Banker Gets $7 Million in LASIK Suit
A New York investment banker has won $7.25 million in damages for vision impairment that he claims resulted from LASIK eye surgery performed by the TLC Laser Eye Center, which has surgery centers nationwide. It's the largest jury award to date involving the popular vision correction procedure.
Mark Schiffer, 32, underwent LASIK surgery on Oct. 6, 2000, a week after he first visited an optometrist affiliated with TLC. The surgery was performed by Dr. Mark Speaker, then-medical director of TLC, who also has his own practice.
In the suit, Schiffer claimed he suffered distorted and blurred vision, particularly in his left eye, because the TLC-affiliated doctors failed to determine that he had keratoconus, a degenerative corneal condition that made the laser surgery unsafe.
Schiffer's lawyer, Todd Krouner, argued that the failure to diagnose keratoconus was a result of TLC's high-volume practice, which he called the "McDonalds of LASIK surgery." He said TLC had placed Schiffer on a "conveyor belt" of LASIK patients, noting that Speaker performed procedures on 10 other patients
LASIK VERSUS Refractive Lens Implants
How to incorporate new refractive lens technology in a co-management relationship.
Co-managetnent of vision corHitection procedures has fostered mutually beneficial relationships between optometrists and ophthalmologists. The advent of phakic, multifocal and accommodating intraocular lens implants broadens co-management opportunities. We can now work together to provide patients, impaired by the highest levels of refractive error, sight restorative surgery.
There are several critical stages in the co-management relationship. First, determine which procedure is optimal for each patient. After counseling the patient extensively, you and the surgeon must decide which procedure is optimal. second, compiete a thorough preoperative work-up. The operative procedure is then performed, and lastly, you must provide postoperative care. Being knowledgeable about new lens technologies and understanding the respective roles of the optometrist and ophthalmologist throughout this process can help patients achieve the best possible outcome.
Lens implants vs. LASIK
Not all patients are candidates for lens implantation, just as not all patients are candidates for LASIK. Parameters like refractive error, age, presence of cataract, corneal thickness and shape all impact whether one procedure or the other is appropriate for a particular patient. There are also patients who may be candidates for either LASIK or IOL implantation. Patients fall into four categories when making the determination about which refractive procedure is optimal for each patient.
* LASIK candidates. Pre-presbyopic patients with refractive errors of less than -8.0OD of myopin or less than +4.0OD of hyperopia, are generally good candidates for LASIK surgery. These patients must have healthy corneas with appropriate thickness in relation to the refractive error, normal corneal topography, normal tear film and the absence of significant medical conditions like diabetes, collagen vascular diseases and pregnancy. Wavefront-optimized and wavefront-guided treatments provide excellent visual results in this group of patients.
* Phakic lens candidates. We prefer phakic lens implants in myopic patients with errors of -10.0OD or more. The ablation profile in LASIK can lead to an increase in higher-order aberrations with subsequent glare and night vision problems for this group.
These lenses are also a good option for patients with refractive errors as low as -5.0OD in whom LASIK is contraindicated due to insufficient corneal thickness, irregular astigmatism or profound dry eyes.
* Multifocal/accommodating lens candidates. Presbyopic patients, including patients with early cataracts, may prefer the multifocal or accommodating lens implants because they can achieve good distance and near vision. Although monovision LASIK is an option, it is often unacceptable because depth perception is compromised.
These implants are ideal for high hyperopes (+4D or greater) who are most interested in eliminating their dependency on distance and reading glasses. However, patients with myopia above -6.0OD are at a higher risk for retinal detachment after cataract or refractive lens exchange. Counsel patients about the additional risk appropriately.
* Candidates for both procedures. Myopic patients who fall between -5.00D and -10.00D with sufficient corneal thickness and normal topography may be candidates for either procedure.
For this group, it is imperative to discuss options with the patient to determine which is the best procedure. Considerations include age, range of myopia, amount of astigmatism, endotheHaI cell count and anterior chamber depth.
