Exposing the LASIK Scam

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Can the Wavefront Challenge be met?
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 Post subject: TAKE THE WAVEFRONT CHALLENGE!
PostPosted: Mon Dec 05, 2005 12:51 am 
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TAKE THE WAVEFRONT CHALLENGE!

If you are considering wavefront-custom LASIK, take the wavefront
challenge (nomal virgin eyes only). Here's how:

Ask the surgeon to provide you with a copy of your pre-op wavefront
scans (these are the scans that measure those "small imperfections" in
your vision, known as higher order aberrations).

Wait 3 months for your eyes to stabilize, then have the surgeon repeat
the wavefront scan at the same pupil diameter of the pre-op scan.

Compare the before and after wavefront scans. Did the higher order
aberrations decrease as they claimed? If not, wavefront did not do what
they say it does. Don't be fooled by the total RMS numbers -- that
includes all that myopia and regular astigmatism they treated -- so of
course the total RMS will be lower.

Be sure to have a refraction done at 6 months, too. Does it read plano,
both eyes (no sphere, no cylinder)? If not, wavefront was not even
successful at correcting the error that glasses can correct. Any
refraction other than plano in both eyes means your vision can be
improved with glasses following wavefront custom LASIK. This is usually
the case.

Read the labeling:
http://www.fda.gov/cdrh/LASIK/lasers.htm

Wavefront does not reduce higher order aberrations (small imperfections
in your vision). It increases them!

So if your surgeon claims that wavefront will give you better vision
than you have with glasses, have him explain why the "small
imperfections" increased instead of decreased.

The Challenge: Is there even one patient, just one, who can show their
higher order aberrations decreased following wavefront-custom LASIK
(primary surgery)? Scour the earth to find one patient for whom
wavefront ACTUALLY WORKED.

Note: If your pupils are larger than 6mm, ask to have the scans taken
at your scotopic (dark- adapted) pupil diameter.


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 Post subject:
PostPosted: Fri Dec 09, 2005 2:51 am 
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This page has been changed by the website operator, but this is what used to be there.

The Jell-O quote:

http://www.pcli.com/lasik/wavefront.html

Potential Risks of Custom Wavefront-guided LASIK

Wavefront measurements are interesting and useful, but we are not convinced that such highly customized treatment should be used to correct every focusing abnormality. Vision could end up worse than if treated by standard LASIK. Our concerns are based on the following risk factors:
Heightened expectations for 20/10 or 20/15 super vision may lead to frustration when patients do not achieve this goal.
Wavefront-guided LASIK may reshape the cornea to compensate for aberrations that arise from the lens. But with time, most patients will develop normal lenticular changes and eventually have their cataracts replaced by plastic lens implants. Now, unfortunately, their custom-shaped cornea will no longer coordinate with the spherical optics of their artificial lens.
Wavefront-guided treatment is much more complex than standard LASIK, so there is more to go wrong. From our experience we have 4 areas of concern:
Wavefront measurements are not consistently accurate. Errors may be present that could misguide the laser treatment.
It is possible for some wavefront measurement data to be lost in the translation to the laser treatment plan.
All computerized eye trackers we have observed have accuracy problems the manufacturers do not seem to recognize. Critical eye centration can be slightly off during treatment. Decentered treatment is never good, but slightly decentered custom treatment can create complex aberrations.
With the cornea being 70% water, highly customized treatment is like trying to precisely sculpt Jell-O. Even when everything is done perfectly, creating the LASIK flap and the normal effects of corneal stretching, molding or healing may negate some of the precision of the planned treatment.
Customized wavefront-guided LASIK may treat temporary irregularities?which would change in time if left alone. So considering the shoe analogy, if measurements for custom-made footwear are taken when part of the foot is swollen, the customized shoe will no longer fit when the foot heals.
The assumption that it is best to reduce or eliminate all abnormalities detected by wavefront is currently in question. Studies so far have failed to show that people with the best vision have less wavefront abnormalities.

_________________
Broken Eyes

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


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 Post subject:
PostPosted: Mon Jan 30, 2006 12:44 pm 
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If wavefront did what they claim it does, there would be no need for retreatments -- afterall, why would you need to retreat eyes with perfect vision?

Wavefront is marketing hype.

http://www.revophth.com/index.asp?page=1_803.htm

Reducing Wavefront Retreatment Rates

Wavefront makes retreatments less common, but there are other steps that the surgeon and staff can take to get it right the first time.

Marguerite B. McDonald, MD, New Orleans


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 Post subject:
PostPosted: Tue Feb 07, 2006 12:26 pm 
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Am J Ophthalmol. 2006 Feb;141(2):360-368.


Wavefront-guided ablation: evidence for efficacy compared to traditional ablation.

Netto MV, Dupps W Jr, Wilson SE.

