I had Lasik originally on October 13, 1998. I was a -6.75 left eye, -7.00 right eye with some astigmatism in both. My problems are not as bad as some of the post I have read, but I do have problems with ghosting and extra images about anything illuminated or that reflects light. For example, while walking in the mall, all of the illuminated lettering for the stores all have about a 1/3 image above each letter. While driving at night, road signs reflecting my headlights have a 1/4 to 1/3 repeated image to the upper right. This is all in my right eye. My left eye turned out beautifully and I have absolutely no complaints about it. I was so distressed about what I was seeing after the initial surgery, at 7 weeks my surgeon decided to lift the flap are re-irrigate the eye. He found cells growing thickly at the edge which he said he had not seen under the regular microscope. He cleared them all away and felt it would make a difference. I lost acuity and developed more astigmatism. I still had the ghosting. As of June, 1999 at an examination, he said it appears I have a farsighted astigmatism and will have to wait for FDA approval for the procedure to correct it.

The whole ordeal cased me such anxiety and regret, I had my first ever bout with depession and began anti-depressants and counseling in December of 1998. Although the psychologist who worked with me had never counseled a lasik patient, we worked through it and by May of 1999 I was able to stop the counseling and the medication. I am now experiencing a relaspe of my depression, obcessing about my eye and worrying about an the success of future surgery. I have again started the anti-depressant medication and am scheduled to begin counseling sessions next week.

I was wondering if you have any information that I might pass on to my psychologist so that she might better understand this lasik induced depression. She had told me before that the anxiety I appeared to be experiencing seemed more akin to cosmetic surgery gone wrong. At the time of my first depression, I was aware of only one bulletin board that was available for lasik patients to discuss their expereinces. I'm so happy to see the number of sites that are now dedicated to helping lasik patients. Any comments are greately appreciated.

Thank you and God bless,

I am sorry you are having difficulties with your
eye and are also having problems with depression.
While the depression showed up after your
disappointment with your eye, I don't think the
basic depression is caused by Lasik. I think your
therapist is probably correct in that it is
related to disappointment but you probably have
some underlying problem which would have surfaced
eventually with some other life stress situation.
I hope both your Lasik problem and your depression
can be solved soon. Best of luck.
Leonard Friedman MD Washington DC..

Dr. Friedman, et al:
While I understand you are trying to be helpful, it really is infuriating to read an opinion discounting LASIK as the cause of a patient's depression when they have had a bad outcome. Unfortunately I know of Vicki's personal hell first hand. It is not a unique story (see http://www.surgicaleyes.com/psychology.htm). The objective evidence suggests to me that it is an emerging complication not yet understood by psychiatry or ophthalmology.

I, too, had no psychiatric history until I learned my LASIK complications were permanent. I spiraled into a deep depression for the first time in my thirty-six year old life last year from LASIK complications: Halos, starburst, anisometropia, eye pain and lack of any surgical solution to relieve the situation (e.g. large pupils, which were not caught due to a gross mismeasurement of 6mm versus their true 8mm+ size in dim light).

There was no escape from the visual problems, and to a normally sighted person with nothing other than mild myopia previously this was psychological torture. Perhaps a detailed oriented, "perfectionist" type personality exacerbated things, but these qualities were never handicaps before.

To shorten the story, medications were prescribed. This was a disaster: I had suicidal thoughts for the first time ever after only three days on them, as I proved to be extremely sensitive to SSRIs. They only made things much worse, and I doing much better without them. There was no chemical imbalance, simply a very real and significant stressor. The 'bottom line' is that permanent visual problems CAN be so stressful as to induce severe depression. But you don't have to take my word for it: Try wearing contact lenses every waking moment which induce anisometropia and blurriness. Let us know what happens!

-Red

Viki I also experienced depression due to a bad outcome from lasik Surgery (blurry double vission). I was able to access new technology and got my eye fixed, but Prior to having my eye corrected I felt drained and exhausted. I'm glad to hear that you are accepting assistance from your Dr. for depression some people try to fight this on their own and it can turn into a downward spiral needlessly. I hope you will post this at www.surgicaleyes.com there are many good people there that can help you find a top fix it doctor ect. I would like to suggest that you locate a Dr. Qualified to give you a second opinion so that you can begin the process of regaining your eye sight.

Again I am sorry for anyone suffering a bad
outcome with Lasik and the accompanying
depression but when I said Lasik does not cause it
I meant the procedure itself does not. It is the
bad outcome which is causing the depression. It
is probably made worse because your bad result did
not occur from an accident but from something that
was elective. I hope things improve for you.
Leonard Friedman MD Washington DC....

