Talk:LASIK/Archive 1

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Archive 1

Comments

LASIK isn't the only type of laser eye surgery. I think this article should not be the receiver of laser eye surgery.

Instead, the reader should be referred to a more general article on the topic, such as eye surgery. Some of the other laser assisted eye surgery methods are PRK and LASEK. Presenting this topic as the sole method for laser eye surgery is biased and misleading. At the very least, a disambiguation page should be created.

It should list the eye surgery article for general information and under it there should be the others. If anyone know show to remove the redirect from laser eye surgery to LASIK and create a disambiguation page linking to it instead, please do so or explain to me how. --Exigentsky 04:52, May 26, 2004 (UTC)

A copyright issue from LASIK site FAQ:
Q: Can I use information from the FDA LASIK website?
A: Yes. Information on this website can be used freely by the public. Any use on other websites or in publications should be properly cited. Mikkalai 04:35, 3 Jan 2004 (UTC)

I don't think it's appropriate for an editor to add a link to their own blog (or other site of their own) unless that site has a significant amount of content that can't be found elsewhere. Since the content on this one was "I've read a lot of reports stating X" and "I saw a good comparison on a reputable website", this is obviously not the case here. Better to link to the original reports.

Also, "a lot of reports stating that when LASIK (Laser-Assisted In Situ Keratomileusis) centers offer laser eye surgery for $499 to $999 per eye, they are usually cutting corners"? While that sounds like a very reasonable conclusion, it also sounds like an unusually specific thing to be stated in 'a lot of' different reports. Offering this claim without citations doesn't strike me as a very high-value source. --Calair 23:54, 17 July 2005 (UTC)

It doesn't belong in the article because it's original research, and I'm inclined to think whoever added it was spamming (judging by his other contributions) →Raul654 23:57, July 17, 2005 (UTC)

Inherent adverse events

While the article is well written, I am concerned that the Wiki traditions of relying on published information is creating bias in this instance where all of the published information comes from physicians and physician organizations that have economic incentives to de-emphasize the adverse possible outcomes. I would like to see a section added to the article that focuses on the needs of a typical reader, who is a person considering LASIK surgery. From personal experience (Lasik Feb 2001) I can say that the "halo/glare" effect is a poor description of what actually occurs and it is not simply an annoyance (as the article infers) but is somewhat debilitating. I now avoid driving at night in unfamiliar areas because my vision is blurry and it is harder to see lane markings and directional signs. Movie theaters are another problem environment where my vision blurs out during low-lit scenes and during the credits.--Forensicengineer 20:54, 12 July 2006 (UTC)

I was surprised at the article's general lack of discussion of any adverse events inherent in LASIK. I'm no expert on the matter, but considering the plethora of anecdotal accounts describing an impaired ability to detect light and color contrast; seeing halos around light sources in dark environments; and, in extreme cases, a seriously-impaired ability to see distinctly in dim light, I was hoping for some analyses—or even an acknowledgement—of such events.

Fundamentally, does LASIK improve visual acuity at the expense of contrast perception? If this is unfounded anecdotalism, then let's see it debunked, but surely these topics deserve some treatment. — Ringbang 15:41, 28 August 2005 (UTC)

The halo effect is extremely common. Beyond that, I've never heard of people losing contrast (and none of the 150 pages of literature on the subject they had me read before my operation mentioned anything of the sort). In discussions with my optholmologist (who literally wrote the book on this sort of things), he said that for people who follow the instructions correctly, a slipped flap is the most common complication (about 1 in 200 patients), followed by mechanical difficulties with the equipment (about 1 in 500), infection (about 1 in 5000), 'etc. So I wouldn't call these common problems. →Raul654 17:30, August 28, 2005 (UTC)

I removed the following information from the article. Weathers had RK, not LASIK: Also, as discovered by former patient and Mount Everest climber Beck Weathers in 1996, eyesight corrected by LASIK has a strong tendency to become blurry to the point of uselessness at high altitude (above 20,000 feet), due to the minute pits made on the eyeball by the laser, which fill with low-oxygen air to blur vision. No study has been done on this, due to the risks associated with high altitude mountaineering. AED 16:25, 30 August 2005 (UTC)

I've added a study indicating that LASIK increases higher order aberrations. The results were very significant (p < .001). I added another that shows that the nerve fibers needed for healthy tear function are reduced by more than half even a year after surgery.

