Wednesday, June 30, 2010
Ectasia / Keratectasia after LASIK
Source from: http://lasikcomplications.com/ectasia.htm
What is ectasia? (Posted: jan 2005)
Ectasia is a bulging of the corneal. Ectasia is also called iatrogenic keratoconus or secondary keratoconus because it is basically a surgically induced version of the naturally occurring disease keratoconus. Ectasia is a very serious long-term complication of LASIK.
What causes ectasia and which surgery(-ies) is it associated with? (posted: jan 2005)
Ectasia is specifically associated with LASIK because LASIK penetrates the cornea much more deeply than other procedures (due to the thick stromal flap) and therefore can result in excessive thinning and structural compromise of the cornea.
Ectasia is caused by biomechanical weakening or destablisation of the cornea due to excessive removal of tissue and distruption to the structure of the cornea. In LASIK, a flap of tissue is created which, studies have shown, never again bonds to the tissue under the flap (called the residual stroma) strongly enough to contribute to its corneal stability. This means that the residual stroma alone will determine the strength and stability of the cornea and therefore it is imperative that certain limits with respect to the amount of stroma left under the flap are respected. However, opinions about what those limits are - the limits that would protect a patient from ectasia - vary.
Factors known to contribute to ectasia risk include: (a) when a patient's corneal thickness is not sufficient to undergo surgery (or a retreatment) safely but surgery (or a retreatment) is performed anyway; (b) the microkeratome cut a thicker flap than it was programmed to (a regular occurrence, according to studies); and (c) the patient had a form of keratoconus - forme fruste keratonus - prior to surgery and this was not detected during screening.
What is the progression and the potential results to the patient? (posted: jan 2005)
Ectasia is typically diagnosed some time in the first two years after surgery but has been known to first be diagnosed later than that. It is a progressive condition and depending on patient particulars and what measures are taken, may progress rapidly or slowly, but typically it will progress over a period of years.
The patient with ectasia may experience progressive myopia; effects similar to irregular astigmatism such as ghosting and other distortions; and fluctuating vision.
How is ectasia diagnosed? (posted: jan 2005)
Ectasia is diagnosed with corneal topography. It can also be seen in confocal microscopy or Artemis VHF digital ultrasound.
How can ectasia be treated? (posted: jan 2005)
There are both surgical and non surgical treatments to mitigate the symptoms of ectasia and attempt to prevent its progression. Gas permeable contact lenses may stabilise it in some patients. INTACS are increasingly being used to treat ectasia; sometimes only one of the ring segments is used. Many cases of ectasia require a corneal transplant (lamellar or penetrating keratoplasty).
Where can I get more information about ectasia? (UPDATE - June 2007)
Click here for LaserMyEye Encyclopedia entry, which may have additional articles and links.
Please also see the http://www.asklasikdocs.com/ site. They have extensive information about ectasia. Look for the Ectasia forum, the Information on Ectasia forum and the support group link.
Source from: http://www.lasermyeye.org/patients/learning/ectasia.html
FDA Lasik Hearing: Lauranell Burch, PhD
I appreciate the opportunity to speak at this FDA hearing on post market LASIK issues. My name is Lauranell Burch. I have a PhD in molecular biology and genetics and have been -- Am I not speaking in the microphone? Sorry. -- and have been a medical researcher for over 20 years. I am trained to design, conduct and review medical research studies. I come here today as a private citizen with no financial interests to report. We are all aware of recent media attempts by the LASIK industry to reframe the discussion of these hearings around post-LASIK satisfaction and quality of life issues. The public should be made aware that the proposed task force to examine post-LASIK quality of life issues is dominated by individuals with conflicts in interests. One of these individuals, Dr. Kerry Solomon, was quoted this week by ABC News regarding this meeting, saying this is not about safety and effectiveness of LASIK at all.
If there were no serious concerns about the safety and effectiveness of LASIK, we wouldn't be here today. What is most important for all of us to consider now is the growing body of evidence accumulating in peer reviewed ophthalmology journals that indicate that LASIK is a harmful procedure. Despite claims made by surgeons in the industry about patient satisfaction, today's happy 20/20 LASIK patients are often today's dangerous drivers on our highways at night due to LASIK induced loss of contrast sensitivity, and may ultimately experience debilitating late onset complications of LASIK. Patients who report that they are currently happy with the LASIK procedure likely have no idea of the nature and extent of the damage they incurred during the LASIK procedure, and the consequences of this damage for their future ocular health and vision. I believe that no patient would want this surgery if they fully understood its consequences.
Here is a short list of permanent adverse effects of LASIK eye surgery.
Number one, the flap never heals. It just seals it better on the edges like a Tupperware lid, leading patients who have had LASIK susceptible to traumatic flap injury for life.
Number two: LASIK separates the stronger anterior corner, leaving only the weaker posterior cornea to support the intraocular pressure of the eye. This can lead to corneal ectasia and corneal failure months or years after the surgery.
Number three: LASIK causes permanent pathologic changes in all corneas. According to an Emory University study that examined post mortem LASIK corneas, a spectrum of abnormal histopathologic and ultrastructural findings was present in all corneas. Some examples of these findings include: Deranged and disordered collagen fibers, granules under the flap, and epithelial ingrowth under the flap.
Number four: There is no evidence that corneal nerves ever fully regenerate to their normal patterns and density after LASIK.
Number five: LASIK complicates future cataract surgery.
Number six: LASIK invalidates intraocular pressure motion which is critical in the diagnosis of glaucoma.
Number seven: Perhaps gravest of all, Mayo Clinic researchers recently found that all patients undergoing laser corneal refractive surgeries lose coracite or corneal stromal cell density at higher rates even years after surgery. Apparently, excimer laser ablation to corneal stroma results in progressive cell loss in the cornea. In a peer discussion following this study, LASIK surgeon Dr. Roger S. Steiner commented, and I quote him, "One can speculate that this loss might lead to corneal ectasia." Clearly, patient satisfaction surveys are no substitute for objective, quantitative testing, particularly when the technology for performing objective tests is widely available. I ask that the FDA abandon the proposed quality of life study in favor of a study which objectively and quantitatively measures aspects of post-LASIK dry eye disease and post-LASIK visual quality. These studies can be performed on existing patient populations with unoperated eyes serving as controls. Withdrawal of FDA approval for the LASIK procedure should take place immediately pending the outcome of these studies. Only then will the FDA be able to achieve evidenced based policy about corneal or refractive surgery devices, and only then will the public receive the benefits of evidence based medicine. Thank you.
Above report from: http://www.lasikfda.com/index.php?option=com_content&view=article&id=51&Itemid=60
Tuesday, June 29, 2010
Lasik suspended in eye centre in Singapore
Eye Centre stops all Lasik ops after spike in infections
By Salma Khalik & Ben Nadarajan
THE Singapore National Eye Centre (SNEC) has suspended all Lasik surgery – at least till the end of this month.It stopped all such operations last Wednesday, following a spike in the number of infections – 17 cases last Monday and Tuesday – among patients who had this operation to correct short-sightedness.
This is the first time the centre has suspended its Lasik procedure since it began offering it in 1996.
The type of inflammation the 17 had is not dangerous and will usually clear up on its own, but the centre decided against doing any more such operations until all equipment has been inspected.
Seventeen cases in two days count as a spike when compared to the first two months of the year, when the centre saw 25 cases of inflammation following Lasik.
Having 25 cases puts SNEC within international limits of inflammation – up to 3.2 per cent of patients is the norm – but it is still much higher than normal for the centre, which can go for months without a single such case.
All 17 patients affected last week are recovering with treatment and will be monitored for some time. Another cause for concern, however, is that none of these cases were mild ones.
The patients suffered some blurring of vision, a result of white blood cells rushing to the surgery site.
Professor Donald Tan, SNEC’s deputy medical director, said there did not seem to be a pattern to the cases. The patients were operated on by different surgeons using all three machines at the centre.
Neither private eye specialists nor SNEC’s outlet at Mount Elizabeth Hospital have come across similar spikes, so the problem appears to be centred at the SNEC in Outram.
Checks will now been done on the Lasik machines by engineers. The facility’s air-conditioning system and the sponges and cleaning fluids used will also be inspected.
Prof Tan said: ‘We like to over-react a little. It may upset some patients, but we put safety first.’
Aside from Lasik, there have been no problems with any other procedures done at the centre.
Following the suspension, some patients will have their Lasik surgery done at SNEC’s Mount Elizabeth outlet.
But because SNEC does between 500 and 600 Lasik surgeries a month, not all can go there. About 160 patients have been told that they will have to wait till next month.
Because there is no subsidy for Lasik, some patients may well turn to the private sector instead of waiting.
