Directory:LASIK Eye Surgery
LASIK Eye Surgery - an Injured Patient's Experience with the LASIK Industry, 1998-2007
WARNING: Ultraviolet Radiation Burns for Sale
Table of Contents.
1. Constant Eye Pain after LASIK.
2. Counting the Casualties.
3. LASIK Surgeons Lie to Close the Sale -- Deceiving Patients as a Standard Business Practice. The 4 Standard Lies:
- The Cornea "Heals" (it doesn't -- not by the normal person's definition of the word heal).
- LASIK is "Safe" (some patients are disabled, some have constant eye pain, some literally go blind ... the LASIK Surgeons still say it's "Safe")
- "Excimer Laser Radiation Doesn't Hurt the Cornea" ( It does hurt the cornea -- just do a web-search using the terms "Ultraviolet Radiation Burn Eye")
- "You will be protected from a Bad Outcome if you have an Experienced Surgeon". (Wrong. Most of the patient casualties I've documented had very experienced surgeons.)
4. Ultraviolet Radiation Burns -- in the Eye. To perform LASIK, the surgeon uses a high power pulsed Laser -- that Vaporizes Corneal Tissue at the Rate of 7.5 Cubic Inches per Second.
5. Injured Patients are Bad for Sales -- Top LASIK Surgeon Alters Clinical Trial Results; TV Reporter Admits that Advertisers Objected to News Coverage of Injured LASIK Patients.
6. Surgical Debris Embedded in Your Cornea -- occurs in all LASIK patients, admits one top LASIK Surgeon.
7. LASIK Surgeons Create an Epidemic of Corneal Disease -- 50,000 Old People with Constant Eye Pain (or will it be 100,000 ?)
8. Patients hurt by All-Laser LASIK.
9. Quotable Quotes -- "We could always sew her eyelids halfway shut" -- said Manche, the head of Refractive Surgery at Stanford, referring to a patient living with constant eye pain after LASIK.
10. Old LASIK vs. New LASIK
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LASIK COMPLICATIONS WEB SITES
~ list provided by Elvira, Websites Created for & by Patients ~
http://www.tlcbigskylasercenter.com/
http://www.eyefordesign.com/lasik.html
http://www.visionsimulations.com/
http://www.lifeafterlasik.com/
http://www.geocities.com/pifanon/
http://home.comcast.net/~joewills/LASIKSTORYKEITH.html
http://www.kathygriffin.net/lasik.php
http://www.visionsurgeryrehab.org/
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<== Introduction ==>
This is not an advertisement. This website contains information of a medical and technical nature, regarding the surgical procedure known as "laser eye surgery."
1. Eye Pain after LASIK.
Yes, it happens.
As I write this, it feels like I have a big piece of dirt in my left eye. Frequently I also have a burning, stinging, aching, and/or itching sensation in my left eye. This is true 24 hours a day, 7 days a week.
Each morning, I take 100 milligrams of Ultram, for eye pain. Each afternoon, I close my eyes, to reduce the eye pain. I spend about 8 hours a day listening to books on tape. Though my condition is categorized by some "doctors" as "Dry Eye Syndrome", eye drops don't help.
Before LASIK, I read voluminously, and had no eye pain.
Eye pain after LASIK is a reality for thousands of patients. The 1998 CRS-USA study, one of the largest studies done to date, involving 1800 eyes, found a .5% rate of chronic eye pain & discomfort after LASIK. Over 2 Million people have had LASIK. About 10,000 of those LASIK patients now live with constant eye pain.
I live with constant eye pain myself, and my surgery was performed by one of the most experienced LASIK surgeons in San Diego -- Michael Gordon.
Here is my plea for help for another patient -- http://www.lasiksos.com/worst-case.htm
This is a real person, a woman who lived a very active life before LASIK. Roller-blading in the mornings, volleyball league in the evenings. A President's Award for Outstanding Performance in Customer Service the week before her LASIK surgery. Her last day at work ? The Tuesday after her LASIK surgery.
The name of her LASIK surgeon ? Thomas Tooma -- one of the most experienced refractive surgeons in Southern California.
The woman lives with bags of ice on her eyes, for the pain. She's seen over 20 doctors. She is unable to work. Light hurts her eyes. Her eye pain started the day of her LASIK surgery. She has lived like this since early in 1999.
Is there a Doctor in the House ?
Early in 2001, it was discovered that this patient has large quantities of metal dust embedded in her corneas. She was not born with metal dust in her corneas. The only time that I can think of when metal dust could have been deposited in her lamellar interface -- below the flap -- is at the time the flap was cut -- at the time of her laser eye surgery.