LASIK has ruined my life. I was a very happy individual who strolled into his surgery 3 months ago; that was the last happy day I have had. The GASH effects will clearly alter my nighttime life in the future, and this has absolutely devastated me. I cannot tell who to be angrier at--myself, for trusting my doctor and going through with this, or the doctor who downplayed all the risks. Now I have a lifetime of starbursts, etc. to look forward, along with a new astigmatism that I never had.
This phenemenon of LASIK depression needs to be understood by the eye surgeons, and made part of their screening, for the emotional trauma of this is far worse than anything I could have ever imagined.
And yes, I will be seeking help in the near future, as this has absolutely paralyzed me. Frankly, I wish I had never heard of LASIK.

Peter,
Would you like me to mention some names of excellent LASIK surgeons who may be able to provide some help with your visual/night time problems? I will be happy to help

Bill Trattler, MD
Miami, FL

I would certainly welcome any and all help, and appreciate your taking the time to assist, Dr. Trattler.

I too have been diagnosed as clinically depressed and am on medications and seeking counselling. I was only moderately myoptic and elected to have lasik. I ended up overcorrected in both eyes (more so in the left -- from -3 to +1.25) and had night time vision problems with severe starbursting and halos. I held out well at first, thinking I'm just going through a healing process and things will get better. I did't mind wearing glasses to correct the hyperopia, I've worn glasses before. But I've since learned that I have 8mm pupils (never properly assessed before the surgery), and that my night time vision will never improve because at night my pupils open up beyond the ablation zone. I can't drive at night because I don't think it's safe, and I've stopped going out with friends because I got too depressed at what my vision was like. At 4 months I developed night time dry eye that prevented me from getting any real sleep for many nights, and that's when I really began to fall apart. I am slowly conquering the depression thanks to the medication, but have real worries about what kind of future if any I can have with my eyes in their current state.

Have you discussed enhancement with your surgeon
to correct the overcorrection?
Leonard Friedman MD Washington DC,.........

Have you seen Parag Majmudar, MD? He specializes in helping patients who have ahd problems following LASIK or PRK. Here is his office information:

Parag Majmudar, MD
Chicago Cornea Consultants, Ltd.
1725 West Harrison Suite 928
Chicago, IL 60612
Tel:

Thank you Dr. Trattler for the reference, and in general for trying to help out where ever you can. I truly appreciate it, and hope you will continue to offer support and hope to all who post on this board. Unfortunately for me I am no where near Chicago, so seeing Dr. Majmudar is not a realistic possibility. Hopefully my counsellor here will be able to help me climb back up out of the hole.

I was trying to recommend a surgeon trained in helping people with problems following PRK and LASIK. There are a few others around the US - i will be happy to provide some more names if you want to let me know where you live

Bill Trattler, MD
Miami, FL

The depression felt by post-refractive casualties is devastating. It took me many months, and my desire to keep my marriage alive, to pull out of the routine.

My obsession with my eyes after my severe complications has hurt my husband and children more than any of us will ever know for sure. My husband nearly divorced me about four months ago, before I began taking medication for my depression. I never experienced depression before my surgery either--it is a direct result of having LASIK gone sour. Everyone I've met who has had a serious complication after refractive surgery is on anti-depressants, because we have to live with this vision every waking moment of our lives. The only escape is sleep, and that's difficult when you lie there in bed going over and over what your doctor did wrong and how they try to blame it on you, the patient.

No one can help me now. There is no cornea left.
My future looks bright---possible ectasia and a transplant. Oh joy!

There are far too many of us out here, so don't feel alone. Do know that we are all looking for solutions. If your cornea is too thin, perhaps a transplant will work for you. I know this is a frightful thought, especially after the surgeons have let you down so badly. But you have to have hope.

Focus on your family and make sure you don't lose them too. Have them go to www.surgiacleyes.org to help them understand that what's happening to you, and them, is not just caused by something in your head.

Kirk

I'm going to be a little crass.. To Blame Depression on the outcome of Lasik is a symptom of other issues which are NOT related to the lasik surgery itself. It is related to disappointment which is related to the outcome. There should be support groups and these post should be a "sign" to the eye surgeons to be more sympathetic to even minor issues as to the outcome of eye surgery especially elective eye surgery. It is one thing to require a surgery to maintain current vision, it is another to have surgery for vain reasons (as most Lasik patients do, including me). Guilt can be caused by a fork in the road that could have been taken conservatively but taken aggressively just as if someone lost in the stock market by betting it all..