The Cole Eye Institute, The Cleveland Clinic Foundation, Cleveland, Ohio; Department of Ophthalmology, University of Sao Paulo, Sao Paulo, Brazil.

PURPOSE: To provide an evidence-based overview of wavefront-guided refractive surgery outcomes, benefits, and limitations. DESIGN: Literature review.

METHODS: Review of FDA study reports and indexed, peer-reviewed literature.

RESULTS: More than 400 reports investigating wavefront applications in refractive surgery exist, but studies comparing the outcomes of wavefront-guided treatment with conventional treatment are few in number. Available studies do not overwhelmingly demonstrate superior visual results attributable to a wavefront-guided approach.

CONCLUSIONS: While wavefront-guided refractive surgery provides excellent results, evidence is limited that it outperforms conventional laser in situ keratomileusis that incorporates broad ablation zones, smoothing to the periphery, eye-trackers, and other technological refinements. However, it is evident that wavefront-customized ablation holds a promising future and merits ongoing investigation.


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 Post subject:
PostPosted: Wed Feb 15, 2006 2:07 am 
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Ophthalmol Clin North Am. 2004 Jun;17(2):225-31, vii.


Corneal wound healing relevance to wavefront guided laser treatments.

Netto MV, Wilson SE.

The Cole Eye Institute, The Cleveland Clinic Foundation, 9500 Euclid Avenue, Cleveland, OH 44195, USA.

Corneal wound healing makes important contributions to the outcomes of both traditional excimer laser ablation procedures and custom corneal ablations and contributes to the poor predictability of keratorefractive surgery in some patients. In addition, wound healing makes important contributions to some complications of PRK, LASEK or LASIK,including haze and diffuse lamellar keratitis. Detailed characterization of the wound healing cascade that occurs following refractive procedures is fundamental to pharmacological and molecular approaches for controlling or normalizing the response to surgery,thereby reducing biological diversity in variables such as epithelial hyperplasia and stromal remodeling that often tend to mask attempts at custom ablation.

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


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 Post subject:
PostPosted: Wed Feb 15, 2006 2:13 am 
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If you want to understand the wavefront hoax, this is the only article you need to read:

http://www.lasikdisaster.com/002NovDecJ ... vision.pdf

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


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 Post subject: does not works with lasik since the first cut
PostPosted: Sun Feb 19, 2006 2:42 pm 
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The wave front technology very is guessed right since corrije aberrations of high order by means of an falsified equipment of sensors, but does not works with lasik since the first cut with steel knife is too irregular raising 160 microns of the 500 totals of cheats on it (that is 1/3) without treating that is that the first third has micro you fold since it presents/displays memora of arc. In summary the single front of wave works and will work well with surface laser.


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 Post subject: LASIK should be banned, but surface treatments also a risk
PostPosted: Mon Feb 20, 2006 2:13 am 
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American refractive surgeons are beginning to wake up to the fact that LASIK is a bad procedure and some surgeons have publicly admitted that they no longer do it. It is refreshing to hear an Optometrist actually come out and state that LASIK is a bad procedure. Thank you doctor!

Although I know many people who have had disastrous outcomes with surface treatments, and one patient who is legally blind as a result of a surface treatment.

There is no safe corneal refractive surgery! They all thin and weaken the cornea, damage corneal nerves and induce higher order aberrations in the cornea.

Patients should compare their higher order aberrations before and after surgery. They would be surprised at how much distortion is induced by the laser.


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 Post subject:
PostPosted: Sat Mar 04, 2006 1:59 pm 
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How interesting. 10% of wavefront (super-vision) patients are not even achieving 20/20 vision and could benefit from glasses.

http://www.escrs.com/Publications/Eurot ... onomic.pdf

"He also encouraged surgeons
to collect and analyse their
surgical outcomes in order to
adjust their personalised
nomograms, noting that in initial
experience with wavefront-guided
LASIK in 2003, 80% of patients
were achieving 20/20 UCVA.
Following a 2004 nomogram
adjustment, that rate increased to
90%."

_________________
Bill

"What concerns me is that if the person informing the patient is themselves poorly or inaccurately informed then how on earth can consent ever be truly informed?" Dr. Sarah Smith


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 Post subject:
PostPosted: Sat Mar 25, 2006 5:29 pm 
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I found this new article interesting. Without knowing the scan diameter, and without reading the full text, I question their conclusions about the low myopes with elevated pre-op HOAs, but I realize they are saying these patients had unusually high pre-op aberrations. I have no problem with their conclusions about the eyes with normal pre-op HOAs and the high myopes. These patients all realized an increase in HOAs from pre- to post-op.

My conclusion: Wavefront doesn't work, except *maybe* on eyes with normal pupil sizes, low myopia and unusually high spherical aberrations.

