The LASIK Blog

Olympic Short Track Speedskater Hopeful Katherine Reutter Looking Forward to the Upcoming Season Following Her LASIK at EyeCare 20/20

We recently heard from Katherine Reutter, the number 1 ranked American Short Track Speedskater.  She is doing very well since her LASIK surgery at EyeCare 20/20 and is anxiously looking forward to testing out her new eyes on the track!

Flomax Side Effects Lead to Call for Cataract Surgery Screening - AboutLawsuits.com

Flomax Side Effects Lead to Call for Cataract Surgery Screening - AboutLawsuits.com Shared via AddThis

Download Flomax Side Effects Lead to Call for Cataract Surgery Screening - AboutLawsuits.com

Cataract Surgery @ EyeCare 20/20: Driving at 126 Years Old!!

I recently received a Thank-You note from a 76 year old patient who I preformed cataract surgery on.  This patient was referred by his ophthalmologist for me to do his surgery.  In his note, this patient mentioned that he sees well enough to drive for the next 50 years!  I guess we will see him on the road for his 126th birthday!!

Video Testimonial: ReSTOR +3.0 Cures an Unhappy Cataract Surgery Patient

With the introduction of the new ReSTOR +3.0 earlier this year, we are now able to give our patients the ability to read, work on the computer, and drive without being dependent on glasses or contact lenses.  This new implant may be implanted at the time of cataract surgery, or as a purely refractive surgery in those patients without cataracts (Refractive Lens Exchange- RLE).  The only caveat is that the ReSTOR +3.0 may only be implanted at the time of these surgeries.  It cannot generally be exchanged for a standard implant that was previously implanted in the past.

Standard implants (IOLs) generally give fairly good distance vision, but do not allow one to see clearly up close.  Reading glasses are needed for both computer distance and reading following standard cataract surgery.  This procedure is fully covered by most medical insurances. 

The ReSTOR +3.0 is a premium IOL.  The cataract portion of the procedure is again covered by most insurances, but the IOL portion is not, requiring an out of pocket expense for the patient.  It is important for the prospective cataract patient to think long and hard about the type of IOL implanted.  This is a one time chance to minimize one's need for reading glasses! 

This brings us to today's video testimonial from Elizabeth Yonks.  Elizabeth had LASIK at EyeCare 20/20 back in 2000.  She enjoyed many years of excellent distance vision, but needed reading glasses for close visual tasks.  She recently noticed a decline in her distance vision and was diagnosed with cataracts.

Prior to surgery, Elizabeth was presented with her IOL options.  She opted for a standard IOL.  After the first cataract surgery on her right eye, Elizabeth was very unhappy.  She had great distance vision but no near or intermediate vision.  We decided to implant a ReSTOR +3.0 in the second eye with hopes that the multifocal IOL in that eye would be a marked improvement.

After the second cataract surgery, Elizabeth was certainly happier, but the first eye was still bothering her.  SInce the original cataract surgery was only 3 weeks out, the IOL was not fully adherent.  We decided to try to exchange th original standard IOL with a ReSTOR +3.0.  Elizabeth had the IOL exchange yesterday, and I am happy to say she is now quite happy. 

THE MORAL OF THE STORY:  Make sure to chose your IOL wisely, it is usually a permanent decision!

Here is Elizabeth's video testimonial:

The Flomax-Cataract Controversary, Continued

In this week's issue of JAMA is an article titled:  Association Between Tamsulosin and Serious Ophthalmic Adverse Events in Older Men Following Cataract Surgery.  The study looked at a group of 96,128 men, ages 66 and older, who had cataract surgery. Among those who had taken Flomax in the two weeks before surgery, 7.5 percent had a serious complication like retinal detachment or inflammation of the eye. Only 2.7 percent of patients who hadn't recently taken Flomax experienced such complications.  The authors concluded that:

Flomax exposure is associated with an increased risk of postoperative complications concurs with prior studies of intraoperative adverse events. We believe that this is the first large study with an adequate study design to describe this effect and provide a population-based risk estimate (something that can only be done using population-based observational research). It is unclear whether drug discontinuation prior to surgery reduces this risk. Because the combination of cataract surgery and tamsulosin exposure is relatively common, patients should be properly appraised of the risks of drug therapy and preoperative systems should focus on the identification of tamsulosin use by patients. In this way, surgeons can plan and prepare for a potentially more complicated procedure or refer to someone with more experience.

This article was also discussed in the New York Times and US News & World Report, among others.

I have already posted two blog posts concerning the problems associated with Flomax use before cataract surgery.  I find that discontinuing the Flomax prior to surgery does not decrease the risk of a more difficult surgery.  I have seen floppy iris syndrome (IFIS) in patients who have been off Flomax for more than 1 year!

In this month's issue of EyeNet, I have a letter to the editor,  Remove Cataracts Before Starting Flomax, published.  Here is a copy if my letter:

I read with interest the article “The Latest Wisdom on Managing Floppy Iris” (Clinical Update, March). Although we are better equipped for handling intraoperative floppy iris syndrome (IFIS) with the aid of the Malyugin ring, we are going about its prevention all wrong.