Inclusion at "Requests For Comment" RE: Prominant proponents/opponents of LASIK section

This article has been added to the Requests For Comment page regarding a newly started edit war between User:Pacian and User:Edwardian. Pacian added a section called Prominant proponents/opponents of LASIK. Edwardian removed it stating it did not belong in the article. Pacian left a comment on Edwardian's talk page then restored the section. Edwardian responded on Edwardian's talk page, removed the section again, and created an entirely new entry at Prominant_proponents/opponents_of_LASIK. Comments are requested on whether or not the section was appropriate. Should it be readded; should the new page be removed? Should things be left as is? Should both the new page and the section for this page be eliminated? After five days of discussion the position expressed by the majority opinion will be enforced.

The section reads as follows:

Comedian and actress Kathy Griffin has been a very vocal opponent of LASIK. She has had five surgeries on her right eye: three LASIK and two corrective. Her final surgery which she was assurred would last 10 minutes lasted 90, and she wound up with 17 stitches in her eye. She has pinpointed a specific doctor as having assurred her of minimal risks only to end up badly injured. She strongly speaks out against LASIK. [1] (The link contains a detailed account of her history with the surgery as well as potentially disturbing photographs of her eye.)
Obviously I think the section belongs in this article. It is important to reference influential people's opinions on a subject. Though one might argue that Kathy Griffin is by no means an expert on LASIK, she has spoken out about her personal horrible experience with it, in both print and on television (most notably on Oprah.) She has an entire section on her web site relating to the subject with an extensive description of what she went through and very clinical photos of the damage done to her eye. When I added this section it was not only because I thought Griffin's EDUCATED opinions and statements on the subject were relevant and appropriate to the subject, but also because I thought that others would be able to expand the section with information about other notable proponents or opponents of the procedure. I believe that the section should be reinstated to the main article and that the newly formed article should be nominated for speedy deletion as it is completely inappropriate. Pacian 04:05, 28 September 2005 (UTC)
Delete. This article is specifically about LASIK, not an opinion page for every outspoken advocate or critic of the procedure. If someone wishes to add specific information critical of LASIK (i.e. risks, side effects, complications, etc.), then that information should be added. If the opinions of every celebrity must be included in Wikipedia, then Prominant proponents/opponents of LASIK is the place for it. Still, it is clear from examples like Wikipedia:Articles for deletion/List of famous pneumonia suffers that most Wikipedians object to lists of this sort either in articles or on their own.
Furthermore, if this section is to educate people about LASIK, why does it include no specific information about LASIK and why should the list be limited to influential or prominant people? Certainly there are websites from those who are not celebrities but who have equally valid "opinions and statements" and are much more educational (e.g. Pro/Neutral and Con). And if this section includes no specific information about LASIK, why is it "completely inappropriate" in its own article but "relevant" and "appropriate" here? AED 06:22, 28 September 2005 (UTC)
It is Wikipedia policy to include pertinent information within an article if it is applicable RATHER than create a new article for information which might be better included in a fuller article on the bigger picture. For instance (not the best example I admit) a child of a celebrity should be mentioned within the celebrity's own wiki-entry, not in an entirely new entry for the child.
Also, "prominant" does not mean celebrity - a prominant person could be a scientist, a published researcher, etc...obviously the everyman Joe-Blow is not worthy of including in an entry if he has an "opinion" on LASIK, or for that matter even a personal experience, but Kathy Griffin (a person of worldwide note) has had a personal experience with LASIK about which she has spoken publicly and to a great degree.
If you have a qualm about how the section is worded, then you should by all means edit it, but that is not grounds for removal. If you feel more specific information should be included, visit the Kathy Griffin weblink, obtain the information, and post it with citation.
Finally, I do NOT appreciate your editing of my entry here on the talk page. It is EXTREMELY BAD WIKI-ETTIQUITE to edit someone's talk-page comments. If you disagreed with any of the content on them you should have made a subposting stating that disagreement. Pacian 19:19, 28 September 2005 (UTC)
So it's obvious that, if "everyman Joe-Blow" has had a personal experience with LASIK, that doesn't belong in the article, but if "a person of worldwide note" has, then it does belong? That's about as blatant a fallacious argument from authority as is possible. Being a person of worldwide note, or a comedian or actress, or having been on Oprah, etc. etc. are attributes that are completely and utterly irrelevant to the subject of the article. -- Jibal 00:47, 29 July 2006 (UTC)
Regarding your first point: I agree that it is appropriate to "include pertinent information within an article if it is applicable"; however, I disagree that the information in question is pertinent or applicable. Regarding your second point: "Prominant" is relevant when it reflects expertise; not necessarily "personal experience". I don't see why any one particular person's personal experience deserves inclusion here. Regarding your third point: The section should be removed not because it is poorly written but because one particular person's personal experience does not deserve inclusion here. Per Wikipedia is not an indiscriminate collection of information, the "current consensus is that Wikipedia articles are not... [l]ists or repositories of loosely associated topics such as quotations, aphorisms or persons." (emphasis mine) "Prominant proponents/opponents of LASIK" qualifies as such a list.
Regarding your final point: The RFC summary on a Talk page, particularly when unsigned and posted in the third-person to give the presumption of neutrality, does not qualify as a personal entry that is not subject to edit. Per Wikipedia:Requests for comment/Maths, natural science, and technology, the RFC summary is to reflect a neutral summary of the issue. On that page and on this one you incorrectly stated that I failed to respond to your initial comments on my Talk page, so I made the appropriate change. If you do not feel that the current RFC summary is either neutral or accurate, please let me know so that we can fix it. Also, your comments to me here and on my talk page are bordering on confrontational, so toning them down a bit would be appreciated. AED 04:37, 29 September 2005 (UTC)

