I am thinking about having this surgery done. I was seen at Dr. Chu's office yesterday but he was out of town so I saw one of his associates who does not actually do surgery. I had all the testing done and she said I was a good candidate. I would have liked her to say excellent but she said good. I am severely nearsighted, -9.00 and -8.75 with astigmatism of +1.25 and +1.00. She said I have a thick cornea and great retina. I am concerned about all the horror stories I have been reading. I saw the lasikdisaster.com website and am now freaked out. I am wondering if I am an excellent candidate and what my changes of not having to wear glasses are. I believe Dr. Chu is a very reputable physician but need a little more info.

Kari,

Please visit the bulletin board at www.surgicaleyes.org for accurate information on common problems from refractive surgery.

If your doctor has promised you that you will not need glasses after lasik he or she is misleading you. Even if you are one of the few lucky people who get to 20/20 (20/40 is considered successful even if you see three of everything with each eye and need to use lubricating drops every 10 minutes forever) you will eventually need reading glasses. It is documented that people who have had refractive surgery need reading glasses earlier in life (which is something the surgeon trying to sell you lasik will not generally tell you). It is also documented that the quality of vision after refractive surgery is poorer than you can get now with glasses or contacts (especially RGP contacts) because of what are called “higher order aberrations”.

I had refractive surgery two years ago and I am now visually disabled. I see three of everything from each eye because the surgeon left me with little islands that distort the light and I also need to regularly use lubricating drops. There is no fix for my condition and no indication that there will be one any time soon (I’ve been told that a fix would be available in six months for at least two years). And I still have nine months of payments for my lasik on top of the thousand dollars I have spent on contact lenses and lubricating drops.

You should value your correctable vision and not have lasik. The only one to profit is the surgeon.

Terri

Accurate information at surgicaleyes.com? NOT! This site clearly discourages factual information that sheds any favorable light on refractive surgery. Such factual information is considered an "inflammatory post" and is not welcome there.

Your post is so skewed and inaccurate, I don't know where to start. This is a type of post that is commonly found at surgicaleyes. Inaccurate claims based on "it is documented" with no actual scientific documentation.

Where is it documented that refractive surgery patients need reading glasses earlier in life? Could this be because a nearsighted individual doesn't need reading glasses?

A "few lucky people" get 20/20? A majority get it. 50 to 87% of individual eyes get 20/20. The percentage of patients with a combined vision (i.e. using both eyes) achieving 20/20 is even higher.

Where is it documented that quality of vision is poorer after refractive surgery? It's better for me.

I'm truly sorry you had a bad outcome. It is surgery and with well over a millions patients electing to have it every year, there are going to be bad outcomes. I know you have good intentions to prevent this from hapenning to others but I think you would be more credible and your goal would be better served if you avoided the unsubstantiated claims.

Personally, I believe that a good portion of problem cases were marginal candidates from the beginning. I try to get everyone I know who is considering LASIK to educate themselves about what is good versus what is marginal (or worse). Some doctors here don't agree on what I consider marginal but that's where the factual information is needed. I think the patient should get educated enough to understand if and why he/she is or is not a good candidate for refractive surgery. I consider this vital.

At the risk of having an "inflammatory post," I have to say that LASIK can be a great thing for a good candidate. It has had a major positive influence on my life. I thank God that I live in a day and age where this is possible.

Regardless, there is a small percentage of problem cases and even a small percentage of a million per year is significant. This is why potential patients need to be vigilant to minimize their chances of being a part of that statistic.

Ditto, although I too would like to say that I am very sorry that things did not turn out well for you, Terri. ALL surgical procedures have their "failures." A girlfriend I dated in high school broke her ankle and had a lethal reaction to the anesthesia while in surgery to repair it! Things go wrong in childbirth. I am certian that Lasik is statistically safer than many surgeries that people have, elective or necessary-and many have support groups for when things go wrong. I am thankful that there is a SI for those people for that reason. But accurate information?! The "information" on that sites borders on propoganda! Try "Askphyscians.com. Plug in "Lasik." That will pull up abstracts of actual research.

www.surgicaleyes.org is not a site dedicated to selling lasik like this one is. There is a lot of information available there that you simply will not find here or on other websites selling lasik.

If you want additional information on early presbyopia after lasik or the quality of vision after lasik just spend some time reading the articles at www.eyeworld.org, www.pconsupersite.com, www.ophthalmologytimes.com (and a host of other websites). Wavefront testing has documented an average of a 20% increase in higher order aberrations (which reduce quality of vision). Early presbyopia is well known enough that even TLC has finally added a warning about it to there consent document (see www.customablation.com). Glen Hagele at www.usaeyes.org has documented that only about 50% actually get to 20/20 (which is why he has not had lasik himself). The data on his website from a recent study shows that “at six months you have 93% chance of 20/40 and a 50% chance of 20/20. The data includes 6,219 eyes at one day, 3,589 at one month, 3,491 eyes at three months, and 1,921 at six months.”