2. Counting the Casualties.
Partial List of Michael Gordon and Perry Binder's LASIK casualties http://users.tns.net/~equity/LASIK_Casualties_SD
Partial List of Robert Maloney's LASIK casualties http://users.tns.net/~equity/LASIK_Casualties_LA
Partial List of Thomas Tooma's LASIK casualties http://users.tns.net/~equity/LASIK_Casualties_OC
Partial List of Glenn Kawesch's casualties -- the URL is long, starting with "http" and ending with "rnum=5" --
Gordon, Binder, Maloney, Tooma, and Kawesch are 5 of the most experienced LASIK surgeons in California.
Gordon himself is responsible for the early retirement and disability of at least 2 San Diegan's, whose cases are described here -- http://users.tns.net/~equity/LASIK_Casualties_SD/cah.htm http://users.tns.net/~equity/LASIK_Casualties_SD/brattvgordon.htm
Thousands of laser eye surgery patients have asked and are asking for help with their post-surgical complications at a number of on-line forums. Some of those forums have been discontinued.
Current Forums. 1. The LASIK Flap website Forums. http://www.theLASIKFlap.com/forum 2. The Vision Surgery Rehab Network http://www.visionsurgeryrehab.org/ 3. USENET newsgroups "sci.med.vision" and "alt.lasik-eyes", from before 2002. Archives exist. http://groups.google.com/groups?q=sci.med.vision&ie=ISO-8859-1&hl=en http://groups.google.com/groups?q=alt.lasik-eyes&ie=ISO-8859-1&hl=en
Discontinued Forums, which further document the existence of LASIK Casualties. Archives of these websites exist. 1. Surgical Eyes. The URL was http://www.surgicaleyes.org/ 2. Ask LASIK Doctors, operated by refractive surgeon William Trattler. The URL was http://www.askLASIKdocs.com/ 3. Chicago Laser Center, operated by refractive surgeon Gerald Horn.
3. LASIK Surgeons Lie to Close the Sale
Michael Gordon performed my own LASIK surgery. My finding from speaking to hundreds of other injured patients is that most other LASIK surgeon tell lies similar to those told by Michael Gordon.
A) During a pre-op consultation, I asked Michael Gordon a question about LASIK, tantamount to the inquiry, "OK, what's the downside of this here LASIK, Doc ?" Michael Gordon responded, "Well, I've had laser surgery, and I use a few eye-drops every now and then." There's only one thing -- at that time, Michael Gordon had had PRK, not LASIK -- at least, according to his own website, I later discovered. PRK does not involve a micro-keratome cut - the first half of a partial corneal transplant. The first half of LASIK is like the first half of a partial corneal transplant - a cut is made through the stroma, the middle layer of the 5 layers of the cornea. In LASIK, the cut stops just short of a complete cut. What's left is called the "flap." In a partial corneal transplant, the cut is all the way through. The flap is cut completely off. At the time, I didn't know that. I thought Michael Gordon was answering my question about LASIK by describing his experience with LASIK. He didn't. He deliberately answered my question about LASIK by describing his experience with PRK. That was Lie #1 that Michael Gordon told, when he was trying to sell me LASIK surgery.
B) I also asked Michael Gordon if the human eye is susceptible to damage from UV Radiation. He said the human eye is not susceptible to damage from excimer laser radiation. That was Lie #2 -- a simple Google Search using the search terms, "Ultraviolet Radiation Burn Eye" will make it very clear that the human eye is susceptible to damage from ultraviolet radiation, including C-band ultraviolet radiation.
C) Lie #3 -- Michael Gordon said the cornea heals. Specifically, his staff said the cornea heals within a week. "Good enough to go body-surfing ?", I asked. "Yes", was the reply. What Michael Gordon and his staff do not reveal is that, when they say the cornea "heals", they are using their own unique version of the term "heal". In their definition of the word, a surgically-created wound can be healed -- and then easily opened up 3 months or six months post-op, to perform an enhancement. Or, the flap heals ... but some patients with "healed" flaps also live with constant eye pain. To quote Corneal Surgeon Lee Nordan, as stated in a meeting with a patient named Sandy Keller, "Oh, you can lift the flap a hundred times, no problem." Now, I think Nordan may have been exaggerating when he said the flap can be lifted a hundred times. The bottom line is, the flap does not heal, using a normal person's definition of the term "heal". If "Doctor" Gordon had said, "In my definition of the word heal, you can have constant eye pain, and I can lift the flap months and years into the future to vaporize some more corneal tissue, and I will consider you healed", he would have been more honest.
D) Lie #4, "LASIK is Safe". That all depends on the definition of the word "safe", doesn't it ? For an interview with the La Jolla News in 2002, Gordon's business partner, "Doctor" Binder stated that "LASIK is safe". That interview was partially about my own surgical outcome, whereby I am left with constant eye pain, at that time, 3 1/2 years post-op. If "Doctor" Gordon and "Doctor" Binder had said, "In my definition of the word safe, you can have constant eye pain, and I will still say that LASIK is safe", they would have been more honest.