A civil servant who was to have been operated on last week may do just that. She wants to get it done soon because she is planning a dive trip and ‘having perfect vision makes it easier to dive’.
Patients who need assistance can call the centre’s hotline on 6322-9599.
salma@sph.com.sg
benjamin@sph.com.sg
KEEPING AN EYE ON SAFETY
‘We like to over-react a little. It may upset some patients, but we put safety first.’PROFESSOR DONALD TAN, SNEC’s deputy medical director, on the centre’s move to suspend all Lasik procedures although there did not seem to be a pattern to the cases
A woman blind in 1 eye after LASIK in Singapore
LIKE thousands of others, Mrs Jasmine Koh went in pursuit of perfect eyesight, but she ended up going blind in one eye.
Doctors say the condition of the 42-year-old, who is undergoing treatment for it, may be reversed. However, there is a chance she may never be able to see with that eye again.
The regional manager of a multinational corporation had had Lasik surgery in both eyes to correct her short-sightedness 'only after my friends and colleagues had gone for it and were successful'.LASIK: A MATTER OF LUCK? The prospect of perfect vision draws many to correct their eyesight with Lasik surgery. But, eager eyes skip the fine print that warns of the potential dangers, such as seeing double or even going blind after the operation.
The procedure to correct short-sightedness by having lasers reshape the cornea is done commonly here. About 6,000 people have gone for it at two government eye centres in the last year or so.
The success rate in the last three years has been between 95 and 97 per cent, but when the operation does go wrong, it can result in double vision, or the patient seeing halos or starbursts of light.
He could also lose his vision, be unable to see as well as before, or end up with painfully dry eyes.
Mrs Koh, who paid $3,000 for the surgery, came out of it with abrasions on her left cornea and a bacterial infection in that eye.
She had her operations at the Singapore National Eye Centre on the morning of Feb 23. The next day, she could make out the letters on the eye chart with her right eye, but saw a white blur with her left.
By the following day, she had such a sharp pain in her left eye that she sought help at the Singapore General Hospital.'
I'd expected a little discomfort, but certainly not the degree of pain I went through,' she said.'
I'm not putting blame on anyone. No one can foresee the infection setting in. What I want is to let the public know that though the promise of perfect eyesight may be attractive, there is still a risk involved. I wouldn't want to wish those few days of pain I went through on anyone.'
A spokesman for the eye centre said patients are told of the many side effects and complications that may occur with Lasik, and that these are listed in brochures and on the consent forms they have to sign before they have the operation.
A thorough examination and a series of tests are also performed before the procedure, to determine if the patient is suitable for it, and the reasons for all this are usually explained to him.
Unfortunately, Mrs Koh fell into that small category of patients where the operation goes terribly wrong. The eye centre's head of cataract and comprehensive ophthalmology service, Dr Peter Tseng, said her case is unfortunate.'
When I saw her a day after the surgery, her corneal flaps were clear and her eyes were healing well. And when she developed pain and her left eye watered, she was immediately treated for an infection, even though there was no obvious sign of one yet.'
Her infection became evident only on the fourth day, he said, adding that the type of bacteria she caught is of an uncommon strain and very virulent.'
This is a very rare occurrence,' he said. 'It's the first time in my 10 years of experience in refractive surgery that I've seen this.'
Mrs Koh was warded for 11 days, which cost her about $3,000. She was discharged on March 9, when doctors saw some improvement, but Dr Tseng will not say if she is out of the woods yet. 'We have to give it a few more weeks.'
He stressed that it is important for the public to know that there are inherent risks involved in Lasik surgery. 'You can't treat it like a day at a spa. It's an operation.'
Article from: http://forums.cozycot.com/health/21366-lasik-eye-surgery-32.html
Woods has second laser eye surgery
Published: May 17, 2007
(AP) — Tiger Woods was once so nearsighted he said he would be considered legally blind without glasses or contacts. He had Lasik surgery in October 1999 after the Ryder Cup, won the Disney Classic in his first tournament back and has done fairly well since.
He realized this spring it was time to do it again.
"My vision started slipping," Woods said after The Players Championship. "I was getting headaches from squinting all the time."
He said he had laser surgery for the second time the Monday after the Masters.
"Mine stayed the way it should for ... what is it, eight years now?" Woods said. "That's pretty good."
Just as in 1999, Woods won his first tournament after eye surgery when he captured the Wachovia Championship by two shots. But that's where the similarity ends. His victory at Disney in 1999 was the second of six consecutive PGA Tour victories. Woods tied for 37th last week, his worst finish since missing the cut at the U.S. Open last summer.
Article from: http://www.golf.com/golf/tours_news/article/0,28136,1621439,00.html#ixzz0sDd8qjO4
Monday, June 28, 2010
Orthokeratology
Orthokeratology (also referred to as Ortho-K, Overnight Vision Correction and Corneal Refractive Therapy), marketed under brand names like "DreamLens", "i-GO OVC", "GOV", "Wake and See", "CRT" and "Emerald", is the use of rigid gas-permeable contact lenses, normally worn only at night, to improve vision through the reshaping of the cornea. This method can be used as an alternative to eyeglasses, refractive surgery, or for those who prefer not to wear contact lenses during the day. The latter may be due to discomfort from working in air-conditioned or dusty environments, from extended computer usage which reduces blink rates and tear film production or from displacement or loss during sports activities.
Source from: http://en.wikipedia.org/wiki/Orthokeratology
Eye surgery deemed too risky for NHS
Watchdog says the chances of damage in treatment do not justify widespread use
By Sam Lister
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.
Article from: http://www.timesonline.co.uk/tol/news/uk/health/article399731.ece
Saturday, June 26, 2010
LASIK Forums
CozyCot:
http://forums.cozycot.com/health/21366-lasik-eye-surgery-84.html
SG Club:
http://forums.sgclub.com/singapore/moh_concerned_over_37041.html
Trevvy:
http://www.trevvy.com/sgboyx/index.php?showtopic=24356
Abbott Medical Optics LASIK technologies - iLasik
STAR S4 IR™ Excimer Laser
WaveScan WaveFront™ SystemIntraLase™ FS Laser
Advanced CustomVue™ Procedure
iFS™ Advanced Femtosecond Laser
Source from: http://www.amo-inc.com/products/refractive/ilasik/star-s4-ir-excimer-laser
Friday, June 25, 2010
Eye Care: 20-20-20 - Tips for Computer Users
Step I :-After every 20 minutes of looking into the computer screen, turn your head and try to look at any object placed at least 20 feet away. This changes the focal length of your eyes, a must-do for the tired eyes.
Step II :-Try and blink your eyes for 20 times in succession, to moisten them.
Step III :-Time permitting of course, one should walk 20 paces after every 20 minutes of sitting in one particular posture. Helps blood circulation for the entire body.
Source from: http://forum.xcitefun.net/eye-care-20-20-20-tips-for-computer-users-t41893.html
MOH stresses dos & don'ts for lasik clinics
By Tania Tan & Shobana Kesava
NO CELEBRITIES, no praise and no numbers.
The Health Ministry on Friday warned eye specialists against producing misleading lasik advertisements, highlighting the three taboo areas for their ads.
The ministry said that it would take action against any doctor or clinic which continued to flout rules.
'We want to ensure the patient's safety, and misleading ads may sometimes jeopardise that,' said a ministry spokesman told The Straits Times.
'These are medical professionals not businessman, so advertising can be tricky - we want to get everyone on the same page.'
The session was held after the authorities got wind that some of these advertisements had given unrealistic expectations about the procedure; with results being oversold and risks and side-effects downplayed.
Some of the 25 ophthalmologists who attended the hour-long, closed-door meeting at the College of Medicine building in the National University of Singapore elaborated on what they were asked to avoid.
Their advertisements should not boast about the number of operations performed, for one. Nor can clinics use celebrities to promote their services; or highlight success stories.
Under the Private Hospitals and Medical Clinics Act, those caught doing so face fines of up to $2,000.
But doctors said they were happy that those who cross the line will be dealt with.
Said Dr Tony Ho, senior consultant and founding director of a private eye clinic: 'Advertising is good - it's helped make Singapore the medical hub it is today.'
'But it can also get out of hand. It's good that the ministry is stepping in.' The market for lasik surgery is red hot.
Public sector hospitals did more than 6,000 operations in the past year.
Two large private clinics here claim that they do about 2,100 procedures in just one month.
The 25 doctors, representing many of the senior experts who perform lasik operations to correct of myopia or near-sightedness here, also agreed to police the ads themselves.
The President of the Singapore Medical Group and managing director of a private lasik clinic Mr Felix Huang said: 'We'll try to make our ads as transparent as possible.'