It's been over five days. I'm going to clear this from Wikipedia:Requests for comment/Maths, natural science, and technology. AED 06:48, 9 October 2005 (UTC)

The first?

I'm making a change:

From: In 1991, LASIK was performed for the first time both in Europe [1] and in the United States by a team of clinical investigators including Stephen Slade, M.D., Robert Maloney, M.D [2]., George Waring, M.D., Marc Michelson, M.D [3], and Stephen Brint, M.D. [4] who began gathering data on the safety and efficacy of LASIK for the United States food and Drug Administration.

To: In 1991, LASIK was performed for the first time in the United States by Drs. Stephen Brint and Stephen Slade [5].

Reason: It is difficult to find truly objective information regarding refractive surgery on the Internet. Most websites offer information about the various procedures, but invariable have a “Find a doctor” link somewhere. (User:151.204.233.81, for example, keeps attempting to insert linkspam for his or her favorite organization here.) With every surgeon claiming to be “the first” or “one of the first” to perform (take your pick) PRK/LASIK/Intra-Lase/LASEK/etc. in (take your pick again) the World/Country/Region/State/City/etc., I found no truly impartial website stating who was the first in the United States or Europe. Brint and Slade claim to be the first in the United States and I found nothing and no one contradicting that.

There is no compelling reason to mention Maloney, Waring, and Michelson at this time because 1) readers probably care about who was the first, not who was among the first and 2) there is contradictory information. Pubmed indicates 8 authors, not 5, in the Summit study [6] and Robert Epstein claims to be the third to do it [7]. Another website claims: “During that clinical trial period (1991-1996), LASIK surgeon Joseph Dello Russo, MD, was the most prominent of the 10 participating clinics, performing more laser vision correction treatments than any of the other study contributors.” [8] And another reports Frederic Kremer “was one of the first 10 ophthalmologists to perform refractive eye surgery in (the United States). He performed the first LASIK procedure in North America and has since completed thousands of these procedures.” [9] And while we're at it, might as well state that Stephen A. Updegraff claims to have done the first LASIK in Asia at the Rujin Hospital in Shanghai, China in 1995 [10].

sigh - AED 05:28, 16 October 2005 (UTC)

  • Same change, for same reasons. AED 05:24, 9 February 2006 (UTC)
  • Same change, for same reasons. -AED 21:08, 2 June 2006 (UTC)

I've removed the following edit by User:Bbanaji: "The first Indian patients were treated by Dr. Burjor P. Banaji of Bombay in 1995." As above, there is no compelling reason for the article to mention who was the first in every country and, per Wiki guidelines, no self-promotion. -AED 22:07, 8 May 2006 (UTC)

"Safety and efficacy" paragraph

I can hardly understand what it is saying. The wording is one of the poorest I have seen. F15x28 05:16, 26 February 2006 (UTC)

I can understand it perfectly. Perhaps it's time for you to go back to English class? --82.31.161.14 10:42, 22 July 2007 (UTC)

citations needed

"Flap wrinkles, or striae, occur because the surface of the eye covers a smaller amount of volume after surgery. This is similar to a deflated ball. These wrinkles can cause substantial loss in vision that is not correctable with glasses[citation needed]. This is one reason why LASIK patients typically have reduced contrast sensitivity[citation needed]. More serious visual symptoms, such as bluring, smearning, and multiple images may also be caused by flap wrinkles[citation needed].