E) Lie #5 -- that you will be "protected" if your surgery is performed by a highly experienced refractive surgeon. Not true. I have spoken, emailed, and met with over a hundred patients that have experienced corneal disease and degraded vision following their own LASIK surgeries. Most of their surgeries were performed by highly experienced refractive surgeons.
4. Ultraviolet Radiation Burns -- in the Eye.
To perform LASIK, the surgeon uses a high power pulsed Laser -- that Vaporizes Corneal Tissue at the Rate of 7.5 Cubic Inches per Second.
Would you stare at the sun ? I hope not.
Would you stare at an Ultraviolet radiation source that is at least 38% -- or 84% -- brighter than the sun, ON AVERAGE ? That's what the LASIK surgeon is asking you to do.
According to the specifications that Bausch & Lomb, and VISX, have given to the FDA, their ophthalmic lasers -- the lasers used during laser eye surgery -- have a "fluence", respectively, of .774 and 1.032 watts per square inch. (References 1, 2, 3)
At sea level, on a very, very bright day, as much as .56 watts per square inch reaches the skin - or eyes - of the person laying in the sun at the beach. (Reference 4)
In other words, it is typical, during laser eye surgery, to stare at a radiation source which is brighter than the sun. The sun emits "broadband radiation" -- in the infra-red, visible, and ultraviolet spectrums. The laser used in laser eye surgery emits mostly 193 "nanometer" radiation. Ultraviolet, C Band, radiation. The kind of radiation which the atmosphere filters out. The kind of radiation we seek protection from when we put "SPF 30" sun-block on our skin, or "UV-protected" sunglasses on our eyes.
Is the human cornea vulnerable to damage from Ultraviolet radiation ? Yes it is, as described below. The first step in collecting this information is a simple web-search using the terms "Ultraviolet Radiation Burn Eye". http://www.google.com/search?hl=en&ie=UTF-8&oe=UTF-8&q=ultraviolet+radiation+burn+eye
Both the Bausch & Lomb ophthalmic laser and the VISX laser are "pulsed" ultraviolet lasers. The Bausch & Lomb Technolas 217 is "on" for .000000225 seconds, or .000000900 seconds, out of every second. The VISX Star S2 is "on" for .000000100 seconds, out of every second. In engineering terms, this relates to what is what is known as "duty cycle".
During a typical laser eye surgery, a section of corneal tissue 8 millimeters in diameter, 80 microns thick, is removed. First, let's translate that into English units: 8 millimeters = 8 x .03937 inches = .315 inches -- about a third of an inch. 80 microns = .080 x .03937 inches = .00315 inches -- about the thickness of a piece of 20-weight Xerox paper. And the ophthalmic laser is on, at most, .000000900 seconds out of every second. (Reference 2)
To get an idea of the power of this laser -- it's ability to slice through Flesh, Blood, and Bone -- let us ask a simple question: what would happen if the patient was exposed to a radiation source of this intensity, and it was continuous, not pulsed ? To make the calculations easier, and more conservative, let's round the duty cycle off, from .00000090, to .000001. A duty cycle of one-millionth. If this radiation source were left on continuously, for the duration of a typical laser eye surgery performed on just one eye, it would vaporize approximately this much soft tissue: a volume about 10 inches in diameter. 3.15 inches deep. Tapered around the edges. In less than a minute. (Reference 5)
That's a powerful laser. If it were left on continuously, it would photo-ablate a volume of soft tissue (eye tissue and brain tissue, for example) about the size of an adult human's head -- in under a minute. In short, the Bausch & Lomb, VISX, Nidek, and Summit/LADAR-Vision Ophthalmic lasers used to perform laser eye surgery are not just pulsed ultraviolet lasers. They are high-powered, pulsed, ultraviolet lasers.
Many of the laser eye surgery patients with whom I have spoken describe 2 specific symptoms: A foreign-body sensation in the eye, and a painful sensitivity to bright lights. Both of these are treated topically, and temporarily, by applying eye-drops, and by wearing sunglasses. Many laser eye surgery patients -- even patients with "positive outcomes" -- in fact, have these 2 symptoms during the early post-op period, and then the symptoms diminish over time, as the tissue of and around the eye heals from the trauma of the surgery. For some, the symptoms do not attenuate, over time. For some, the symptoms escalate, over time. I find that my own symptoms fall in this latter category. 5 years, and 2 month2, at the time of this writing.