No new guidelines were set yesterday, said the Health Ministry, but doctors present said it was clear the ministry would come down hard on those who continue to flout them.
A relatively simple surgery, lasik has seen its popularity surge worldwide, resulting in similar problems.
In the US, where the public began to view it as a simple cosmetic procedure, the experts began an education drive five years ago to make sure people knew exactly what they were getting into.
While doctors here say they have seen more botched surgeries surfacing, Singapore remains one of the world's best for the surgery, which involves cutting the surface of the eye and turning back the flap, before using a laser beam to reshape the cornea.
Fewer than 2 per cent of patients have complications such as double vision and headaches.
Nonetheless, prospective patients must be warned fully of them, said the ministry yesterday.
Several people who had gone through the surgery here told The Straits Times that this had not happened, and hard sell tactics have left them seeing red.
One said she was rushed into making a decision immediately after preliminary tests, and had to pay a $200 deposit which would be forfeited if she so much as changed her appointment date.
On the day itself, Ms Susan Wang said she was packed into a clinic with 40 others, and shown the door five minutes after her 20-minute surgery.
'I felt like I was in a factory,' said the 26-year-old, who is suffering from glare and halos a month later.
The ministry said it has received no complaints, but that patients should step forward with any such feedback.
Said a ministry spokesman: 'We will investigate each case seriously.'
Article from: http://forums.sgclub.com/singapore/moh_concerned_over_37041.html
Singapore's largest private Lasik centre eyes regional prospects
Shinagawa Lasik Centre is a joint venture between the public and private sectors aiming to tap into Singapore's growing reputation in the region as a medical hub.
The new 6,000 square foot clinic is a collaboration between a Japanese Lasik clinic, a local eye care company and Singapore National Eye Centre (SNEC) Eye Associates.
The tie-up is unusual, as both SNEC and the local eye care company, Capitol Optical, offer services that appear to compete with the new Lasik centre.
SNEC Eye Associates is the private arm of the Singapore National Eye Centre that also does Lasik surgery. But its spokesman said there are more benefits to the venture than meets the eye.
Dr Chan Wing Kwong, Head, SNEC Eye Associates, said: "The intent of this collaboration is to increase the pie for Lasik services in Singapore by providing cost effective good quality Lasik to more and more Singaporeans."
The S$4 million centre employs the IntraLase Method of surgery. It is aiming for an initial target of 2,000 procedures a month.
Dr Chan said: "There are only so many Lasik operations you can do for Singaporeans... and throughout the Asia-Pacific region. In South East Asia there are many more myopic patients who are looking for good high-quality Lasik surgery, and by embarking on this venture, we hope to encourage more foreign medical tourists to come to Singapore to have Lasik surgery."
Some 30,000 Lasik procedures were performed in Singapore last year. The Shinagawa Lasik Centre is eyeing half of all Lasik surgeries performed here in the next five years. - CNA/ms
Article from: http://www.channelnewsasia.com/stories/singaporelocalnews/view/345223/1/.html
MOH meets Lasik operators on advertising regulations
About 25 operators like the Singapore National Eye Centre and Lasik Clinic attended the meeting.
Officials from the Ministry's Health Regulations Division went through the regulations that operators should follow when advertising their services.
They said the regulations are designed to safeguard against indiscriminate promotions.
One doctor said the public should not just look at advertising when choosing their services.
Dr Lee Hung Ming, Medical Director of Parkway Eye Centre, said: "The critical factor to consider in considering any Lasik surgery will be, firstly, the surgeon in terms of his experience and his surgical outcome. The second factor will be the technology that he uses. I think the least important of all is the price that he quotes in advertisements."
Article from: http://forums.sgclub.com/singapore/moh_concerned_over_37041.html
http://www.channelnewsasia.com/stories/singaporelocalnews/view/313360/1/.html
Thursday, June 24, 2010
The Latest Laser Technology for Lasik Eye Surgery
Lasik is fast becoming a popular method for improving vision. The surgery is quick-usually under two minutes per eye and relatively painless. Patients are able to walk out of the recovery room and recovery time is minimal. Within a week, most patients are able to perform all of their regular activities. For those who rely on glasses and contacts, having the Lasik vision correction procedure drastically improves their quality of life.
In the past, the only way Lasik was performed was by using a hand held blade to cut open the cornea. This method did not always have the desire affect and relied on the doctor to be extremely experience while making the cut. While no Lasik procedure can promise to completely eliminate the need for contacts or glasses, new technology in Lasik is making that more of a reality. There are several new Lasik techniques that now offer more accuracy and better vision results.
When having the Lasik procedure, the surgeon uses a tiny laser called an excimer to cut a flap in the cornea. After the flap is pulled out of the way, tiny bits of corneal tissue is removed. Often more patients fear the creation of the flap more than any other part of the Lasik procedure. One new technique used in Lasik is called the Intralase. This is a laser that is safer than any other type of laser used in Lasik. When Intralase is used, the computer-guided laser assists the Lasik surgeon in creating the corneal flap with a beam of light. The use of this laser ensures that the flap has the exact corneal centration, thickness and diameter. Because of this innovation, more exact results are achieved. As opposed to the old hand-held microkeratome blade, this is often the most preferred.
Another popular form of Lasik technology is the Custom Lasik procedure. This procedure used the wavefront-guided method and is set to exactly match the needs of the patient. With Custom Lasik, the laser maps out three-dimensional scans of the eye. The scan shows all vision impairments so the exact amount of corneal tissue is removed. This gives the surgeon more accurate results. This often does away with the possibility of needing a second “enhancement” surgery to remove more corneal tissue. Custom Lasik can help correct and improve vision problems such as hyperopia, myopia and astigmatism. It can also correct worse vision problems that affect a patient’s vision. These can include starbursts or seeing halos around objects at night, sensitivity, and complications from traditional Lasik surgery. Many Lasik surgeons offer this method of Lasik surgery. Often, doctors recommend this method to help patients achieve a safer, more accurate vision correction surgery.
Another popular Lasik procedure that utilizes the latest technology is called Wavefront Guided Technology. When a doctor uses Wavefront, it can give the most accurate results. Wavefront technology uses micro sensors and wave light that is directed from a laser mean through the eye to the retina. When the light is reflected back to the eye, it allows corneal irregularities to be measured. It serves as a virtual blueprint to the patient’s eye. These irregularities can be mapped out on a three dimensional map. The problems with the eyes are recorded and transferred to the actual laser that is used to reshape the cornea during the Lasik procedure. This method is often chosen to give extremely accurate results and for patients that experience more severe vision problems.
There are many forms of Lasik surgery. Each one essentially uses a laser to map out the eye, target vision problems and reshape the cornea. Each surgery is designed to help doctors give patients the most accurate results possible. When the latest technology is used, patients often experience a better outcome with their Lasik vision correction surgery. Your eye care professional will be able to tell you through a thorough eye exam which Lasik surgery most fits your needs. As with any medical procedure, questions regarding these new forms of Lasik technology should be directed towards your Lasik surgeon.
Source from: http://www.solveyourproblem.com/lasik-eye-surgery/latest_in_laser_lasik_technology.shtml
Wednesday, June 23, 2010
All about Lasik
The Straits Times
By Poon Chian Hui
Ever since the Lasik procedure emerged two decades ago, millions of myopia sufferers have had their blurred vision reversed.
Lasik - laser in-situ keratomileusis - is a painless 15-minute procedure that frees one of the need for glasses or contact lenses permanently.
It involves creating a flap in the cornea either with a blade or laser, and subsequent laser treatment to reshape the cornea, hence sharpening one's vision.
The cornea is the transparent outer layer that covers the front of the eye.
Associate Professor Leonard Ang, the opthalmologist and medical director of Premium Lasik Surgery Clinic, answers some common questions about the popular procedure that was performed on about 32,000 people here last year.
Why go for Lasik?
It is a proven, safe and effective way of correcting refractive errors - myopia and astigmatism.
The key benefit is that of convenience. You do not have to spend time cleaning contact lenses or stay away from certain sports.
You also save money in the long run as you no longer have to regularly change your spectacles or buy contact lenses and solutions.
More importantly, you no longer have problems associated with improper contact lens care. For instance, corneal infections commonly occur with prolonged lens wear and inadequate cleaning.
Who is suitable?
You must be at least 18 years old, with no increase in refractive error (when light does not focus perfectly onto the retina) for the past year. You are never too old for Lasik, so long as an opthalmologist assesses you to be suitable.
Lasik can treat refractive errors of up to 1,500 degrees.
However, it is not advisable for people with an existing eye disease, like glaucoma and cataracts. It may not suit people with irregularly-shaped or overly thin corneas as well.
But people cured of their eye diseases, like cataracts, may be found suitable.