Dry eyes are believed to be caused by the cutting of nerves during the creation of the flap[citation needed]. The nerves are needed to communicate the need for tear production. The extent to which the nerves grow back is not understood, but some doctors question whether they ever heal completely[citation needed]. The flap itself does not seem to ever completely reattach, and can easily be opened up even years after being cut[citation needed]."

Whatever the source, I'd find it more credible if it was identified, along with some indication of why the interest. Midgley 01:29, 24 March 2006 (UTC)


Complications

The complications section seems to be constantly monitored by a pro-LASIK propaganda machine. The slightest change of wording, such as the removal of subjective terms such as "small" or "uncommon" is immediately removed. The intent seems to be to convince the reader that complications are uncommon, but no substantial research is ever presented to back up this claim, nor is "uncommon" ever sufficiently defined. On the contrary, there are many people who have had complications. It wouldn't be difficult to fill this page with household names who have had serious complications, though I don't think it would be fair to them to do so. Andecdotally, unqualified success stories seem to be more rare than people with complications.

A little bit of honesty would help a lot of people make a better decision. Unfortunately, the editors of this page seem to prefer to promote LASIK over an informed decision.

I'll repeat my edit comment: I have no vested interest in LASIK other than as a very satisfied patient. —Joseph/N328KF (Talk) 03:27, 24 March 2006 (UTC)

The word "uncommon" is inappropriate. I'm glad you're happy with you results, if indeed you are not a shill. Perhaps you are one of the few who have a perfect outcome. Or maybe you have minor complications and they don't bother you. The fact is though, that the vast majority of people I talk to personally about LASIK have complications. Many of them are still happy with the results even when they see halos and have puntal plugs. Other consumers, however, would be horrified by the same results.

Regarding the charges of promoting LASIK, I think the edit history will show that it was I who expanding the section entitled "Complications" and have repeatedly removed advertising for LASIK surgeons. With that said, I also watch out for anti-LASIK types who repeatedly insert unsubstantiated claims into the article. (Those with anonymous IPs tend to stick out on my watchlist.) If someone would like to help build-up the "Complications" sections with referenced claims, it would be more than welcome. -AED 04:19, 24 March 2006 (UTC)

The complications section began by saying that complications are uncommon. It was backup up by two citations. The first is a web page that claims a complication rate of 3% per patient but that does not mention any studies. The second is an article written in German that does not appear to be a comprehensive study. The German article doesn't even appear to focus on LASIK complications. It's abstract begins by discussing surface ablation, which is a different techique. Further, a 3% defect rate, to many, would mean that defects are common.

More disturbing is that the complication list includes overcorrection and undercorrection in that 3%. While I agree that those are complications I know of no doctor who is willing to claim a 97% chance of getting both eyes to plano. Other common complications, such as regression and epithelial ingrowth, are not mentioned at all. The complications sections is so blatently wrong, and so aggressively defended that one cannot trust that those guarding it are not biased.

A number of assertions need to be challenged here:
  1. Regarding the "web page that claims a complication rate of 3% per patient but that does not mention any studies". I'm sorry that you don't approve of the citation for the statement. It would be nice if you even attempted to provide a citation for yours.
  2. Regarding the "article written in German that does not appear to be a comprehensive study". The abstract is in English and backs up the statement: "The following are some of the more frequently reported complications of LASIK", not "complications are uncommon".
  3. Regarding "More disturbing is that the complication list includes overcorrection and undercorrection in that 3%. While I agree that those are complications I know of no doctor who is willing to claim a 97% chance of getting both eyes to plano." So, anything but plano is an "unresolved complication six months after surgery". No wonder we can't agree on what is common, uncommon, and rare!
  4. Regarding "Other common complications, such as regression and epithelial ingrowth, are not mentioned at all." Utter BS. Did you bother to read the article? I added a laundry list of items 8 hours before you posted your complaint. If you want to add some referenced figures about regression, stop complaining and do it.
  5. Regarding "The complications sections is so blatently wrong, and so aggressively defended that one cannot trust that those guarding it are not biased." More BS. If you bothered to read what I wrote earlier, "it was I who expanding the section entitled 'Complications' and have repeatedly removed advertising for LASIK surgeons."
  6. Please sign your posts with ~~~~.
-AED 21:29, 24 March 2006 (UTC)
I think the balance of the current 'External links' section - one fairly neutral FDA article, two pro-LASIK sites, and four given over largely or entirely to complications & dissatisfied customers - is fairly strong evidence that this page is not dominated by LASIK shills.
Speaking of which, before throwing around remarks like "pro-LASIK propaganda machine" and "if indeed you are not a shill", I strongly urge editors here to read and absorb WP:AGF. Accusations of that sort do *not* encourage other editors to accommodate your concerns; they only lead to an antagonistic climate and fruitless edit warring. --Calair 00:41, 25 March 2006 (UTC)

