Exposing the LASIK Scam

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 Post subject: Dr. Terry Kim confused about vision after amputated flap
PostPosted: Thu Aug 16, 2007 2:36 am 
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Posts: 621
It is astonishing that Dr. Terry Kim would claim that a patient with an amputated flap would have reasonable visual acuity. Keep in mind that re-epithelialization will only provide about 30 microns of depth. The lost flap was probably 100-160 microns. Maybe thicker. In what alternate universe is this NOT a refractive disaster? Dr. Terry Kim was the only surgeon on the panel who did not advocate doing everything possible to find and replace that flap. Perhaps Dr. Terry Kim views other people's visually significant complications as trivial because... hey - they aren't HIS eyes and they don't guarantee outcomes at Duke! He certainly was very dismissive and callous about my visual problems after he performed LASIK on me. What, flap striae? Why bother to treat those. Lose a flap? What the heck! Give a patient chronic pain to contend with - perhaps for life? All in a day's work for Dr. Terry Kim, MD?

Notice that Dr. Terry Kim, MD discusses patients with amputated LASIK flaps as a group, casually, as if this happens all of the time:
Dr. Terry Kim said:
Quote:
These patients actually do fairly well with just re-epithelialization without flap replacement.

Dr. Terry Kim said:
Quote:
There have been studies to show that in patients who have had amputated or missing flaps, visual acuity is quite reasonable after re-epithelization over the stromal bed, so that?s also an option.


What studies? MULTIPLE studies about amputated or missing flaps? If there are enough of these patients to form a study - then, in my opinon, these 'doctors' are practicing some very bad medicine. Below is the PubMed search result of the only amputated/missing flap visual outcome result that I could find. The patient is 'best corrected' to 20/40, which is NOT good vision. His best corrected Snellen vision may also be very distorted due to the irregular astigmatism the authors mention:

Quote:
J Cataract Refract Surg. 2007 Jul;33(7):1332-5.
Late traumatic LASIK flap loss during contact sport.
Tetz M, Werner L, M?ller M, Dietze U.
Augentagesklinik Spreebogen, the Berlin Eye Research Institute, and the Augenklinik Berlin Marzahn, Berlin, Germany.
Abstract:
Three years and 5 months after uneventful laser in situ keratomileusis, the left eye of a 39-year-old man was struck by the finger of a friend while the two were practicing karate, resulting in loss of the flap. The patient had performed this contact sport regularly for years. When last seen 16 weeks after injury, the best corrected visual acuity in the left eye was 20/40 with -1.75 -0.50x30. Mild central corneal haze was observed under slitlamp examination, the flap was missing, and the patient complained of dysphotopsia. Pachymetry in the left eye was 394 mum, with an irregular corneal contour. Flap loss is a serious complication because severe irregular astigmatism and unpredictable refractive change can occur. This case highlights the vulnerability of flaps to trauma even late postoperatively.


OCULAR SURGERY NEWS U.S. EDITION August 15, 2007
Excerpts:

Case study: Losing a flap during a LASIK procedure
http://www.osnsupersite.com/view.asp?rID=23169
In this month?s Corneal Health column, surgeons discuss the best ways to avoid infection after a flap becomes contaminated.

By Eric D. Donnenfeld, MD
Eric D. Donnenfeld, MD:
Quote:
This is a case I have talked about before, but I think it makes a good teaching point so I?m going to talk about it again. A 45-year-old woman came in for routine LASIK. I?m doing my LASIK, I hand off the keratome, and they blow out the keratome. And suddenly there is no flap.


Eric D. Donnenfeld
Quote:
Now we?re looking for the flap, but we can?t find it. And all of you know how to find out if spaghetti is done. You throw it against the wall. If it sticks, it?s done. And that?s exactly what happened. The cornea ended up against the wall. We find it, but now it?s been sitting on the wall for about 5 minutes. What do you do next?