If Lasik is not an option, are there others?
There are two alternatives: epiLasik and contact lens implants. The former is like Lasik but without cutting of the cornea. Only the laser treatment is done. The problem is that more healing is involved.
If you have high myopia, there may be more scarring which can cause blurred vision again. Hence, epiLasik is recommended for myopia of under 700 degrees.
Implantable contact lens are like permanent contact lenses. Inserted in front of the natural lens, they are suitable for those with thin corneas and whose myopia is very high.
Can myopia ever return after eyesight has been corrected by Lasik?
Myopia can either return naturally - a person's myopia may continue to increase slightly over his lifetime - or when the eyes are over- or under-corrected after the initial Lasik surgery.
Enhancement surgery can be done for both cases. This is like a 'top-up' of the laser treatment and there is no need to cut the cornea again.
This cannot be immediate - it can be done three or four months after Lasik, when your eyesight has stabilised.
On average, 3 to 7 per cent of patients may need a re-treatment to obtain perfect vision.
What are the common side effects?
Dry eyes, seeing halos and starbursts at night. However, these symptoms are temporary and will fade after a few weeks.
What are the possible risks?
During surgery, there may be complications involving the corneal flap. In this case, the surgery is likely to be postponed for a few months.
Severe complications, such as infections, are extremely rare - averaging one in 5,000. If detected early enough, the problem can be fixed and good vision can still be attained.
What steps are involved?
You will first go through a three-hour evaluation to assess your suitability for the procedure.
The procedure is an outpatient one, you do not have to be hospitalised.
During surgery, a series of eye drops - antibiotics and drops to numb the eye - will be applied. You are awake throughout. Up to seven minutes is needed to treat each eye.
After the operation, the patient has to wear protective eye glasses. Lubricating eye drops and topical medication are also given.
Three follow-up appointments are required - the following day, one to two weeks later, and one to three months after the last appointment.
What happens the day after the procedure?
You can expect your eyesight to improve by 80 to 90 per cent. There is no need for you to stay at home to rest and you can go back to work.
What should I avoid doing?
Avoid touching the eye and definitely no vigorous rubbing. The corneal flap is still unstable in the first few days after surgery and it may get displaced. However, should that happen, the flap can be easily realigned.
Stay away from swimming and contact sports for at least a month, as it takes about two months for the cornea to heal completely.
Will there be any problems if I suffer from other eye diseases in the future?
No. Lasik does not hinder you from receiving standard treatment for other eye conditions in the future. It does not lower your chances of successful surgery, nor does it increase your risk of getting an eye disease.
How much does it typically cost?
Prices range from $1,000 to $2,500 per eye, depending on the surgeon's credentials and the technology used, as well as the centre you go to. For instance, bladeless Lasik (where laser is used to cut the cornea) costs more as the technology is more advanced. It was introduced here about eight years ago.
This article was first published in Mind Your Body, The Straits Times.
READERS COMMENTS
I did my Lasik a few years back. There are advantages but let me state the downside. Night vision is poor and you may not be able to make out steps in low light. I had to go for a cataract a few after my lasik. The doctors had a hard time figuring out the correct implants to use. I had to do the cataract operation twice. Also, if Lasik was as safe as it is made out, where do some of these doctors performing lasik not do the treatment on themselves ...... instead they use contact lens?
Posted by: phangfg at Tue Jun 09 18:55:06 SGT 2009
They say that u may require a second lasik because your eyesight tend to stabilize only after 40. Is this true?
Posted by: Magenta at Tue Jun 09 16:55:40 SGT 2009
I went for Lasik treatment in 2006 for both of my eyes. Till today, I am still glad that I made that choice of doing it. I ghave done away with my spectacles and I can go for sports such as swimming and tennis without eye wear. It was a right decision that I made in year 2006. And I did it at half the price in JB as compared to Spore price at that time. simon
Posted by: Posted at Tue Jun 09 16:49:34 SGT 2009
Article from: http://www.asiaone.com/Health/News/Story/A1Story20090604-146076.html
Tuesday, June 22, 2010
Custom LASIK
What is Custom LASIK?
In the past, LASIK eye surgery was based simply on your prescription: whether you were nearsighted, farsighted, or astigmatic, and your degrees of each. However, excellent vision is also dependent on higher-order aberrations — more complicated and personalized visual imperfections that affect the crispness and clarity of your vision. New custom LASIK technology is able to diagnose and treat these visual imperfections like never before. Custom LASIK eye surgery has the same mechanical components of traditional LASIK, but is fully personalized and guided by a detailed Wavefront™ map of your eyes.
Candidates for Custom LASIK Surgery
Find out if you are a candidate for custom LASIK. Various medical conditions, eye diseases, and medications can affect your custom LASIK candidacy. Other determining factors include the stability of your refractive error, your age, and certain aspects of your eye’s anatomy. Learn more about custom LASIK candidacy.
Risks and Benefits of Custom LASIK
Like any surgery, custom LASIK has its risks. However, custom LASIK also produces better visual improvement than one-size-fits-all LASIK procedures, and has a lower incidence of undesirable side effects such as halos and glare. Learn more about custom LASIK risks and custom LASIK benefits.
The Custom LASIK Procedure
If you are curious about the process of undergoing custom LASIK surgery, you are not alone. Custom LASIK is an innovation in vision correction that lets LASIK surgeons provide customized, precise treatment based on a detailed map of the patient’s visual irregularities. Learn more about the custom LASIK procedure.
Custom LASIK Systems
There are numerous FDA-approved custom LASIK systems currently used in the United States. These computer-guided systems carry out the custom LASIK procedure based on the Wavefront™ map of your eyes’ specific irregularities. However, each system is unique. Learn more about custom Wavefront™ LASIK systems.
Wavefront™ Technology
Custom LASIK is made possible by Wavefront™ technology, which is able to diagnose, measure, and map out your eyes’ irregularities to an unprecedented degree, paving the way to custom corneal reshaping. Learn more about the history and science behind Wavefront™ LASIK technology.
Custom LASIK FAQs
Do you have questions about custom LASIK? Do you wonder whether you may need glasses after custom LASIK surgery, whether custom LASIK is more effective than traditional LASIK, or whether insurance will cover your procedure? These questions, and many more, are answered on our custom LASIK FAQ page.
Custom LASIK Cost and Financing
With a little strategizing, custom LASIK can be within your financial reach. Read about the cost breakdown of custom LASIK, tips for finding a great price for custom LASIK eye surgery, and methods of distributing the cost of the procedure over time. Read more about custom LASIK costs and financing strategies.
Custom LASIK Statistics
What sort of outcomes does custom LASIK produce? Is it really more effective than traditional LASIK? Learn about the clinical results of custom LASIK eye surgery, as well as the procedure’s outcomes compared with those of other vision correction methods. Read more about custom LASIK surgery statistics.
Source from: http://www.docshop.com/education/vision/refractive/custom-lasik/
The IntraLase® Laser
What is IntraLase®?
The IntraLase® laser is a technology used to replace the metal mechanical blade microkeratome traditionally used to cut the necessary corneal flap during a laser vision correction procedure. Rather than creating a flap with a blade, the IntraLase® laser uses laser energy to make a quick, painless incision.
Is IntraLase® laser vision correction new?
Laser vision correction using the IntraLase® laser was approved by the Food and Drug Administration in 2001. Though it is a relatively new procedure, it has already been used on more than 250,000 eyes. Since 2001, surgeons have gained invaluable experience in the use of the IntraLase® laser and have adjusted their methods accordingly to fully benefit their patients.
Though the procedure is still relatively new, it is imperative that you take into account the amount of experience a surgeon has had with the technology when choosing an IntraLASIK surgeon.
How the IntraLase® Laser Works
The IntraLase® laser uses quick pulses of laser energy to create the flap in the cornea needed to correct refractive errors. The computer-guided Intralase® laser quickly pulses light through the outer layers of the cornea as it moves back and forth across the eye to create microscopic bubbles at a specified depth in the eye. The bubbles under the cornea eventually create a perforation. The laser is guided by a computer, allowing the the depth, position, and diameter of the flap to be made with extreme precision.
After the IntraLase® laser has finished forming the microscopic bubbles beneath the outer cornea, the surgeon is able to gently separate the perforated tissue to create a flap, allowing him or her to continue with the laser vision correction procedure.
Source from: http://www.docshop.com/education/vision/refractive/intralasik/intralase/
LASIK Technology Part 2
IntraLASIK with IntraLase®
For many patients, the creation of the corneal flap is the most feared portion of the LASIK procedure. The introduction of the IntraLase® laser has dispelled these fears, offering unprecedented safety through the latest advance in LASIK technology. The IntraLase® utilizes a computer-guided laser that assists in creating the hinged flap with a beam of light. This ensures the flap has exact corneal centration, thickness, and diameter, providing patients with the most precise results possible. Learn more about IntraLase®, including how the device works and what results can be achieved with this innovative technology.