We may argue about whether to stop tamsulosin prior to cataract surgery or to have the urologist prescribe a different alpha blocker, but we are missing the point. The use of alpha blockers does cause an increased incidence of IFIS and, with it, an increased morbidity during routine cataract surgery! It is time to follow the guidelines for patients who are about to be prescribed chloroquine: a baseline ophthalmic exam prior to the initiation of therapy.

If the urologist is considering starting a patient on an alpha blocker to treat urinary symptoms, a baseline exam from the ophthalmologist should be considered prior to treatment. If a cataract is detected, it might make sense to treat the cataract prior to the initiation of alpha antagonist therapy. This would go a long way toward minimizing the morbidity in these patients.

Cary M. Silverman, MD

East Hanover, N.J

Download May09_Letters

I firmly believe that Flomax and other alpha agonists may have a severe adverse effect on cataract surgery.  I will be making it my mission to advocate for the above protocol when contemplating the start of this therapy.

OBSERVING MEMORIAL DAY: Honoring Our Fallen Heroes

This Memorial Day, we at EyeCare 20/20 would like to take this time to reflect and remember all the brave men and women of the United States who have given their lives while defending our freedom and country. We extend our deepest gratitude for their courage and dedication to preserving peace.

 

Memorial Day Facts:

• Memorial Day is celebrated every year on the last Monday of May.

• Memorial Day was first observed to honor Union soldiers who had perished during the American Civil War. It has since been expanded to observe casualties of all American fought wars and actions.

• Memorial Day was first declared a national holiday in 1971.

• In November 1918, while working at the YMCA Overseas War Secretaries Headquarters, Monina Michael wrote the poem We Shall Keep The Faith and vowed always to wear a red poppy as a sign of remembrance. Today, poppy flowers are used to represent Memorial Day. They are worn to remember those who died for our country.

    

    We Shall Keep The Faith

  “We cherish too, the poppy red
That grows on fields where valor led,
    It seems to signal to the skies
 That blood of heroes never dies."

 

• One tradition on Memorial Day is to fly the American flag at half staff from dawn until noon.

• A national moment of remembrance is observed at 3:00pm on Memorial Day.

• Memorial Day is often referred to as the unofficial start of summer.

 

LASIK @ EyeCare 20/20: Free LASIK Winner Steve Baldassari

I received a letter this past winter from a long time patient of EyeCare 20/20 named Steve Baldassari.  Steve is a former Parsippany police officer who has been forced to go on disability due to some health issues.  He stated that he had been interested in LASIK in the past and could not afford the surgery at this time, but more importantly was in need of some eye care to determine the cause of many of his symptoms.  After examining Steve, I informed him that he would be receiving free LASIK surgery if he was eligible for the LASIK surgery.

This all took place in December, around the holiday season.  It has taken 5 months to get to the bottom of Steve's eye problems, and he is now eligible to receive his free LASIK.

This video was filmed in December when I first informed Steve of my decision to treat him free of charge.

LASIK for the Gold: Olympic Luge Hopeful Dan Joye Gets LASIK at EyeCare 20/20

Dan Joye made the trip to New Jersey recently to get his LASIK surgery at EyeCare 20/20.  Dan is a member of the USA Luge Team.  His results include: 

• 2007-08 World Cup Results: 5th, 7th, 6th, 8th, 7th, 8th, 7th, 8th
• Finished eighth in the final 2008 overall World Cup rankings
• Fall 2007 World Cup team relay gold medalists (Nov. 17)
• Winter 2008 World Cup team relay bronze medalists (Jan. 6)
• Finished sixth at the 40th World Luge Championships
• Finished fifth in the 40th World Luge Championship team relay event
• Finished 10th in the final 2008 overall Challenge Cup rankings
• 2008 Verizon U.S. National Champions

Dan reports that his surgery went well, with him achieving 20/20 vision.  We hope that this new vision will help in his ultimate goal of an Olympic Metal in Vancouver!  Welcome to Team EyeCare 20/20 Dan..

LASIK the Refs!: Scott Cherrey Discusses his LASIK Experience

Professional Hockey Ref Scott Cherrey had his LASIK surgery yesterday.  Today, 1 day after the surgery his vision is already 20/15!  In this video, Scott discusses his experience at EyeCare 20/20.

LASIK the Refs!: Scott Cherrey 2nd to Get Free LASIK

Professional Hockey Ref Scott Cherrey flew down to New Jersey today to get his LASIK through EyeCare 20/20's "LASIK the Refs!". 

This program started Back in September, when Ed Hochuli blew a call that cost the San Diego Chargers the game.  At the time, I offered Hochuli a chance to make his job easier, free LASIK surgery.  He has yet to accept the offer!

Paul Stewart was the first ref to take advantage of EyeCare 20/20's "LASIK the Refs!" program back in March.  He has been encouraging several Professional Hockey Refs to take advantage of this program.  Scott Cherrey was the first to do so.

Today's surgery went perfectly!  in this video, Scott discusses what he thinks LASIK will do to help him in his officiating.