Exposing the LASIK Scam

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 Post subject: Have you ever seen so much misinformation in one place?
PostPosted: Mon Jan 09, 2006 2:56 am 
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http://www.austin-eye.com/about_lasik.html

Unbelievable that no one has turned this center in for false advertising to the FTC.


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PostPosted: Mon Jan 09, 2006 3:01 am 
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http://www.ncbi.nlm.nih.gov/entrez/quer ... med_docsum

Eye Contact Lens. 2003 Oct;29(4):252-4.


Flap folds after femtosecond LASIK.

Biser SA, Bloom AH, Donnenfeld ED, Perry HD, Solomon R, Doshi S.

Ophthalmic Consultants of Long Island, Rockville Centre, NY, USA.

PURPOSE: To report a case of bilateral flap folds after a laser-assisted in situ keratomileusis (LASIK) procedure in which the flap was created by the femtosecond laser.

METHODS: Retrospective chart review.

RESULTS: A 43-year-old white woman underwent bilateral simultaneous LASIK. The corneal flap was created with the femtosecond laser. Postoperatively, the patient noted significantly decreased visual acuity, glare, and haloes. She was diagnosed with corneal flap striae, which were treated unsuccessfully with a lifting and stretching procedure, but responded to subsequent bilateral flap suturing.

CONCLUSIONS: Despite the increased accuracy in flap creation with the femtosecond laser, large flap folds may develop.


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PostPosted: Mon Jan 09, 2006 3:05 am 
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http://www.eyeworld.org/article.php?sid=2455

"Some surgeons may be unaware laser keratomes leave small areas of residual stroma that have to be broken when cutting a flap. ?I use the analogy of a perforated postage stamp that can usually be ripped down the middle but not always,? he said. ?I?m just trying to emphasize that although there is all of this marketing out there for laser keratomes, it is not without its downsides.? Ripped flaps also appear to occur much more often with laser keratomes..."


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PostPosted: Mon Jan 09, 2006 3:12 am 
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Quote:
Healing takes approximately one day.



No it doesn't. It never heals.


http://www.journalofrefractivesurgery.c ... hing=11320

Cohesive Tensile Strength of Human LASIK Wounds With Histologic, Ultrastructural, and Clinical Correlations

Journal of Refractive Surgery
Vol. 21 No. 5 September/October 2005

Ingo Schmack, MD; Daniel G. Dawson, MD; Bernard E. McCarey, PhD; George O. Waring III, MD, FACS, FRCOphth; Hans E. Grossniklaus, MD; Henry F. Edelhauser, PhD

PURPOSE
To measure the cohesive tensile strength of human LASIK corneal wounds.

METHODS
Twenty-five human eye bank corneas from 13 donors that had LASIK were cut into 4-mm corneoscleral strips and dissected to expose the interface wound. Using a motorized pulling device, the force required to separate the wound was recorded. Intact and separated specimens were processed for light and electron microscopy. Five normal human eye bank corneas from 5 donors served as controls. A retrospective clinical study was done on 144 eyes that had LASIK flap-lift retreatments, providing clinical correlation.

RESULTS
The mean tensile strength of the central and paracentral LASIK wounds showed minimal change in strength over time after surgery, averaging 2.4% (0.72 ? 0.33 g/mm) of controls (30.06 ? 2.93 g/mm). In contrast, the mean peak tensile strength of the flap wound margin gradually increased over time after surgery, reaching maximum values by 3.5 years when the average was 28.1% (8.46 ? 4.56 g/mm) of controls. Histologic and ultrastructural correlative studies found that the plane of separation always occurred in the lamellar wound, which consisted of a hypocellular primitive stromal scar centrally and paracentrally and a hypercellular fibrotic stromal scar at the flap wound margin. The pathologic correlations demonstrated that the strongest wound margin scars had no epithelial cell ingrowth?the strongest typically being wider or more peripherally located. In contrast, the weakest wound margin scars had epithelial cell ingrowth. The clinical series demonstrated the ability to lift LASIK flaps without complications during retreatments up to 8.4 years after initial surgery, correlating well with the laboratory results.

CONCLUSIONS
The human corneal stroma typically heals after LASIK in a limited and incomplete fashion; this results in a weak, central and paracentral hypocellular primitive stromal scar that averages 2.4% as strong as normal corneal stroma. Conversely, the LASIK flap wound margin heals by producing a 10-fold stronger, peripheral hypercellular fibrotic stromal scar that averages 28.1% as strong as normal corneal stromal, but displays marked variability. [J Refract Surg. 2005;21:433-445.]


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PostPosted: Mon Jan 09, 2006 3:36 am 
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http://www.osnsupersite.com

OCULAR SURGERY NEWS 10/1/2004

Transient light sensitivity a minor complication of IntraLase use

Excerpt:

Some users of the IntraLase femtosecond laser keratome first noticed the complication when they began working with the system more than 2 years ago. Since then, the phenomenon has gone under multiple names.

