The LASIK Blog

Balanced Reporting: CNN to Air LASIK Debate This Morning

I have received a large response to my post last week that criticized Diane Sawyer's one-sided coverage of LASIK.  I urge everyone to tune in, Tivo, or DVR this morning's CNN Newsroom. 

This morning, CNN’s Kyra Phillips will talk with Morris Waxler and Dr. Stephen Slade who performed the first Lasik surgery in the U.S. at 10:15am ET on CNN Newsroom. We want you to weigh in on this conversation… Do you think Lasik surgery is safe and effective? Tell us what you think and we’ll read some of your comments during the show.

Dr. Slade is a very respected LASIK surgeon, and should do a good job in providing a true assessment of the risks and benefits associated with LASIK.  I also hope some light can be shed into how Waxler came up with his "statistics", and his motivations.

I plan on commenting further on this issue after it airs and will hopefully have a link to share with you all.  In the meantime, I urge everyone to post a comment on the CNN link.

PRETTY IN PINK: THIS OCTOBER, HAVE LASIK AND JOIN THE FIGHT AGAINST BREAST CANCER

One person is diagnosed with breast cancer every three minutes in the United States.

One in every eight women will be diagnosed with breast cancer in her lifetime.

Together we can help fight back against breast cancer.

This October, in observance of Breast Cancer Awareness Month, EyeCare 20/20 is gearing up to participate for its fifth year in Lee National Denim Day on Friday, October 8, 2010. his grassroots program has raised more than $70 million for breast cancer research.Employees at EyeCare 20/20 are encouraged to wear denim in exchange for a donation to the Women’s Cancer Programs of the Entertainment Industry Foundation (EIF). Funds raised support some of the most promising treatment and early detection research in the country, as well as the grassroots advocacy work of the National Breast Cancer Coalition. 

Donate $37.50 per eye to our Lee National Denim Day’s Team Page.   EyeCare 20/20 will match it, and extend a $375.00 per eye discount towards your LASIK.  So, a $75 donation turns into a $150 donation and $750 off the LASIK!  Just bring in your contribution receipt for the discount, its that simple.

Please, make your donation and then pass this link along to a friend or family member who is interested in LASIK and have them do the same, and then encourage them to do the same, get the picture?!

Blog it, tweet it, post about it on Facebook, tell your friends. The more people involved, the more change we can make. 

This offer will end on Halloween, so please hurry!

1 to 2 Drinks a Day Lowers Cataract Incidence, I'll Drink to That!

In last month's American Journal of Ophthalmology was an interesting article, Alcohol Consumption and the Long-Term Incidence of Cataract and Cataract Surgery: The Blue Mountains Eye Study. This study evaluated if there was any correlation between alcohol consumption and cataract formation in over 3,500 people over the age of 49 years.

The results were very interesting:

• After adjusting for age, gender, smoking, diabetes, myopia, socioeconomic status, and steroid use, total alcohol consumption of over 2 standard drinks per day was associated with a significantly increased likelihood of cataract surgery.
• Abstinence from alcohol was also associated with increased likelihood of cataract surgery when compared to a total alcohol consumption of 1 to 2 standard drinks per day.

The conclusion:

A U-shaped association of alcohol consumption with the long-term risk of cataract surgery was found in this older cohort: moderate consumption was associated with 50% lower cataract surgery incidence, compared either to abstinence or heavy alcohol consumption.

This study seems to support the belief that moderate consumption of alcohol is beneficial to our health.  If you are looking for a good source for a wine deal, check out Cinderella Wine.  They offer a daily that expires at midnight.  What a great name! 

Just remember, stop after that second glass!!

One-Sided Reporting: Diane Sawyer of ABC News Covers LASIK With Bias Reporting

In some of the most one-sided journalism that I have seen, Diane Sawyer and ABC's World News Tonight  reported on the safety of LASIK surgery.  The story was based on an interview with Morris Waxler, a former FDA official who was involved in the approval process of LASIK in the 1990's. 

I take exception with many points in this story, including:

• Diane Sawyer introduces Waxler as the "official who led the drive to approve the procedure."  As an FDA official, he led no such drive, his job with the FDA would have been to review clinical results and either recommend or strike down LASIK's approval.  He was not involved in the clinical trial process itself.
• The reporter asks Waxler if he would ever recommend LASIK surgery to anyone interested in the procedure. His response, "no, absolutely not."  Although he is introduced as "Dr. Waxler," he is not an MD, he has a PhD.  I would love to know what clinical experience he purports to have.
• Waxler states that people don't understand that LASIK "is not like getting your nails done."  I agree, LASIK is not a manicure, it is surgery.  I think this is certainly conveyed to all of my patients!
• The reports states that "compromised cornea can develop microscopic scar tissue and cause vision problems."  This is simply not true.
• Waxler claims that 50% of LASIK patients have side effects and 33% continue to need glasses or contact lenses.  I do not know where he gets his data, this is simply not true!  If these claims were true, no one would opt for the procedure.

