"Brent Hanson - USAEyes.us" <do_not_contact[at]anywhere.com> wrote in message
news:C5adne41mNHgPVDVnZ2dnUVZ_sDinZ2d[at]comcast.

A handful of people who had a bad Lasik outcome have decided to direct
their ire toward me. Their attacks include lying about my financial
history, insulting my wife, publishing my personal identity including
Social Security number, bank account numbers, credit card numbers on
their bulletin boards, defamation, trademark infringement, listing
doctors we have not certified as recommended, harassing those who fund
and govern our nonprofit organization, and often doing this while
hiding behind false identities and multiple aliases.

Considering the work I do to advocate for Lasik patients and the
nonprofit patient advocacy I founded, their acts seem to have no logic
or reason. Even stranger is the fact that these people did not seek
our information before surgery and did not use doctors certified by
our organization, but you can't use logic and reason on illogical and
unreasonable people.

The outrageous accusations, manipulations, half-truths, outright lies,
false complaints, and attacks on me and others by these anti-Lasik
zealots have caused them some serious trouble.

One recently had the FBI show up at his door investigating an alleged
extortion attempt against his former surgeon and had previously been
charged with felony use of false identity and resisting arrest.

Another is being sued in North Carolina Superior Court for publicizing
my personal identity including Social Security number on her website.
Her employer is investigating how her access to federal secure
computer systems was used to publish defamation on the Internet, and
she uses so many aliases it is hard to keep up.

And one has a permanent restraining order against him for threatening
Dallas Lasik doctor William Boothe, MD with physical violence, has
been sued for defamation, lost, found in contempt of court and
sentenced to jail, is in bankruptcy, and I'm personally suing him for
defamation and invasion of privacy in California Superior Court where
another restraining order has been issued against him.

Rather than copy and pasting the details again and again, just Google:

Brent Hanson
http://tinyurl.com/yrjayg

Lauranell "Nell" Burch
http://tinyurl.com/2y74l7

Dean Andrew Kantis
http://tinyurl.com/2zf3qa

Or visit my personal website:

Brent Hanson
http://www.GlennHagele.com/BrentHanson/

Lauranell "Nell" Burch
http://www.GlennHagele.com/LauranellBurch/

Dean Kantis
http://www.GlennHagele.com/DeanAndrewKantis/

USAEyes is a trademark of the Council for Refractive Surgery Quality
Assurance (http://www.USAEyes.org). The use of usaeyes.INFO,
usaeyes.BIZ, usaeyes.NET, usaeyes.US, and other use of USAEyes by
Brent Hanson is not approved by Council for Refractive Surgery Quality
Assurance. Arbitration under the authority of the Internet Corporation
of Assigned Names and Numbers (ICANN) found Brent Hanson's use of the
USAEyes trademark inappropriate and ordered the domains usaeyes.INFO,
usaeyes.BIZ, usaeyes.NET transferred to the Council for Refractive
Surgery Quality Assurance.

See http://www.usaeyes.INFO

For those who would like to form their own opinion about the work I do
and the organization I founded, visit our website and/or our Lasik
Patient Forum listed below my signature.

Glenn Hagele
Executive Director
USAEyes (R)
Patient Advocacy Surgeon Certification

"Consider and Choose With Confidence" (TM)

Email to glenn dot hagele at usaeyes dot org

http://www.USAEyes.org

Lasik Bulletin Board
http://www.USAEyes.org/Ask-Lasik-Expert/

I am not a doctor.

Copyright 2008
All Rights Reserved

A handful of people who had a bad Lasik outcome have decided to direct
their ire toward me. Their attacks include lying about my financial
history, insulting my wife, publishing my personal identity including
Social Security number, bank account numbers, credit card numbers on
their bulletin boards, defamation, trademark infringement, listing
doctors we have not certified as recommended, harassing those who fund
and govern our nonprofit organization, and often doing this while
hiding behind false identities and multiple aliases.

Considering the work I do to advocate for Lasik patients and the
nonprofit patient advocacy I founded, their acts seem to have no logic
or reason. Even stranger is the fact that these people did not seek
our information before surgery and did not use doctors certified by
our organization, but you can't use logic and reason on illogical and
unreasonable people.

The outrageous accusations, manipulations, half-truths, outright lies,
false complaints, and attacks on me and others by these anti-Lasik
zealots have caused them some serious trouble.

One recently had the FBI show up at his door investigating an alleged
extortion attempt against his former surgeon and had previously been
charged with felony use of false identity and resisting arrest.

Another is being sued in North Carolina Superior Court for publicizing
my personal identity including Social Security number on her website.
Her employer is investigating how her access to federal secure
computer systems was used to publish defamation on the Internet, and
she uses so many aliases it is hard to keep up.

And one has a permanent restraining order against him for threatening
Dallas Lasik doctor William Boothe, MD with physical violence, has
been sued for defamation, lost, found in contempt of court and
sentenced to jail, is in bankruptcy, and I'm personally suing him for
defamation and invasion of privacy in California Superior Court where
another restraining order has been issued against him.