Many patients prefer to undergo bladeless LASIK with the IntraLase® laser as opposed to LASIK with the traditional hand-held microkeratome blade. Although both methods are safe and effective, some surgeons have found that IntraLASIK reduces the risks of complications following LASIK surgery. The reduced risk of complications, use of a computer-guided laser, and accurate results make the bladeless form of LASIK the preferred choice for many patients. The IntraLase® laser can be used during both the traditional LASIK and custom LASIK procedures.
What is Wavefront™ Custom LASIK?
Also known as Wavefront™ or Wavefront™-guided LASIK, custom LASIK surgery incorporates the use of microsensors and wavelight directed from a laser beam through the eye to the retina. This light is reflected back out of the eye, allowing corneal irregularities to be measured on a 3-D map, which serves as a blueprint for your eye. The recorded aberrations of your visual system are then transferred to the actual laser that is used to reshape the cornea during LASIK surgery, providing the most accurate and precise results achieved by any laser vision correction system.
Source from: http://www.docshop.com/education/vision/refractive/lasik/technology/
Monday, June 21, 2010
Which Is The Best Lasik Laser?
The type of laser beam may be very important or may mean very little, depending upon your individual circumstances. As a (very) general rule, the true flying spot laser (Alcon’s LADARVision, Bausch & Lomb’s Technolas, Allegretto, etc.) is considered superior to the variable spot (newer Visx), which is considered superior to the broadbeam (NIDEK, Summit, older Visx). Depending upon the circumstances, only a flying spot laser would be appropriate or maybe any laser would do. Depending upon the circumstances, it may be that only a broadbeam would be appropriate. The laser used is much less important than the doctor’s proven abilities. An inexperienced doctor with the fanciest equipment is worse than the best doctor with an older laser. All good doctors understand the limitations of their tools and techniques and will not perform surgery (no matter what the laser) if there is not a high probability of you receiving a good outcome.
Some doctors have very definite preferences about lasers, microkeratomes, testing equipment, etc. We have created a table of refractive surgery devices where you can compare FDA approved parameters side-by-side.
Using the "which laser" question to choose a doctor is filled with folly. Any doctor with a checkbook can buy the newest and latest. That doesn't mean the doctor knows how to use it.
Do you really know which laser is better for your individual needs? Do you know which will remove less tissue at the same ablation width? Is the amount of tissue removed going to be an important consideration for your corneas? Do you know which has an optical ablation zone larger than your naturally dilated pupil? Do you know which will accommodate astigmatism, if you have astigmatism? Do you know on which laser your doctor has enough experience to run it optimally?
Choosing a doctor based upon the tools s/he uses is filled with folly. Would you only take your car to a mechanic who uses Snap-On tools but never take it to someone who uses Craftsman? What is important is the experience of the doctor combined with the techniques and technology. The better doctor will either offer a high probability of providing you with the results you require, or will turn you down.
It may be that for you only one laser can do the job. It may be that any can. It may be that you would need to travel outside the US to find a laser that can do what you need. Refractive doctors do not agree on what is the best equipment, it is highly unlikely that the average consumer will be able to evaluate all of the nuances required to select the best technology. Even then, no amount of technology will make up for a lousy doctor.
Source from: http://www.usaeyes.org/faq/subjects/which_laser.htm
Sunday, June 20, 2010
LASIK Technology
VISX
LADARVision
Bausch & Lomb Zyoptix
Custom LASIK & Wavefront
Hansatome Microkeratome
Since the FDA approval of LASIK in 1998, incredible breakthroughs in technology have been discovered to improve the consistency of great results and minimize the risks of LASIK. With the introduction of state-of-the-art equipment, LASIK is now more accurate, predictable and safer than ever before. Ongoing research and development continues to improve the quality of LASIK results available to consumers.
Click on the links below to read about these incredible LASIK lasers and microkeratomes.
Laser Technology
The laser chosen by your LASIK doctor is incredibly important in your LASIK outcome. Surgeon skill and laser technology are two of the main factors to consider when choosing a LASIK provider. The following lasers are recognized for their precision and ability to provide outstanding results:
VISX
LADARVision
Bausch & Lomb Zyoptix
Custom LASIK & Wavefront
Microkeratome Technology
The microkeratome is the instrument that creates the corneal flap during LASIK surgery. When LASIK was first FDA approved, the microkeratomes used were complicated machines that contributed to higher rates of LASIK flap complications. With extensive research and development, microkeratome technology has come along way. Today’s modern microkeratomes are designed with precision to significantly reduce flap complication risks.
Hansatome Microkeratome
Saturday, June 19, 2010
Visx Laser Correction FAQ
What is VISX CustomVue (individualized laser vision) correction?
VISX CustomVue individualized laser vision correction is WaveScan-driven, which, enables the physician to measure and correct unique imperfections in each individual's vision. Many of these imperfections could never be measured before using standard methods for glasses and contact lenses.
Who is a candidate for VISX CustomVue procedure?
If you are 21 years of age or older and wear glasses or contacts to correct nearsightedness and/or astigmatism you may benefit from CustomVue. If you meet the criteria, you should see your eye doctor for more information.
What is Personal Best Vision?
Because every individual's eyes are unique, each individual may benefit from a correction custom-tailored for them. For the first time, CustomVue using WaveScan technology can measure and correct the unique characteristics of each individual's vision, potentially providing them with the best possible vision for their eyes, or their Personal Best Vision.
Measure and Correct
What is WaveScan technology?
WaveScan technology was originally developed for use in high-powered telescopes to reduce distortions when viewing distant objects in space. This technology has now been applied to laser vision correction, measuring imperfections in the eye never before measured using standard methods for glasses and contact lenses. WaveScan-based digital technology identifies and measures imperfections in an individual's eye 25 times more precisely than standard methods. Physicians use this information to treat individuals with the CustomVue procedure.
Why is WaveScan technology so important to the CustomVue procedure?
Until now, physicians were forced to practice one-size-fits-all vision. An off-the-shelf lens corrects an individual's vision fairly well, but it does not correct it precisely because it is not uniquely tailored to that person's fingerprint of vision. Now, with WaveScan technology, we can custom tailor a correction for the unique characteristics of each individual's vision.
This new level of measurement provides 25-times more precision than standard measurements for glasses and contact lenses. Then, WaveScan technology produces a detailed map of the eye - much like a fingerprint, no two are alike.
How is the information transferred from the WaveScan to the laser?
The WaveScan digital information is transferred to the laser, providing a new level of precision and accuracy.
Can you briefly explain what a patient will experience during the course of this procedure?
The individual will initially meet with our eye doctor for an evaluation to determine if he or she is a good candidate for the CustomVue procedure. A WaveScan measurement will be taken to map the unique characteristics of his or her vision. The doctor will assess several criteria including level of correction, and overall eye health and discuss the benefits and risks of the procedure with the patient. Once it is confirmed that the individual is a good candidate, he or she can be scheduled for CustomVue. The doctor will provide details for the individual on how to prepare for the day of the procedure.
If the doctor feels it is beneficial, he may choose to provide the patient with a PreVue Lens during the consultation. The PreVue Lens allows an individual to "preview" their potential vision before the CustomVue procedure. The doctor will place a plastic lens under the laser. Using the information from the WaveScan, the individual's unique correction will be placed on the lens. The lens is then fitted in a trial frame for viewing. If a PreVue Lens is used in this evaluation, your vision through the PreVue lens is not meant to be predictive of the end result that you might achieve.
On procedure day, the individual will be seated in a reclined position. Anesthetic drops will be placed in the eyes and a flap will be created in the cornea. The individual's treatment information is transferred from the WaveScan to the VISX laser in order to drive the CustomVue procedure. The actual laser procedure typically takes several seconds. The majority of individuals feel no pain during the procedure.
After CustomVue, individuals will notice results immediately, and vision will continue to improve over the next few days. The individual will be scheduled for a follow-up visit the next day, and again several weeks after the initial procedure.
PreVue Lens
What is the PreVue Lens?
The PreVue Lens allows individuals to test drive their potential new vision before undergoing the procedure. Once the WaveScan measurement is taken, the physician will place a plastic lens under the VISX laser. The individual's unique correction will be placed on the lens, then the lens will be fitted in a trial frame for viewing. The PreVue Lens is not a requirement for the CustomVue procedure. Your physician will decide if this tool is beneficial for each individual. If a PreVue Lens is used in this evaluation, your vision through the PreVue lens is not meant to be predictive of the end result that you might achieve.