How could the estimate for *all* complications range only from 3% to 6% when chronic dry eye happens to 28% of Asians? The dry eye study is a peer reviewed scientific study. The 3% is merely stated by a website without reference to any studies. There seems to be a bias towards underreporting complications.

Did you bother to read the comment? (i.e. Albietz: 15 of 54 + 41 of 878 = 56 of 932 (i.e. 6.01%) The overall incidence of dry eye for entire population was 6.01%. In other words, you can't take a case history and say, "The incidence of blindness is as high as 100%". -AED 21:31, 24 March 2006 (UTC)

Nobody has taken a case history and substituted it for a population. The difference between Asians and Caucasions was significant at the p < .001 level. You can't ignore that. You can't tell Asians that they have only a 6% chance of complications when you include chronic dry eye.

The point I'm trying to make is that the total complication rate has been listed at 3% or 6% depending on the day of the week. Some negative outcomes are listed as complications, but not included in that 3% to 6%. I think we can all agree that this is misleading. Whenever I try to correct this I'm shouted down, and this isn't right either. If we want to reclassify "complication" into "severe complication" and "minor complication" then possibly that's workable. Whatever we do we should be truthful, honest, and not misleading.

Specifically, we need to say what we include in complications, and what we don't. The incidence of overcorrection and undercorrection is higher than 6% by itself. For Asians, the incidence of chronic dry eye is much higher than 6% by itself. Also, I'm a bit concerned about the figures being mixed up between per surgery and per patient. Most patients have a least 1 surgery per eye.

Let's keep in mind that this is surgery were talking about here. If we're going to post anything it ought to be accurate. We don't want someone getting the surgery because Wikipedia told them that is was safer than it really is and then suing Wikipedia.

Yes, I do believe that peer reviewed scientific journals carry more weight than numbers posted on websites without reference to any research. It does bother me a bit that the first number posted in the complication section is just such a number.

I do not think Wikipedia should be setting itself up as a source of medical advice to prospective LASIK patients (or for any other type of surgery). It can certainly provide some basic information and pointers to more, but in an evolving field where the consequences of a bad decision are serious, the Wikipedia editing process is simply too haphazard and unreliable for for us to say "here is the data on which you should base your decision".
In an ideal world, prospective patients would have an information source that gives them the best possible estimate of their chances of success, calculated from age, gender, ethnicity, correction, pupil size, and anything else likely to influence the calculation. But Wikipedia cannot be that source, and a presentation which implies that it is such a source is dangerous. I would sooner have a vague article that leaves readers thinking "I need to ask around and do more research on this" than a very detailed - but still incomplete - article that leaves readers thinking "I can make my decision based on this information".
I'm not arguing for 'no change' here. IMHO, if one group has a 6% complication rate and another has a 28% complication rate, that ought to be somehow acknowledged. (I would also point out that most medical statistics of this kind show such variance; the question of how to present data for a nonhomogenous population is not a simple one, and choosing one presentation over another is not prima facie evidence of a vested interest.)
What I am saying is that the figures in this article should be illustrative rather than exhaustive. By all means say "reported complication rates vary widely depending on factors such as ethnicity, with one study reporting an overall complication rate of 6% but 28% among Asian patients". But once we've made the point that "lots of factors affect the odds of a good outcome", we shouldn't attempt to be exhaustive in that discussion; I think the most important thing this page can do for prospective patients is tell them that they need more information than this page can provide. (For instance - given the wide range of subgroups comprising 'Asian', telling Asians that they have a 28% chance of complication probably isn't much more reliable than telling people-in-general that they have a 6% chance.) Does that make some kind of sense?
BTW, I also would appreciate it if you could sign your comments - even an anon-IP signature makes it easier to follow discussions than no signature. If you're using the basic web editor, you just need to hit the 'signature' button (above the edit box, third from the right).--Calair 00:50, 26 March 2006 (UTC)


Possibly we're in some agreement here. The complication page is confounding numbers in a way that is factually incorrect. Let me enumerate the most significant problems

1) The complication section starts by presenting a total complication rate for all complications. Then it lists as complications things that are not included that rate. This materially underestimates the likelihood of those complications.