Klin Monatsbl Augenheilkd. 2006 Mar;223(3):217-24.

Correction and Induction of High-Order Aberrations after Standard and Wavefront-Guided LASIK and their Influence on the Postoperative Contrast Sensitivity.

Hammer T, Heynemann M, Naumann I, Duncker GI.

Universitatsaugenklinik und Poliklinik der Martin-Luther-Universitat Halle-Wittenberg.

BACKGROUND: Wavefront-guided LASIK-treatments should reduce high-order aberrations (HOA). However, both the microkeratome cut as well as the ablation itself induce HOA. The purpose of this study was to investigate the amount of corrected preoperative measured HOA and induction of new HOA.

METHODS: In this retrospective study 67 eyes of 45 myopic patients (- 2 to - 8.1 D SE; spherical equivalent) were treated by standard and wavefront-guided LASIK (Keracor 217z). Pre- and postoperative measurements of total aberrations and contrast sensitivity were performed. The follow-up time was 5.7 +/- 0.9 months.

RESULTS: Patients with preoperative increased aberrations of 3rd and 4th order and myopia up to 5 D showed a slightly reduction of wavefront deformation. Cases of higher myopic corrections and lower preoperative spherical aberrations developed an increase of spherical aberrations after LASIK. The changes of other HOA showed no correlation with the amount of corrected myopia. Up to - 5 D patients showed the trend to better postoperative contrast sensitivity under 3 and 85 cd/m (2) after wavefront-guided LASIK than after standard LASIK. A significant advantage of wavefront-guided LASIK can be detected under a spatial frequency of 3 CPD (cycles per degree) and 85 cd/m (2). No advantages of any treatment procedure were shown after higher myopic corrections.

CONCLUSION: If preoperative aberrations of 3rd and 4th order were increased and the myopia is < 5 D (SE) - wavefront-guided LASIK can reduce total ocular HOA. Aberrometric findings after wavefront-guided LASIK in patients with lower preoperative HOA and myopia > 5 D (SE) are comparable with the results after standard treatment.

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


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 Post subject: Notice they are also comparing standard to wavefront
PostPosted: Sat Mar 25, 2006 11:33 pm 
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They are not saying that that wavefront improves the HOA of the NORMAL virgin eye - normal people aren't bothered by high HOAs. That's rare. The average person on the street who has never had surgery has very low HOAs and is NOT bothered by them. It's generally the hand of the corneal refractive surgeon that induces this devastation upon the eye.

I haven't read the full text of this article, and therefore I have a question... Are you certain all the patients with pre-existing elevated HOAs (how on earth did they find THESE PEOPLE???) are not victims of a previous laser eye surgery?


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 Post subject: Re: Notice they are also comparing standard to wavefront
PostPosted: Sun Mar 26, 2006 12:16 am 
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Eye wrote:
I haven't read the full text of this article, and therefore I have a question... Are you certain all the patients with pre-existing elevated HOAs (how on earth did they find THESE PEOPLE???) are not victims of a previous laser eye surgery?


I wondered about that, too. Only way to know is to get the full text. It's possible they found a few people with unusually high pre-op HOAs. But, once again, the scan diameter is extremely important in scrutinizing this study.

One of my favorite sayings is, taking the scan at a diameter smaller than the scotopic pupil is like weighing a 200 lb. woman on a scale that only goes up to 150 lbs.

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


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 Post subject:
PostPosted: Fri Mar 31, 2006 7:08 am 
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my understanding is that HOAs arent anything new, theyre just a way of quantifying the optical effects of an irregular or uneven cornea. refractive surgeons have known that RS can induce corneal irregularities since the dawn of RS. for them to pretend that HOAs are a new finding is just utter bullshit.

if wavefront really worked there wouldnt be any need to research topographically-guided enhancements. this line of research exists because someone somewhere realized that wavefront was a joke and that patients need a smooth cornea..........like the one they had before RS.


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 Post subject:
PostPosted: Sun Apr 02, 2006 3:13 am 
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http://www.escrs.org/eurotimes/September2003/26.asp

"The flap itself is another problem. He cited studies by Dr MacRae and others showing that the creation of the flap itself induces unpredictable amounts of astigmatism and higher order aberrations. Cutting a flap causes irreversible damage to the associated collagen fibres, resulting in an immediate worsening of RMS values."

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


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 Post subject:
PostPosted: Sun Apr 02, 2006 11:13 pm 
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Am J Ophthalmol. 2006 Apr;141(4):660-668.


Conventional and wavefront-guided myopic LASIK retreatment.

Jin GJ, Merkley KH.

The Eye Institute of Utah, Salt Lake City, Utah, USA.


CONCLUSIONS: In the study period with the current equipment, our results showed that conventional LASIK retreatment was superior to wavefront-guided LASIK retreatment in both efficacy and safety. :shock:

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


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