Pre-op work-up
Co-managing doctors must agree on the division of labor when performing the pre-operative tests. Unlike LASIK, which is typically performed bilaterally, IOLs are implanted one eye at a time. Depending on surgeon and patient preference, there may be a one to four week interval between procedures for the first and second eyes. During this interval, patients may need to wear a contact lens in the untreated eye to minimize anisometropia or aniseikonia. In our case, Dr. Kasslaow performs all pre-operative tests with the exception of the anterior chamber depth, endothelial cell count, ?-scan and IOL calculation.
No matter what the choice for correction, a thorough and precise preoperative work-up must be performed. Critical tests include: a careful dry and wet refraction; pupil size measurement; keratometry; IOP measurement and dilated fundus exam. The refraction is the most important part of the preoperative work in these patients. Young, highly myopic patients can easily accommodate more minus in their prescription. Take care to measure the refraction both with contact lenses in (over-refraction) and after lenses have been kept out for the appropriate time (one week for soft lenses, two weeks for gas permeable). In addition, for highly myopic refractions, keep the vertex distance constant to ensure accuracy. A full cycloplegic refraction should be performed as well.
7 Tips About Lasik Procedures
For many people wearing glasses is a signal that you are somehow different from everyone else. The other kids at school drill this into your head as child. Therefore, when the chance to get rid of glasses forever was introduced, the surgery, known as the LASIK procedure was embraced with open arms. Unfortunately, the price of the surgery kept it out of reach for some people. Thankfully, the price is going down and interest is being renewed.
1- Before jumping into a LASIK procedure, it is important to know what to expect and how to pick the doctor who will perform the surgery for you. When you visit you eye care professional to discuss if this option is right for you, there will be some tests that need to be completed. These tests will let the doctor know if you are a candidate for the LASIK procedure and, if you are, how much tissue needs to be removed from your cornea to improve your vision.
2- When you enter the room where your procedure will take place you will see a recliner type chair. This is where you will be sitting for the surgery, so get comfortable. There will also be a large machine, with which the surgeon will perform the surgery. This machine might look clumsy, but it is a precision piece of equipment.
3- The first thing that will happen is your eye will get a washed out with a numbing solution. The lid will then be held in an open position with special clamps to prevent blinking. Once the numbing solution has started to work, the surgeon will use the machines magnifying lens and a scalpel to cut a flap-like incision in the cornea.
4- The incision will allow the laser access to the tissues below the cornea that need to be removed. The tests that were performed during your initial visit to the eye doctor determined how much of this tissue was to be removed. The machine that is in the room houses the laser and is attached to a computer.
5- The laser works based on pulses, when enough tissue is removed, the computer tells the laser to shut off. The surgeon then closes the flap of the cornea. That's it; your LASIK procedure is complete!
6- The surgeon does not use any sutures to close the incision on the cornea, instead a patch will be placed over the eye for protection during the healing process. You will end up looking like a pirate, but the patch will protect the cornea from the scratches and bumps of everyday life.
7- Most LASIK procedure patients return to work with in a couple of days and to normal everyday activities gradually over a couple of weeks. Be prepared to have blurry vision and sensitivity to light. These will both pass, and your vision will be as clear as it was with glasses or better.
Thx~John Manci
Is Lasik Eye Surgery For You?
Lasik eye surgery can be used to correct myopia, astigmatism and hyperopia. Presbyopia, which causes those of us in our late 40's to need reading glasses is actually a loss of flexibility of the eye lens and cannot be treated with lasik corrective eye surgery.
During lasik surgery the ophthalmologist actually reshapes the cornea with the use of a laser. How much reshaping you have done to your cornea depends entirely on your particular sight problem. The FDA first approved the excimer laser for eye correction in October of 1995. Lasik was approved in 1998.