So Lasik Patients, Don't blame the doctors for doing the procedure. you placed your bet.

And Doctors, Don't blame the patients for reacting in this manner, you took the bet.

Both groups must pay the price and that is why Lasik Operations MUST get more precise and more predictable. And it will over time I'm sure..

In the mean time, I hope there are many more doctors that see this real issue and understand the intercommunication that MUST happen to fulfill the job they have taken on. These Doctors are NOT just Surgeons, they ARE and SHOULD be psychologists as well. Not just to keep business, but to fulfill the job as might be required. These surgeons are not just dealing with a look (like a cosmetic surgeon does), these surgeons are dealing with the whole of one sense. Vision, which is 1 of 5 senses that all people revolve around to function; not a minor issue at all especially if it is elective surgery that goes wrong.

Tom

Tom,

That is downright insensitive!

I wore contacts full-time. Most of the 25 years I wore them, I didn't even have a back-up pair of glasses. But due to an incompetent OD, I became unhappy with the discomfort and finally became desperate enough to have LASIK.

I'm not dealing with merely a bad outcome. I'm dealing with two doctors who don't give a damn about what happened to me.

So, I'll make them care. One way or another.

In the meantime, I'm being treated for major depression and post-traumatic stress disorder due to the deception, betrayal and incompetence of two doctors. To say this isn't a direct result of LASIK is just a play on words. If I hadn't had LASIK, I wouldn't need therapy for what it did to me.

I'm either insensitive or you refuse to look at what I said. Which is it really? I suggest you don't answer with your emotions, but with your logic. It's really your choice. I am sensitive to your thinking, but you are ignoring mine. Re-read what I said.

All of Daniel's posts are about emotion. He has made it his mission in life to respond to every question posted to this board with misinformation and horror stories. By his own admission his problem was a bad doctor. That he indicts the entire procedure and all doctors who perform it proves there is no logic involved in his presence on the board.

And I agree with your post as well.

I couldn't agree more with your statement (see below). This is why it is so important for patients to meet their surgeons priuor to surgery, and have their surgeons talk about all of the issues with LASIK. As well, for the postop visits, the surgeons need to see their patients. I see all of my patients before and after surgery, on every visit. But there are many LASIk centers set up where a patient only sees their surgeon on the surgery day - and that's it. It might work OK if everything is perfect, but since there are risks, many patients get short-changed when they have a problem after LASIK. This is why I do not agree with co-management for LASIK. I have no problems if my patients have a relationship with their optometrist - they can visit their optometris all they want. But they also need to see me until everything is perfect and they are 100% happy.

Thank you again for your insightful comments

Bill Trattler, MD
Miami, FL

"In the mean time, I hope there are many more doctors that see this real issue and understand the intercommunication that MUST happen to fulfill the job they have taken on. These Doctors are NOT just Surgeons, they ARE and SHOULD be psychologists as well. Not just to keep business, but to fulfill the job as might be required. These surgeons are not just dealing with a look (like a cosmetic surgeon does), these surgeons are dealing with the whole of one sense. Vision, which is 1 of 5 senses that all people revolve around to function; not a minor issue at all especially if it is elective surgery that goes wrong."

I admit that my emotions come through loud and clear. But that is because having LASIK has ruined my vision.

I have nothing personal against Dr. Trattler. What I have a problem with is the continued growth of the Surgical Eyes membership, because LASIK continues to damage people. It's upsetting to watch the carnage continue and to see people who read about all the problems continue to pursue this elective cosmetic surgery on their vision, which is our most important sense. Dr. Trattler just happens to be a part of this scene. The pain I witness daily in other people who have had complications is heart-breaking and we have a huge problem with the way this surgery is touted as a SAFE 20 minute miracle. It is not that for everyone.

If I didn't feel the urgency to warn people of what can and might go very wrong for them if they have LASIK, I'd be focusing all of my emotions at my doctors.

I'd rather try to save virgin eyes than try to change two incompetent money-grubbing sleezeballs.

Sorry, but I do think that LASIK will be a bleep in history. Flaps are already being cut with lasers, and now they are working on lasering under the epithelium without cutting a flap at all.