Rather than copy and pasting the details again and again, just Google:

Brent Hanson
http://tinyurl.com/yrjayg

Lauranell "Nell" Burch
http://tinyurl.com/2y74l7

Dean Andrew Kantis
http://tinyurl.com/2zf3qa

Or visit my personal website:

Brent Hanson
http://www.GlennHagele.com/BrentHanson/

Lauranell "Nell" Burch
http://www.GlennHagele.com/LauranellBurch/

Dean Kantis
http://www.GlennHagele.com/DeanAndrewKantis/

USAEyes is a trademark of the Council for Refractive Surgery Quality
Assurance (http://www.USAEyes.org). The use of usaeyes.INFO,
usaeyes.BIZ, usaeyes.NET, usaeyes.US, and other use of USAEyes by
Brent Hanson is not approved by Council for Refractive Surgery Quality
Assurance. Arbitration under the authority of the Internet Corporation
of Assigned Names and Numbers (ICANN) found Brent Hanson's use of the
USAEyes trademark inappropriate and ordered the domains usaeyes.INFO,
usaeyes.BIZ, usaeyes.NET transferred to the Council for Refractive
Surgery Quality Assurance.

See http://www.usaeyes.INFO

For those who would like to form their own opinion about the work I do
and the organization I founded, visit our website and/or our Lasik
Patient Forum listed below my signature.

Glenn Hagele
Executive Director
USAEyes (R)
Patient Advocacy Surgeon Certification

"Consider and Choose With Confidence" (TM)

Email to glenn dot hagele at usaeyes dot org

http://www.USAEyes.org

Lasik Bulletin Board
http://www.USAEyes.org/Ask-Lasik-Expert/

I am not a doctor.

Copyright 2008
All Rights Reserved

A handful of people who had a bad Lasik outcome have decided to direct
their ire toward me. Their attacks include lying about my financial
history, insulting my wife, publishing my personal identity including
Social Security number, bank account numbers, credit card numbers on
their bulletin boards, defamation, trademark infringement, listing
doctors we have not certified as recommended, harassing those who fund
and govern our nonprofit organization, and often doing this while
hiding behind false identities and multiple aliases.

Considering the work I do to advocate for Lasik patients and the
nonprofit patient advocacy I founded, their acts seem to have no logic
or reason. Even stranger is the fact that these people did not seek
our information before surgery and did not use doctors certified by
our organization, but you can't use logic and reason on illogical and
unreasonable people.

The outrageous accusations, manipulations, half-truths, outright lies,
false complaints, and attacks on me and others by these anti-Lasik
zealots have caused them some serious trouble.

One recently had the FBI show up at his door investigating an alleged
extortion attempt against his former surgeon and had previously been
charged with felony use of false identity and resisting arrest.

Another is being sued in North Carolina Superior Court for publicizing
my personal identity including Social Security number on her website.
Her employer is investigating how her access to federal secure
computer systems was used to publish defamation on the Internet, and
she uses so many aliases it is hard to keep up.

And one has a permanent restraining order against him for threatening
Dallas Lasik doctor William Boothe, MD with physical violence, has
been sued for defamation, lost, found in contempt of court and
sentenced to jail, is in bankruptcy, and I'm personally suing him for
defamation and invasion of privacy in California Superior Court where
another restraining order has been issued against him.

Rather than copy and pasting the details again and again, just Google:

Brent Hanson
http://tinyurl.com/yrjayg

Lauranell "Nell" Burch
http://tinyurl.com/2y74l7

Dean Andrew Kantis
http://tinyurl.com/2zf3qa

Or visit my personal website:

Brent Hanson
http://www.GlennHagele.com/BrentHanson/

Lauranell "Nell" Burch
http://www.GlennHagele.com/LauranellBurch/

Dean Kantis
http://www.GlennHagele.com/DeanAndrewKantis/

USAEyes is a trademark of the Council for Refractive Surgery Quality
Assurance (http://www.USAEyes.org). The use of usaeyes.INFO,
usaeyes.BIZ, usaeyes.NET, usaeyes.US, and other use of USAEyes by
Brent Hanson is not approved by Council for Refractive Surgery Quality
Assurance. Arbitration under the authority of the Internet Corporation
of Assigned Names and Numbers (ICANN) found Brent Hanson's use of the
USAEyes trademark inappropriate and ordered the domains usaeyes.INFO,
usaeyes.BIZ, usaeyes.NET transferred to the Council for Refractive
Surgery Quality Assurance.

See http://www.usaeyes.INFO

For those who would like to form their own opinion about the work I do
and the organization I founded, visit our website and/or our Lasik
Patient Forum listed below my signature.

