The LASIK Blog

Colbert Pokes Fun at Board Certification & LASIK

Stephen Colbert had a great show yesterday, poking fun at Rand Paul's board certification in his own National Board of Ophthalmology instead of the American Board of Ophthalmology.  He then "performed" LASIK on his intern.  It was very funny!!

BTW, I am Board Certified in the ABO, and would love to do the intern's and Colbert's LASIK!  Hey Stephen, give me a call, my office is not far from Montclair, we already have the US Speedskating connection thru LASIK for the Gold, and I will do it for free!!

The Colbert Report	Mon - Thurs 11:30pm / 10:30c
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LASIK the Refs Program Offered to FIFA Refs Following Poor Performance at 2010 World Cup

This year's World Cup has showcased some of the world's best Soccer players and teams.  Unfortunately, it has also been marred by some of the worst officiating in years. 

Fans have been dismayed in seeing USA's Maurice Edu's goal dissallowed by a phanthom penalty, numerous questionable red cards, Brazil's Luis Fabiano's "hand ball" goal, offside goals by New Zealand's Shane Smeltz and Argentina's Carlos Tevez, and Frank Lambard of England's "missed goal."  All these bad calls, and we are only into the round of 16!

Much has been reported about the officiating inadequacies including:

1. The 10 worst calls of this year's World Cup
2. Referees requiring security following bad calls
3. FIFA ignoring bad calls
4. The need to add security to FIFA officiating

As the controversies mount, I have decided to extend EyeCare 20/20's LASIK the Refs Program to all FIFA refs participating in this year's World Cup.  After the tournament is concluded, any of thes refs can hop on a plane, fly to New Jersey, and get your free LASIK surgery.  In this way, maybe we can do our small part in making sure that the game is decided on the pitch, and not by the zebras!

Here is a copy of our most recent press release on the subject:

 

For Immediate Release: June 21, 2010

Media Contact: Keri Muli – 973-560-1500, ext. 111; [email protected]

LOCAL SURGEON OFFERS FREE LASIK TO WORLD CUP SOCCER REFEREES

EAST HANOVER, NJ - As a result of the blown call by a World Cup soccer official in the United States’ last match versus Slovenia, local ophthalmologist Dr. Cary Silverman is offering free LASIK surgery to any World Cup or professional soccer referee.  As Medical Director of EyeCare 20/20, Cary M. Silverman, M.D., oversees one of the premier vision care facilities in the tri-state area, and the first practice in New Jersey to offer treatment using custom wavefront LASIK with the ALLEGRETTO WAVE® laser.

On Friday, June 18, referee Koman Coulibaly of Mali called a much-debated, late penalty against the United States that nullified a potential match-winning goal in Johannesburg.  The Americans, who ended up in a 2-2 tie with Slovenia, now need a victory Wednesday against Algeria to move out of Group C and into the Round of 16.

 “This is maddening,” Silverman said, “These are the greatest athletes on the biggest stage in the world and they deserve to have the games officiated correctly.  Frankly, so many of these errors could be avoided if the officials had better eyesight.  LASIK is the best way to achieve that and I make an open offer to any World Cup official to utilize our service, for the good of the sport.”

Former NHL referee and current ECAC Director of Officiating Paul Stewart was the first to take advantage of Silverman’s “LASIK the Refs” program.

Silverman recently provided free LASIK to eight members of several United States Olympic teams, including winter medalists: Curt Tomasevicz (bobsled – gold), Chad Hedrick (speedskating – silver and bronze), Molly Engstrom (hockey – silver), Katherine Reutter (short track speed skating – silver and bronze), and Erin Pac (bobsled – bronze).  For more information on Dr. Silverman’s Olympic initiative, go to: www.lasikforthegold.com.

LASIK uses a computer-controlled laser to reshape the cornea and correct refractive errors such as nearsightedness, farsightedness, and astigmatism. Dr. Silverman employs the latest advances in LASIK surgery to provide patients with the highest level of vision correction possible. With the ALLEGRETTO WAVE® laser technology, he is able to customize the LASIK procedure to the vision needs of each individual patient.