I understand why you are upset. I think the problem is not with LASIK alone, but with the fact that there are many who try to minimize LASIK into a "painless laser procedure" - when in fact LASIK is a surgery, just as liposuction, facelifts, breast augmentations, etc. are surgeries.
As you are probably aware, there have been fatalities with liposuction, and other elective cosmetic surgeries have resulted in permanent disfigurement, etc. LASIK is not unlike these elective surgeries, as there are serious risks. I think that the problem is that since LASIK appears so easy and simple to the patient, it is easy for the doctor to pass LASIK off as easy and simple, and minimize the risks. However, you and I both know that there are serious risks with LASIK, and that for any patient, even the best candidate, there is a chance that they could end up with vision worse than yours.
We at AskLasikDocs.com never try to minimize or hide the risks with LASIK. I think you will note by reading all of my postings that we are here to help patients who have had problems with LASIK. I am also happy to explain whether a condition such as diabetes or hypertension or other medical problem makes LASIK more dangerous, etc.
I would ask that you understand that we have helped many patients via AskLasikDocs.com. I can not speak for all of the other doctors on the site, but I have been able to help a number of patients who have had LASIK elsewhere. Not only by answering questions via this web site, but by taking phone calls from concerned patients, and as well seeing patients for second opinions. I believe that I have been able to help many patients.
I think if you carefully read my answers to questions, I and the other doctors try to provide helpful information.
I would ask that you respect what we are trying to do here. If you notice, we in general do not edit postings (although certain postings that are aimed at other individuals do get removed), but in general every posting where you describe your problems or argue the merits of LASIK are up. So you are more than welcome to keep posting.
My thoughts are - instead of trying to make it your mission to scare away people from having LASIK, you should work together with surgical eyes at making significant changes in the way LASIK is marketed. In particular, ti would be great to be able to pass legislation, etc, where it would be illegal for doctors to claim they are the best or that a procedure is so simple , or that the surgery comes with a money back guarantee
As well, it would be great to work with surgical eyes to require that doctors perform a complete informed consent, and that patients have time to review the informed consent (and are not just presented the informed consent a few minutes before the surgery.
Another change - would be to do away with the surgeon never seeing the patient except under the laser. This type of situation prevents the surgeon from being able to evaluate whether the patient is actually a good candidate. Since many LASIK centers that employ this type of set up are corporate-run, there are concerns that the goal is on how many surgeries are performed and how the bottom line profits are, rather than the bottom line of how happy patients are and how well they can see.
Another change - along the same light - is to tighten up the criteria in which LASIK is performed. By this, there are so many patients that are not the best candidates that get LASIK, and these patients are often the ones that end up with problems after LASIK. For example, patients that have LASIK with severe dry eyes prior to LASIK, or patients with high myopia and either thin corneas or large pupils.

I hope these thoughts are helpful, and I look forward to your response.

Thank you

Bill Trattler, MD
Miami, FL

Is is the doctors who have portrayed LASIK as safe and painless, not the patients! You are twisting it around and blaming us again. You are part of an industry that is selling elective surgery, and it is in your best interest that the industry minimizes the real incidence of complications, and the severity of complications. It is also in your best interest that patients are not aware that long-term risks and results are not known.

How high would the complication rate have to be in order for you to look at LASIK and decide that you just cannot rationalize the complications any longer? 5%? 10% No one even knows what the real complication rates are! How many people is it okay to damage? You surgeons have replaced animal experimention with people. People who need their vision in order to perform their lives and live happily. A poor outcome from LASIK means complete misery, depression and anxiety about the future.

Are YOU working together with Surgical Eyes to change the way that LASIK is marketed? We need the doctors' help.

I have reported my doctor and his laser center to the FTC for their claims of being the best. It would have been much better if they'd never made that claim in the first place.

I know that LASIK surgeons have been warned that meeting their patients under the laser increases their risk of malpractice claims. Since that doesn't seem to stop this practice, what do you think it is going to take? The surgeons are the ones who have to do away with this practice. It is not up to the patients to make this change.

I still have to disagree with your recklessness with concern to large pupils. Low myopes are experiencing disabling starbursts too.

Low myopes are also developing ectasia. Do you know why? Where is the answer going to come from? How many more patients will have to develop this condition which requires a corneal transplant before you guys figure out how thick the residual cornea must be to prevent it?

We are being experimented on and I can tell you that we heavily resent it!