Glenn Hagele
Executive Director
USAEyes (R)
Patient Advocacy Surgeon Certification

"Consider and Choose With Confidence" (TM)

Email to glenn dot hagele at usaeyes dot org

http://www.USAEyes.org

Lasik Bulletin Board
http://www.USAEyes.org/Ask-Lasik-Expert/

I am not a doctor.

Copyright 2008
All Rights Reserved

"Brent Hanson - USAEyes.us" <do_not_contact[at]anywhere.com> wrote in message
news:BtGdnZscDYmvPFDVnZ2dnUVZ_hGdnZ2d[at]comcast.

"Brent Hanson - USAEyes.us" <do_not_contact[at]anywhere.com> wrote in message
news:K4CdnVVd4cxFPVDVnZ2dnUVZ_jednZ2d[at]comcast.com

"Brent Hanson - USAEyes.us" <do_not_contact[at]anywhere.com> wrote in message
news:C5adne41mNHgPVDVnZ2dnUVZ_sDinZ2d[at]comcast.

http://usaeyes.us/reports/the-lasik-...procedure.html

The LASIK Report - A Call for the Discontinuation of a Harmful
Procedure
LASIK is one of the most commonly performed elective surgeries in the
United States today. The public perception of LASIK is based largely on
advertising, which is intended to entice patients to have surgery without
disclosing risks, side effects and contraindications.

The perceived benefits of LASIK surgery are obvious, whereas risks and
adverse effects are not. It is unwise to assume that a surgeon who has a
financial interest in a patient's decision to have LASIK will provide
adequate informed consent.

LASIK is irreversible and may result in long-term, debilitating
complications. There are permanent adverse effects of LASIK in 100% of
cases, even in the absence of clinically significant complications. This is
unacceptable in the context of an elective surgery when safer alternatives
such as glasses or contact lenses exist.

I. BACKGROUND

In 1998, when the first laser received FDA approval for LASIK, little
was known about complications and long-term safety of the procedure. Early
clinical trials did not thoroughly examine adverse effects of LASIK.

Since that time, numerous medical studies have examined the risks of
LASIK. It is now widely reported in ophthalmic medical journals that
complications such as dry eye and visual disturbances in low light are
common, and that creation of the corneal flap permanently compromises
tensile strength and biomechanical integrity of the cornea.

In 1999 during the initial boom in popularity of LASIK, Marguerite B.
McDonald, noted refractive surgeon and then-Chief Medical Editor of EyeWorld
magazine, stated in an editorial:

"We are only starting to ride the enormous growth curve of LASIK in
this country. There will be more than enough surgeries for everyone to
benefit if we keep our heads by sharing information openly and honestly and
by resisting the temptation to criticize the work of our colleagues when we
are offering a second opinion to a patient with a suboptimal result. Who was
it who said, 'When the tide comes in, all the boats in the harbor go up?' "

Today some prominent refractive surgeons are finding superior outcomes
and better safety profiles with surface ablations such as PRK and LASEK,
which avoid creation of a corneal flap. Yet LASIK continues to be the most
common refractive surgical procedure performed.

II. DRY EYE

A report by the American Academy of Ophthalmology published in 2002
stated that dry eye is the most common complication of LASIK surgery.1
Refractive surgeons are aware that LASIK induces dry eye, yet patients are
not receiving full informed consent as to the etiology, chronic nature and
severity of this condition.

"My LASIK dry eye is not a minor problem, as downplayed by some
ophthalmologists. It's a disability. I estimate that I am blind
approximately 10 percent of the time due to my eyes being closed because of
the pain. At the time of my surgery, I was told only a small number of
patients experience a complication from this procedure. There is substantial
evidence that shows this crippling side effect to be relatively common."

LASIK patient, David Shell, testifying before the FDA Ophthalmic
Devices Panel in August, 2002.

Persistent Dry Eye and Quality of Life after LASIK

Patients elect to undergo LASIK surgery with the expectation of
improved quality of life. Instead, many are living with chronic pain from
LASIK-induced dry eye. The FDA website states that dry eyes after LASIK may
be permanent

(http://www.fda.gov/cdrh/LASIK/risks.htm). Patients should be informed
that LASIK surgery severs corneal nerves that play a crucial role in tear
production, and that these nerves do not return to normal. Inability to
sense and respond to dryness may lead to ocular surface damage.

Medical Research on the Duration and Severity of Dry Eye

Dry eye disease is a painful, chronic condition for some patients
after LASIK surgery. In 2001, Hovanesian, Shah, and Maloney found that 48%
of LASIK patients reported symptoms of dryness at least 6 months after
surgery, including soreness, sharp pain and eyelid sticking to the eyeball.2

A Mayo Clinic study published in 2004 demonstrates that 3 years after
LASIK corneal nerves are less than 60% of preoperative densities.3

In 2006, researchers at Baylor College of Medicine reported the
incidence of dry eyes six months after LASIK at 36% overall and 41% in eyes
with superior-hinges.4 These findings were based on objective medical tests
rather than patient questionnaires, which is significant as patients with
nerve damage may not be capable of sensing dryness.

