Exposing the LASIK Scam

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 Post subject: Doctor Minarik Dusts off Some Old Activism
PostPosted: Mon Mar 20, 2006 4:51 am 
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This article was published in Optometric Management Magazine in June of 1995. There was no LASIK, and the article was already submitted for publication in February of 1995...when Ron Link was getting his first RK.

Ron must always be remembered as the founder of the modern movement against refractive surgery. A few years ago Ron told me that if he EVER even imagined the things that were going wrong in RK were already being published...he never would have had the surgery.

Portions of the article,reprinted here from OPTOMETRIC MANAGEMENT magazine, address the fitting of lenses on eyes that had RK.

Correcting Vision After RK
BY KENNETH MINARIK, O.D.
Rockford, Illinois

So much attention is focused on the excimer laser. Are we forgetting the special needs of all the patients who've already undergone Radial Keratotomy (RK)? More than a million RK procedures have been performed in the United States since 1978, and more are coming - an estimated 300,000 per year. As you may know, many of the patients still need visual correction because of inadequate surgical results or changes in their vision after surgery.

Are you prepared to take care of them? Before you say yes, consider that you can't always rely on autorefractors or even retinoscopes. And RK patients may still need post-operative teaching, even years after undergoing the surgery.

OVERCOMING THE BARRIER OF RK
Is it time to overcome the barrier that separates O.D.'s from M.D.'s who perform radial keratotomy (RK)? I believe it is. We need to get past our personal fears and objections to give post-RK patients the quality of follow-up care they deserve.

Understandably, many of us are reluctant to deal with the complications of a procedure that an M.D. has performed, especially when it is a procedure that optometry hasn't fully embraced or participate in. But, we also have to consider these patients' needs, the real priority here. The fact is, many of them really need our help.

I've had the opportunity to work with many post-RK patients because I provide follow-up care for M.D.'s. These patients are generally young, affluent, well-educated and very easy to work with on a personal level. On a clinical level, their eyes can be as challenging as any you'll ever encounter.

Keep in mind that thousands of RK patients couldn't be happier at first, having left their ophthalmologists' office with 20/20 vision. But when the unhappy ones walk into your office, you need a strategy for taking care of them.
- Kenneth R. Minarik, O.D.

.....(and then there's this one!)......
Why hasn't he lost vision in his right eye? Because the result in his right eye is a statistical anomaly that we refer to as a "progressive bifocal cornea." In some post-RK patients, you'll find a distinct central optical zone that's somehow emmotropic, but an aspheric zone just off center that's moderately myopic. As a result, these patients have a central cornea that functions like a progressive-addition, aspheric contact lens.


Case 2: Lenticular astigmatism
Cathy, a 30-year old office worker who underwent RK two years ago, comes into your office with an acuity of 20/30 OU. She complains of blurred vision and headaches. Her corneas show four radial cuts, with no T-cuts, and an open central area of 4.25mm. Cathy's surgeon has forwarded copies of her corneal topography maps, which are spherical pre-operatively and post-operatively.
As it turns out, however, Cathy's problem is not on the map. You determine that she has lenticular astigmatism. Her refraction is Plano -1.25 X 90 OU. After providing appropriate correction, you see that her acuity jumps to 20/15.
This case illustrates a common problem - an overdependence on the corneal topographer. Granted, this instrument provides a detailed, full-color representation of the
corneal surface. But you can't rely on it for all of your information, ignoring the other refractive surfaces of the eye. Most surgeons won't just rely on corneal topography, as Cathy's surgeon apparently has done. But you should at least be aware of this possibility.

Case 3: Correcting Misperceptions
Earl, a 43-year-old maintenance worker, was a 1.50 diopter myope pre-operatively. Before surgery, he would take his spectacles off to shave and comb his hair. But since his surgery, he hasn't been able to do that. He says his eyes feel like they've been "pulling". What makes him most uncomfortable is when his left eye can't see near objects well, yet his right eye sees fine, near and far.
What's gone wrong? First of all, Earl is now presbyopic. No one told him before his surgery that he would lose his near modified monovision, you can prescribe a near prescription in progressive-addition forms to make him feel more comfortable.

