Exposing the LASIK Scam

As of tonight, I am scheduled to undergo LASIK this coming Friday (Feb. 9). Though I was described as a great candidate for it, I have my doubts, especially after reading the horror stories of others. Though I have several friends who have had great success with LASIK, I am unwilling to take the risk and will be canceling my appointment on Monday.

In doing my research on LASIK, I encountered limited discussion on Ortho-K (which, from what I gather, is also call CRT). To me, this sounds like an infinitely better alternative to LASIK, and I was hoping someone here could answer my questions about it.

For reference, I am nearsighted (Left eye -2.25; Right eye -2.00), have had a stable prescription for over 5 years, have no astigmatism, and am a 26 year old male. I am in law school, so I spend a lot of time on the computer and reading. Just thought I'd throw in that stuff in case it changes anyone's answer.

1) I have moderate dry eye (keeps me from comfortably wearing soft contacts) and large pupils (over 7.5mm dialated). This is what ultimately convinced me to forgo LASIK. Will either of these pose problems with Ortho-K?

2) My dry eye is not severe, but can be annoying, especially at night. Is dry eye a problem with this type of treatment like it is with soft contacts?

3) For those who have had it, are you happy with the results you have had?

4) For those who have had it, did you have any complications? I'm interested in both medical complications and complications of convenience (the lense didn't fit right, doctor was rude, etc...).

5) What was the approximate cost (exam, lenses, etc...)?

6) What questions do you wish you had asked the examiner? Anything I should look for in choosing a practitioner to fit me (certain technology or exam procedure)?

7. Anything else I should know that might be useful?

I'm sorry if these seem like elementary questions, but I can't find info on the net from many people who are using Ortho-K. I've checked out the website of various companies that sell Ortho-K services, but I'm taking these with a grain of salt after my experiences researching LASIK. Any feedback you all could give me would be very appreciated.

Hi aaslong80,

Welcome to the flap. Corneal refractive surgeries, such as LASIK are serious surgeries with permanent consequences that cannot be reversed.
No one can predict how your corneas will react to the surgery and the healing response can have permanent effects on your visual quality.

Please read The LASIK Report at the top of this forum. A PDF form is available at htttp://www.thelasikreport.com .

As for Ortho K - go ahead and try it. It's not likely to hurt you. While you are in law school and doing a lot of reading, my advice would be to stick with your old reliable glasses.

You are entering a profession where much reading and computer work will always be required. After LASIK, even young patients can have trouble seeing their computer screen for more than a month. Some have permanent difficulty reading. Is this risk really worth the 'possiblity' of going without glasses for some period of time?

I really don't have answers about the efficacy and patient satisfaction rate of Ortho K. I do know it is unlikely to hurt you. I do know many patients, including myself... have been permanly harmed by the surgery you're scheduled to have this coming Friday.

I would do almost anything to be able to go to the time of my surgical decision and just say no.

Please be aware that the LASIK flap never heals, that LASIK actually *induces* permanent distortions in your cornea, on average... it doesn't reduce or treat them in normal eyes as the marketing would imply. LASIK also damaged corneal nerves that can lead to permanent dry eye disease.

I didn't have dry eye problems before LASIK. Now I do. You already have some dry eye issues. This makes you an extrememly bad candidate for ANY form of corneal refractive surgery as they all damage the corneal nerves responsible for comfortable wetting of the eye.

Large pupils are also a risk factor for a poor outcome. The larger your pupils the more you will be affected by surgically-induced distortions in dim light. It is a horrible experience to have your night vision ruined. I can speak with some authority on this subject.

Your career choice, dry eye history and large pupils are all risk factors for dissatisfaction/complications with your LASIK eye surgery.

Many damage corneal refractive surgery patients are unable to restore their former crisp vision by any means including contact lenses. The damage continues, even with so-called 'new technology'.

The only kind of treatment for surgically induced distortion that typically works best (hard lenses) is something you wouldn't be able to tolerate because of your pre-existing dry eye. So, to put it simply, the only 'fix' for a bad LASIK likely won't work for you. You have no 'safety net' and these are your only pair of eyes.

Please call and cancel your appointment and enjoy your healthy, intact corneas and good correctable vision.