The scientific literature is replete with case reports and studies of
LASIK-induced dry eye. This complication is widely recognized in the
industry as the most common complaint of LASIK patients, yet the problem is
downplayed in the informed consent process. Most dry eye therapies provide
only marginally effective symptomatic relief. There is no cure for
LASIK-induced dry eye. Internet bulletin boards with forums devoted to
post-LASIK dry eye are a testament to this widespread, debilitating
condition.
III. Night Vision Impairment

Millions of LASIK surgeries have been performed in the United States
since its approval in 1998. Many patients now suffer from visual impairment
at night. Some of these patients, especially those with large pupils, are
unsafe to drive at night and can no longer live normal, independent lives.

"When I drive to work every day, fighting the DC traffic I hear lots
of great advertisements including the advertisements from the center that
did my surgery talking about 95, 98 percent, whatever the percentage is of
their patients who achieve 20/20 or 20/40 or better vision, and they
consider that a success. I am considered a success by that criteria as well.
However, in anything but extremely bright daylight I am visually impaired by
starbursts, halos, multiple ghost images because of LASIK done on my
8-millimeter pupils.

FDA approval of devices should include not only approval within a
certain range of myopia or astigmatism or hyperopia but within a range of
pupil sizes such that any use of that device outside of that pupil size
should be considered against the FDA approval of that device.".

LASIK patient, Mitch Ferro, testifying before the FDA Ophthalmic
Devices Panel in July, 1999.

Unfortunately the FDA turned a deaf ear on this recommendation and did
not place a pupil size limit on the approval, nor did it include large
pupils in the list of LASIK contraindications. Instead, the FDA approved
lasers for LASIK with watered-down cautionary language in the labeling
regarding large pupils. Dissemination of this labeling to patients was
mandated by the FDA but not enforced, which violated the right to full
informed consent for many patients with large pupils.

Reduced visual quality in dim light is frequently reported by LASIK
patients.1 Patients with pupils that dilate larger than the effective
optical zone of the LASIK treatment are at increased risk for debilitating
visual aberrations and loss of contrast sensitivity.5 Even patients with
normal pupil sizes are at risk, as the laser loses efficiency on the slope
of the cornea resulting in an effective optical zone that is smaller than
intended.6 Newer laser technologies attempt to compensate by applying more
laser energy in the periphery of the ablation, but this technique removes
more corneal tissue, increasing the risk of surgically-induced
keratectasia.7

In a study published in 2004, dark-adapted pupil sizes of candidates
for refractive surgery were found to range from 4.3 to 8.9 mm with a mean
diameter of 6.5 mm.8 This finding explains why many patients had severe
nighttime visual aberrations in the early days of photorefractive
keratectomy when optical zones as small as 4 mm were used. In an attempt to
overcome pupil size/optical zone mismatch, the standard treatment zone was
increased incrementally over several years. However, even the 6.5 mm optical
zone commonly used today does not prevent aberrations in many patients with
large pupils, or high corrections and associated small effective optical
zones.

Image degradation and visual aberrations in low light after LASIK were
predictable. These problems had been widely recognized and reported with
previous refractive surgeries such as radial keratotomy (RK) and
photorefractive keratectomy (PRK), and were related to pupil size.9 If
refractive power is not consistent across the entire diameter of the pupil,
visual aberrations and loss of contrast sensitivity result. After cataract
surgery or refractive lens exchange, patients also report poor vision at
night when the pupil dilates. As phakic IOLs begin to replace LASIK for high
myopia due to safety concerns, the pattern of patients with large pupils
experiencing night vision disturbances is consistent.

Public Health Concerns following LASIK Surgery

Dr. Leo Maguire forewarned of the threat to public health posed by
impaired vision following refractive surgery.10 The following is an excerpt
from an editorial published in the March, 1994 edition of American Journal
of Ophthalmology:

"I hope the reader will now understand how a patient may have
clinically acceptable 20/20 visual acuity in the daytime and still suffer
from clinically dangerous visual aberration at night if that patient's
visual system must cope with an altered refractive error, increased glare,
poorer contrast discrimination, and preferentially degraded peripheral
vision. People die at night in motor vehicle accidents four times as
frequently as they do during the day, and these figures are adjusted for
miles driven. Night driving presents a hazardous visual experience to adults
without aberrations. When we discuss aberration at night we are considering
a possible morbid effect of refractive surgery."
A Brief Chronology of Scientific Literature on Night Vision
Impairment after Corneal Refractive Surgery

Factors responsible for visual impairment in low light following
refractive surgery have been discussed in articles and reported in
peer-reviewed studies for nearly two decades.