Beyond Glasses and Contacts
Will I need glasses or contacts after the CustomVue procedure?
Probably not. Six months after the clinical study, all participants saw well enough to drive a car without glasses or contacts. Ninety-four percent had 20/20 vision. However, individual results may vary.
Clinical Study Results
How many sites were included in the FDA clinical study and where are they?
Six sites participated in the FDA clinical study at the following locations:
•Bascom-Palmer Eye Institute, Miami, FLWilliam Culbertson, MD
•Baylor College of Medicine, Houston, TXDouglas Koch, MD Coleman Vision, Albuquerque, NM
•Stephen Coleman, MD Kraff Eye Institute, Chicago, IL
•Colman Kraff, MD Maloney Vision Institute, Los Angeles, CA
•Robert Maloney, MD Wilmer Eye Institute, Baltimore, MD
•Terrence O'BrienNada Jabbur, MD
What were the visual acuity results of the FDA clinical study?
A significant result was that six months after the VISX CustomVue procedure:
•100% of participants could pass a driving test without glasses or contacts
•94% of participants could see 20/20 or better without glasses or contacts
•74% of participants could see better than 20/20 without glasses or contacts
What does better than 20/20 mean?
20/20 is the current standard for excellence in vision. But, with the CustomVue procedure, individuals have the potential to see even better than 20/20. In fact, six months after the CustomVue procedure more than 74% percent of clinical study participants saw 20/16 or better.
How could the CustomVue procedure affect my night vision?
Many patients found their night vision was improved after the CustomVue procedure. In fact, in the clinical study, four times as many participants were very satisfied with their night vision after the procedure as compared to their night vision before with glasses or contacts.
Source from: http://www.asiamedic.com.sg/EYEVisxFaq.aspx
MOH concerned over misleading Lasik ad claims
Salma Khalik
Thu, Nov 22, 2007
The Straits Times
THE Ministry of Health (MOH), concerned over misleading advertisements by some Lasik clinics, wants to meet eye surgeons tomorrow to discuss what can or cannot go into their ads.
A letter from MOH to all ophthalmologists doing Lasik said it has received feedback that some print and online advertisements have given the public 'unrealistic expectations' about what the procedure can fix.
Results are oversold, while the risks and possible side-effects are downplayed.And some ads cite success rates for Lasik done elsewhere, said an MOH spokesman.
Several ophthalmologists in private practice told The Straits Times that they felt the ministry's warning was a matter of time in coming.
After all, the market for the surgical treatment of myopia or near-sightedness is red hot. Thousands of people from here and overseas have been flocking to eye surgeons for the procedure.
With Lasik surgery being 'cosmetic', these patients do not get government subsidies; neither can they draw down on their Medisave funds for the operation, so people often go to ophthalmologists in private practice.
But even so, public sector hospitals have done more than 6,000 Lasik operations in the past year.
Private clinics and hospitals do not reveal their patient numbers, but one private clinic claims to do 1,600 Lasik procedures every month.
Competition is so stiff that some clinics offer 'discounts' to patients who sign up immediately or who are willing to do both eyes at the same time.
Some in medical circles are concerned that, in the race for the patient's dollar, proper 'before' and 'after' care may be compromised, or that patients are not briefed on the risk of post-surgery complications. Worse, they fear some surgeons are taking on patients not suited for the treatment.
Dr Jerry Tan, an ophthalmologist in private practice, has been seeing more patients from other clinics who need 'repair jobs' - five to six such patients a week, up from three to four a year ago.
'Most come because of poor night vision and over- or under-correction,' he said. Some have more serious complications, like the one patient he has seen whose sight in one eye has been permanently damaged.
Dr Gerard Chuah, another private practitioner, says that on average, he tends to three complaints a month, mainly related to the side effects of Lasik.
Women in their 40s and up, for example, have a higher risk of getting permanently dry eyes.
One patient Dr Chuah came across now sees four of everything - the result of his previous surgeon not letting a badly-cut cornea flap heal first before going ahead with the Lasik procedure proper.
While doctors agree that Lasik is generally a very safe procedure, patients should know there are risks.
Precision is key in Lasik, he said, adding: 'The distance between a good outcome and a mediocre or disastrous one is a fraction of a millimetre.'
The Singapore National Eye Centre has seen at least one patient who needed a corneal transplant after a botched Lasik job.
Dr Lee Hung Ming, the medical director of Parkway Eye Centre, had this piece of advice for patients: 'Avoid the centre that hard-sells you the procedure or the surgeon who does not have time to see you for your most important pre-operative and post-operative consultations.'
Article from: http://www.asiaone.com/Health/News/Story/A1Story20071122-37967.html
Friday, June 18, 2010
Thinking of Lasik surgery? Don't rely on ads alone
Jessica Jaganathan
Fri, Dec 07, 2007
The Straits Times
(Dec 5) The competition has heated up so much among private clinics and hospitals providing Lasik surgery that some have even run advertisements offering patients 'discounts' for signing up immediately or for doing both eyes at once.
The 'market' for Lasik is certainly sizzling with many hoping to correct myopia this way and dump their spectacles.
But clear vision has not been the result for some who have had the operation. They've complained instead of shoddy service, even worse eyesight and inadequate before and after care.
One patient last month filed a report with the Singapore Medical Council against the doctor who operated on her. She regretted choosing a clinic based on its price and claimed that it was clinic assistants who had pronounced her fit for surgery, and that the doctor did only a summary examination before the procedure.
The Ministry of Health (MOH) has warned eye specialists about using misleading Lasik advertisements to attract customers. On Nov 23, it announced three taboo areas for eye surgery ads - no celebrity endorsements, no mention of the number of operations done and no highlighting of success stories.
Mind Your Body spoke to eye surgeons for their opinion on what you should ask your doctor if you are considering Lasik surgery.
Before surgery
Be mentally prepared for Lasik, say surgeons. And decide if you really need it. Lasik is appropriate for those with myopia, astigmatism and far-sightedness.
You are not suitable for Lasik if you are:
- Below 18 years old because you are still growing and eye power is not stable yet
- Pregnant- Have a pre-existing eye condition like cataract and glaucoma
- Have extremely thin corneas or high myopia (more than 1,500 degrees).
Scour the Internet for information and ask friends who have already undergone Lasik for their feedback before you choose your doctor.
'Another good thing is to ask your family doctor,' said Dr Lee Hung Ming, medical director of Parkway Eye Centre. 'The most important thing though is to not base your decision just on advertisements.'
To be thoroughly prepared, jot down all questions you plan to ask the surgeon during the pre-surgery consultation.
Pre-surgery consultation
Doctors should spend adequate time explaining the procedure to patients. Ask your doctor how many cases he handles per week.
'If the doctor says 1,000 cases a week, you think to yourself, how many seconds does he have for the patient? One case a week is also too little. So there needs to be a balance,' said Dr Jerry Tan, an ophthalmologist in private practice.
Enquire about the doctor's background and whether he has had any appropriate training in Lasik. Ask the doctor for his results. According to an MOH study released last year, which was based on four centres offering Lasik surgery, 98 per cent of patients achieved 6/12 vision or better. But Dr Tan warned that some may mislead patients by showing other people's results.
Ask for the doctor's enhancement rate. This is used to determine how many people return to the doctor to correct the procedure because of unhappiness with their results. Doctors interviewed showed an average of a 2per cent enhancement rate.
Find out about the characteristics of your eyes from the surgeon and ask why the particular type of Lasik procedure recommended is appropriate for you.
A pre-surgery consultation would take three to four hours during which a series of tests is done to check your eye power and cornea thickness. Eye drops are used to dilate the pupils in order to check the retina. There should be a gap of at least 24 hours between consultation and surgery, to allow for the natural constriction of the eye as the effect of the eye drops wears off.
Surgery
It takes about 15 to 20 minutes, depending on the technique used.
Doctors are divided on the practice of doing Lasik surgery on both eyes at the same time.
Dr Jerry Tan cautioned that some centres might be tempted to use the same blade for both eyes which, in turn, made the second cut more blunt.
But Dr Lee said he had not seen any discernible difference in doing one eye at a time and both eyes at the same time.
Post-surgery
There are usually at least four consultations with the doctor: One day after surgery, one week later, one month later and three months after.
Avoid strenuous sports, swimming, vigorous rubbing of eyes and eye make-up for up to one month.
Complications that could arise from Lasik surgery include dry eyes and night-vision problems like halos and glares. But these usually disappear within three to six months of surgery, said Dr Lee.
More severe problems involve the flap which can be irregularly cut or cut off totally, resulting in scarring of the cornea. But this is rare if the procedure is done using a bladeless laser technique.
