Exposing the LASIK Scam

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 Post subject: Incidence & risk factors for developing dry eye after LA
PostPosted: Fri Apr 21, 2006 11:45 am 

Joined: Sat Nov 26, 2005 1:23 pm
Posts: 2080
Am J Ophthalmol. 2006 Mar;141(3):438-45.

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Am J Ophthalmol. 2006 Mar;141(3):542.

The incidence and risk factors for developing dry eye after myopic LASIK.

De Paiva CS, Chen Z, Koch DD, Hamill MB, Manuel FK, Hassan SS, Wilhelmus KR, Pflugfelder SC.

Department of Ophthalmology, Cullen Eye Institute, Baylor College of Medicine, 6565 Fannin Street, NC 205, Houston, TX 77030, USA.

PURPOSE: To determine the incidence of dry eye and its risk factors after myopic laser-assisted in situ keratomileusis (LASIK).

DESIGN: Single-center, prospective randomized clinical trial of 35 adult patients, aged 24 to 54 years, with myopia undergoing LASIK.

METHODS: setting and study population: Participants were randomized to undergo LASIK with a superior or a nasal hinge flap. They were evaluated at 1 week and 1, 3, and 6 months after surgery. intervention: Bilateral LASIK with either a superior-hinge Hansatome microkeratome (n = 17) or a nasal-hinge Amadeus microkeratome (n = 18). main outcome measures: The criterion for dry eye was a total corneal fluorescein staining score > or =3. Visual acuity, ocular surface parameters, and corneal sensitivity were also analyzed. Cox proportional-hazard regression was used to assess rate ratios (RRs) with 95% confidence intervals.

RESULTS: The incidence of dry eye in the nasal- and superior-hinge group was eight (47.06%) of 17 and nine (52.94%) of 17 at 1 week, seven (38.89%) of 18 and seven (41.18%) of 17 at 1 month, four (25%) of 16 and three (17.65%) of 17 at 3 months, and two (12.50%) of 16 and six (35.29%) of 17 at 6 months, respectively. Dry eye was associated with level of preoperative myopia (RR 0.88/each diopter, P = .04), laser-calculated ablation depth (RR 1.01/microm, P = 0.01), and combined ablation depth and flap thickness (RR 1.01/microm, P = 0.01).

CONCLUSIONS: Dry eye occurs commonly after LASIK surgery in patients with no history of dry eye. The risk of developing dry eye is correlated with the degree of preoperative myopia and the depth of laser treatment.

Broken Eyes

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

 Post subject:
PostPosted: Fri Apr 21, 2006 3:24 pm 

Joined: Mon Apr 17, 2006 5:34 pm
Posts: 9
I don't understand this research. Lasik has been FDA approved to like 12 diopters (I forget the exact figure, does it depend on the laser?). 12 diopters is a large range. Wouldn't the relationship between dry eye and amount of correction be old news from the clinical trials?


 Post subject: Dry eye was not listed as a complication
PostPosted: Mon Apr 24, 2006 12:40 am 

Joined: Sat Nov 26, 2005 1:06 am
Posts: 621
Believe it or not, although dry eye in and of itself can be a debilitating chronic medical condition, corneal refractive surgeons have not classified dry eye as a complication. They consider it a side-effect, and temporary, which it is NOT.

Some people may find relief of their symptoms over time only to experience a life-altering return of dry eye with a few years of time behind them and some age. From studies I have read I have some lingering concern that corneal nerve loss may be progressive. It is certainly true that the risk of dry eye is higher in females, and increases with age.

So you would expect that women who have had corneal refractive surgery would be in the dry eye danger zone, a medical fiasco waiting to happen. It has already happened to me. I have had painful dry eye that interferes with my vision since my LASIK at Duke University in 2004.

Julie, this article compares creating a flap with a hinge at the top with a flap with a hinge near the nose in terms of the incidence and persistence of dry eye. In this study, superior hinge flaps caused more dry eye and it lasted longer.

It only makes sense that patients with higher corrections and deeper ablations would have worse dry eye. The new larger ablation zones and the wavefront treatments that laser deeper in the periphery probably leave patients with worse dry eye than conventional treatments.

This is permanent nerve damage we are talking about here. This procedure should be banned, it's just that simple.

LASIK surgeons are harming patients.

 Post subject:
PostPosted: Mon Apr 24, 2006 6:08 pm 

Joined: Fri Apr 21, 2006 5:21 pm
Posts: 3
Flap thickness and degree of ablation were factors. So, if you have a thicker flap, the nerves can't grow through it as well, right?

 Post subject: I think the problem may be they are cut deeper
PostPosted: Mon Apr 24, 2006 11:50 pm 

Joined: Mon Nov 14, 2005 4:28 pm
Posts: 643
With a thicker flap, the nerves have a deeper cut. That may be the problem. With a thin flap, the nerves aren't cut so deeply, saving many branch points.

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