In article <g1sbr0d9gnk6fc6a0f5icji5vmeq30p7lu[at]4ax.com> ,
Glenn - USAEyes.org <glenn.hageleSTOPSPAM[at]USAEyes.org> wrote:

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Exactly my point.
everyone has a bias, even you Glenn

You cannot be entirely objective either. For every "fact" or data you
include or choose to respond to, you have left something else out.

That's scientific: Two objects cannot occupy the same space at the same
time. One of them has to be pushed aside. Therein lies the bias which
makes all presentations of that "object" inherently subjective. for
every utterance, something remains unuttered.

In article <Xns95B87B079ECCCDrLeukoma[at]207.217.125.201> ,
"Dr. Leukoma" <drg[at]leukoma.com> wrote:

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Well, yes I agree if you want to categorize me. I do believe that
someone should be able to have LASIK if they qualify. What should those
qualifications be? I don't know, I'm not an opthalmologist. Do I think
pre-screening is stringent enough and free from advertising hype? No.
Do I think people get operated on even when they have
contra-indications? Yes. Do they know the risks and proceed anyway?
Yes and no. Sometimes doctors gloss over the risks so they don't really
know the true risk of what they are doing given their individual
circumstances, and sometimes I think some people want it so bad they
will lie or gloss over their own risk factors and gamble that all will
work out in the end.

So yes, I do think LASIK should be available as an option for someone
who qualifies for it. I do not think LASIK should be performed on
people who don't qualify for it.

Again, my response was a criticism on the hype and bias. It is easy for
you to see where the bias lies in others, but not so easy in your own
comments and the "way" in which you, Dr. G, read certain articles.
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Supposed to be, but all "facts" are open to interpretation. In fact,
people have been known to use the "facts" to support contesting sides of
an issue. Think about the "facts" of a criminal case. Furthermore,
"reality" is not even constant. Scientists are constantly discovering
new scientific laws and redefining old ones. Otherwise, we'd still be
in a world where the sun revolves around the earth.

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No, my field is all about subjective interpretation. I may be a doctor,
but not a medical one. I'm a PhD. I'm all about treating philosophical
ills

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I'm beginning to think that it is all in the matter of definition, not
only of subjective experience, like visual disturbance from
complications or side effects, but medical ethics. Why does the
government regulate medication differently than medical devices?

~RT

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After more than 20 years of reviewing "objective" scientific studies,
I have come to the conclusion that the numbers almost never lie, but
bias is shown in the analysis.

When someone with a vested interest looks at raw data, that person
will often attribute benefits to his or her device or technique, even
if the data does not empirically support that position. It's not the
study or the data that is biased, but the analysis often is.

That is just a part of human nature. When your kid hits one out of
the park, it must be because of all those hours of you training with
him/her.

I've learned to wait until people without a direct interest publish
results, and until something gets out to the rank and file. Then you
can reasonably rely on the analysis.

Glenn Hagele
Executive Director
Council for Refractive Surgery Quality Assurance

Email to glenn dot hagele at usaeyes dot org

http://www.USAEyes.org
http://www.ComplicatedEyes.org

I am not a doctor.

RT <RTMD24[at]NOSPAMyahoo.com> wrote in
news:RTMD24-8DA64D.11453707122004[at]newssvr14-ext.news.prodigy.com:

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The legal definition is 20/200 or worse with correction in the better
seeing eye, or a visual field of 20 degrees or less. Debilitating
starbursts are not in any definition of blindness.
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I believe that commonly occurring symptoms that resolve could justly be
termed side-effects. If they are visually degrading or cause discomfort,
are long-term, then they are complications. The only thing I left out
was the patient's perception. Are they only complications if the patient
thinks they are? I have patients who don't really meet the DPS
requirements for driving, yet they don't appear particularly "bothered"
by this fact. I think Glenn would say a complication is defined by the
patient.....food for thought.
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My bias is that LASIK should be performed only on consenting adults. I
particularly abhor the thought of having it performed on someone who is
not of the age of consent. My only "bias" was in thinking that the term
"child" meant a minor. I think that the authors' bias is self-evident.
They are just biased in a way you approve -- in favor of LASIK for
everybody who qualifies, the 4 or 10 percent who are turned away
notwithstanding (seems like it should be more than that).
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I am sure that you have read some studies in your field that were so well
designed and executed that you would agree with the results even if you
didn't like them. If we could all agree on the definition of a
complication vs. side-effect, and then conduct a large scale population
study, we might be able to put some of these questions to bed.

DrG

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The last I heard it was 20/200 or worse, best corrected vision. I
assume that some government agencies and some disability insurance
companies may have a slightly different definition, but all would be
pretty close to this.

At -4.50, you would be legally blind without glasses, however I'm sure
that corrective lenses brought you to 20/20, so you are not legally
blind.