The first thing you need to do before you see the doctor is homework. Read online about lasik, write down questions for your ophthalmologist. Talk to friends and family who have had the procedure. Ask them their experiences. As with any medical procedure there are real risks involved with lasik and you must weight the risks and benefits of the procedure based on your personal desires.
Some patients seeking lasik eye correction surgery come away with a worsening of their vision. Some come away fighting constant eye dryness. Some have bouts with severe infections. Some suffer from halos and double or triple vision.
Your doctor will evaluate you on an individual basis to see if he thinks you will be helped by lasik eye surgery. Not everyone is a candidate for lasik. Women who are pregnant or nursing are not. People with autoimmune or immunodeficient diseases are not candidates. People who form keloids are not good candidates for lasik. People who suffer from cataracts cannot have lasik. Your ophthalmologist will also most likely want you to have no change in your eye glass prescription for at least a period of one year prior to lasik.
The best way to help yourself obtain the best result from lasik is to arm yourself with knowledge.
Thx~Terry Lowery
What Is LASIK?
Laser In-situ Keratomileusis or commonly known as LASIK is a surgical procedure that is used treat a wide range of refractive errors in the eye.
The eyeball, cornea or lens being shaped imperfectly causes refractive errors of the eyes. The three common types of problem resulting from refractive errors are as follows:
1. Myopia or nearsightedness. This condition is where only nearby or close objects appear clear to the eye.
2. Hyperopia or farsightedness. This condition is the opposite of myopia and it is where only objects far away or at a distance are clear to the eye. Commonly elderly people require glasses to read a book.
3. Astigmatism, these are where images are blurred at a distance and near. A combination of the above two conditions.
As indicated above, LASIK is a procedure-using laser that can change the above condition that results in patients seeing clearly. In effective, LASIK eliminates the reliance on glasses and contact lenses and thus increases the individual's safety during outdoor activities or sport. In addition, the 24 hour corrected vision and improved conveniences are achieved with as little as 1% risk of side effects post surgery.
The LASIK procedure
Prior to the operation, anaesthetic is placed onto the surface of the eye to numb and reduce irritation. The eye surgeon then starts with an instrument (Microkeratome) to cut or peel a hinged thin flap of corneal tissue off the outer layer of the cornea or eyeball. The flap is then lifted to the side where the laser treatment can takes place.
The laser is then precisely pulsed to reshape the underlaying corneal tissue. The LASIK procedure uses an excimer laser, which is a new class of UV laser (approved by the FDA). It was originally developed for use in the microprocessor industry and later found its application in vision correction. These lasers have a much higher precision and accuracy that can change the shape of the cornea in the eye. It does this by breaking the intra molecular bonds in the collagen molecules during the laser pulse and thereby improving the way light is focused or "refracted" by the eye.
One pulse of the laser can remove and reshape the internal cornea with an accuracy of +/-0.25 microns. To understand the accuracy of one micron, a grain of salt is about 60 microns and the eye can see particles to about 40 microns. It would take about 200 pulses from an excimer laser just to cut a human hair in half. Once the corneal is adjusted, the flap is laid back to the original position prior to the cut and serves as a protective layer during the healing process. The whole process takes only 15 minutes for each eye, which is why LASIK has become popular.
After the procedure, the healing takes place quite rapidity as the cornea bonds quickly. Healing can vary from three days to a week with a final clear vision obtained. Your are now ready to view and see the whole world without glasses or contact lens.
Thx~Virginia Wong
LASIK is an efficient and fairly innocuous procedure. It is capable of treating several refractive errors, such as myopia, hyperopia and astigmatism. The procedure itself entails virtually no pain and provides rapid recovery. Though the vision will be blurry immediately after surgery, visual acuity will be restored within a few days. However, it takes about 3 to 6 months for the refraction to stabilize. It is imperative that you carry out a scrupulous postoperative regime in order to boost the recovery process and avoid unnecessary complications.