How would you manage this? My major concern is going to be infection with this having sat on the wall. What are you going to do with this flap to make certain the patient doesn?t get an infection?


Terry Kim
Quote:
Terry Kim, MD: These patients actually do fairly well with just re-epithelialization without flap replacement. There have been studies to show that in patients who have had amputated or missing flaps, visual acuity is quite reasonable after re-epithelization over the stromal bed, so that?s also an option.

In this scenario, I would evaluate the condition of the amputated flap to determine if I would replace it or discard it. Either way, I would recommend the use of a topical broad-spectrum fluoroquinolone such as moxifloxacin in addition to topical povidone iodine to prevent any potential infection.

Dr. Kim: I would certainly recommend the use of mitomycin-C 0.02% on the stromal bed for at least 1 minute to minimize the risk of haze formation if I chose to discard the flap.


For more information:
Eric D. Donnenfeld, MD, can be reached at Ryan Medical Arts Building, 2000 North Village Ave., Rockville Centre, NY 11570; 516-766-2519; fax: 516-766-3714; e-mail: eddoph@aol.com.
Terry Kim, MD, can be reached at Duke University Eye Center, Erwin Road P.O. Box 3802, Durham, NC 27710-3802; 919-681-3568; fax: 919-681-7661; e-mail: terry.kim@duke.edu.

_________________
We can easily forgive a child who is afraid of the dark. The real tragedy of life is when men are afraid of the light. -Plato


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 Post subject: Re: Dr. Terry Kim confused about vision after amputated flap
PostPosted: Thu Aug 16, 2007 4:31 am 
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Joined: Fri Jun 29, 2007 3:11 am
Posts: 102
Scientist wrote:
Dr. Terry Kim was the only surgeon on the panel who did not advocate doing everything possible to find and replace that flap. Perhaps Dr. Terry Kim views other people's visually significant complications as trivial because... hey - they aren't HIS eyes and they don't guarantee outcomes at Duke! He certainly was very dismissive and callous about my visual problems after he performed LASIK on me. What, flap striae? Why bother to treat those. Lose a flap? What the heck! Give a patient chronic pain to contend with - perhaps for life? All in a day's work for Dr. Terry Kim, MD?


IMO, all of the MD's on this panel are morons, but some are bigger morons than others. These "MD's" create MAJOR problems that they cannot fix on a person's most vital organ and discuss it in a matter of fact manner as if it is just part of a day's work. Perhaps they are so enamored with their stock portfolios that they forget that they have and continue to personally destroy HUMAN LIVES all for the sake of greed!

I am confident that if Dr. Terry Kim, MD's personal flap was dislodged and lost, he would want an MD to find it, clean it, and reattach it. However, that would never happen since Dr. Terry Kim, MD appears to value his own corneas too much to risk them to LASIK.

It's much more lucrative to ruin other people's eyes and lives for profit. If a flap is dislodged during a day's work there is no need to find the flap according to Dr. Terry Kim, MD. After all, Dr. Kim will sleep just fine at night by rationalizing that this patient that he has no connection to will have "visual acuity (that) is quite reasonable after re-epithelization". It appears Dr. Kim's standards of success are quite low for his patients. As long as the patient can drive in the day-time without needing glasses per DMV standards, Dr. Kim seems to feel quite good about his work. Night vision disturbances, severe dry eye, chronic pain, flap dislocations, poor visual acuity, etc, etc. No sweat to Dr. Terry Kim, MD. The fact that he does not properly inform his patients of the risks of LASIK. No problem for Dr. Terry Kim, MD. The fact that he provides poor follow-up care to damaged patients. Dr. Terry Kim, MD is personally fine with that too.

These LASIK MD's are total "SICKOS"/MORONS and Dr. Terry Kim, MD is ahead of the pack in winning the top "SICKO"/MORON award.

_________________
Let the FDA know about your poor LASIK outcome by reporting it through the FDA MedWatch program ... http://www.lasik-flap.com/forum/viewtopic.php?t=1620


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