Exposing the LASIK Scam

glaucoma + LASIK
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Author:  kaleyedoscope [ Fri May 18, 2007 3:30 pm ]
Post subject:  glaucoma + LASIK


"Be mindful, surgeons. What looks like diffuse lamellar keratitis (DLK) or edema could be a pocket of interface fluid in disguise.
One recent case study pointed to an unlucky glaucoma patient who developed interface fluid in his LASIK flap, which improperly diagnosed, was eventually given a corneal transplant."

?If after LASIK, somebody has high eye pressure and has either steroid-induced glaucoma or angle-closure or anything that, fluid?because of high eye pressure?could be forced into the cornea and it has the tendency to accumulate in the interface and form a space in the interface,? said Daniel S. Durrie, M.D., clinical professor of ophthalmology, University of Kansas, Overland Park, Kan.
If that happens, it is important to recognize it and not misdiagnose, he said."

?Based on the cases reported to date and what is currently known about the histopathology of human LASIK wounds, it appears that aqueous fluid preferentially collects in the central and paracentral interface wound ... because of a deposition of abnormally large proteoglycans during LASIK corneal stromal wound healing,? Dr. Hovis reported."

Author:  Broken Eyes [ Sat May 19, 2007 12:47 am ]
Post subject: 


J Refract Surg. 2006 May;22(5):441-7.

Interface corneal edema secondary to steroid-induced elevation of intraocular pressure simulating diffuse lamellar keratitis.

Galal A, Artola A, Belda J, Rodriguez-Prats J, Claramonte P, Sanchez A, Ruiz-Moreno O, Merayo J, Alio J.
Refractive Surgery and Cornea Unit, Instituto Oftalmologico de Alicante, Spain.

PURPOSE: To describe interface corneal edema secondary to steroid-induced elevation of intraocular pressure (IOP) following LASIK.

METHODS: Retrospective observational case series. Diffuse interface edema secondary to steroid-induced elevation of IOP was observed after LASIK simulating diffuse lamellar keratitis (DLK) in 13 eyes. Mean patient age was 31.4 +/- 5.3 years. Patients were divided into two groups according to provisional misdiagnosis: DLK group (group 1) comprised 11 eyes and infection group (group 2) comprised 2 eyes (microbial keratitis). Mean follow-up was 8.1 +/- 0.5 weeks.

RESULTS: In the DLK group, typical diffuse haze was confined to the interface and extended to the visual axis, impairing vision in all eyes. Provisional diagnosis was late-onset DLK and topical steroids were started. Repeat examination showed elevated IOP as measured at the corneal center and periphery using applanation tonometry (mean 19.1 mmHg and 39.5 mmHg, respectively), causing interface edema with evident interface fluid pockets. Steroids were stopped and topical anti-glaucoma therapy was started. The interface edema decreased and at the end of follow-up the corneal transparency was restored and IOP dropped to normal values. The infection group demonstrated a microbial keratitis-like reaction and underwent flap lifting and interface wound debridement and biopsy with administration of fortified antibiotics and steroids. After elevated IOP was detected, steroids and antibiotics were stopped and topical anti-glaucoma therapy was started, resulting in the resolution of the interface edema.

CONCLUSIONS: Interface fluid syndrome secondary to steroid-induced elevation of IOP might develop in steroid responders after LASIK with a misleading clinical picture simulating DLK or infectious keratitis. Management includes stopping topical steroids and starting topical antiglaucoma therapy.

Author:  kaleyedoscope [ Tue Sep 11, 2007 1:18 am ]
Post subject: 


It would be inadvisable for any patient with moderate to advanced glaucoma to undergo LASIK, not only due to the well-documented problems in measuring IOP leading to problems in monitoring and appropriate management of the glaucomatous status, but also due to the potential for increasing glaucomatous nerve fiber loss and increasing visual field defects due to the transient yet high levels of IOP that occur during LASIK.

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