Avoid rubbing your eyes for at least the first week after LASIK surgery. The corneal flap cut out during the surgery requires substantial time to heal. Unnecessary rubbing may inadvertently aggravate the wound. You should also take extreme caution to avoid soap, hair spray or shaving lotion from entering your eyes. The eye surgeon will typically provide you with a postoperative kit, which may include a set of eye shields/goggles. Wear them while you are sleeping, at least for the first three nights after surgery.
For at least a week after LASIK, prevent water from entering your eyes, since water hinders the natural clotting mechanism, and therefore might delay the healing process of the cornea. You must also cancel any swimming plans for a minimum of 10 days following LASIK. You must not wear eye makeup for at least one week after LASIK.
Contact sports are to be avoided for at least a week or so following surgery. Furthermore, it is advised that you wear some kind of protection gear for your eyes for a period of a month, even after resuming exercise and other sporting activities. Bright sunlight may lead to scarring, and therefore, sunglasses are recommended on bright days until the cornea heals.
To summarize, though you will able to resume your usual lifestyle within a week or so after LASIK surgery, it is crucial that you protect your eyes to prevent injury or infection. And since the corneal flap does not heal instantly after surgery, you must prevent washing your eyes for at least a few days after surgery.
If you find a LASIK surgery that you are confident with, you will be able to get more information about post LASIK complications.
Thx~Nicola Kennedy
Lasik Eye Surgery: New York
When it comes to lasik eye surgery, New York has some of the most surgeries of the east coast. In New York, there is a trend for improving your looks and improving your health. Individuals are continuously looking for a way to improve themselves so that they can stand out from the crowd and really make a difference. Lasik eye surgery is just one way that they can make that happen. Other areas of the country, such as Miami, Florida and many cities in California, also have these large numbers of eye surgery performed.
What does that mean for someone that is looking to have their eyes improved with the use of lasik eye surgery? For one thing, there are plenty of qualified doctors in the area. In some cases in some areas of New York, lasik eye surgery is offered by several physicians which means there is a bit of competition for your business. Although prices are significantly higher in these areas because of the cost of living in those areas, it is still possible to get an affordable price on the surgery.
Of course, the cost should be one of the last things that you think about when it comes to having lasik eye surgery. New York is filled with qualified physicians that provide for the best possible reduction of risks and the best results possible. Still, there are those out there that aren’t as experienced and perhaps don’t have the best training. For that reason, you should invest in finding out as much as you can about the physician that will be handling your surgery.
There is no question that you can have an excellent lasik eye surgery in New York. By insuring that you learn as much as you can about the surgeon that will be handling your surgery, you also improve your risks and get the best possible surgery.
Thx~Frank Montes
Finding Lasik New York Area
One of the best types of eye surgery out there is lasik. New York has some of the best eye surgeons to provide that surgery, too. Throughout the area you will find many different companies that offer this type of surgery, but you are likely not to be able to tell the difference between them just by looking at them. Unfortunately, though, there are differences that can affect the quality of the vision that you end up with as well as the experience that you go through. The good news is that you can find quality lasik, New York area and beyond.
To do this, take the time to look for other patients that have gone through lasik in your area. In New York, one of the largest areas for this type of corrective surgery, you’ll find many people that have experiences to tell you about. You can also look for reviews on the web of local doctors. That’s a great way for you to understand who is out there and who the right company to work with is.
You should also invest ten minutes in visiting the website of the Better Business Bureau. There, you can learn about the company and any possible complaints that have been filed against them. This is a great way to learn not only who isn’t satisfied but what the company has done to help correct it. Another stop should be the New York State Medical Board website where you can learn about the eye surgeons and their experience and history.
Take the time to really explore the options that you have in lasik in New York. The good news is that there are some of the best eye surgeons available in your area. You can get excellent care and you will find the right doctor to put your trust into.
Thx~Frank Montes