To learn more about EyeCare 20/20, visit: www.eyecare2020.com. For more information on recent blown calls and the LASIK THE REFS program, go to: www.lasiktherefs.com. 

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"Vodka Eyeballing": What's The Matter With Kids Today?

Now I've heard it all, the latest trend from the youth in England is called "Vodka Eyeballing."  It involves putting an open bottle of vodka in direct contact with one's open eye!  The claim is that it leads to a faster high, although it appears that those doing it on YouTube are already wasted!

The American Academy of Ophthalmology has issued a statement that I totally agree with:

A dangerous drinking game called "vodka eyeballing" is attracting public attention on YouTube. People need to be aware that anyone who pours vodka directly into his eye risks damaging the surface epithelial cells–often causing pain and infection. More seriously, "eyeballing" can also lead to permanent vision damage by killing endothelial cells in deeper layers of the eye's cornea. This is unlikely, but possible. The cornea is the clear outer part of the eye that focuses light and provides much of the optical power. Depending on the amount of alcohol and length of time it is in contact with the eye, epithelial cell loss could result in corneal ulcers or scarring, not to mention a great deal of pain. And if endothelial cells die off, vision recovery would be uncertain. "Eyeballers" do not even get a "quick high" as claimed, because the volume of vodka absorbed by the conjunctiva and cornea is too small to have that effect.

The American Academy of Ophthalmology strongly advises the public not to engage in "vodka eyeballing."

With ObamaCare Coming, the Time to Get LASIK is NOW!

photo from:  http://moneypennydd.wordpress.com/2009/07/22/obamacare-increases-health-care-costs/

Much about ObamaCare has been written .  One of its negative consequences will be a reduction in the amount of money one can set aside for their Flexible Spending Account (FSA).  The most common variation of the FSA is the Health Spending Account (HSA).  According to Wikipedia:

A health savings account (HSA), is a tax-advantaged medical savings account available to taxpayers who are enrolled in a High Deductible Health Plan (HDHP). The funds contributed to the account are not subject to federal income tax at the time of deposit. Unlike a flexible spending account (FSA), funds roll over and accumulate year to year if not spent. HSAs are owned by the individual, which differentiates them from the company-owned Health Reimbursement Arrangement (HRA) that is an alternate tax-deductible source of funds paired with HDHPs. HSA funds may currently be used to pay for qualified medical expenses at any time without federal tax liability or penalty.

The New York Times reported on this last week.  The most important points of this article point out:

• THANKS to the sweeping new health law, your flexible spending plan is about to become a bit less flexible.  Flexible spending accounts have long been a valuable tool for budget-wise consumers. They let you use pretax dollars to pay for eligible out-of-pocket health care expenses. You agree to set aside a certain amount each year, usually through paycheck deductions, based on what you expect your health care needs to be. By using pretax dollars, you can reduce your overall cost for these items by about 20 percent.
• An attraction had been the extremely generous list of eligible expenses — including deductibles and co-pays, eyeglasses and dental work, over-the-counter cold medicine, sunscreen and vitamins. But under the new law, starting Jan. 1, flex-spend users will no longer be able to submit claims for over- the-counter medicines unless they have been specifically directed to use them by a doctor. Another big flex-spend change ahead: starting in 2013 the annual limit that any employee may contribute to these plans will be restricted to $2,500. Many companies had allowed much more.
  
• LOOK AHEAD. There are still about two-and-a-half years before the lower flex-spend maximum takes effect. If you know a big elective medical or dental procedure is in the offing — like Lasik surgery, braces or long-needed tooth implants or caps — you may want to schedule these treatments while you can still pay for a big chunk of the out-of-pocket expenses with pretax dollars.

The last point says it all.  By cutting HSA contributions to $2,500, it will not be possible to fully fund LASIK with pre-tax dollars!  Paying with these pre-tax dollars can save you at least 20% on the procedure.  Because of the new ObamaCare legislation, THE TIME TO GET LASIK IS NOW!!