Following are the symptoms described by an occupational safety health organization in Canada - the symptoms associated with the use of an arc-welder which emits significant amounts of Ultraviolet-C band radiation. The symptoms are identical to the symptoms experienced by many LASIK patients, and identical to the symptoms experienced by some LASIK patients. What do these 2 groups of people -- arc welders and LASIK patients -- have in common ? Exposure to extreme amounts of ultraviolet radiation.
- pain - ranging from a mild feeling of pressure in the eyes to intense pain in severe instances
- tearing and reddening of the eye and membranes around the eye
- sensation of "sand in the eye" or abnormal sensitivity to light, and
- inability to look at light sources (photophobia)." (References 6, 7, 8, 9)
And, what does the occupational safety health organization in Canada recommend for persons who used insufficient eye protection while operating an arc-welder ? Eye-drops.
5. Injured Patients are Bad for Sales -- Removing Bad Outcomes from Clinical Trial Results; Putting the Kibosh on News Coverage of Injured LASIK Patients.
Simply put, we injured patients are bad for business. Very few people would ever submit to laser eye surgery if they knew the full breadth and extent of patients injured, disabled, crippled, and blinded by the refractive surgery profession.
<== Did "Doctor" Thomas Tooma Alter the Results of a Clinical Trial ?? ==> The patient previously referred to -- the patient with the constant eye pain, and the metal dust embedded in her corneas, was told that their LASIK surgery was part of a clinical trial. That clinical trial was conducted in conjunction with Loma Linda University. When we called the clinical trial administrator at the university to request a copy of the record of that patient's participation in that clinical trial, we were told that there was NO RECORD of that patient's participation in that clinical trial. In my opinion, the logical explanation for this is that Doctor Tooma removed that patient's record from the records of that clinical trial. Subsequently, given that that patient's surgery was allegedly performed using a Technolas 116 and that Technolas is owned by Bausch & Lomb, I perused the Bausch & Lomb literature. Lo and behold, there's Doctor Tooma himself in a recent Bausch & Lomb annual report. Now, I'm a design engineer -- you know, one of those people who enjoyed calculus classes in high school. I know that equipment manufacturers loan expensive equipment to potential customers -- in this case, laser eye surgeons. I'm also a human being. And common sense tells me that you don't get your picture in an annual report by being loaned an expensive ophthalmic laser workstation, and using it to cripple a patient. You can, however, get your picture in an annual report by borrowing the surgical workstation, and reporting back that "it works great" -- even when it most clearly doesn't.
<== KWSB-TV Reporter Admits that Advertisers Objected Strongly to News Coverage of Injured LASIK Patients ==>
I have placed the initial email below (Reference 10). What follows is a transcript of a message that KSWB reporter Darlynne Reyes left on my answering machine, approximately May 22, 2003
"Hey Roger it's Darlynne Reyes calling from KSWB Thanks for ... uhh ... returning my call I appreciate that and ... uh ... actually it's kind of funny that you would leave that message for me as far as ... uh ... you being curious what our advertisers would say because ... uh ... (laughter) when you had left me that message I talked to my news director and ... uhh ... that's actually ... uhhh ... exactly what she talked to me about and apparently we have done this story before I came on board here and ... uhh ... there was actually some ... uh ... big problems with the piece (laughter) so unfortunately I guess I will not be doing this piece ... uhhh ... for next month even though i had hoped to and (in-audible) Doesn't seem like it's in the cards ... oh well ... thank you so much Roger and ... uhh ... I appreciate it and ... uhh ... maybe we'll work together on some other type o' story in the meantime thanks for returning my call OK talk to you later bye bye."
6. Surgical Debris Embedded in Your Cornea -- occurs in all LASIK patients, admits one top LASIK Surgeon.
In fact, Ultraviolet radiation burns -- in the eye -- are not the extent of the damage frequently associated with laser eye surgery.
Many laser eye surgery patients are left with surgical debris embedded in their cornea.
Following is an excerpt of an email I received from Doctor Robert Maloney, one of the more experienced laser eye surgeons in Los Angeles. The email is re-printed in its entirety in the 'References' section (Reference 11)
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"Recent clinical studies show that everyone has microscopic debris, and as you well know, most people do not have symptoms of your severity." (email received Feb. 20, 2003)
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As is evident from reading the excerpted email, the debris which Doctor Maloney says is embedded in patients' corneas after LASIK surgery is conveniently considered to not cause pain, in the cases of patients that do have significant post-op eye pain, such as myself.
I have spoken to another patient, who has stated affirmatively that they have a metal sliver in their cornea, which is large enough that they can see it themself in the bathroom mirror. A result of their own LASIK surgery, also performed by a "top" laser eye surgeon in Southern California.
How much eye pain does the patient with the metal sliver have ? Good question.
Would you like to participate in the Experiment ? (Reference 12)
7. Corneal Surgeons Create an Epidemic of Corneal Disease -- 50,000 Old People with Constant Eye Pain (or will it be 100,000 ?)