The FDA is in the process of reviewing long term LASIK results.  One study, USAEyes CORE survey, found:

• 99% report quality of life as expected, better, or much better
• 98% day vision as expected, better, or much better
• 98% no complications or issues are seldom problematic
• 98% would recommend surgery to family and friends.
• 97% would have surgery again, knowing what they know now
• 96% wear corrective lenses as often as expected, less, or much less than expected
• 96% report post op vision without lenses as expected, better, or much better than expected when compared to preop vision with lenses
• 96% report overall quality of vision as expected, better, or much better than expected
• 91% no complications at any time
• 91% night vision as expected, better, or much better
• 7% complications seldom problematic
  – yet 91% of these same patients would have surgery again
• 2% complications frequent or always problematic
  – yet 22% of f these same patients would have surgery again

These survey results makes one take pause and wonder where Waxler gets his statistics from and what his motivations might be.  Since retiring from the FDA, Waxler now runs Waxler Regulatory Consultancy, LLC, which "provide consultant services on Food and Drug Agency regulatory issues for the entire life cycle of your medical devices."  One wonders if one of his clients might be an anti-LASIK organization?

R. Doyle Stulting, MD, PhD, president of the American Society of Cataract and Refractive Sugeons (ASCRS) has also had something to say about Waxler in the past:

“In summary, your letter is filled with false statements, incorrect citations of the published literature, references that do not fairly represent the existing literature, mischaracterization of a study protocol you have never seen, incorrect reference to outcomes of PRK as if they were for LASIK, citation of results for a laser designed two decades ago as if were representative of modern lasers, mischaracterization of results from older lasers as “better than most,” reference of a graph that does not exist in the reference you cite, and misrepresentations of the actual performance of modern excimer lasers for the correction of refractive errors”

I am a little surprised at World News Tonight for reporting in such a biased manner.  Shame on you, Diane Sawyer!

Here is the story.

2 EyeCare 20/20 Docs Named Inside New Jersey's 2010 Top Doctors

Inside New Jersey Magazine came out with their 2010 Top Doctor List this past weekend.  EyeCare 20/20 had 2 on the list:

• Dr. Joel Eichler for retinal surgery.

• Dr. Cary Silverman for LASIK and refractive cataract surgery.

According to Inside New Jersey:

This year’s lineup of Top Doctors is IJ’s largest, covering the entire state, north and south.

IJ’s continuing partnership with Castle Connolly Medical, the gold standard for medical ratings research, provides consumers with the most authoritative and informed assessment of doctors in the region.

The selection process for IJ’s Top Doctors edition is conducted by Castle Connolly’s physician-led research team.

It begins by asking thousands of physicians and health care professionals to identify excellent doctors in every specialty in their region and throughout the nation.

Doctors do not, and cannot, pay to be selected as a Castle Connolly Top Doctor. The screening process Castle Connolly follows a rigorous survey, research and screening processes.

Here is how it works. Castle Connolly . . .

★ Selects only physicians who are board certified and for whom the company has validated that the board certifications are current.

★ Uses “minimum years in practice” standards, based on the medical specialty, because studies show quality increases with clinical experience.

★ Surveys, by mail and online, thousands of physicians and other health care professionals and asks them to identify excellent doctors in every specialty in their region and throughout the nation. While the nomination process is anonymous and confidential, each invitee has a unique access code to the nomination website. This code helps ensure doctors do not nominate themselves.

★ Makes thousands of phone calls each year, talking with leading specialists, chairs of clinical departments and vice presidents of medical affairs, seeking to identify top specialists for most diseases and procedures.

★ Reviews the credentials of every physician under consideration, including his or her medical education, training, hospital appointments, administrative posts, professional achievements, and malpractice and disciplinary history. Information on outcomes, procedure volume and malpractice is becoming increasingly available, but the public disclosure varies from state to state. Castle Connolly uses its best efforts to gather the information that is available and use it effectively. Ultimately, however, it is the professional judgment of the Castle Connolly editors, the chief medical and research officer and the research staff that determines Castle Connolly Top Doctors selection.

Parents Beware: Laser Pointers Not Toys!!

There was a very intersting Letter to the Editor in last weeks New England Journal of Medicine last week, Retinal Injuries from a Handheld Laser Pointer.  The authors report a case of a 15 year old boy who bought a laser pointer on the internet to use as a toy. 