I am not blaming you or anyone. I agree with you, in that I disagree with the way that LASIK is advertised, and as I mentioned, I do not advertise. The advertisements I see and hear on the radio are often misleading in many respects.
As for complications - the overall complication rate - and by complication - lets be specific and say the overall chance of a patient having loss of best corrected vision, or other significant problems (starbursts, severe dry eyes) is well less than 1% in my personal experience. I rule out many patients that might be considered LASIK candidates by other doctors, based on severe levels of myopia or hyperopia, severe dry eyes, large pupils, and thin corneas (to name some of the things I am overly strict on). As well, many patients come in with false expectations - and I explain to them why LASIK is not for them.
But for the LASIK surgeries that I do perform - I can tell you that my patients are extremely happy. I see all of my patients during the post-operative period, so I know how every patient is doing. I also have 30 patients that I work with on a daily basis who have had LASIK (including 2 surgeons and atleast 28 employees). So if late complications where as prevelant as you suggest, then I certainly would by now be seeing some of these problems.
Please also see my answer to your other posting about low myopia and large pupils. As I mentioned, I have personal experience with many patients who have done fantastic after LASIK who fit in a similar category as you pre-LASIK. Obviously, there are exceptions, and as you clearly express, being an exception can result in significant disabilities.
AGain - as I mentioned previously - I have taken care of patients who have had LASIK elsewhere who have had large pupils and high myopia - and their night time vision problems cleared up with the use of medications to constrict the pupil. I wonder whether you have talked with your own doctor about this - as this could bring some normalcy back to your life.

I am happy to answer any further questions

Bill Trattler, MD
Miami, FL

>Is is the doctors who have portrayed
>LASIK as safe and painless, not
>the patients! You are twisting
>it around and blaming us again.
> You are part of an
>industry that is selling elective surgery,
>and it is in your best
>interest that the industry minimizes the
>real incidence of complications, and the
>severity of complications. It is
>also in your best interest that
>patients are not aware that long-term
>risks and results are not known.
>

>How high would the complication rate have
>to be in order for you
>to look at LASIK and decide
>that you just cannot rationalize the
>complications any longer? 5%?
>10% No one even knows
>what the real complication rates are!
> How many people is it
>okay to damage? You surgeons
>have replaced animal experimention with people.
> People who need their vision
>in order to perform their lives
>and live happily. A poor
>outcome from LASIK means complete misery,
>depression and anxiety about the future.
>

>Are YOU working together with Surgical Eyes
>to change the way that LASIK
>is marketed? We need the
>doctors' help.

>I have reported my doctor and his
>laser center to the FTC for
>their claims of being the best.
> It would have been much
>better if they'd never made that
>claim in the first place.

>I know that LASIK surgeons have been
>warned that meeting their patients under
>the laser increases their risk of
>malpractice claims. Since that doesn't
>seem to stop this practice, what
>do you think it is going
>to take? The surgeons are
>the ones who have to do
>away with this practice. It
>is not up to the patients
>to make this change.

>I still have to disagree with your
>recklessness with concern to large pupils.
> Low myopes are experiencing disabling
>starbursts too.

>Low myopes are also developing ectasia.
>Do you know why? Where
>is the answer going to come
>from? How many more patients
>will have to develop this condition
>which requires a corneal transplant before
>you guys figure out how thick
>the residual cornea must be to
>prevent it?

>We are being experimented on and I
>can tell you that we heavily
>resent it!

Dan, I agree with Dr Tattler. I have had lasik so that gives me the basis to make these statements. 1) you should have researched lasik before you had it done, do you normally make decisions about something so valuable as your sight without research? 2) Did you not read the consent form that problems could result from this surgery. 3) lasik at least were I am from, is touted as being able to REDUCE OR ELIMINATE YOU DEPENDENCY ON CONTACTS OR GLASSES, not produce miracles nature did not bless you with.

Doctor,
I have to disagree with some of what you write. Whether or not it is the surgeon or another qualified doctor that checked the eyes post-op should not be an issue. Just as one can get a low or no experienced surgeon or a top-notched surgeon, having two individual doctors look at the eyes as part of the package plan is better then having one doctor look at the eyes. To say it must be the surgeon that performs post-ops is giving no credit to the other "doctors" at all. After all, these doctors have degrees in the field. As a Laik eye surgeon can be less experienced and screw up the eye just as easily as a that post-op doctor can mis-interpret the symptoms of a problem that might occur. Your statement reflects that you don't like competition as it drives the price down. Competition is the mother of invention and generally helps revolve technology. As long as a DOCTOR performs the post op, I really don't see the issue. BTW, my pre-op was the most thorough eye exam I've ever had in my lifetime and it was not performed by my surgeon. It was one month before the surgery and all issues were discussed with me at that time. I was sent the consent form to read 1 and a half months before the surgery. I was walked through the consent form in detail before the surgery but had already read it as I had it in my hands far before that day and it was made clear to me that I should read it before hand. I was given another thorough exam before the surgery on the surgery date to make sure of my prescription and health of the eyes. I was very impressed by the professionalism of the clinic I went to. My Surgeon, however, did look at my eyes before the surgery. I get the impression that the clinic I opted for is very concerned about the outcome of my eye sight and has done everything with care taken. I can call the surgeon at any time or my local doctor at any time of day or night. I have two opnions on my outcome as my surgeon saw me the next day (I was required to stay the night in Canada) and the local doctor this week. If I feel I want the surgeon to look at my eyes, I can make an appointment and drive to Canada at anytime and the visit would be free of charge.