Thanks for your reply. I canceled my LASIK appointment today. Interestingly, my friend's sister just had the surgery (LASIK) several days ago and is loving it. Different doctor than what I was scheduled to go to. However, she said she has large halos around light sources in the dark (said the power light on her DVD player looked about as big as a half-dollar when she was watching a movie). She's still in early recovery, so I hope it gets better for her. Other than that though, she is pleased.

But as for me...

When I called to cancel, the understandably asked why. I explained that 1) I was concerned with my large pupil size and 2) Feared aggravation of my dry eye. His explanations were interesting. Maybe someone can tell me what they thought (i'm cross posting this in the "General" part of the forum too).

1. For pupil size, he said that the laser they use (Allegretto Wave is what the informed consent form said) has a 9mm zone it can work in. He said that this is plenty large to handle even the biggest pupils. He said this had all but eliminated problems that this doctor had experienced with people complaining of halos/starbursts/glare. Anyone know if this might be true?

2. As for the dry eye, he said the intralase method (which I would be getting) has almost eliminated problems they've had with dry eye. According to him, Intralase doesn't damage the nerve tissue under the cornea as much as having a blade cut the cornea does. As a result, less nerve damage equals less dry eye. While this certainly seems plausible, I was thinking that this still is making a cut in the cornea. I still have to have the cornea flapped up. As such, it would seem like it would still cut the nerves. Anyone have experience with Intralase or know its effects on dry eye compared to the blade?

I am scheduled to visit with Dr. Trent Pitt of Vision Source in Oklahoma City tomorrow morning to discuss Corneal Refractive Treatment (like ortho-k). Not any particular reason I chose him, other than he's close to where I live. Got his name off the Bausch and Lomb website as being certified in whatever their brandname of the procedure is. The appointment is just for a consult. I'm want to find out what experience he has doing this, his particular success rate, etc... I'm hoping deeply this won't turn into a session where they try to convince me I would be a good candidate for LASIK.

I'll update tomorrow with results of how it went for me.

I went and saw Dr. Pitt today concerning the Corneal Refractive Therapy (CRT). Nice guy. Pretty young (only a few years older than me). I had my corneal topography taken, had a vision test, etc... Results came up pretty much as I expected (though he said I was -2.25 in my right eye, which is higher than I thought, but not a biggie). They had the contacts in stock for my right eye, but are having to order the ones for my left. They wanted to wait until both sets are in before starting me, so it will probably be the middle of next week.

He said I'll put them in on whatever night we decide to start, and have to come in early the next morning for a checkup. There will be periodic checkups after that (I believe at 1-2 weeks, 1 month, and then 3 months). He said we may go through several sets of contacts before finding the best ones. Again, based on what I'd read about CRT, this is not unusual. I was actually glad to hear that he wasn't trying to sell me on how perfect everything would be right off the bat. Made me feel he was being pretty honest.

Total cost, including getting the correct lenses, the checkups, the screening, and 2 sets of lenses once the correct ones are found came to $1100 ($550/eye).

I'll post more once I have some initial results/impressions next week.

My lenses came in wayyy early, so I was able to pick them up this afternoon. The size they ordered didn't quite fit, so they tried a different size (that were already in stock) that apparently fit better. They have to make sure the skirt of the lense forms a good bond with the eye so that no air bubbles (or as few as possible) form under the lense. I had worn soft contacts before, so touching my eye was no problem. But Rigid Gas Perm contacts are NOT comfy. Kind of like having a rock stuck under each eye (ok...that's an exageration). They aren't bad when my eyes are closed, and even for the 10-15 minutes I had them in, they started to become more tolerable. Still, they don't have that "in but not there" feeling of soft contacts.

I try them out for the first time tonight. When I wake up, I have to leave the lenses in and drive up to see the doctor first thing in the morning. Should be an interesting rush hour drive.... My vision with them in is 20/20 and clear, but damn it hurts to blink.

Wore the contacts last night. Uncomfortable while I was awake, but didn't really notice them laying down in bed. Did not notice them at all while I was asleep. In fact, when I woke up this morning, I wasn't sure if they were still in or not. This was good, because I feared that I would either rub my eyes while I was asleep or attempt to claw them out of my eye. But once I sat up, I immediately knew they were there again. I normally have somewhat dry eyes, and if I fall asleep in soft contacts its like someone glued my eyelids closed when I try to wake up. With these contacts though, I didn't really have any dry-eye problems.