Every experienced LASIK Surgeon in Southern California now has hundreds of patients who have undergone a procedure known as "punctal occlusion."
There's a reason people don't go out to night clubs or state fairs for punctal occlusion. It's not fun.
Punctal occlusion refers to the process of inserting plugs -- or cauterizing shut -- the lacrimal tear ducts which drain tears from the surface of the cornea. Thereby, the tears don't drain, and the patient experiences less discomfort. Why do patients undergo punctal occlusion ? Because they are experiencing corneal discomfort -- or corneal pain. Most of those patients are in their 30's, 40's, and 50's.
What will happen as those patients age ? Their dry eye discomfort will escalate. A simple web-search using the terms "dry eye old" will verify this. National Institutes of Health http://www.ncbi.nlm.nih.gov/PubMed/ United States Food & Drug Administration http://www.fda.gov/search.html Slack Inc., Publisher of the Journal of Refractive Surgery and similar quasi-medical magazines. http://slackinc.com/
The connection between LASIK and dry eye is not a secret in the ophthalmological profession. Ocular Surgery News Special Meeting Report December 15, 1999 "At this year's meeting, there was an emerging recognition of an important complication of LASIK -- postoperative dry eye." "Severe vision loss after LASIK is now a rare occurrence." "However, he said, dry eye is being seen with increasing frequency, is making patients very unhappy, and must be recognized and treated aggressively."
In 2002, Allergan -- the eye-drop company -- co-sponsored a LASIK sales seminar with the Long Beach Laser Center. Now, why would an eye-drop company promote a surgical procedure that causes patients to consume vast quantities of eye-drops ?
This brings us to a fact about LASIK surgery which the LASIK Surgeons have been working very hard to avoid publicizing -- LASIK causes corneal disease.
In other words, the frequency of corneal disease in the general population of persons below the age of 45 -- the population of persons who have not had RK, PRK, or LASIK -- is less than 1 in 2000. In this context, "corneal disease" is defined as a condition which causes the disabling of a patient -- the inability to read late at night, for example, without eye pain.
The frequency of corneal disease in the population of persons below the age of 45 who have had LASIK is 1% or greater. In other words, LASIK increases the probability of disabling corneal disease by at least a factor of 20.
Just as smoking increases the probability of cancer and emphysema, having a "doctor" vaporize your cornea using a high-powered laser drastically increases your chances of having a diseased cornea. Of course, the LASIK "doctors" say that it's all a big coincidence -- at least when they're being deposed in conjunction with a medical malpractice trial.
8. Patients hurt by All-Laser LASIK.
The same "doctors" that said that "LASIK is Safe" now say that a new experimental technique, all-laser LASIK, is "safer." Given that these "doctors" have already demonstrated that they can not be trusted to hold a new-born baby -- which is about how fragile our corneas are -- there claim that all-laser LASIK, also known as "Intra-LASIK", is safer, is quite dubious. After all, these are the same "doctors" that falsify clinical trial results -- the same doctors that routinely lie to close the sale.
I am in possession of an email from a Boston-area patient who is experiencing continued eye-pain 1 1/2 months after their initial surgery, which was performed using the Intralase laser to cut the flap, and an ophthalmic laser to perform the ablation.
To quote brief excerpts from that patient's recent emails, they are experiencing a "foreign body sensation" in the eye, eye "pain", and a feeling of "pressure" in the eye" -- the exact symptoms of an Ultraviolet Radiation Burn. After all-laser eye surgery.
My feeling is that the laser eye surgery industry needs to mobilize itself to help this patient, and all other injured laser eye surgery patients.
Additionally, the experience of one of Thomas Tooma's patients is represented online at this URL: http://users.tns.net/~equity/LASIK_Casualties_OC/NavTooma.htm
That patient is now blind in one eye. They experienced a broken major blood vessel in the eye -- shortly after their own LASIK surgery. The broken blood vessel is believed to have occurred because of the tissue trauma induced by the suction ring (the device used to immobilize the eye) and the speculum (the device used to move the eyelid out of the way.) During "all-laser eye surgery", both the suction ring and the speculum are used. In other words, what happened to Tooma's patient, the human being associated with Orange County case #01CC06832, can happen to any all-laser eye surgery patient.
So, too, are all laser eye surgery patients vulnerable to the damaging effects of Ultraviolet Radiation, which is known to be both carcinogenic (causing cancer) and cataractogenic (causing cataracts) (References 6, 7, 8, 9)
STOP !!! Hold the presses !! More news about IntraLASIK -- "Intralase FS Laser Recalled by FDA" Enforcement Report for August 27, 2003
So, let me see if I have this straight ... all-laser LASIK is safer than LASIK ... except that the laser keratome used in all-laser LASIK was recalled by the manufacturer during the third quarter of Calendar Year 2003. Got it ?