Tom

First of all - co-management for patients who have surgery in the same city is a diffent issue than flying across the country (or to different countries) for surgery.
Lets talk about Co-management in the same city - which is where an optometrist or another ophthalmologist sends their patients for surgery to another docor (the surgeon)- but does the pre- and post op visits. In every other specialty, the surgeon is in charge of the surgery, and also sees and examines the patient before and after surgery. For example - if you have a retinal detachment - the retina surgeon will examine the eye prior to surgery, and also follow the patient after surgery until the healing is complete. For elective eyelid surgery, the eye plastic surgeon sees and examines the patient prior to surgery to make sure that the patient is a good candidate for the surgery, and understandts the risks and benefits.
With LASIK - there are set ups where the surgeon is like a robot - never seeing the patient before or after surgery. The surgeon has no idea whether the information about the patient is accurate. The surgeon does not know whether the patient understands the risks. The surgeon does not make sure that the patient is a good candidate. There is no other surgery that I can think of where a patient walks in and gets operated on without being examined by the surgeon prior to surgery.
As for cost - the costs actually go up in this setting. First - what often happens is that the doctor with the patient finds the surgeon who pays the most for the referral (gives the largest co-management fee). For example, in Miami there is a doctor in Ft. lauderdale who was paying $1200 per referral. Patients ended up paying about $800 to $1000 more in this, because the total price was almost $5000 (when many of the surgeons in Miami are charging about $4000). I thought it was funny that some optometrists were making so much money, that they actually cancelled their morning for seeing patients, and drove their patients up to Ft. Lauderdale for surgery.
Anyway - one of the other key issues you are missing is accountability. As you are well aware, there are risks with LASIK. However, the way things are set up with co-management, the surgeon often never sees the patients post-operatively, so does not know how the patients are doing. There are many co-management set ups where the co-managing doctors send reports the the surgeon, but there are also many situations where this does not happen.
Obviously, there are many co-managing doctors that can check eyes before and after surgery, and are good at spotting problems. But there are clearly others who have not done the most complete jobs before and after surgery. In particular, I am aware of a number of cases where striae identified early post-LASIK was not referred immedeiately back to the surgeon. As you should be aware, delay in treating striae can significantly and permanently affect the final outcome.
Tom - from your description, it sounds like you received a through exam both before and after LASIK. I am not saying that there are not optometrists who can provide pre and post-operative care, and it is not my goal to challenge any particular optometrist - but I am aware of many situations in which this was not the case.
And just to reiterate - I know many places across the US where a patient can see their surgeon before and after LASIK, and pay alot less than they would if they went the co-management route. So co-management does not save money or cut the cost of LASIK to the consumer as you are suggesting (Case in point is TLC, which utilizes the co-management system, and charges a premium price).

I also want to add that these are my opinions, and I do not know which (if any) of the doctors who also participate at AskLasikDOcs.com agree or disagree with my thoughts. These are just my personal opinions.
I would also add that I feel that I work very well with optometrists, and count many as my friend. But it is to the "fee-splitting" or buying of LASIK patients that I do not agree with.

Bill Trattler, MD
Miami, FL

The idea of having somebody else, even another physician do the postop care is not a "competition" issue at all. This is just an arguement doctors involved in comanagement arrangements use to justify their actions. Anyone whom has done any type of surgery, not just eye surgery knows that a lot of times, there may be one part of the procedure that may not go perfectly smoothly. Postoperatively, that particular concern or body area in question will get extra scrutiny. If you didn't do the surgery, how are you to know this. Don't be naive to think that the surgeon calls the doctor doing the postop care after each case and goes over the procedure in detail...it doesn't happen. As was alluded to by Dr. Trattler, often a complication such as DLK (sands of sahara syndrome) or striae can be easily treated if caught early with minimal effects on vision while these same problems identified later on can be much more difficult to treat effectively. It seems to make sense that the surgeon who may know a particular part of the case was a bit rocky (maybe he had to refloat the flap a few times because it wasn't sitting right for instance) will be more apt to pick up a postoperative complication than another doctor, no matter how well trained he is. Tom, I'm glad you feel safer with your 2 doctors than one but I think somebody just did a very good sell job on you.