So, after I woke up, I had to leave them in and go first thing to see my doctor. I had my wife drive me, because I was concerned about driving in rush hour traffic with the lenses in my eye. After getting to his office, he looked at my eyes with the lenses in, checked centration, etc... All looked well. I then took the lenses out (which was a RELIEF), and I could immediately tell that my vision was much better than what it normally is without glasses. He ran a quick corneal topography on each eye, and then went to check my vision. I was 20/15 in my right eye with no haziness. My left eye could do 20/20 in terms of accuity, but, it was very foggy. Almost double vision. A look at the corneal topography showed there was a bump on the cornea pretty much centered over the pupil in my left eye. The doc said it was like having an astigmatism. Doc said this was not unusual, and it would probably take a few days before the lenses work it down, but it shouldn't be a problem. All-in-all, I was very pleased with the initial results.

I went through the morning and part of the afternoon unaided by glasses. To me this is a big deal b/c I never do anything without my glasses because I feel like I can't see a thing. But today without them, I could see pretty well. I could read the road-signs on the trip home (something I can NEVER do without glasses until I'm right up on them). I could read the clock and chalkboard in my classes today as well. The only annoying part was that my left eye made the vision kind of fuzzy/hazy due to the astigmatism, but it was certainly a great experience not wearing glasses. Around noon, I could start sensing my vision getting slowly more fuzzy. I was told to expect this, especially during the first few weeks of the treatment. I got home from class, and took a long nap this afternoon (about 2:30-6:30...isn't being in college great?). When I woke up, my vision had reverted back to the way it normally is (I didn't wear the lenses during my nap). I'm now back in glasses for the night. Anxious to see if the left eye improves tomorrow and if I start to see more longevity in the treatment.

All things said though, I am very pleased with the initial results of the treatment. If it continues to go well, I will be recommending it to others over LASIK. Interestingly, most of my friends at school were asking where my glasses were. I told them about CRT and what my results had been. Most seemed very interested in it. None had ever heard of it before. I did have one girl tell me it sounded like a scam [which was odd, considering it seemed to do exactly what I was told it would]. By in large though, everyone thought it sounded pretty cool and wanted me to let them know how it went.

I'll post more as things progress

Well, it's about 3:00 in the afternoon. Vision in the right eye is still doing decent. The left eye is getting pretty fuzzy. Seems to be a bit more long lasting than yesterday. Also, I didn't have the nasty double vision problem in the left eye this morning from the astigmatism. Lenses also didn't feel nearly as uncomfy when I put them in. They were *almost* tolerable when I woke up this morning. I was going to try to shower before taking them out, but decided not to push my luck. Long story short: so far, so good.

One thing that I am noticing that is pretty annoying are issues with halos. In bright light, I have crisp vision. However, get me in a darker room, and any light source has a very prominent halo around it. If I turn the lights in the room on, they go away. I'm hoping that this will start to fade more as I wear the lenses, but I'm concerned it may not. I'm not sure what pupil size CRT can handle, but I fear mine may be too big. I have a feeling the halos are very similar to what lasik patients complain of. While it would suck if this ends up making me quit the treatment, at least I have the solace of knowing that they aren't permanent.

Can anyone who has halo issues from LASIK tell me if wearing sunglasses while driving at night alleviates the problem at all?

I strongly suspect that the lenses are not flattening a large enough diameter to account for your pupil size in dim light. This is similar to what patients, like myself, experience after LASIK with an optical zone too small for our pupil size. The halo effect you're seeing is the unfocused light entering your eye through the peripheral cornea. Welcome to my world of "spherical aberrations".

Wearing sunglasses at night will not help this problem. You need more light, not less light, to alleviate the problem. I turn on my map lights, adjust my rear view mirror so headlights from cars behind me are shining in my eyes, and sometimes shine a flashlight into my eyes while driving. Also, glaucoma drugs such as Alphagan make pupils smaller which helps. (I wouldn't recommend you do any of the above.)

Thanks for the info. I suspect that my large pupils may account for some of the problems. From what I've read, this effect is not uncommon with CRT, and should dissipate over time [though it may never completely go away]. I certainly hope it will. I don't think my problem is as bad as what many have post-LASIK. I was able to drive tonight with no particular difficulties [I did have a small-correction contact in my left eye b/c it had lost most of the CRT effect throughout the day]. It's mostly just an annoyance. When I see my doctor next Thursday, I'll discuss it with him if the problem hasn't been alleviated.

