jul 11, 2007 11:33 am
Posts: 14
Location: Iowa
Broken Eyes wrote:
So far I haven't found a consensus on whether to proceed or abort when a free cap occurs.

Standard of care in LASIK is "how low can you go?"...


That's just it... there isn't consensus. That is one of tools that they use to avoid the Standard altogether, right? As long as the Standard keeps moving, there is no accountability.

I know that you and others here understand my frustration. A lady can sue McDonalds for spilling hot coffee on herself - coffee that she purchased electively - and no one is responsible for the destruction of my vision even though we have uncovered several errors in my records. Unreal. :evil:

_________________
Didn't think it could happen to me.


Top
 
 Post subject:
PostPosted: Wed Feb 20, 2008 5:12 pm 
Offline
 Profile

Joined: Sat Nov 26, 2005 1:23 pm
Posts: 2080
TheEyesHaveIt wrote:
No, I didn't notice that my pupils were grossly mismeasured prior to the surgery. There were a lot of things, in retrospect, that I did not notice or chose not to notice for fear that my "dream" would be shattered. :roll: Now my vision is shattered instead. :shock: Holy cow. :evil: I hate to keep sounding like all I am looking for is something to sue these jerks on, but that has to be prosecutable. A 33% mis-measurement in pupils is a medical error, plain and simple. Just because it is an elective procedure doesn't give them the right to make gross errors.


I could not agree more. It should be cut and dry -- if a surgeon does a treatment on a patient with an optical zone smaller than his or her pupils, you should be able to sue his pants off. From the beginning, they have been covering up the importance of matching the optical zone to the patient's pupils. It's the biggest coverup in refractive surgery. The coverup continues to this day. This pupil size issue is the reason I've been an activist for 7 1/2 years. My pupils are 8mm, but they were measured as 6mm. I was given a 6mm optical zone, no blend. My vision is pure garbage in dim light and it cannot be corrected with glasses. Not until you try to sue a surgeon do you really understand how deep the coverup goes. It's disgusting and evil. There are lying phony experts just waiting to be paid off to lie for your surgeon and say that pupil size doesn't matter. If you only knew what I know...

TheEyesHaveIt wrote:
I have also read about flat corneas in relationship to the risk of free cap. I just didn't know that I had flat corneas. Another thing that I should have been warned about. :roll:


I agree. But what do I know?... :roll:

TheEyesHaveIt wrote:
Does the mismeasurement in corneal thickness have any contribution to my side effects? Is it used in some of the calculations?


It may not have a thing to do with your side effects. The industry uses a guideline of 250 microns of residual stromal thickness under the flap after surgery, and I'd guess you have at least that much. But one thing on your records raised a small red flag... In the April 7, 2007 letter, the doctor wrote: "There was posterior vaulting of each cornea being between 30-40 microns suggestive that he is still unstable following surgery." If it were me, I would want current tests to ensure my corneas are stable now. Most likely they are... You haven't been regressing in the last few months, have you?

_________________
Broken Eyes

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


Last edited by Broken Eyes on Wed Feb 20, 2008 5:35 pm, edited 1 time in total.

Top
 
 Post subject:
PostPosted: Wed Feb 20, 2008 5:30 pm 
Offline
 Profile

Joined: Sat Nov 26, 2005 1:23 pm
Posts: 2080
TheEyesHaveIt wrote:

That's just it... there isn't consensus. That is one of tools that they use to avoid the Standard altogether, right? As long as the Standard keeps moving, there is no accountability.


Yes, by keeping the standard of care low, even knowingly putting patients at risk, as long as most of them keep doing the same thing, they keep the standard of care low and protect themselves from liability. Let me give you a couple of examples. When LASIK was approved, they didn't really know what a safe residual stromal bed limit was. They used 250 microns as a guideline, but no one was sure if that was really safe to prevent ectasia. Over the years many patients with over 250 microns developed ectasia, and conservative surgeons raised their limit, but the majority of surgeons keep using 250, even though we now know 250 is not safe. But just try and sue a surgeon if you develop ectasia with 250 microns. Here's another example. It's now known that microkeratomes cut flaps of unpredictable thickness, and the only way to know for sure if it's safe to proceed with ablation is to perform pachymetry after cutting the flap and before doing the ablation. But do you think most of them do it? Of course not! It would slow them down and they might have to abort some procedures and that would be bad for business! So as long as most of them don't do it, it's not standard of care, and if you happen to be a patient whose flap was cut way too thick and you later developed ectasia, you'd have no case. I could go on and on with different examples. Dry eye is another example.

TheEyesHaveIt wrote:
I know that you and others here understand my frustration. A lady can sue McDonalds for spilling hot coffee on herself - coffee that she purchased electively - and no one is responsible for the destruction of my vision even though we have uncovered several errors in my records. Unreal. :evil:


I understand better than you know! You don't know what I've been through! I have a very, very hard time trusting doctors now. Even if I need a medically necessary surgery, I don't know if I could make that leap of faith ever again. I've seen too much.

_________________
Broken Eyes

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


Top
 
Display posts from previous:  Sort by  
Post new topic Reply to topic  [ 32 posts ]  Go to page Previous  1, 2, 3  Next

All times are UTC


Who is online

Users browsing this forum: No registered users and 1 guest


You cannot post new topics in this forum
You cannot reply to topics in this forum
You cannot edit your posts in this forum
You cannot delete your posts in this forum
You cannot post attachments in this forum

Search for:
Jump to:  
cron
Powered by phpBB © 2000, 2002, 2005, 2007 phpBB Group  
Design By Poker Bandits