1987
"For a patient to have a zone of glare-free vision centered on
the point of fixation, the optical zone of the cornea must be larger than
the entrance pupil. The larger the optical zone, the larger the field of
glare-free vision."11

1993
"Optical zone diameters must be at least as large as the entrance
pupil diameter to preclude glare at the fovea, and larger than the entrance
pupil to preclude parafoveal glare."12

1996


"At nighttime, when the pupil dilates, rays from treated and
untreated areas of the cornea reach the retina at different foci and produce
haloes."13

1997


"Corneal modulation transfer function calculations suggest that a
significant loss of visual performance should be anticipated following
photorefractive keratectomy, the effect being the greatest for large pupil
diameters."14

1998


".after PRK, the diameter of the entrance pupil greatly affects
the amount and character of the aberrations."15

1999


"Changes in functional vision worsen as the target contrast
diminishes and the pupil size increases."16

2000


"The increase in ocular aberrations was significantly related
with the virtual pupil size."17



"Thus, an optical system may have no refractive error in the
center of the pupil and an increasing error in the annular zones surrounding
the pupil center. The resultant image may be sharp for small pupil diameters
but degrade as the pupil expands."18

2002


"The relation between pupil size and the optical clear zone are
most important in minimizing these disturbances in RK. In PRK and LASIK,
pupil size and the ablation diameter size and location are the major factors
involved." 19


The LASIK industry failed to take corrective action in response to
scientific evidence regarding the importance of matching the effective
optical zone to a patient's pupil size. As a result, many LASIK patients are
now permanently visually impaired in dim light.
IV. IATROGENIC KERATECTASIA

The cornea is under constant stress from normal intraocular pressure
pushing outward. The collagen bands of the cornea provide its form and
biomechanical strength. LASIK thins the cornea and severs collagen bands,
permanently weakening the cornea. This results in forward bulging of the
cornea, which may progress to a condition known as keratectasia,
characterized by loss of best corrected vision and possible corneal failure
requiring corneal transplant.

The FDA, laser manufacturers, and refractive surgeons are aware of
limits on flap thickness, ablation depth, and diameter of the optical zone
imposed by corneal biomechanics. When the FDA initially approved lasers for
LASIK, it established a minimum of 250 microns of corneal tissue under the
flap after LASIK surgery to prevent corneal instability and progressive
forward bulging. Subsequent reports in medical literature indicate that 250
microns is not sufficient to ensure corneal biomechanical stability.20,21 In
response, some surgeons stopped performing LASIK or raised the residual
stromal thickness limit in their practices. However, the majority of
surgeons continue to observe the 250 micron rule initially established by
the FDA, even though this limit has been shown to be insufficient.

The 250 micron rule is often violated inadvertently during surgery, as
microkeratomes that cut the LASIK flap are unpredictable and produce flaps
of varying thickness.22 For this reason, flap thickness should be measured
intraoperatively. Most surgeons have not incorporated this important
measurement into the surgical procedure prior to ablation, which places
patients with thicker flaps at increased risk.

Keratectasia may develop months or years following LASIK.23 Since most
cases are never reported, the true rate of this devastating complication may
never be known. The safest solution for patients would be to abandon LASIK
altogether. It is important to remember that LASIK is elective surgery.
There is no sound medical reason to place patients at risk of vision loss
from unnecessary surgery.

V. LIMITED HEALING OF THE CORNEA FOLLOWING LASIK

The human cornea is incapable of complete wound healing after LASIK
surgery. In 2005, researchers at Emory University found permanent pathologic
changes in all post-LASIK corneas examined, including undulation of Bowman's
layer, spatial separation of the LASIK flap from the stromal bed, epithelial
thickening over the wound margin, interface debris, and severed and severely
disordered collagen fibrils.24 The study reveals that the healing response
never completely regenerates normal corneal stroma.

Another recent study demonstrates that the LASIK flap produces a scar
at the margin that is only 28.1% of the tensile strength of normal corneal
stroma, and the flap itself heals to only 2.4% of normal tensile strength.25
The article reports that one author has lifted LASIK flaps out to 11 years
after initial surgery, further attesting to long-term weakness of the LASIK
interface wound. Reports of late flap dislocations suggest that LASIK
patients are vulnerable to traumatic flap injury for life. 26

VI. OTHER COMPLICATIONS AND CONCERNS

Potential Complications

Other vision-threatening complications are seen following LASIK
surgery such as infection, retinal breaks and detachment, macular holes and
hemorrhage, optic nerve damage, diffuse lamellar keratitis, irregular flaps,
flap folds and striae, slipped flaps, epithelial defects, and epithelial
ingrowth. These and other complications may have severe, lasting adverse
effects.

Inaccurate IOP Measurement after LASIK

The changes in corneal thickness and curvature following LASIK affect
intraocular pressure measurements, resulting in falsely low readings. LASIK
patients face lifetime risk of undiagnosed high intraocular pressure
(glaucoma), a leading cause of blindness.

Cataract Surgery after LASIK

Like the general population, LASIK patients will develop cataracts
later in life. The altered corneal surface following LASIK prevents accurate
measurement of intraocular lens power for cataract surgery. This may result
in a "refractive surprise" for LASIK patients following cataract surgery and
exposes them to increased risk of repeat surgeries.