9. Quotable Quotes -- things LASIK Surgeons say to Injured Patients.
To get an idea of the kind of follow-up care that a person injured by LASIK can expect from practicing LASIK surgeons, I believe it is useful to look at some of the "quotable quotes" -- offhand comments made by these "doctors".
In the year 2000, I called "Doctor" Manche, the head of Refractive Surgery at Stanford, to ask for help with one of Tooma's patients, we first ran down a laundry list of "standard remedies" -- eye-drops, punctal occlusion, occlusive goggles, and so on. He then said, "We could always sew her eyelids halfway shut." He wasn't kidding. He was serious.
He then went on to perform more LASIK surgeries, knowing ahead of time that he was dooming some patients to a corneal condition for which the best treatment he has to offer is -- to sew their eyelids halfway shut.
I call that reckless endangerment.
There are a few lists of Quotable Quotes at the LASIK Flap Forums - http://thelasikflap.com/forum/viewtopic.php?t=40 http://thelasikflap.com/forum/viewtopic.php?t=102 http://www.thelasikflap.com/forum/viewtopic.php?t=368
10. Old LASIK vs. New LASIK
Since putting up this website in 2003, I have received LOTS of emails, and met some very good people. Whose eyes, unfortunately, have been damaged by LASIK.
As it turns out, 2 of the people I've met recently - people whose eyes were very significantly damaged by LASIK - had their surgeries in 2004.
One of those injured patients is actively couseling patients who had bad outcomes from LASIK surgeries performed in 2005, 20006, and 2007.
In 2004 Allergan sold $100,000,000 worth of Restasis - 200,000 bottles of eyedrops that retail for $100 a bottle.
Why would anybody spend $100 on a bottle of eye drops ? People with Dry Eye Syndrome after LASIK eye surgery.
Allergan's Restasis sales have increased since 2004. Why are so many people spending $100 on a small bottle of eye-drops ?
In approx. 4th Quarter 2002 Allergan co-sponsored a LASIK sales seminar with Long Beach Laser.
Why would an eye-drop company sponsor a sales seminar for an elective surgery that turns patients into volume consumers of eye-drops ?
I cite Allergan's booming Restasis sales as one example of the size of the epidemic of corneal disease being created by the LASIK industry. Including both groups of patients, those who had "Old LASIK", and those who had "New LASIK".
In 2006 I met a Psychiatrist at a public gathering. We talked about LASIK. He stated that he was having more and more patients who are coming to see him because they are having troubles coping with a bad outcome from LASIK eye surgery.
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I hope this website is helpful to you.
If you are an injured LASIK patient and you are in the process of coming to grips with your condition, some of the information presented here may be very upsetting.
In 1999 I called a retired Stanford Doctor and Professor, who was the head of Pulmonary Surgery at Stanford. I asked him to tell me what he knew about LASIK. He said, "I can't, because I'm afraid it will upset you." I believe that I have learned most or all of what he may have had to say, if he was willing to talk about his refractive surgeon colleagues.
I know Dr. Robbins worked around the clock for 11 days to help my grandmother when she had an aortic aneurysm in 1984. My own mother, also a Stanford grad, was his secretary in the early '80's. When I called him in 1999, I'm sure he did what he thought was best.
At that time, he himself was about to have a major surgery. He told me it was the kind of surgery that was serious - that he might not be available to talk afterwards. He was not available afterwards.
For any injured LASIK patient who is in distress, I suggest going to the forums at the LASIK FLap, which is run by and for injured LASIK patients.
I have seen 15+ doctors about my own LASIK complications. I have a friend who has seen 25+doctors about their own LASIK complications. Both of us have found that other injured patients are far more honest and forthright about the subject of LASIK complications, than are most of the doctors we have asked for help.
Sincerely,
~ Roger ~
Roger E. Bratt
Copyright 2003 Roger E. Bratt -- All Rights Reserved.
REFERENCES.
( Reference 1 ) Bausch & Lomb FDA Filing for the Technolas 217 Ophthalmic Laser Laser Wavelength 193 nm Laser Pulse Duration 18 nanoseconds Laser Head Repetition Rate 50 Hz Effective Corneal Repetition Rate 12.5 Hz Fluence (at the eye) 120 mJ/cm2 Range of Ablation Diameter 2.0 to 2.05 mm http://www.accessdata2.fda.gov/Google/fda_search.pl?client=fdagov&site=fdagov&restrict=&searchselector=&q=Technolas+217 Search yielded a document named "P990027S002b.doc" when performed June 7, 2003. Ref. http://www.fda.gov/search.html These numbers give 2 options to derive peak power from average power - does the laser fire 12.5 pulses at the patient's eye every second, or 50 pulses ? I emailed Bausch & Lomb asking for technical input; this matter has not yet been clarified. Therefore I shall perform the calculations for both cases.