?Patients would walk into the office with two pairs of sunglasses on and a baseball cap,? said Brian R. Will, MD, director of Will Vision & Laser Centers in Vancouver, Wash. ?No one knew what to make of the symptoms ? light sensitivity, preserved visual acuity and no slit-lamp findings.?

Dr. Will coined the term track-related iridocyclitis and scleritis (TRISC) syndrome to describe the condition he thought was due to gas bubbles and debris migrating toward the limbus during LASIK with IntraLase.

Karl G. Stonecipher, MD, another early user of IntraLase, called the syndrome good acuity plus photophobia (GAPP). ?It?s similar to the late-onset inflammation we once saw with PRK,? Dr. Stonecipher, of Greensboro, N.C., told Ocular Surgery News. He believed that the inflammation was due to activated keratocytes in the interface.

As time passed, speculation grew among users. Surgeons became concerned about the cause and identity of the rare aftereffect of IntraLase flap creation.

?It was scary when we didn?t know what it was ? frightening to the surgeon and the patient,? said Daniel S. Durrie, MD, director of Durrie Vision in Overland Park, Kan.

In July, IntraLase surveyed users of its system and discovered that the apparent photophobia phenomenon was unique to LASIK cases using IntraLase for creation of the flap.

?Transient light sensitivity, or TLS, is the term coined by IntraLase to describe the complication,? Dr. Durrie said.


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PostPosted: Mon Jan 09, 2006 3:44 am 
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Am J Ophthalmol. 2004 Oct;138(4):657-9.

Macular hemorrhage after laser in situ keratomileusis (LASIK) with femtosecond laser flap creation.

Principe AH, Lin DY, Small KW, Aldave AJ.

Cornea Service, Jules Stein Eye Institute, University of California Los Angeles Medical Center, Los Angeles, California 90095, USA.

PURPOSE: To report the first case of macular hemorrhage following laser in situ keratomileusis (LASIK) with femtosecond laser flap creation.

DESIGN: Observational case report.

METHODS: A 36-year-old woman underwent uncomplicated, bilateral, simultaneous LASIK procedures for correction of moderate myopia (-5.00 diopters OD and -6.00 diopters OS). LASIK flap creation was performed using the IntraLase femtosecond laser.

RESULTS: On postoperative day 1, the patient's uncorrected and best-corrected visual acuities were 20/20 OD and 20/40 OS. A dilated fundoscopic examination revealed a one-third disk diameter macular hemorrhage OS. An intravenous fluorescein angoiogram ruled out the presence of predisposing macular pathology. Two months after LASIK, the macular hemorrhage had cleared, and 6 months later, the BCVA improved to 20/25 OS.

CONCLUSIONS: Macular hemorrhage may occur after LASIK, even in the absence of previously identified risk factors, such as high myopia, pre-existing choroidal neovasculaization, lacquer cracks, and sudden changes in intraocular pressure associated with microkeratome-assisted flap creation.


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PostPosted: Mon Jan 09, 2006 3:46 am 
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http://www.ophmanagement.com/article.aspx?article=86298

IntraLase: Changing the LASIK Landscape

Excerpt:

Though the exact cause of TLS is still uncertain, some surgeons believe that the inflammation is caused by necrotic cellular debris, a byproduct of the gas bubbles that are formed to create the flap. Others speculate that the cause may be inflammatory cykotines migrating from the flap interface and sidewall to the perilimbal sclera and iris base.


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PostPosted: Mon Jan 09, 2006 3:58 am 
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J Cataract Refract Surg. 2004 Jan;30(1):26-32

Flap dimensions created with the IntraLase FS laser.


"Two slipped flaps and 20 cases of interface inflammation occurred early in the series".


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PostPosted: Mon Jan 09, 2006 3:38 pm 
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Bill wrote:
Unbelievable that no one has turned this center in for false advertising to the FTC.


If you turn them in to the FTC, I doubt that you will get anywhere by reciting a littany of studies. You would probably be more effective if you quoted excerpts from the web site, and dispute each excerpt.


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PostPosted: Mon Jan 09, 2006 11:23 pm 
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Archives of Ophthalmology

Volume 123(2), February 2005, p 265-266

Refractive Surgery and Cornea: The Never-Ending Spiral of Technology

Excerpt:


"Disadvantages of using a femtosecond laser are greater early postoperative
corneal inflammation, including flap margin diffuse lamellar keratitis and
central keratitis noted by many surgeons, including the authors. This increase
in inflammation is likely due to the rupture of far greater numbers of
epithelial cells at the flap margin with a femtosecond laser than with the
microkeratome, resulting in the release of high levels of proinflammatory
cytokines."


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