The boy’s life changed when he was playing with his laser pointer in front of a mirror to create a “laser
show,” during which the laser beam hit his eyes several times. He noticed immediate blurred vision in both of his eyes. Hoping that the visual loss would be transient and afraid of telling his parents, he waited 2 weeks before seeking an ophthalmic assessment, when he could no longer disguise his bad vision. His visual acuity was so poor in his left eye that he was only able to count fingers at a distance of 3 ft, and it was 20/50 in his right eye.

The clinical findings were consistent with severe bilateral retinal laser injury. After 4 months, the boy’s visual function remained impaired but improved to 20/32 in the right eye spontaneously and to 20/25 with a remaining scar just beside the center of the fovea in the left eye after one intravitreal injection of ranibizumab

This kid was very lucky, although he does have a visual deficit, he had an excellent response to treatment!  There are several take away points from this letter:

1. Never shine a laser pointer at anyone. Laser pointers are designed to illustrate inanimate objects.
2. Do not allow minors to use a pointer unsupervised. Laser pointers are not toys.
3. Do not point a laser pointer at mirror-like surfaces. A reflected beam can act like a direct beam on the eye.

American Medical Care Continues to Lag: AcrySof® IQ ReSTOR® Multifocal Toric IOL Released Outside the USA

Alcon labs announced this week the release of the AcrySof^® IQ ReSTOR^® Multifocal Toric intraocular lens (IOL) outside the United State.  The AcrySof® IQ ReSTOR® Multifocal Toric IOL combines the technologies of the ReSTOR® +3 add multifocal IOL and the Toric IOL.  Data demonstrated that the AcrySof^® IQ ReSTOR^® Multifocal Toric IOL delivers similar quality of vision when compared to the AcrySof^® IQ ReSTOR^® +3.0 D IOL.

This lens will allow surgeons to offer their patients who have pre-existing astigmatism a lens that provides quality vision at all distances after cataract surgery or clear lens exchange. Up until now, I have treated these patients with the ReSTOR^® Multifocal implanted at the time of cataract surgery.  Residual astigmatism is then treated about 1 month later with LASIK.  This new lens will allow me to treat both conditions at the same time, and use less surgery. 

There is only 1 problem:  this new lens is NOT AVAILABLE IN THE UNITED STATES!  Alcon plans to file a Pre-Market Application (PMA) for the lens with the U.S. Food and Drug Administration (FDA) in early 2012.  Once again, the draconian ways of our FDA have allowed medical care outside the US to out pace our own, we continue to provide third world medical technology to our patients...  Another part of our broken health care system in need of repair.

Charity: Water 4 Year Anniversary Today

After today's earlier post linking LASIK discounts with Charity: Water, I received this e-mail discussing Charity: Water's 4 year anniversary.  I think You will find it very interesting:

Live Drill: It Doesn't Always Work.

Today is the fourth anniversary of charity: water. Our team spent it in a village called Moale, trying to dig our 200th water project in Central African Republic. We've been in constant contact with our team on the ground throughout the drilling process. Here's an update straight from charity: water founder Scott Harrison:

It was going to be an amazing story, and charity: water’s 200th completed project in the country. The people of Moale had been waiting for water for more than a decade. After two failed attempts to reach clean water many years ago, our local partner ICDI brought in a new drilling rig that could dig up to 700 feet. Unfortunately, they never made it that far. In what was by far the most challenging drill we’ve ever witnessed, the team came up short after 30 straight hours when the second borehole caved in.

It was a heartbreaking and messy day. We'd hoped to show you footage of a joyful village celebrating a successful drill, but we didn't achieve that today. We’re committed to transparency at charity: water, so instead, our Live Drill video will show you the reality and challenges we face on the ground.

Tomorrow, we'll start drilling in another nearby Bayaka village. We haven't given up on Moale. For now, the people there will have to wait a little bit longer for their well -- but we will be back. In the meantime, with your help, we can provide clean and safe drinking water for every Bayaka through this year's September Campaign.

-- Scott Harrison

See : Water Campaign Extended Thru September; Donate & Save $1,000 of LASIK!

Last month we started our See : Water campaign.  The idea was simple, donate $100 to Charity : Water, EyeCare 20/20 matches the donation, and receive  $1,000 off a bilateral LASIK procedure!  The results have been incredible, with over $3,500 raised for this worthy cause. 

The campaign was slated to end yesterday, Labor Day, but because of the overwhelming response, I have decided to extend See : Water through the month of September. This will coincide with Charity: Water's "This September Birthdays can Change the World" campaign.  Since my birthday is in June, and not September, this is my way of doing my part.

Please pass this offer on to your friends and family, the more we can raise, the better!  And if you are so inclined, please donate here.  If your donation is going to be for the LASIK discount, be sure to mention it in the comments section!