( Reference 2 ) Translating from milli-watts per square centimeter to milli-watts per square inch
Power for lasers is frequently expressed using an energy term (joules), instead of a power term (watts).
120 mJ/cm2 ==> 120 mW/cm2
Radiation Source: Bausch & Lomb Technolas 217
Laser Eye Surgery Laser CW (continuous wave) or pulsed ? : Pulsed
Duty Cycle: .000000225, 12.5 pulses per second ... each pulse is 18 nanoseconds long
"Fluence", Power Density of laser beam: 120 milli-watts per square centimeter - 774 milli-watts per square inch - about 3/4 of a watt per square inch.
Power Density: .774 watts per square inch, about 3/4 of a watt per square inch. Peak Watts per Square Inch, if the 120 milli-Joules specification is a physical average: 3,440,000 Average Watts per square inch for the sun, term used in comparison with excimer laser: .56 watts per square inch Beam Width: 2 millimeters, about 1/ 12 of an inch
Radiation Source: Bausch & Lomb Technolas 217 Laser Eye Surgery Laser CW (continuous wave) or pulsed ? : Pulsed Duty Cycle: .00000090, 50 pulses per second ... each pulse is 18 nanoseconds long. Power Density: .774 watts per square inch, about 3/4 of a watt per square inch. Peak Watts per Square inch, if the 120 milli-Joules specification is a physical average: 860,000 Average Watts per square inch for the sun, term used in comparison with excimer laser: .56 watts per square inch Beam Width: 2 millimeters, about 1/ 12 of an inch
( Reference 3 ) VISX FDA Filing for the Star S2 Ophthalmic Laser
http://www.fda.gov/cdrh/pdf/p930016s014b.doc
V. DEVICE DESCRIPTION A. Laser System "The device used in the clinical study was the VISX STAR S2 Excimer Laser System for which a full description can be found in the SSED for supplement 7. The excimer is an argon-fluoride laser that generates pulses at 193 nm wavelength. The output of the excimer laser also has the following characteristics: fluence of 160 mJ/cm2; 20 nanoseconds pulse duration; and, pulse repetition rate of up to 10 Hz."
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Power for lasers is frequently expressed using an energy term (joules), instead of a power term (watts). 160 mJ/cm2 ==> 160 mW/cm2 160 mW/cm2 = 1032 milli-watts per square inch Average Watts per square inch for the sun, term used in comparison with excimer laser: .56 watts per square inch = 560 milli-watts per square inch The stated "fluence" for the VISX laser is approximately 84% greater in magnitude than the radiation that your body receives from the sun, when you're sitting at the beach on a very bright day.
( Reference 4 ) Radiation Source: The Sun
CW (continuous wave) or pulsed ? : CW
Duty Cycle, daytime: 100%
Average Watts per square meter, in outer space: 1367
http://stratus.ssec.wisc.edu/streamer_web/userman/solar.html
Amount of radiation filtered out by the atmosphere: 51%
http://www.geog.ouc.bc.ca/physgeog/contents/7f.html
Average Watts per square meter, on the average beach: 697
Average Watts per square foot, on the average beach: 65
Average Watts per square foot, term used in comparison with excimer laser: 80
(Note: one of the goals of the analysis is to express the ratio as conservatively as possible, that is, to not over-state the ratio when comparing the ophthalmic excimer laser to the sun.)
Average Watts per square inch, term used in comparison with excimer laser: .56 watts per square inch
Frequency Spectrum of the Sun: Broadband - Infrared, Visible, Ultraviolet
( Reference 5 )
The area of a surface varies with the square of the radius. To increase the area by a factor of 1000, the radius is increased 31.6 times.
( Reference 6 ) Canadian Center for Occupational Health Safety (CCOHS)
"Occupational Safety Guidelines regarding Exposure to Ultraviolet-C Band Radiation during Arc Welding."
"Certain types of UV radiation can produce an injury to the surface and mucous membrane (conjunctiva) of the eye called "arc eye," "welders' eye" or "arc flash." These names are common names for "conjunctivitis" - an inflammation of the mucous membrane of the front of the eye. The symptoms include
· pain - ranging from a mild feeling of pressure in the eyes to intense pain in severe instances,
· tearing and reddening of the eye and membranes around the eye, · sensation of "sand in the eye" or abnormal sensitivity to light, and · inability to look at light sources (photophobia)."