In the most extreme case, infection could set in, causing blurred vision.
There are a variety of Lasik procedures available, so ask your doctor to recommend the type which is most suitable for your eyes. It depends on individual characteristics.
'It's not like buying the cheapest stereo or television, so it's important to do your homework,' said Dr Chan Wing Kwong, head of refractive surgery service at the Singapore National Eye Centre.
Article from: http://www.asiaone.com/Health/News/Story/A1Story20071207-40084.html
Thursday, June 17, 2010
Lasik surgery price war breaks out
AUG 22, 2004 SUN
By Salma Khalik
THE cost of Lasik surgery, which corrects short-sightedness, is tumbling at both public and private institutions.
After two public hospitals cut the cost by 20 per cent on Monday, the Singapore National Eye Centre (SNEC), which does the bulk of Lasik treatments here, announced yesterday that it had slashed rates by up to 30 per cent.
Not to be left out, two Parkway Group Healthcare hospitals - Mount Elizabeth and Gleneagles - have cut prices by 10 to 20 per cent. Depending on the specialist, it will cost between $1,596 and $1,796 from today.
The SNEC, reversing its stand that it can command a premium because of its branding, has gone from being the most expensive to being the cheapest, at $1,320 for normal Lasik by a consultant.
For the more advanced wavefront Lasik, the $1,520 its consultants now charge is cheaper than at other hospitals. Its senior consultants charge $1,520 for normal Lasik and $2,050 for wavefront Lasik.
The price war started last week when two National Healthcare Group hospitals - National University Hospital and Tan Tock Seng Hospital - cut charges to $1,590 for conventional Lasik and $1,780 for wavefront Lasik.
Dr Lee Hung Ming, who heads the Eye Institute at these hospitals, said they had received triple the number of inquiries this week as a result of the price cut.
Lasik is considered cosmetic so there is no subsidy for it, nor can Medisave funds be used. Both public and private sectors compete for the same group of paying patients. Some even go to Bangkok for the procedure, paying about $1,000.
The number of Lasik operations at the two hospitals has doubled from 100 a month last year to 200 a month this year. The SNEC has also seen higher demand, with Lasik operations up from 300 a month last year to 400 a month this year.
SNEC director Ang Chong Lye said its 'competitive' rates were deliberate as it was also aiming to attract more foreign patients.
'We have already seen an increasing number of patients from Indonesia and Malaysia,' he said.
When told of the SNEC cuts, the other hospitals said they would keep their rates.
Consultant Ronald Yeoh, who did about 500 Lasik operations last year at Gleneagles, said the earlier cuts took the price to about as low as it could go in the private sector. 'If the price goes ridiculously low, it can be dangerous.'
He said some centres in the region used the same US$100 (S$172) blade for about 10 eyes, instead of just one per eye, which is the practice here.
But Dr Ang said: 'With the competitive pricing, we believe we can chalk up even more volume that will only mean better economies of scale...without compromise to quality, safety and standards.'
So prices may keep falling.
Article from: http://singaporeforums.com/forum/showthread.php?t=307
Wednesday, June 16, 2010
Lasik prices expected to fall further when pte sector publishes bill sizes
SINGAPORE: Inflation and healthcare costs may be on the rise but the cost of Lasik surgeries has bucked the trend.
Eye doctors expect rates to fall further when the private sector joins the public sector in its current practice of publishing the size of their medical bills.
Singapore has one of the highest rates of myopia in the world, so there is a ready pool of people eager to do away with glasses and contact lenses through Lasik surgery.
Some four years ago, it used to cost about S$2,300 to 'Lasik' one eye. Now, prices have tumbled 40 percent to about S$1,300.
The price war started in late 2003 when the Health Ministry required all public hospitals to publish their bill sizes.
Apart from cost competitiveness, doctors said increased cost efficiency in equipment and medical products has also allowed doctors to adjust prices.
Dr Chan Wing Kwong, Senior Consultant Ophthalmologist, Head of Refractive Surgery Services, Singapore National Eye Centre, said: "In the earlier years when Lasik was relatively more expensive, there was a market for some patients who are budget conscious to go overseas to have their surgery. (But) I think many Singaporeans would rather have their surgery done in Singapore by a Singapore facility.
"The moment the cost competiveness becomes better, I think many Singaporeans who were going to take the overseas route would decide to do it here. So basically the number of people who go overseas for Lasik is very negligible now."
Prices are set to come down further as Health Minister Khaw Boon Wan has said he wants all private hospitals and centres to post their bill sizes online. With greater transparency and competition, prices could only head southwards.
But patients need to realise that price is not everything.
Dr Lee Hung Ming, Medical Director, Senior Consultant Ophthalmic Surgeon, Parkway Eye Centre, said: "It's good to have bill sizes published for the public because transparency is very important. But patients should not just look at the price alone. More importantly, the surgeon's experience and his expertise is a critical factor.
"The second important factor should be technology and then price should be the third factor. I don't think that the price should spiral all the way because ultimately, if the price really spirals down, then there're bound to be some centres that are cutting costs and also cutting corners, and that may eventually affect the outcome of Lasik."
Technological advances have made Lasik not only cheaper, but also safer.
Good surgical outcomes and reputation of Singapore doctors have also helped to draw in foreign patients like Ronald Butterfield.
The 63-year-old Canadian wants to correct his vision through Lasik. In the last seven years, he has consulted doctors back home and in Hong Kong, but no one wants to operate on him as he also suffers from cataract. So he came to Singapore for a second opinion.
Although he was told to wait till his cataract 'ripens' before having a Lasik surgery, Ronald walked away impressed.
He said: "The kind of brutal honesty was there and I felt that I've come to a medical centre that was concerned with my health, opposed to going to a business. If I were to go down the street to a Lasik centre, they could have done the Lasik tomorrow. He was supposed to have come from a medical point of view and I sensed that, and I trust him and I will come back!"
The Singapore National Eye Centre said it has been seeing 5 to 10 percent more foreign patients every year, most of them from Asia and even Middle East.
Article from: http://www.channelnewsasia.com/stories/singaporelocalnews/view/327682/1/.html
Tuesday, June 15, 2010
Lasik clinic's hard sell left her confused and fuming
Sun, Dec 07, 2008
The Straits Times
I refer to last Sunday's article, 'Lasik price wars'.
I almost fell prey to a Lasik clinic's hard-sell tactics.
At first, I was impressed by the many sophisticated machine tests at the clinic that lasted for three hours, and the hour-long counselling by its good-looking staff.
But later, I was left feeling confused and fuming.
An optometrist there informed me that my left eye was my dominant eye, instead of my right one.
She claimed I had been wrongly diagnosed by my personal optometrist of five years.
I was asked to place a full payment before leaving the clinic, in order to enjoy the promotional rates.
But I left the clinic, insisting that I should try wearing contact lenses to test if I was really left-eye-dominant first before making any decision.
The clinic followed up with calls to ask about my condition, although I had not yet tried the lenses. The staff said I should secure the promotional rates by making an appointment.
After checking the prices for the standard Lasik procedure, I withdrew $3,100 from my savings, and went to make payment.
When I arrived, I was told I had 'steep corneas', which would require a bladeless procedure that would cost me $3,888 before goods and services tax.
I saw red upon hearing this.
The senior surgeon had not informed me I had 'steep corneas' during my evaluation, and had given me the impression that I could have a standard procedure.
The clinic then slashed the price by $200, but I still refused to sign.
Later, I was informed that I could opt for a standard procedure for one eye, and a bladeless procedure for the other eye, which would save me another $200 - but I had to have the operations done by end-October.
I stomped out of the clinic fuming.
I found such conduct unprofessional - the clinic was out to make money, not to help me see better.
I have since visited another clinic, which does not advertise or engage in a price war and has been very patient.
And guess what? I am actually right-eye-dominant.
Connie Loh (Ms)
Article from: http://www.asiaone.com/News/the%2BStraits%2BTimes/Story/A1Story20081207-106087.html
Thursday, June 10, 2010
Lasik @ LSC. I want it to be done by Marc Tay =)
Dr Marc Tay on Channel 5's Rouge
AsiaOneHealth
This eye surgeon has done Lasik surgery on 10,000 eyes
IF numbers are anything to go by, one man here seems to have cornered the Lasik market.
Dr Marc Tay, consultant ophthalmologist at the Lasik Surgery Clinic, operated on 10,000 eyes last year.
At the Singapore National Eye Centre, where there are believed tobe 10 ophthalmologists doing Lasik surgery, it is understood that 5,000 eyes were operated on last year.
And at the TTSH Lasik Centre where there are four ophthalmologists who do Lasik surgery, the figure was 1,471 eyes last year.