LASIK Results in Loss of Near Vision

Patients are routinely misinformed that they will require reading
glasses after the age of 40 whether they have LASIK or not. Nearsighted
patients who do not have refractive surgery actually retain the ability to
see up close naturally after the age of 40 simply by removing their glasses.
LASIK increases the need for reading glasses by changing the eye's focus
from near to distance. The loss of near vision after myopic-LASIK affects
many daily activities, not just reading. LASIK patients over the age of 40
may discover they have simply traded one pair of glasses for another.

VII. PATIENT SATISFACTION

LASIK success is measured by the LASIK industry as uncorrected visual
acuity under bright illumination. Patients seeking vision correction are
most concerned with elimination of glasses or contact lenses, and are
unaware what it means to lose visual quality. Patient surveys typically show
a high level of satisfaction with LASIK. However, an alarming number of
'satisfied' patients also report symptoms such as visual disturbances in dim
light and dry eye.

In May, 2001, results from a questionnaire completed by PRK and LASIK
patients revealed that 19.5% reported a worsening in functioning, 27.1% a
worsening in symptoms, 34.9% a worsening in optical problems, 33.7% a
worsening in glare, and 41.5% a worsening in driving.27

In one report, researchers suggest that factors such as the Hawthorne
effect and cognitive dissonance may play a role in patient satisfaction
following LASIK.28 The Hawthorne effect favorably influences patients'
survey responses merely because patients are aware that they are enrolled in
a study. Cognitive dissonance is a change in one's attitude or beliefs to
eliminate internal conflict with negative consequences of an irreversible
action.

VIII. NEWER TECHNOLOGIES

Wavefront-guided and wavefront-optimized LASIK

Newer laser technologies were designed to reduce induction of new
aberrations and prevent night vision disturbances. As complications from
current technologies generate bad publicity, pressure to develop and market
alternative technologies emerge. "Real" complication rates are openly
discussed, not when a procedure is popular, but rather when providers push
newer, "improved" technology. The LASIK industry and LASIK surgeons
aggressively promote new technologies as "safer and more effective", blaming
older technologies for past complications. Although the introduction of
wavefront-LASIK was surrounded by hype, studies have shown that
wavefront-guided and wavefront-optimized LASIK actually increase, not
decrease, higher order aberrations, reducing visual quality in previously
untreated eyes.29,30 A recently published review of literature on
wavefront-guided LASIK concludes that evidence does not support claims that
wavefront outperforms conventional LASIK.31 Wavefront, like previous forms
of refractive surgery, fails to deliver on its promises.

Femtosecond laser flap creation (Intralase-LASIK)

Mechanical blade microkeratomes have been linked to flap complications
and damage to the epithelium. The femtosecond laser keratome is currently
promoted as a safer alternative. Studies have shown that the femtosecond
laser produces flaps with smaller deviations from planned thickness than
mechanical microkeratomes. However, it does not reduce most complications
associated with the LASIK procedure and has been linked to extreme light
sensitivity,32 a new complication of this technology. Femtosecond laser
flaps are more difficult to lift than flaps created with a blade, which may
result in a higher incidence of torn flaps.

The femtosecond laser keratome currently requires longer suction on
the eye than blade microkeratomes to create the LASIK flap. The incidence of
posterior vitreous detachment with blade microkeratomes is high, at 13%
overall and 24% for patients with high myopia.33 Increased suction ring
exposure associated with use of femtosecond lasers likely induces posterior
vitreous detachment at even higher rates as well as other serious
complications such as retinal detachment, macular hemorrhage, retinal vein
occlusion, and optic nerve damage following LASIK.

A search of peer-reviewed literature reveals problems associated with
the femtosecond laser such as slipped flaps, interface inflammation, flap
folds, infectious keratitis, corneal stromal inflammation, delayed wound
healing, macular hemorrhage, and gas bubbles in the anterior chamber after
surgery.34-40 The FDA medical device adverse events database
(http://www.fda.gov/cdrh/maude.html) contains numerous reports involving
femtosecond laser keratomes.

IX. CONCLUSION

Patients are denied the whole truth about the negative effects of
LASIK; therefore they are unable to give informed consent. The LASIK
industry has been unresponsive to results of medical research, which should
have resulted in a higher standard of care. Instead, LASIK surgeons have
resisted raising the standard of care in order to maintain the potential
pool of candidates and to protect themselves from liability.

The American Medical Association endorses certain principles of
medical ethics. One principle states that: "A physician shall uphold the
standards of professionalism, be honest in all professional interactions,
and strive to report physicians deficient in character or competence, or
engaging in fraud or deception, to appropriate entities."
(http://www.ama-assn.org/ama/pub/category/2512.html). The white wall of
silence called for by Dr. McDonald in 1999 violates this principle.