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The definition of a complication is very much an issue, and when it is
defined is also an issue. A patient at one month postop may have
debilitating complications, but at six months have none. If you
evaluate at one month, you get a very different statistic than if you
evaluate at six months.

Subjective complications are difficult for some clinicians if they
cannot be objectively observed or measured. Before wavefront, a lot
of doctors deep down thought their patients were nuts because they
could see Snellen 20/20 but complained that their vision was "not
right". Fortunately, quality of vision has become much better
understood (and measurable).

What constitutes a complication for one person may be a
inconsequential nuisance to another. By subjective measurement, I
have more night vision halos than some people who have had LASIK and
complain of their halos. I have not had surgery. By that
measurement, I have a complication, but it is perfectly natural for
me.

We have seen in this forum many people complain bitterly about issues
that others have remarked are no big deal. Try telling the complainer
that they don't have a complication.

- quote -

My bias is objectivity. 8^)

Glenn Hagele
Executive Director
Council for Refractive Surgery Quality Assurance

Email to glenn dot hagele at usaeyes dot org

http://www.USAEyes.org
http://www.ComplicatedEyes.org

I am not a doctor.

In article <Xns95B848E663AFEdrgleukomacom[at]216.148.227.77> ,
"Dr. Leukoma" <drgNOSPAM[at]leukoma.com> wrote:

- quote -

What is the definition of blindness? Apparently I was functionally
blind before LASIK as -4.50. If that's the case, then I suppose one
could consider debilitating starbursts as "blindness." That would be a
complication of "blindness."

If it resolves with healing, like most dry eyes and halos, is that a
complication? or a side effect of healing? Could it be that the
definition of "complication" is the issue? Are side effects and
complications different things? What do you think?

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I just find the "spin" everyone puts on things so very interesting and
illuminating. I was responding to the quote you highlighted from the
article, which showed *your* particular bias. I didn't read that their
children are "youths" but rather to show that they are willing to
perform LASIK on their nearest and dearest.

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Please! I'm not Ragnar. I'm sorry he came up with the RM name. That
seems to be causing some confusion.

~RT

PS: Everything has a bias. "Studies" have a bias. Remember, for
everything that is included, something has been left out. Even
"objective" Glenn has a bias 8^)

RT <RTMD24[at]NOSPAMyahoo.com> wrote in news:RTMD24-
5EDDC6.22503806122004[at]newssvr14-ext.news.prodigy.com:


- quote -

RT,

Even to an objective person, the article seems to show a bias. It is clear
that the authors consider as a complicaton only those that would lead to
blindness. Everything else -- such as dry eye and halos -- are but minor
nuisances to them. I know quite a few people who do not consider those
symptoms minor nuisances, even years after surgery.

Sorry, but I infer the meaning of words as they are commonly used, and the
dictionary defines "child" as somewhere between infancy and youth.

Nice try, Ragnar, but I don't think we'll be reading the results of their
study in the Lancet any time soon.

DrG

Sorry to hear of the family loss.

The majority of the attendees were cataract surgeons thinking about
getting into refractive surgery by way of lens-based surgery. All the
manufacturers - Alcon, Eyeonics, Zeiss, Staar, Oasis, B&L - presented
information regarding their products and where they are in
development. Faculty included many of the well known, Arturo Chayet,
Stephen Brint, Warren Hill, John Doane, John Vukich, Lee Nordan, and
on and on.

The program was narrowly focused on refractive lens procedures, their
relative advantages and relative disadvantages. Stop by
http://www.crstoday.com/vegas/agenda.html

Glenn Hagele
Executive Director
Council for Refractive Surgery Quality Assurance

Email to glenn dot hagele at usaeyes dot org

http://www.USAEyes.org
http://www.ComplicatedEyes.org

I am not a doctor.

In article <Xns95B7CCFB53E2Cdrgleukomacom[at]204.127.204.17> ,
"Dr. Leukoma" <drgNOSPAM[at]leukoma.com> wrote:

- quote -

Please explain what is so terrible about these statements? Most dry eye
resolves within a few months, as do halos. I think most people would
consider these minor complications, a temporary nuisance with a payoff
of great vision after a few months. Yes, there are a few cases of
severe dry eye post-LASIK, but from all that I can tell, this usually
occurs in patients who are pre-disposed due to a medical condition and
who are not caught b/c of poor prescreening.

I'm glad they perform LASIK on their children and relatives (and
themselves). I think it shows they do trust the technology.

Oh, you probably thought "children" meant while they are young.
Unlikely, their children are probably adults.

Nice try.

Glenn,
I was unable to attend due to a death in the family. Sounds like useful
meeting. What does "a whole lot more" refer to. Please share...WK

Glenn - USAEyes.org wrote:
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