Tom, I'm glad you
>feel safer with your 2 doctors
>than one but I think somebody
>just did a very good sell
>job on you.

Actually, Doctor, those were my own thoughts and not a single time was this discussed with my by the co-management Lasik center I opted to go with. No-one did a sell job on me at all. I made the decision to go with the clinic I did based on results which BTW are very good and quite a lot better then many other non-co-managed clinics.

Tom

For most people, lasik is a miracle of modern science. For the minority, its a bittersweet experience or even a total disaster. The complication rate was much higher in the past with early lasers, now its considerabily lower and dropping. Many people with complications werent good candidates to begin with and should have never gotten lasik to begin with. Those include people with less than -2 diopters or more than -10 diopters. hyperopes more than +4 shouldnt get lasik either. large amounts of astigmastim may be tricky too, especially with hyperopia. Others have thin corneas, dry eyes, huge pupils or other contridictions.

10-20% of people experience a minor complication such as a slight undercorrection or worse, an overcorrection. Others experience a slight decrease in night vision, regression, mild dry eyes, etc.

1-3% experience a more serious complication than the above and a fraction of a percent are devasated.

doing your research will let you make an informed choice to get lasik or not. I have done my research and I think ill choose intacs instead. If im not a candidate for intacs, I dont see myself as being one for lasik either.

When you cite statistics, it is always helpful to name your sources. There is a big spread between 1 percent and 3 percent. Is this due to sampling error? Of course not. It is due to two different physician groups quoting different statistics. What was their sampling methodology? How many patients did they interview? You don't know that. I don't know that. Even the FDA doesn't know.

DrG

When you cite statistics, it is always helpful to name your sources. There is a big spread between 1 percent and 3 percent. Is this due to sampling error? Of course not. It is due to two different physician groups quoting different statistics. What was their sampling methodology? How many patients did they interview? You don't know that. I don't know that. Even the FDA doesn't know.

DrG

Not to discount what anyone else said or anyone else's problems with depression, because I know that depression is serious, but I just wanted to add something.
Last year, I was diagnosed with depression. I never knew I suffered from this, but something somewhat traumatic had happened to me, I decided to go to therapy and was told that I had underlying depression, I had always had it, and oftentimes it takes an incident to really bring it on. Perhaps it's similar with you and those that have lasik-induced depression. In other words, it wasn't the lasik that caused the depression, but rather it just triggered something that is already there.
I now take Paxil and it does seem to help quite a bit. I was wary about resorting to medication, but I'm glad I did. However, SSRI's such as Paxil or Prozac can also cause your pupils to enlarge, which could result in increased starbursts, depending on how large the pupils were prior to the medication. I had lasik three days ago and started the pazil before I went in for the procedure, so I won't know the difference with or without the medication.

wow,posts from 5 years ago.I bet all those lasik disaster sites have really multiplied since then.I know quite a few with post lasik problems.I wish I had known them before my eyes were screwed up.Lasik left me nearsighted in one eye ,farsighted in the other with induced astigmatism in both eyes.I suffered vertigo headaches, nausea.I now have 3 pairs of glasses and am trying to get my balance back.I am told it's lasik induced antimetropia.6 months disabled now.

Ed,

You have to understand percentages. There were about 3 million people that had LASIK in 2001(taken from business monthly). I believe the odds for the severe problems were about one in a thousand. If you applied it to a population of 3,000,000 you would have 3000 people each year frantically looking for a solution. Which over the past five years would result in 15,000 people with severe side effects. That's a lot of people.

The vast majority of people you usually see in forums are desperate people in dire need of help(fewer than 15,000). Fortunately you will also find people willing to share their experience/knowledge and try to help those who are unfortunate. That's what the forums are for; helping people. So when you hear all these horror stories keep in mind that it is for a small percentage of people even though there are a lot of them.

That "LASIK induced antimetropia" sounds so scary, but in reality all it means is what you already described :

antimetropia (an·ti·me·tro·pia) (an”te-, an”ti-mə-tro´pe-ə) [anti- + metr- + -opia] difference in the refractive error of the two eyes, e.g., hyperopia in one eye with myopia in the other.