There has been and continues to be a pattern within the refractive
surgery industry placing patients' interests secondary to financial
interests. Medical doctors are ethically bound to put the best interests of
patients first. LASIK is an unnecessary surgical procedure that permanently
damages the eyes of every patient; therefore it is a violation of a primary
principle of medicine, "First, Do No Harm". As such, the practice of LASIK
should be discontinued.
References

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2. Hovanesian JA, Shah SS, Maloney RK. Symptoms of dry eye and
recurrent erosion syndrome after refractive surgery. J Cataract Refract
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3. Calvillo MP, McLaren JW, Hodge DO, Bourne WM. Corneal reinnervation
after LASIK: prospective 3-year longitudinal study. Invest Ophthalmol Vis
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4. De Paiva CS, Chen Z, Koch DD, Hamill MB, Manuel FK, Hassan SS,
Wilhelmus KR, Pflugfelder SC. The incidence and risk factors for developing
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5. Schwiegerling J, Snyder RW. Corneal ablation patterns to correct
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7. Mrochen M, Donitzky C, Wullner C, Loffler J. Wavefront optimized
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8. Netto MV, Ambrosio R Jr, Wilson SE. Pupil size in refractive
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9. Hjortdal JO, Olsen H, Ehlers N. Prospective randomised study of
corneal aberrations 1 year after radial keratotomy or photorefractive
keratectomy. J Refract Surg. 2002 Jan-Feb;18(1):23-9.

10. Maguire LJ. Keratorefractive surgery, success, and the public
health. Am J Ophthalmol. 1994 Mar 15;117(3):394-8.

11. Uozato H, Guyton DL. Centering Corneal Surgical Procedures. Amer J
Ophthal. 1987 Mar 15;103(3 Pt 1):264-75.

12. Roberts CW, Koester CJ. Optical zone diameters for photorefractive
corneal surgery. Invest Ophthalmol Vis Sci. 1993 Jun;34(7):2275-81.

13. Alster Y, Loewenstein A, Baumwald T, Lipshits I, Lazar M.
Dapiprazole for patients with night haloes after excimer keratectomy.
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14. Oliver KM, Hemenger RP, Corbett MC, O'Brart DP, Verma S, Marshall
J, Tomlinson A. Corneal optical aberrations induced by photorefractive
keratectomy. J Refract Surg. 1997 May-Jun;13(3):246-54.

15. Martinez CE, Applegate RA, Klyce SD, McDonald MB, Medina JP,
Howland HC. Effect of pupillary dilation on corneal optical aberrations
after photorefractive keratectomy. Arch Ophthalmol. 1998 Aug;116(8):1053-62.

16. Holladay JT, Dudeja DR, Chang J. Functional vision and corneal
changes after laser in situ keratomileusis determined by contrast
sensitivity, glare testing, and corneal topography. J Cataract Refract Surg.
1999 May;25(5):663-9.

17. Seiler T, Kaemmerer M, Mierdel P, Krinke HE. Ocular optical
aberrations after photorefractive keratectomy for myopia and myopic
astigmatism. Arch Ophthalmol. 2000 Jan;118(1):17-21.

18. Schwiegerling J, Snyder RW. Corneal ablation patterns to correct
for spherical aberration in photorefractive keratectomy. J Cataract Refract
Surg. 2000 Feb;26(2):214-21.

19. Fan-Paul NI, Li J, Miller JS, Florakis GJ. Night vision
disturbances after corneal refractive surgery. Surv Ophthalmol. 2002
Nov-Dec;47(6):533-46.

20. Miyata K, Tokunaga T, Nakahara M, Ohtani S, Nejima R, Kiuchi T,
Kaji Y, Oshika T. R. Residual bed thickness and corneal forward shift after
laser in situ keratomileusis. J Cataract Refract Surg. 2004
May;30(5):1067-72.

21. Pallikaris IG, Kymionis GD, Astyrakakis NI. Corneal ectasia
induced by laser in situ keratomileusis. J Cataract Refract Surg. 2001
Nov;27(11):1796-802.

22. Flanagan GW, Binder PS. Precision of flap measurements for laser
in situ keratomileusis in 4428 eyes. J Refract Surg. 2003
Mar-Apr;19(2):113-23.

23. Lifshitz T, Levy J, Klemperer I, Levinger S. Late bilateral
keratectasia after LASIK in a low myopic patient. J Refract Surg. 2005
Sep-Oct;21(5):494-6.

24. Kramer TR, Chuckpaiwong V, Dawson DG, L'Hernault N, Grossniklaus
HE, Edelhauser HF. Pathologic findings in postmortem corneas after
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25. Schmack I, Dawson DG, McCarey BE, Waring GO 3rd, Grossniklaus HE,
Edelhauser HF. Cohesive tensile strength of human LASIK wounds with
histologic, ultrastructural, and clinical correlations.

J Refract Surg. 2005 Sep-Oct;21(5):433-45.

