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:
- quote -

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:
- quote -

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:
- quote -

Glenn - USAEyes.org <glenn.hageleSTOPSPAM[at]USAEyes.org> wrote in
news:esi9r0dj9thg6us4gds1hkkknbmq4n83ha[at]4ax.com:

- quote -


Well, it looks like there are pro-LASIK zealots just as there are anti-
LASIK zealots. Read this:

================================================== =======================
..
"We perform 100 per cent audit checks on all cases and the safety data
showed that there has been no vision loss, blindness or severe
complications leading to blindness," said Prof Tan.
..
At the TEI, the Lasik success rate for myopia of up to 600 degrees is 98.3
per cent, as the institute takes stringent precautions to prevent long-term
complications.
..
But even with the good track record, both Dr Lee and Prof Tan cautioned,
there is always a risk, as with any other surgical procedure.
..
At the SNEC, the complication rate is about 0.4 per cent. These are
primarily minor complications like dryness of the eyes and seeing halos at
night.
..
The SNEC, like the TEI, screens patients prior to Lasik surgery. This year,
the SNEC turned away 10 per cent of up to 5,000 cases who were not
suitable, while the TEI turned away five per cent of some 300 cases each
month.
..
"Some of our own Lasik surgeons have had Lasik; we have also performed
Lasik on our children and relatives, so I think that's proof of the pudding
that we believe in it," said Prof Tan.
Report that Britain will prohibit the procedure due to long-term safety
concerns was 'misleading'
================================================== =========================

"...minor complications like dryness of the eyes and seeing halos at
night....we have also performed LASIK on our children."

DrG

- quote -

IMO, this is a huge problem with unsupportable, misrepresentative, and
outlandish claims on both sides of the issue. What inevitably happens
if someone says everything about LASIK is bad, is that someone else
will say everything about LASIK is good. Neither side is correct and
the public just gets confused. Confusion is seldom a good thing when
it comes to medicine.

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.

Glenn - USAEyes.org <glenn.hageleSTOPSPAM[at]USAEyes.org> wrote in
news:u7c9r0lm03b3ce8aja0j7cl4hvhllq6pas[at]4ax.com:

- quote -

stringent pre-operation screening." It would be safe to say that
stringent pre-operative screening is not always observed.

The other point is that Dr. Lee considers all side-effects of LASIK to be
mild and mostly short-term. There are bound to be some disagreements
with this rather benign assessment.