Have you asked your LASIK surgeon if he could fix it with an enhancement? My father had his astigmatism fixed with an enhancement. Was this 6 months ago you had surgery or six months ago you began having problems? What were your eyes like before LASIK? How severe is the difference?

If you answer all those questions and maybe mention if you have other health problems like... oh say diabetes or something, Bill Trattler just might be able to provide some insight to help you out.

Anyone heard of a Lasik surgeon that elected to have the surgery, then had bad results that couldn't be fixed easily or at all? I'd like to hear his comments. There has got to be an eye doctor that had a bad outcome.

I'm going to go on a little rant here.

I see a lot of comments stating that people's Lasik complications stem from a lack of pre-surgery research. That is a ridiculous statement as you can have a horrible outcome even after "researching." I'm willing to bet all kinds of money that EVERY Lasik surgeon has had patients with bad outcomes for various reasons. I don't care if you have perfect stats and the best doctor, you can still have a bad outcome. I beleive there are some factors we still don't know about and/or can't control that play roles in the recovery of this surgery.

All you people with good outcomes: Congratulations! I am extremely happy for you as I would not wish certain complications on my worst enemy. Go and enjoy your eyesite, but do not blame people with complications for their problems. You could easily be on their side. Very easily. They care about their eyes just as much as you and did nothing different than you. It's not like they went to some back alley doctor to get black market surgery done. They went to the same surgeon thousands of good outcome people went to.

When you have a poor outcome with any surgery you can get depressed. Lasik is elective and things can go bad. This is true. But let me tell you something: When you cannot see correctly, your whole world is (expletive) up. Ok? You cannot do ANYTHING without it being a pain in the ass. It is COMPLETLEY debilitating to do normal, easy, everyday life. Ok? Can you haters wrap your mind around this for one second? You got lucky. You played Russion Roulette and didn't get the bullet.

Yes, it is an elective surgery. But does that make it right? Has anyone else noticed just how many people are complaing about complications on various bulletin baords around the internet. Take a look! There's a lot. This surgery is ruining a lot of lives. Believe it. How can you argue against that fact??? And to hide behind the, "hey, the surgery is completley elective," statement is crazy and it doesn't make the surgery right.

So you probably think I'm against the surgery and live with my parents and blah, blah, blah right?!? Well, no. I believe the surgery CAN be very helpful for many people. Right now, there are just way to many people experiencing life altering problems. Is it really hard to see this? I wish everyone could walk around with permanent "LASIK Complication Eyes" for just one day. Just one day! Believe me, many of you, if not all of you would be singing a different tune. This is one of those "you need to experience it to understand it" things. And you DO NOT want to experience it.

Here's and example: Everybody recall what their vision was like before their surgery WITHOUT wearing contacts or glasses. Pretty blurry for most of us. Now imagine not having the contacts or glasses available to you. You CANNOT correct this. Now go out and do your job. Now go out and go shopping. Watch tv. For a different experience go ahead and imagine better vision, but streaks of light all over your line of site, or floaty things all over. I bet no one wants this. You can check out crazy Lasik outcomes on other sites. I beleive surgical eyes is one.

Whew. This post needs to end, sorry. I'd like to say that I do not blame the doctors at all for bad outcomes. I believe there is something within the surgery that still needs to be worked out. It is way to easy to get this surgery. I would not be surprised if there is some kind of fallout that occurs down the road. By the way, I bet everyone thinks I have Lasik complications right? Well, yes. My right eye (which is 20/20 !!??!!) seems blurry because of multiple images and slight glare. I consider this MINOR compared to most of the horrible complications I read here. I find it hard to do everyday things because of this. My moods swing back and forth. I have changed because of this. I CANNOT imagine having WORSE problems. Just because YOU had a good outcome doesn't mean this surgery does not need to change. I worry everyday about my vision getting worse, because I've got a taste of what can happen. Even if my vision all of a sudden gets perfect, I will worry about what's coming down the line. I really would take back my untouched corneas and my trusty contacts and glasses and rest easy.

End of rant :)

P.S. Doctor Trattler: Know a good doctor in the Maryland area?

Funny you should say that, but I do know of an eye doctor who had a bad outcome -- not a LASIK surgeon, but an ophthalmologist.

I agree 100% with everything you said. Some of these people -- more than a few, in fact -- are depressed and full of anxiety when the outcome is not as expected. They are not all like Bryce. I have even came to believe that all prospective LASIK patients ought to undergo a psychological screening. The road out of post-LASIK depression can be long and harrowing, but it starts with getting the vision restored by some means -- any means possible. I am happy to be able to help these people with contact lenses.

DrG