Your Follow-up role
As you can see, refractive surgery produces patients with a lot of different needs. But you can meet those needs with good refracting and clinical skills, mindful of the insights I've just shared. By taking on these challenges, you win their confidence. You'll also play an important role in the care and management of this rapidly growing segment of the patient population.

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For resources, check www.doctormyeye.com


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 Post subject: Re: Doctor Minarik Dusts off Some Old Activism
PostPosted: Mon Mar 20, 2006 6:46 am 
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DrMinarik wrote:
Ron must always be remembered as the founder of the modern movement against refractive surgery.


Ron Link NEVER took a public stance against refractive surgery. I know many well informed casualties out there who feel that if Ron had taken a public stance against this industry, that maybe we would not be where we are today. Dr. Minarik, please do not rewrite history!


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 Post subject: I Disagree With You 100%....
PostPosted: Mon Mar 20, 2006 1:16 pm 
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Location: Rockford, IL
When you look at the politics and environment from when Ron started SE, there was no "movement" of activists to provide support. There was no private money, other than his own. By creating the public awareness that RK and then LASIK could go terribly wrong, the basis of the movement was created. His public awareness campaign started with people from inside the industry as well as outside. Ron had to "straddle the fence" to fund the movement, much like the anti-smoking movement needed tocacco money. I think of Ron kind of like the way I think of Bob Dylan. When you see Bob Dylan today, you see this restless old hillbilly living in seclusion with a shotgun trained at the door. When you listen to his poetry in song, it will last forever. When I think of Ron, I imagine him with long hair as well, still training that shotgun at the door... ;)

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 Post subject:
PostPosted: Mon Mar 20, 2006 11:16 pm 
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i think ron link honestly believed there would be solutions, but unfortunately the industry produced a surgery so vicious they cant fix the problems they created, not with any technology. that wasnt ron links fault. so the industry just kept churning out victims, and when the dust settled, ron link looked like the bad guy who had the industry in his sites and let them go.


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 Post subject:
PostPosted: Tue Mar 21, 2006 1:35 am 
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I used to get angry that Ron and SE didn't do more on the "prevention" side of the issue. But now when I think back, Ron had a right to do it his way. He started it. He always said if any of us didn't like the way he did it we should go out and start our own organization and do our own thing.

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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: Tue Mar 21, 2006 7:20 am 
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i dont think people are disappointed with ron link because he started a site to help people. i think people are disppointed that ron link couldnt shift gears when the writing was finally on the wall, and the numbers kept growing and growing, with no solutions forthcoming

when it became obvious that complications were epidemic, it completely undermined the legitimacy of surgical eyes as politically neutral ("se is not against refractive surgery blah blah). it lost its moral authority, and was abandoned by its constituency.

surgical eyes was doomed.

had lasik never been invented, though.................had prk evolved into wavefront lasek, then surgical eyes might now appear as the most rational approach to the industry and to rehab, and we would all be thanking ron link.


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 Post subject:
PostPosted: Thu Mar 23, 2006 11:09 pm 
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TotallyScrewed -

"Ron Link NEVER took a public stance against refractive surgery. I know many well informed casualties out there who feel that if Ron had taken a public stance against this industry, that maybe we would not be where we are today. "

I really don't want this to turn into a debate on SE or Ron, and I don't speak for Ron. But I have to take strong exception to your characterizations. My recollection of the early days of SE were very much "activist" with respect to creating awareness of all the casualties out there. And his work on that front was more effective than just about anyone since.