DrG

Okay, it's Singapore, but I suspect there will be many articles like
this in the near future.

~~~~~~~~~~~~~~~~~
Tuesday December 7, 2:17 AM
Doctors say LASIK is proven safe, only 1% of patients get
complications

SINGAPORE : Eye doctors say laser eye surgery is safe and effective,
with less than 1 percent of patients developing complications.
So the two main public LASIK centres will continue to offer the
surgery to correct short-sightedness.

The reassurance comes after London newspapers had raised concerns over
the long-term safety of laser eye surgery.

In the last 12 months alone, nearly 6,000 Singaporeans had gone to
public hospitals for laser eye surgery to correct myopia and
astigmatism.

Given the rising popularity of LASIK, many were concerned over reports
that UK is putting a 'block on laser eye surgery in Britain'.

But The Eye Institute says no one has called to cancel any surgery,
and that the report is misleading.

Dr Lee Hung Ming, Head of Refractive Surgery at The Eye Institute
(National Healthcare Group), said: "A little bit misleading because it
gives people the impression that the British government is banning
LASIK procedure all over the country.

"If you read into the report, they are trying to block the move to
prevent LASIK from becoming a subsidised item under the healthcare
system."

The report also quoted American Journal of Ophthalmology saying the
failure rate for eye surgery was one in 10, when it is widely known to
be one in a 1,000.

That figure puzzled doctors too.

Associate Professor Donald Tan, Deputy Director of Singapore National
Eye Centre, said: "We have done 18,288 LASIKs since 1998 and that is a
lot of cases.

"We have at present a 100 percent safety record which means no patient
has developed a bad complication and who has gone blind. LASIK is
probably the safest operation that we have."

Dr Lee said: "The long-term safety concern that they mentioned include
the corneal ectesia, which is the progressive thinning of the cornea
that can result in progressive loss of vision for the patients."

Doctors say long-term complications from LASIK, where the cornea gets
progressively thinner, are rare.

But to make sure they do not happen, doctors carry out very stringent
pre-operation screening.

Those with pre-existing corneal problems or thin cornea will not be
operated on.

The centre says it enjoys a success rate of over 98 percent.

And in the four years since it opened, it has carried out more than
5,500 cases, and only one patient so far, has developed complications
such as corneal infection.

Both the Singapore National Eye Centre and the Eye Institute say they
will continue to offer laser eye surgery.

Dr Lee added: "I do not know what is their definition of a failure
rate. But as in all surgical procedures, LASIK does have some side
effects.

"The mild side effects are dry eyes, glare halos at night. But these
are usually short-term and usually persist for three to six months.
But this is mild compared to the new found freedom from the surgery."
- CNA




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.

As a practical matter it was never really on the cards that the NHS
would do elective refractive surgery. Hoewver, the report when
published on the 15th is expected to have considerable impact here in
the UK.

I think that the 10% failure rate simply refers back to a report that
came out in summer of 2003, which unfortunately has since often been
referred to in such an imprecise way that it's impossible to tell what
they mean. What WAS meant was failure to achieve the desired refractive
error because of under or overcorrection (which, let's face it, IS a
perfectly legitimate use of the word failure, if the surgery doesn't
accomplish what it was intended to). But to the average reader it might
imply there were other complications.

The back-stories and twisted representations on this could take up an
entire ream of paper.

Glasses and contacts are safer than LASIK, so the UK's national health
system does not want to pay for refractive surgery. No real surprise
there. US federal insurance plans under Medicare and Medicaid don't
pay for LASIK for similar reasons. Private indemnity and managed care
insurance plans don't normally pay for LASIK.

Of course, absolutely nothing is being done to curtail refractive
surgery in UK private clinics where the patients are not relying on
the government to pick up the tab. LASIK is okay in the UK, so long
as the UK isn't paying the bill.

I'd like to know what "Ophthalmology" article they are referring to
that states LASIK has a one in ten "failure" rate, and what the London
Times has decide failure means.

Think about it. If LASIK had a 10% failure rate, then there would be
about 800,000 "failures" out there. That is more than every man,
woman, and child in the entire state of Delaware. It seems like you
would have heard a bit more about all the purported "failures".

BTW, WizKid. Since you have presented yourself here as some sort of
expert proponent of phakic intraocular lenses, did you happen to
attend the CRST Refractive Intraocular Lens convention in Las Vegas
last weekend? If you had, you would have had renowned experts
presenting precisely the same information (and a whole lot more) that
I related in this forum, such information you promptly disputed
without any substantiation whatsoever.

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.

Another shoe drops...

The London Times, December 06, 2004

Eye surgery deemed too risky for NHS
By Sam Lister

Watchdog says the chances of damage in treatment do not justify
widespread use

Moves to make laser eye surgery available on the NHS are likely to be
blocked by the Government's clinical watchdog amid growing concerns
over its long-term safety for patients.

A year-long review by the National Institute for Clinical Excellence
(NICE) into the procedure known as Lasik, which is currently available
only at private clinics, has concluded that current evidence on the
treatment's safety does not justify its widespread use on the NHS.

The decision comes after revelations in The Times of two American
lawsuits alleging that a type of laser used by Boots, the high street
chemist, could develop faults leading to blurred vision and damage to
eyesight.

Boots, which was unaware of the concerns before being contacted by The
Times, later announced that it would close its nine laser treatment
centres by the end of the year after failing to win public confidence
in the high-tech procedure.

Bruce Campbell, chairman of NICE's interventional procedures advisory
committee, said that there was very little information about how many
people had been harmed as a result of the Lasik procedure.

A draft of the NICE report, to be published on December 15, has
concluded: "There are concerns about the procedure's safety in the
long term and current evidence does not appear adequate to support its
use without special arrangement for consent (from the NHS)."

Professor Campbell said that questions about the potential damage
caused to some patients had not been answered, leaving the treatment a
cause for concern.

"Lasik offers improvement to people who have mild or moderate trouble
with their vision. This is a problem that can easily be corrected by
spectacles or contact lenses, so any risk of damage to the eye by
Lasik is a real concern," he said.

"Although many people have had Lasik treatment, there is very little
information about how many are harmed as a result. We know that vision
gets worse in a few people after Lasik and eye specialists are also
concerned about the effects of thinning the cornea of the eye in the
long term. We need to know more about these potential problems."

In its draft report, NICE concludes: "current evidence does not appear
adequate to support its use without special arrangements for consent
and for audit and research."

As myopia can be corrected safely with spectacles or contact lenses
NICE says that an alternative treatment "must have excellent safety to
be suitable for use".

Laser surgery, which was introduced in Britain in 1989 in the form of
PRK (photo refractive keratectomy) costs about £2,000 to £3,000 and is
performed on about 100,000 people each year in Britain.

The model Cindy Crawford, the actress Nicole Kidman and the singer
Barry Manilow are among celebrities reported to have undergone the
procedure.

Lasik is the most popular type, where a flap about one third of the
thickness of the cornea is cut, the bed underneath reshaped using the
laser and then the flap is replaced. Last year the medical journal
Ophthalmology said that the failure rate for eye surgery was one in
ten, not the one in a thousand figure widely advertised.

Which?, formerly known as the Consumers' Association, has said that
people having surgery are "gambling with their sight". It found that
some clinics do not highlight possible side-effects until after
patients are signed up for treatment. The Medical Defence Union said
that negligence claims involving laser eye surgery had more than
doubled among its members since 1998.

Minor side-effects that have been reported are dry eyes and night-time
"starbursts". It is estimated that in about 2 to 4 per cent of
patients there will be a measurable decline in the quality of vision.