26. Cheng AC, Rao SK, Leung GY, Young AL, Lam DS. Late traumatic flap
dislocations after LASIK.
J Refract Surg. 2006 May;22(5):500-4.

27. Schein OD, Vitale S, Cassard SD, Steinberg EP. Patient outcomes of
refractive surgery. The refractive status and vision profile. J Cataract
Refract Surg. 2001 May;27(5):665-73.

28. Garamendi E, Pesudovs K, Elliott DB. Changes in quality of life
after laser in situ keratomileusis for myopia. J Cataract Refract Surg. 2005
Aug;31(8):1537-43.

29. Kohnen T, Buhren J, Kuhne C, Mirshahi A. Wavefront-guided LASIK
with the Zyoptix 3.1 system for the correction of myopia and compound myopic
astigmatism with 1-year followup: clinical outcome and change in higher
order aberrations. Ophthalmology. 2004;111:2175-2185.

30. Brint SF. Higher order aberrations after LASIK for myopia with
Alcon and Wavelight lasers: a prospective randomized trial. J Refract Surg.
2005 Nov-Dec;21(6):S799-803.

31. Netto MV, Dupps W Jr, Wilson SE. Wavefront-guided ablation:
evidence for efficacy compared to traditional ablation. Am J Ophthalmol.
2006 Feb;141(2):360-368.

32. Stonecipher KG, Dishler JG, Ignacio TS, Binder PS. Transient light
sensitivity after femtosecond laser flap creation: clinical findings and
management. J Cataract Refract Surg. 2006 Jan;32(1):91-4.

33. Luna JD, Artal MN, Reviglio VE, Pelizzari M, Diaz H, Juarez CP.
Vitreoretinal alterations following laser in situ keratomileusis: clinical
and experimental studies. Graefes Arch Clin Exp Ophthalmol. 2001
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34. Binder PS. Flap dimensions created with the IntraLase FS laser. J
Cataract Refract Surg. 2004 Jan;30(1):26-32.

35. Biser SA, Bloom AH, Donnenfeld ED, Perry HD, Solomon R, Doshi S.
Flap folds after femtosecond LASIK. Eye Contact Lens. 2003 Oct;29(4):252-4.


36. Chung SH, Roh MI, Park MS, Kong YT, Lee HK, Kim EK. Mycobacterium
abscessus keratitis after LASIK with IntraLase femtosecond laser.
Ophthalmologica. 2006;220(4):277-80.

37. Kim JY, Kim MJ, Kim TI, Choi HJ, Pak JH, Tchah H. A femtosecond
laser creates a stronger flap than a mechanical microkeratome. Invest
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38. Ratkay-Traub I, Ferincz IE, Juhasz T, Kurtz RM, Krueger RR. First
clinical results with the femtosecond neodynium-glass laser in refractive
surgery. J Refract Surg. 2003 Mar-Apr;19(2):94-103.

39. Principe AH, Lin DY, Small KW, Aldave AJ. Macular hemorrhage after
laser in situ keratomileusis (LASIK) with femtosecond laser flap creation.
Am J Ophthalmol. 2004 Oct;138(4):657-9.

40. Lifshitz T, Levy J, Klemperer I, Levinger S. Anterior chamber gas
bubbles after corneal flap creation with a femtosecond laser. J Cataract
Refract Surg. 2005 Nov;31(11):2227-9.

CRSQA (Council for Refractive Quality Assurance) is a referral service for
LASIK surgeons, operated by Glenn Hagele out of his home. Despite its
pretentious name, CRSQA is just a cynical marketing ploy that "certifies"
refractive surgeons willing to fork over $7,000 in the first year and
$5,000/year thereafter. In exchange, Glenn Hagele provides these surgeons
with a bogus seal of approval on his USAEYES.org web site to promote their
practices. Don't be fooled by Glenn Hagele's advertising claims - CRSQA's
quality "standards" are actually below industry standards. Glenn Hagele is
not qualified to issue certifications as he is not a doctor, but simply a
high school graduate with a single college course in marketing.

Out of 17,000 ophthalmologists in the US, about 30-50 pay Glenn Hagele to
market their practices. It is somewhat difficult to tell exactly what
ophthalmologists are members of CRSQA at any one time, as Glenn Hagele has
designed his web site in such a manner to implicitly suggest that 17,000
ophthalmologists are members.

http://www.lasiksurgeryblog.com/2005....html#comments

For more more information about Glenn Hagele's consumer fraud and abuse of
LASIK patients, visit the following web sites:

http://www.theglennhagelereport.com
http://www.usaeyes.us
http://www.lasikpimp.com
http://www.lasikfraud.com
http://www.lasikdisaster.com
http://www.lifeafterlasik.com
http://www.lasik-flap.com/forum/viewforum.php?f=21
http://www.lasikscam.com/viewforum.php?f=21
http://www.jackholladay.com/avoid_this_doctor.html