Over at National University Hospital, there are three surgeons who do Lasik surgery who operate on 600 to 800 eyes a year. This does not include military personnel.
So how did one man come up with such impressive numbers?
Part of the answer lies in Dr Tay's expertise - he can operate on two eyes and finish within eight to 10 minutes, while other doctors typically take 15 minutes, his clinic's chief executive officer, Dr Cheryl Baumann, said.
A check with two doctors showed that how long a surgeon takes to perform Lasik depends on whether it is standardised or customised Lasik, the surgeon's expertise and how calm the patient is.
Dr Lynn Yeo, a consultant ophthalmologist at Asia HealthPartners, said: 'On average, I take about 15 minutes to operate on a patient with customised Lasik.'
The bulk of Dr Tay's work is Lasik surgery, but he also does three to four cataract operations a week.
FOCUS ON MEDICAL WORK
Part of the reason Dr Tay can perform efficiently could also be that Dr Baumann runs the day-to-day affairs of the clinic so that he is left to do what he does best, without having to deal with matters such as buying of equipment, hiring of the clinic space and so forth.
Dr Baumann, 39, who has a PhD in law, started the clinic with Dr Tay in April 2005 and is the majority shareholder.
Dr Tay, 47, does not own any share in the clinic. He is paid a salary.
Dr Baumann told The New Paper: 'In this way, the workload is divided and we can make the workflow very efficient.'
They started with a 600 sq ft space at Paragon Medical Centre.
As the number of patients grew, the clinic moved in 2006 to another floor in the same building with a 7,000 sq ft space.
The clinic now has 40 employees, including two other ophthalmologists, nurses, optometrists, a human resource team, a finance team and a marketing team.
The other two eye surgeons also do Lasik surgery.
Dr Tay said: 'I used to work in a one-man private clinic setting, where I had to do everything, from hiring the staff members to buying equipment.
'Now, it's much better because all those things are taken care of.'
He said that he takes breaks like everyone else. 'I have three weeks of holidays a year where I travel anywhere I wish.'
Dr Tay, who did not want to disclose if he was single or married, works from about 9am till about 8pm from Mondays to Saturdays. He works for an hour on Sundays.
On a typical day, he spends half his time seeing patients, counselling and going through the procedure with them. He spends the other half of the time operating.
Dr Baumann said: 'We worked out that Dr Tay does, on average, 34 eyes a day, if he works 288 days ayear.
'At 10 minutes for two eyes, he spends about five hours operating each day.'
Dr Tay estimated that he gets one complication in about 3,000 operations.
LOW COMPLICATION RATE
The clinic did its own study on its infection and complication rates and compared them to rates worldwide.
Their results showed that they had zero infection rate last year compared to 0.4 per cent in other international centres.
The clinic's complication rate was 0.27 per cent compared to 1.26 per cent in other international centres.
Their study was based on a total of 16,089 operations done at the clinic for 2007.
Ms Salimah Ali, a co-ordinator in a headhunting company, will be going for a Lasik procedure by Dr Tay next week.
She said: 'I attended a talk organised by the clinic and found Dr Tay very knowledgeable.'
She also said the clinic was well-known.
This story was first published in The New Paper on Apr 25, 2008.
Article from: http://www.asiaone.com/Health/News/Story/A1Story20080427-62095.html
Wednesday, June 09, 2010
Lasik ;)
I don't want to wear spectacle anymore. It makes me look nerd and I can't enjoy my sports. Neither do I like wearing contact lens. I have to buy the contact lens and the solution every month. I have to clean the contact lens after I use them. I have to take care of my eyes to prevent infection. And everytime I wear it, it get so dry, especially when I wear it for long hours.
A few years ago, three of my aunties and cousin asked me to join them to undergo the lasik procedure. I didn't join them because I was very concern of the consequences after the surgery. Will I go blind? Will my eyes have side effects after the surgery?
Last year, one of my ex-colleague asked me to join her for the lasik surgery too. Again, I didn't dare to do it.
A few months ago, my colleague made an appointment with the opthalmologist and asked me to join her too. She told me she was going for the pre-lasik consultation. The doctor will assess whether her eyes are suitable for the surgery. If she is a suitable candidate, she can then undergo the lasik procedure. After the surgery, the doctor will conduct the post-lasik consultation. Everything sounds so safe.
There are so many people undergoing the lasik surgery nowadays and it seems like nothing happens to them. I have been checking online on the lasik surgery clinics and asking relatives and friends who had underwent the lasik procedure. I found out that the lasik technology is very advance now and it is not as scary as I think.
Hence, I have decided to take the plunge. Now, I'm deciding which clinic I should go. =)
Tuesday, June 08, 2010
Starting life over at 60
Starting life over at 60
Setting up a retail business is an achievable dream, whether you're 17 or 70
by Chan Seet Fun 05:55 AM Jun 07, 2010
Retired banker T S Soh, 60, has been working as a kitchen helper, a waiter and at the counter of cafes.
"I believe that there are opportunities in F&B. Everybody needs to eat but not anyone has time to cook. So, I want to have my own F&B business," said Soh, who retired in 2008, after more than 30 years in banking.
"I've tried to get a job but when they learnt about my age, they said 'so sorry' and they don't interview me. But I believe that you have to be adaptable. So, I will start something on my own."
With his business ownership dream in mind, he switched gears and went from managing a team at a bank branch to starting from scratch in the food and beverage industry. If that meant making tea and coffee, he was prepared to do it.
"I wanted to learn about the business, from the very basics. I wanted to find out first-hand what problems are faced by the staff and by the owners," he said.
Now, with two years of F&B experience under his belt, he is adept at making cappuccinos, sandwiches and pastries from frozen dough. Not only that, he is also "familiar with NEA (National Environment Agency) requirements".
And while he was chalking up valuable hands-on experience, he also went back to school. Last November, he earned a Certificate in Retail Studies from the Singapore Institute of Retail Studies (SIRS). Last month, he completed SIRS' new "Set Up A Retail Business" course.
"I wanted to see what I could learn before actually setting up my business," he said. "I was the oldest participant in the class. But that's fine. I was there to learn. I should not have to feel inferior."
He added that the course was well worth attending. "Some of the things they taught us hadn't even crossed my mind. There are so many things to consider when starting a business. I've also learned how to do a business plan. This is important, especially if you need financial help. You can use it to present your case. It was a detailed and practical course. I would recommend it. It's short but you learn a lot in that short time. And with the 90 per cent subsidy from the Workforce Development Authority, I only paid $16.05," he said.
Soh is now on the lookout for a suitable location and hopes to get his business up and running within the next six months. For day-to-day support at his F&B outlet, he will look to his friends and family.
And once things find their rhythm, he might even go into consulting, drawing on his experience as a business owner, and his years in banking, to teach others about becoming their own bosses.
He said: "Some of my ex-colleagues ventured into business without any business experience and without taking any courses first. They just tried. And if they failed, they closed shop. But I am more cautious. I want to look carefully before plunging in. Money is not easy to earn."
Learning about the retail business
A new course on setting up retail businesses has piqued the interest of the members of the Women's Initiative for Ageing Successfully (WINGS).
Said WINGS programme executive, May Tan: "The response has been very good. We publicised this course, which is offered as part of our skills programme, in our weekly newsletter and within 10 days of sending out the email blast, all 24 spots were filled. There is a waiting list now."
She added that if the list grows, WINGS will talk to the Singapore Institute of Retail Studies (SIRS), which runs the course, about organising subsequent intakes for WINGS.
SIRS introduced the course in April this year. Said the institute's manager of business development, Megan Ong: "The response has been tremendous. We've conducted more than 10 intakes since and a good number of participants have been seniors."
She added: "On the whole, the age of our trainees ranges from 17 to 70 and there has always been a fair proportion of mature trainees. Some courses, such as 'Sell Products & Services', are popular with seniors as the skills and certification acquired helps them work as promoters or in freelance sales positions. We have also seen that this group is interested in the 'Set Up A Retail Business' course. Some of them have retired and are ready to pursue a second career as a business owner."
The "Set Up A Retail Business" course provides insights and tools that will help participants in setting up their new business. Spanning 40 training hours, the course will show participants how to study the retail environment, develop a retail business plan and implement it.
Participants are taught by experienced trainers who aim to impart useful skills rather than just theory and they also benefit from networking with fellow participants who have prior working experience.
The course's first run in partnership with WINGS will begin on June 15 and those who have signed up include housewives, retirees and women who are working part-time. Tan said that one participant is employed full-time and will take leave to attend the course.
She added: "We constantly scout for new and exciting things for our members. And they come with open minds and are eager to learn."
Article from: http://www.todayonline.com/Silver/EDC100607-0000026/Starting-life-over-at-60