Ron did an unbelievable job on the media relations front in the first year or two of SE to get the word out on the problems with refractive surgery. Besides loads and loads of local news spots, there was quite a bit of national media, including a very large NY Times article, a Washington Post article, and a 20/20 feature spot. All of these, in my opinion, were very much driven by an activist anti-refractive-surgery approach from SE (i.e., Ron). And I think these very much got the word out about the evils of refractive surgery.

I haven't seen similar coverage since Ron left the movement. I'd like to know who has gotten more anti-RS coverage in the mainstream press than Ron did in the early days.

SE did shift gears at one point, and it was to narrow its focus on rehabilitation, away from activism, and towards a more neutral stance on refractive surgery. Again, I can't speak for Ron, but I believe this was about a few things, including focusing limited resources and wanting to actually do something to those of us who were suffering. In order to achieve this, Ron believed that it was important to have bridges to the refractive surgery community. (Again, I don't speak for Ron here and don't want to put words in his mouth.) Whether that was right or wrong, I believe it was driven by a sincere desire to try to help people who were suffering.

BTW, in the early days of SE I was able to turn away many RS candidates by pointing them to SE and to the various mainstream press articles that Ron made possible. Ron did more than anyone else at that time to shine the light on the industry's problems. To say we wouldn't be here if Ron had come out more strongly against refractive surgery is insulting to the hard work he put into all of this.

Sorry to turn this into an argument around the past. To try to turn this back into something positive: How do folks propose moving forward with getting the word out in an effective manner?

- Mitch


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 Post subject: Building an effective movement
PostPosted: Fri Mar 24, 2006 1:22 am 
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There are many bright, talented people on this BB. Organizing ourselves and making the best use of our talents as a team would be our best bet to effect change.

Looking for the next Ron Link likely isn't the answer, but we can learn from history. We can make room for different approaches and beliefs and link our websites so that we form a single online community. A shared bulletinboard that belongs equally to all members of this community is essential. There will always be differences of opinion, however when we disagree, we must do so in a civil and respectful manner.

Changes are coming that are certain to be galvanizing. Publishing documents that expose wrongdoing on the part of laser eye industry participants will go a long way toward ensuring that eye care professionals are indeed going about the business of 'caring' for eyes.

It will require a great deal of external pressure to build a momentum for change, and the team that will ultimately be capable of exerting this pressure is assembling right here on the flap.

Mitch, try turning away refractive surgery candidates by pointing them to the flap. Bet it will work!


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 Post subject: I never saw any of the media articles
PostPosted: Fri Mar 24, 2006 2:47 am 
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Mitch,
Unfortunately, I never saw any of the media articles. I was working full time and going to night school and doing homework so you can imagine that I was not watching too much tv. My husband stayed at home at night but he either went to bed early or watched sports on tv. After having my lasik surgery, I went back and checked the night that 20/20 was aired with Ron and it was my wedding anniversary, so my husband and i were not home. And somehow people did not discuss it at the office, I do not know why. As far as local, I am sure there was nothing local because it was about that time, 1999 or 2000 that several tv anchors had lasik done by a local surgeon who got a lot of publicity from that tv station. Amazing to me that you could work at a tv station and not be aware of the national news. At this point what is in the past is in the past and somehow we have to find a way to move forward with "getting the word out in an effective manner" like you say. If the media does not want to air Kathy Griffin's experience, how can we get the media to listen. We all need to start thinking out of the box. I do believe though that between the time Ron was able to get his information out and now, many doctors are now advertising heavily in newspapers, magazines and tv stations, so now we are also fighting the possible lost revenue if these newspapers and tv stations pick up our stories. It is quite a challenge, doable, I do not know how, but there has to be a way.


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 Post subject:
PostPosted: Fri Mar 24, 2006 5:15 pm 
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Elvira -

I agree! I don't watch much TV either, so I probably would not have seen it. The shame of it is that even high visibility media placements are often out-gunned by the relentless advertising of the lasik mills. It's hard to compete against radio ads every 30 minutes ...

- Mitch


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