Flawed Conclusions: Physician Ownership Linked to Higher Surgery Volume

There has been a lot of buzz on the web this past week concerning an article in this month's Health Affairs titled: Physician-Ownership Of Ambulatory Surgery Centers Linked To Higher Volume Of Surgeries.  In this article, John M. Hollingsworth, M.D., of the University of Michigan in Ann Arbor, and colleagues used  Ambulatory Surgery Databases to analyze data from Florida from 2003 to 2005. They looked at all patients in Florida who underwent one of five common outpatient procedures including  cataract extraction. They compared the number of surgeries performed among ASC owners before and after they acquired ASC ownership with that of physicians who were non-owners. They found that owners performed  twice as many procedures as non-owners.  Assuming that these are the facts of the study, you can't argue with numbers; what I have a problem with is the author's conclusion:

"To the extent that owners are motivated by profit, one potential explanation for our findings is that these physicians may be lowering their thresholds for treating patients with these common outpatient procedures."

I find this conclusion offensive.  Lowering treatment parameters to generate profits?  Cataracts cause a decrease in one's vision, what patient is going to submit to eye surgery without the symptoms that warrant this surgery?  I have been a part-owner in River Drive Surgery Center for the past 8 years.  During this time, my cataract volume has certainly increased.  It is NOT because  profits have lowered by treatment parameters!  Here are some of the reasons that I can think of of the top of my head (I find it amazing the that author's of this paper couldn't come up with any of these):

• Patient friendliness.  Patients find the ASC setting much less daunting than the hospital setting.  They are not shuffled from department to department, they are treated as individuals in a very caring matter.
• Efficiencies. ASC's are much more efficient than hospitals.  When I did my cataract surgery in a hospital, I found myself sitting around for the room to be ready.  It was difficult to do more than 1 procedure per hour.  In my ASC, there is no waiting for a room, and no down time.  I am now able to perform 6 cataracts an hour, without rushing.
• Costs.  ASC's are able to deliver care that is far superior than hospitals at a fraction of the cost.  This saves insurance companies as well as patients money.
• Equipment.  By owning an ASC, surgeon-owners are now able to continually upgrade equipment.  At River Drive, we pride ourselves on always having the most current, cutting edge equipment.  This allows us to provide superior care to our patients!
• Patient Experience.  We strive ourselves into providing a superior patient experience and outcome.  We generally succeed, and because we do, patients are apt to refer their friends and family to us for their surgery.  Success breeds success!

In conclusion, I agree with Dr. Hollingsworth, owners of ASC's do more cataract surgery!  However, this is NOT because we have lowered our operating standards.  It IS because we strive to do a better job.  Obviously, we are succeeding!

Prevent An Eye Injury: How to Open that Champagne Safely on New Year's Eve

There is no doubt that improper handling of a champagne bottle can lead to serious eye injuries, and lead to an awful start to the new year.  Last year I posted the following clip on YouTube.  It explains how to safely open a champagne bottle.  SInce the posting I have received several comments on the proper way to open a bottle.  One comment suggested never leaving the un-caged cork unprotected.  I agree, pressure should be placed on the cork as soon as the cage is removed!

While we are on the subject of champagne, @GaryVee of the Wine Library just came out with his top 10 champagne selections:

1. Legras Brut Champagne Presidence Vv 2002

2. Legras St Vincent 2000

3. Legras St Vincent 1990

4. Jose Michel Special Club Brut 2002

5. Pierre Peters Brut 2003

6. Jacquart Allegra 1999

7. Legras St Vincent 1996

8. Conde De Subirats Brut Nv 

9. Andre Clouet Brut Grand Reserve 

10. Dumont Brut 

All of us at EyeCare 20/20 wish all of you a Happy, Healthy, Safe, and Propsperous New Year.  We look forward to keeping you all informed on eye care topics in 2010!

No Proof in ABC's GMA Claim to Link Between Nearsightedness and Texting

There was an interesting story this morning on ABC's Good Morning America:  Study Finds More Nearsighted Americans.  This story was based on a recent National Eye Institute Story.  The lead in to this story claimed a link between our kids texting and myopia.

Also called myopia, nearsightedness is a refractive error that produces clear vision for near objects but blurs objects seen in the distance. Nearsightedness is caused by an abnormally steep curvature in the cornea or by an elongated eyeball. As a result, light rays passing through the cornea converge at a point before the retina.

