Exposing the LASIK Scam

Glaucoma medications may damage basal corneal nerves
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Author:  Truly [ Mon Jan 01, 2007 3:23 am ]
Post subject:  Glaucoma medications may damage basal corneal nerves

Long-term use of topical glaucoma meds may damage basal corneal nerves



Confocal microscopy measures corneal nerve density
Ophthalmology Times


The subbasal nerves decrease by about 40% as the result of long-term topical antiglaucoma therapy.

The second study, which was part of the Ocular Hypertension Treatment Study, also was conducted at the Mayo Clinic and evaluated the effect of glaucoma medications on corneal nerves. Patients with ocular hypertension either received medications or were observed for 6 years. Dr. Bourne and coworkers examined the 38 of 54 patients who were studied at the Mayo Clinic using confocal microscopy 6 to 9 years after the start of the study. Of the 38, 19 patients had received various medications for a mean of 8 years. Nine patients were observed and switched to treatment at the end of 6 years when they were offered treatment or they received treatment if glaucoma progressed; 10 patients were only observed.

"The nerve density was about 40% less in the treated patients compared with those who were observed, a difference that was statistically significant," Dr. Bourne said.

The investigators questioned if the medications affected the epithelium in such a way as to affect visualization of the nerves, in which case the decrease in density would be an artifact. They determined that the brightness of the frame was similar in the treatment and observation groups, which indicated that the decrease in nerves in the treated group could not be attributed to an artifact, he explained.

Author:  Broken Eyes [ Mon Jan 01, 2007 2:01 pm ]
Post subject: 

Oh, great. I guess this means we shouldn't be using Alphagan for the rest of our lives, as prescribed by LASIK surgeons for night vision disturbances.

Author:  Eye [ Mon Jan 08, 2007 5:52 pm ]
Post subject:  Permanent post-LASIK dry eye made worse from medication?

I am very concerned about the use of these pupil-shrinking medications for refractive surgery patients period! A male patient, aged 21 had a very bad outcome from a VISX wavefront treatment and afterward used Alphagan heavily to shrink his pupils so that he could function. His dry eye is now so severe that his eyes dry completely shut each night. He goes to the shower each morning with his eyes closed to rip them open.

With no family or personal history of dry eye and no other medical condition aside from a disastrous LASIK surgery to explain his problem we are left with nerve damage from LASIK and the effects of pupil shrinking meds on corneal nerves to explain what has certainly been a life-altering and debilitating medical condition.

This young man has 'smeared' vision in both eyes and constant eye pain.

If corneal refractive surgery were safe and effective and pupil size were not an issue, no patient would ever need a prescription for pupil-shrinking medications! Think about it!

I am aware of at least one doctor who has a prescription pad in his LASIK office that is pre-stamped so that all he has to do is fill in the patient's name. This pad is in his LASIK office, where he only sees corneal refractive surgery patients. Think about that, too.

Author:  Broken Eyes [ Sat Mar 22, 2008 9:27 pm ]
Post subject: 

Cornea. 2006 Oct;25(9):1046-52.

Effects of glaucoma medications on corneal endothelium, keratocytes, and subbasal nerves among participants in the ocular hypertension treatment study.

Baratz KH, Nau CB, Winter EJ, McLaren JW, Hodge DO, Herman DC, Bourne WM.
Department of Ophthalmology, Mayo Clinic College of Medicine, Rochester, MN 55905, USA. baratz.keith@mayo.edu

PURPOSE: To compare subbasal corneal nerve and keratocyte density and endothelial characteristics of ocular hypertensive patients treated with medications or observation.

METHODS: Participants in the Ocular Hypertensive Treatment Study (OHTS) randomized at Mayo Clinic to medication or observation were evaluated with specular microscopy annually for 6 years. Confocal microscopy was performed 78 to 108 months after enrollment. Subbasal nerve density was calculated by manual tracing and digital image analysis. Keratocyte density was determined by manual counting methods. Data were compared using a t test and a rank sum test.

RESULTS: After 6 years, corneal endothelial cell density, percent hexagonal cells, and coefficient of variation of cell area for the observation (n = 21) and medication groups (n = 26) were similar (2415 +/- 300 vs. 2331 +/- 239 cells/mm; 63% +/- 11% vs. 65% +/- 10%; and 0.32 +/- 0.07 vs. 0.30 +/- 0.06, respectively). Of 38 participants undergoing confocal examination, the medication group (n = 19) had fewer nerves (3.8 +/- 2.1 vs. 5.9 +/- 2.0 nerves/frame; P = 0.02) and a lower nerve density (5643 +/- 2861 vs. 9314 +/- 3743 mum/mm; P = 0.007) than the observation patients (n = 10). An additional 9 patients in the observation group, who began medication before confocal scanning, had intermediate nerve densities. Full-thickness keratocyte density was similar, with 22,257 +/- 2419 and 23,430 +/- 3285 cell/mm in the observation and medication groups, respectively.

CONCLUSIONS: Chronic administration of glaucoma medications causes a decrease in the number and density of corneal subbasal nerve fiber bundles but does not affect keratocyte density or corneal endothelial characteristics.

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