( Reference 7 ) Thomas Jefferson National Accelerator Facility, in Virginia --
http://www.jlab.org/ehs/manual/EHSbook-465.html
"Cornea An important function of the cornea is to focus light. Damage to the cornea is caused by exposure to ultraviolet and far infrared radiation. The cornea is most susceptible to damage from ultraviolet light. Over exposure to ultraviolet burn light can cause photokeratitus (also known as Welder's flash, arc eye, snow blindness). Signs of photokeratitus include redness, tearing and discharge from the mucous membrane that lines the inner surface of the eyelid. Symptoms include an acutely painful sensation of gritty material in the eye."
( Reference 8 ) Department of Environmental Health & Safety, at UC-Davis --
http://ehs.ucdavis.edu/sftynet/sn-106.html
"The cornea of the eye is composed of a thin layer of specialized epithelia cells. These cells can also absorb UV radiation, resulting in tiny lesions on the cornea that may not be felt for several hours after exposure. The sensation is much like having sand in your eye. Known as photokeratitis, welders flash or snow blindness, the effects can last up to 48 hours but subsides as the cells of the cornea rebuild. Although most UV radiation that enters the eye is absorbed in the cornea, molecular changes can occur in the lens as photons bombard proteins and change their configuration, resulting in cataract formation."
( Reference 9 ) The Canadian Ophthalmological Society
http://www.eyesite.ca/english/program-and-services/policy-statements-guidelines/UV-radiation-eye.htm
"UV phototoxicity has been implicated in causing or accelerating the progression of several diseases of the eye or its supporting structures, including the eyelids. The following is a partial list of some of the more common diseases involved.
Basal cell and squamous cell carcinoma, melanoma: skin cancer of the eyelids.
Pingueculae, pterygia: conjunctival growths between the eyelids that may encroach on the visual axis and obstruct or distort vision.
UV photokeratitis, snow blindness, arc welder's burn: acute superficial "burn" of the cornea from high-intensity short-term exposure to UV radiation.
Spheroidal degeneration, Labrador keratopathy: loss of corneal clarity from long-term exposure to UV radiation.
Cataracts: opacification of the crystalline lens of the eye.
Eclipse or solar retinopathy: damage to the retina from acute exposure during an eclipse or while gazing directly at the sun.
Macular degeneration: central retinal damage in the part of the retina responsible for the best sight.
Acceleration of the progression of the pigmentary retinopathies (retinitis pigmentosa), iritis (intraocular inflammation) or cystoid macular edema (central fluid accumulation in the retina)."
( Reference 10 ) The initial email from KSWB reporter Darlynne Reyes.
NOTES ...
1. 99.99% of the time, I treat incoming email as sacrosanct and confidential. However, when the email is able to shed light on a public health epidemic, I make exceptions to that rule.
2. I have masked Ms. Reyes' contact information using "*" characters. I have also removed the mailing address and fax and phone number.
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"From: "Reyes, Darlynne" Dmreyes@*******.com To: "'rogerebratt@yahoo.com'" rogerebratt@yahoo.com Subject: Lasik surgery Date: Wed, 14 May 2003 22:05:02 -0500
Dear Roger,
My name is Darlynne Reyes and I am a reporter at KSWB-TV. I am currently doing research for a possible story on LASIK eye surgery and I came across your website. I would like to talk to you more about this topic. Would you please give me a call? I'm hoping you can help me out or point me in the right direction.
My work phone number is: <excised>. Thanks for your time!!
Darlynne Reyes KSWB-TV Reporter"
( Reference 11 ) Email received from Doctor Robert Maloney Regarding Debris Embedded in the Cornea During LASIK.
"From: drmaloney@*************.com
To: rogerebratt@yahoo.com
Subject: RE: LASIK Date: Thu, 20 Feb 2003 06:28:47 -0800
Would you like me to help you find someone in the area to do confocal microscopy on your cornea? To be honest I doubt very much that embedded debris is the cause of your troubles. Recent clinical studies show that everyone has microscopic debris, and as you well know, most people do not have symptoms of your severity.
I appreciate the issue of delicacy in discussing my patients, but would you be comfortable talking in general terms rather than discussing specific patients?
Robert K. Maloney, M.D. Maloney Vision Institute"
( Reference 12 )
In this context, "Would you like to participate in the Experiment ?" is a rhetorical construct. The most heart-felt advice I could give you is -- laser eye surgery is one very poorly-administered experiment that I suggest you NOT participate in.
( Reference 14 ) Copyright Statement, URL for LASIK SOS.com, & Legal Statement.
Copyright 2003 Roger E. Bratt -- All Rights Reserved.
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This is Not an Advertisement for any of the following persons or organizations: Doctor Michael Gordon Doctor Perry Binder Doctor Thomas Tooma Doctor Robert Maloney Doctor Glenn Kawesch Bausch and Lomb VISX Summit Technology Nidek TLC Laser Eye Centers Loma Linda University KSWB-TV Intralase