Thought I'd give a quick post-weekend update. My left eye is finally coming along pretty well. I feel like, at least in the morning, I am 20/20 out of both eyes. The left eye still regresses faster than the right though, but I now feel I can go without glasses the entire day and function well.

Still having halo issues in the dark. Maybe those of you with LASIK halo problems can tell me if this is what you experience. With my right eye, I see a halo (or perhaps it might better be described as ghosting) to the left and slightly down of the image. If, for instance, I stare at the red power light on my DVD player using only my right eye, the halo effect only appears on the left side of the light. There is no halo effect of any kind of the right side. With my left eye, I have the same thing happen, except that the halo appears only on the right side of the light source. It would seem to me that if this were purely a problem relating to my pupil size, I would be encountering the halo all the way around, not just on one side or the other. Anyone encounter this effect with their eyes post-LASIK? I'll be asking my doctor about it on Thursday. It may be the result of contacts that don't fit quite right, or something that may improve on its own (which supposedly happens in many instances of CRT, though they also say the same about LASIK).

Sounds to me like the lenses are not perfectly centered -- or the flattening effect is not centered exactly over the pupil -- and yes, this still is a pupil size issue -- it sounds more like what patients with "coma" experience at night with a large pupil. I have coma, too, but my spherical aberrations are so high that the coma is not as noticeable. With LASIK, coma is caused by a decentered ablation. Maybe your corneas will mold to the shape of the lenses more over time and this effect will go away -- just a guess. I know my lenses sometimes have some weird visual disturbances that tend to resolve over time.

Thought I'd give another update. Went to see my doc this morning. All is going well acuity-wise with my right eye. The left is still having some troubles. Way better than my normal vision, but not as sharp as the right.

I told the doc of my problems with the left eye and the halo issues, especially how I get halos "towards the center" (i.e. the left eye produces a halo on the right, and the right eye produces a halo on the left). The doc examined the contacts while in my eyes, ran a corneal topography, etc. Broken Eyes was right. The contacts, while centered when I'm awake, slide to the outside a bit while I sleep. Also, he thought we should go ahead and increase the ablation zone a bit as well. So, I've got two new contacts coming in sometime in the next few days. I'll try them out for a week and then have another follow-up. So far, so good. Again, I knew this treatment does not provide a quick "fix" like LASIK (and I know fix is a misnomer in terms of LASIK, but you know what I mean), so having to do several pairs of contacts is not surprising or unexpected. I'm glad he's actually taking the time to work it out instead of doing what so many LASIK docs do after they get your money and just saying "Sorry. Tough luck."

In more good news, while reading about the CRT procedure and halos on the net, I encountered the blog of someone who had had halo issues as well. To my amazement, he went to the same optometrist for his treatment as I'm going to. This was very surprising to me, because Oklahoma City is kind of backwaterish. I've never randomly encountered anyone living here who writes on the internet about anything I've seen/done here. Although he was seeing a different doctor (there are two in this office...I'm seeing the younger one). I wrote to him, and he said it took several tries, but they worked with him and got his halo issues resolved. It was comforting news to hear, especially since I didn't have anyones recommendation of who to choose for a doctor when I began treatment.

LASIK is no quick fix, it's a quick butchery that can cause problems for a lifetime. Just so you know, my vision varies from day to day and at different times of the day. Never the same. My glasses are never right - I always feel like I am wearing someone else's glasses.

Then there are the starbursts, halos etc. I'm glad you're trying something that is reversible!

I think anyone with large pupils is going to have more problems with any corneal therapy correct refraction. The beauty of Ortho K is that if you've had enough of that you can go back to glasses or contacts. With LASIK you're stuck with a mess for life.

Just to give credit where credit is due: my visual trash is from LASIK surgery with Dr. Terry Kim at Duke University Laser Vision 'Correction' Center. That 'correction' center gave me poor quality vision, especially at night.

Alsong~ I am following your story/progress with great interest. I too, am potentially interested in Ortho-K after giving up on the idea of Lasik due to my large pupils. If possible, please keep us updated about your halo issues. Thanks!

Courtney - any time you go in for contacts ask for the largest optical zone that they can make for you. Undersized optical zones for large pupil patients cause visual disturbances... especially at night!

Let us know if you have any further questions!