Several interesting points were made in the piece:

• Myopia in the US increased from 25% in the 1970's to 41% today.
• Myopia effects 40 to 50 million Americans.
• Costs of treatment is $2 to $3 billion annually.

The story further went on that there is a genetic predisposition to develop myopia and suggests that close work may be a contributing factor, however, there is no scientific proof if this linkage.  Adding the fact that there are over 110 billion text messages sent annually just clouds the issue.  Many more people eat sushi today than in the 1970's, maybe this is the cause of myopia development?!?

It might simply be that nearsighted patients like to do close tasks more because it is easier for them.  The question becomes:  What comes first the task or the condition?, just like the chicken and the egg story.

In my opinion there is no correlation between myopia development and close work, computer work, or texting.  Further study is certainly warranted to determine environmental causes.  I do agree with the takeaway message:  Regular eye exams are required to maintain eye health!  If there are no problems, get that eye exam every 2 years..

Vision Harvest 2009: Free Cataract Surgery Program Reveals a Health Care System in Crisis

As I stated in my previous blog post, November 25 was the inaugural Vision Harvest free cataract surgery day at River Drive Surgery Center.  Twenty patients without insurance, or the means to pay, were provided free cataract surgery.  I promised to post interviews of many of these patients the day after their surgery.  Well, here they are.  The video is in 3 parts, due to YouTube's 10 minute time constraint.

While you are watching these videos I am sure that you will notice several recurring themes dealing with a breakdown in our health care system.

• Many people who are gainfully employed cannot afford coverage.
• Tying health care to employment leads to no health care when unemployed, creating a vicious cycle.
• There are many large cracks in our current system which are not being addressed by the current health care debate.

After viewing these videos, I am sure that you will come to the same conclusion:  our health care system is broken and in need of an overhaul.  What do you think needs to be done?

Avastin vs Lucentis: Genentech Co-Pay Card Program Not Nearly Enough!

I received an e-mail this week from Genentech BioOncology, introducing their new Co-Pay Card Program.  Genentech is the maker of the two drugs I have blogged about involved in the current macular degeneration treatment controversy, Lucentis and Acastin.

According to the e-mail:

"We are committed to ensuring that all eligible patients have access to the therapies they need. That is why we created the Genentech BioOncology Co-Pay Card Program, a program that gives eligible patients help with their BioOncology product co-pay."

This program will basically pay the 20% co-pay for those patients that financially qualify.  I think this is wonderful for certain treatment modalities, but not so in the case of Lucentis to treat macular degeneration.  The co-pay would be around $400.  What a nice gesture, what great marketing...  In my opinion, this is a joke.  What Genentech should be doing is seeking approval for the treatment of macular degeneration with Avastin!  Then let the patient handle the $10 co-pay themselves!!  Shame on you Genentech, hiding behind charity where corporate profits are the real issue!

Download Genentech Co-Pay Card Program

Medicare Appears to be Reversing Avastin Ruling

In my October 12 Blog post I wrote about Medicare's foolish decision to reimburse retinal specialists less than their costs for treating macular degeneration with the much- less expensive drug, Avastin.  This decision would cost our government millions of dollars annually.  I questioned how this system could ever manage healthcare.

I received an e-mail from both Dr. Joel Eichler (EyeCare 20/20's Retinal specialist) and the AAO today:

Kohl Indicates CMS Will Reverse Avastin Reimbursement Decision

The Academy is encouraged by an announcement today from Sen. Herb Kohl, D-Wis., chairman of the Senate Special Committee on Aging, who indicated CMS intends to reverse its Oct. 1 implementation of a new reimbursement code (Q2024) created for physicians (including ophthalmologists) who use smaller doses of Avastin for patient treatments. The Academy, along with the American Society of Retina Specialists, the Macula Society and the Retina Society, had challenged the new code’s implementation because it poses significant challenges for members’ practices and our patients’ access to care.

While the Academy is pleased by Kohl’s announcement, we await official word from CMS and details of its reversal, which are expected later this week.

I am hopeful this reversal will go into effect ASAP, the cost savings are enormous.  I will keep you all posted!