There is plenty of information online describing the real quality of vision after lasik. I am glad that George and Steven had good results. They are the exception. Steven’s example is meaningless since his girlfriend did not voluntarily choose to break her ankle. The only comparison here would be if her surgeon promised to break her ankle and repair it better than new and then she chose to allow him to do this to her. The askphysicians.com website has some good information but remember you cannot trust someone who profits directly from selling you lasik.

Terri,

Lasik does not bring on early presbyopia,
nearsightedness merely masks this condition.
Once you correct the myopia, presbyopia will reveal itself.

BG99

>Terri,

>Lasik does not bring on early presbyopia,nearsightedness
>merely masks this condition.Once you correct
>the myopia, presbyopia will reveal itself.
>

>BG99

What you say is partially true but only for those who wear glasses.

For those who wear contacts the correction is at the same plane as lasik (within a few hundred microns depending on the ablation). It is documented that the aberrations induced by the flap cut and laser do bring on presbyopia at an earlier age. There are sizable numbers of people in their late 30's to early 50's who did not require reading glasses with their contact lenses pre-lasik but who needed them immediately after lasik and will need them forever.

Terri,

I really can't agree with this generalization,because judging from my own experience and that of others who have had lasik,this hasn't yet happened(presbyopia).
I have used contacts in the past. I am 42 yrs. of age, and the people who have had lasik in my age bracket don't use readers yet. Although the people in my age bracket who use readers and had lasik still use them. Becaues of my age, my surgeon did warn me that I may need readers right away, but so far I have dodged that bullet.

BG99

>Terri,

>I really can't agree with this generalization,because
>judging from my own experience and
>that of others who have had
>lasik,this hasn't yet happened(presbyopia).I have used
>contacts in the past. I am
>42 yrs. of age, and the
>people who have had lasik in
>my age bracket don't use readers
>yet. Although the people in my
>age bracket who use readers and
>had lasik still use them. Becaues
>of my age, my surgeon did
>warn me that I may need
>readers right away, but so far
>I have dodged that bullet.

>BG99

BG99,

The evidence is already in and the surgeons admit it. You are lucky in that you do not yet need readers. You will probably need them a few years earlier than you would have if you had not had lasik and wore contact lenses. Everyone is different. People just need them earlier if they had refractive surgery. It's all dependent upon the attempted correction and the induced amount of aberrations from the surgery.

Terri

>BG99,

>
>You are lucky
>in that you do not yet
>need readers. You will probably need
>them a few years earlier than
>you would have if you had
>not had lasik and wore contact
>lenses.
>Terri

Terri,

I have no doubt that I will need readers sooner, but only because I am no longer nearsighted.
Example: If I were nearsighted I would need them at say age 50. But since I am now no longer nearsighted I will probably need them much sooner.
I'm not sure if there is a right or wrong in this debate, there are still too many unknowns.

BG99

>Terri,
>I have no doubt that I will need readers sooner, but only because I am no longer nearsighted.
>Example: If I were nearsighted I would need them at say age 50. But since I am now no longer >nearsighted I will probably need them much sooner.
>I'm not sure if there is a right or wrong in this debate, there are still too many unknowns.
>BG99

BG99,

You don’t understand. I am not talking about someone who can remove their glasses to read needing readers after lasik. I am speaking to those who did not need reading glasses while wearing their contact lenses needing to immediately begin using reading glasses after lasik. The lasik changes many of the aberrations so that you have a tougher time focusing close-up. The wavefront researchers are investigating this to try to change the laser program to preserve your close-up vision.

Terri

OK, let's compare what you said before and what you are saying now.

Then: "Even if you are one of the few lucky people who get to 20/20..."
Now: "Glen Hagele at www.usaeyes.org has documented that only about 50% actually get to 20/20."

Truth: Your "now" statement jibes with what I said; not with what you originally said. I said "50 to 87%" of eyes. The Bausch & Lomb Technolas 217 achieved 87% of eyes for -1 to -7 OD. Other lasers generally achieved 50 to 60% for their respective ranges. And, by the way, these numbers are for individual eyes; not for combined vision with both eyes which is significantly higher.

Then: "It is also documented that the quality of vision after refractive surgery is poorer than you can get now with glasses or contacts."
Now: "Wavefront testing has documented an average of a 20% increase in higher order aberrations (which reduce quality of vision)."

Truth: Typically, prior to LASIK, the amount of high order aberrations is close to zero. 20% of "close to zero" is still "close to zero." The dominant aberrations found prior to LASIK are the low order sphere and cylinder. Contrary to your "then" statement, your quality of vision after refractive surgery is, on average, imperceptably different from what you got with glasses or contacts beforehand with one notable exception. This exception is when large pupils are treated with a small laser treatment zone. This is the area where significant high order aberrations occcur. And this typically only affects night/dark vision. Patients need to educate themselves about LASIK to avoid or minimize this situation.

Presbyopia is a natural condition where, as you get older, the eye cannot focus over the large range that it once could. Once you correct your eyes for distance vision, if you are older, you will naturally have more difficulty seeing up close and need reading glasses. LASIK did not induce this condition; it merely exhibited the preexisting limit of your focusing range. LASIK doctors typically point out that you may end up needing reading glasses -- not because LASIK causes it -- but because they want to avoid unrealistic patient expectations.

Your "then" statements are typical of what you find over at surgicaleyes.org. The big difference is that, over there, no one will challenge such statements. They are accepted as Gospel truth.

George,
I am happy you have had good results but they have blinded you to the truth.

-50-60% of people getting to 20/20 (with both eyes together) is not a good track record. The B&L laser states are for both eyes together, not for individual eyes. There is a huge difference between vision with two eyes that are 20/30 each getting to 20/20 and eyes that are 20/20 each.

-The amount of higher order aberrations is not nonexistent. If it were and if the laser did not introduced higher order aberrations then the wavefront people would not be scrambling to reduce them and the lasik sales people would not be promising people wavefront enhancements to improve their quality of vision. For some, this is not noticeable because of regular astigmatism (which is sometimes corrected with regular lasik but not always perfectly). This why lasik vision is described as a “SOFT 20/20” or a “LASIK 20/20” when it is perfect. Higher order aberrations do have to do with the size of the ablation in relation to the pupil but it also has to do with the smoothness of the lasering.

-See my post above on presbyopia. The changes in higher order aberrations do indeed cause people to become presbyopic earlier in life. Wavefront researchers are trying to understand why this happens and if they can alter the laser pattern to avoid it. There are numerous articles on this online. Also, TLC and other major lasik providers have started including information on this in their consent documents.

Your statements are typical of someone who has had a good outcome. It’s amazing that you have decided to accept every promise of the lasik community as truth until proven otherwise. I guess that all those people over at surgicaleyes.org are a bunch of fakers since lasik is so safe.

Terri

Terri, where do you get this stuff? Let's get down to real, honest to goodness, verifiable facts. OK?

Terri's claim 1: "The B&L laser states are for both eyes together, not for individual eyes."

The Real Truth 1:
Terri is dead wrong here. It is unequivocable.
Get the FDA study here:
http://www.fda.gov/cdrh/pdf/P990027b.pdf

See Table 16. 302 out of 346 EYES achieved UCVA 20/20 or better. That is 87.3% of EYES. I said "87%."
The only huge difference here is between what Terri is saying and the truth.

Terri's claim 2: [I said] "The amount of higher order aberrations is not nonexistent."

The Real Truth 2: I never claimed it was nonexistant. I said that for pre-LASIK it was close to zero. This truth is evident by the fact that MOST folks achieve excellent vision with eyeglasses which ONLY correct for the low order sphere and cylinder aberrations. Contacts and eyeglasses provide NO correction for high order aberrations yet provide excellent vision for most patients.

And I did specify that there was a specific condition that created significant high order aberrations. Terri chose to ignore this.

Terri's claim 3: "The changes in higher order aberrations do indeed cause people to become presbyopic earlier in life."

The Real Truth 3: These are two independent items. Terri, if you have a specific link that suggests otherwise, please provide it. I found nothing that supports this claim at the generic links you have provided. I think the burden is on you to support your claim. I've supported mine.

I don't accept every claim -- especially those, such as Terri's, which cannot be backed up. What I accept as truth can be backed up with scientific evidence. If this is "typical" of some group, I'd say that is a good thing.

And, regarding the individuals over at surgicaleyes.org, I never said they were faking. There are indeed casualties of refractive surgery -- just like any other surgery. But, over there, they wallow in myth and misinformation, just like what you are giving us here, Terri. And for you to equate my rejection of your misinformation with not believing that harm has occurred is just another extension of your flawed logic.

Well stated George!

Again Terry, the point I was making was that ALL surgery has it's risks whether it be elective or necessary and that, even knowing the risks, and being that they are less than most surgeries, I would still recommend Lasik to my friends and do! The point about whether someone is electing the surgery or not is what's irrelevant to my point-being that even surgery that anyone would undertake has it's tragic outcomes. Risk in any surgery is a given. Does it mean one should never risk surgery if it falls under the heading of "elective?" Who's to say?

I also implore people to do their own research and suggest that they start at askphyscians.com. Part of the misinformation you are sharing Terry is that askphys.com is a site of docs selling Lasik. That is not true. You can pull up abstracts on that site referencing research of sound methodology from a plethora of sources, university and hospital studies etc. As always, readers should be discerning-checking the methodology, sample size, etc. I also tell my friends about SI by the way.

I was told that at my relatively high prescription that I probably WOULDN'T get to 20/20 "at least not on the first attempt." (By the optometrist). I still went ahead as I would have been OK with 20/30 or so even if it meant needing glasses for movies and plays or whatever just to be less dependant on corrective lenses. I use to literally have to crawl around on all fours if I misplaced my glasses.

Personally, I care not at all about reading glasses in the future. I was told that I would probably need them but at 45 I was anticipating them at some point anyway. I still don't need them at all and as I mentioned I had a fairly high script so it's clearly not true that everyone will need them right away.