2) The 6% estimate for total complication is estimated by using only a single complication -- Chronic dry eye.

3) The 6% is calculated using two populations known to be materially different. Here we may have a slight disagreement. I believe I understand your desire for simplicity. But generally, you don't present breast cancer rates, or prostate cancer rates combined among men and women.

4) The 3% estimate is of questionable origin, and as I've noted, couldn't possibly represent the complications lists.

Whether we like it or not, I think people will use Wikipedia as an information source when deciding on medical procedures. I don't no what the legal risks are. But regardless, I think it's important to be factually correct and to not be misleading.

Anyway, I'm tired of working on this. I've made my contribution for what little it's worth. I've also made my own conclusing that although I've barely scratched the surface, I've already uncovered enough information to indicate to me that LASIK doesn't live up to the hype. I don't even want to go into the prognosis for those who have complications. It doesn't look good. I've seen enough already. Sadly, LASIK appears to be nothing but bad news.

Hopefully someday we will all have perfect vision, no discomfort and no unwanted side effects. If so, it doesn't seem likely that it will have anything to do with slicing the eye open or using lasers.

The previous comment was clearly a biased comment. I think it's interesting that there has been an assault on this article (which in my view was already inordinately biased towards the con viewpoint) lately to place LASIK in a bad light. The article seems to place very little emphasis on the pro perspective. As a very successful LASIK patient (20/10 in right, 20/15 in left, no side effects beyond the first few weeks), the procedure has added tremendously to the quality of my life. Other than that, I have no stakeholding in LASIK as a procedure. I am curious what the agenda is of some of the vitriolic editors of late. —Joseph/N328KF (Talk) 14:43, 27 March 2006 (UTC)
It's hard to get a level-headed discussion about LASIK. Compared to some of the vision-science forums I used to watch, this has been quite mild and respectful. (FWIW, I work in the contact lens industry; it'd probably be good news for my career if LASIK went away, but I don't feel obliged to demonise it on that account.)
IMHO, there are several considerations involved here. The first is that there are some cowboys out there (hopefully less than there used to be); some surgeons aren't too picky about who they laser, resulting in surgeries on people who aren't good candidates for LASIK. When that goes wrong and the victims do their research after the fact, and discover that they weren't suitable candidates, they're very justifiably angry and upset. People are very prone to over-generalising from their own experience, so it's not a big psychological leap from "my surgeon was an irresponsible hack" to "people need to be warned about irresponsible hacks in LASIK" to "all LASIK surgeons are irresponsible hacks". Once you reach that position, it's pretty easy to reinforce via confirmation bias.
The second is that it's elective surgery. If you've got a defective heart valve, there's not much alternative to surgery with all the risks it entails. But if you get LASIK and it goes wrong, there's always going to be the thought of "If I'd stuck with my glasses this wouldn't have happened". That's a very frustrating thought, and it's very tempting to turn that anger outwards.
There are people out there with legitimate reasons to be angry about their LASIK experience, because their surgeons let them down. There are others who knowingly took a chance and got unlucky, and if that happens to you it's not much consolation afterwards to be told the odds were good; at that point, the complication rate in the population most important to you is 100%. But that doesn't warrant presenting the entire industry as a fraud; for some people, being able to function without glasses 100% of the time is well worth the risks. --Calair 23:32, 27 March 2006 (UTC)

I've not much else to add to this current discussion other than to request that those who disagree with the article add referenced information to improve it. AED 02:46, 28 March 2006 (UTC)

I'm a neuroscientist and have had "successful" LASIK surgery with a highly reputable surgeon. Before getting the procedure, did a great deal of research on the pros and cons of this surgery, including a thorough review of about 150 papers on LASIK over the past few years. Regardless of my personal feelings on this subject, given that this is an encyclopedic reference of a medical procedure, editorializing the pros and cons of LASIK under "industry concerns," "safety and efficacy," and without a comprehensive review of the literature is a disservice to Wikipeida readers. By editorializing, I mean that the use of unreferenced and inflammatory phrases such as "There are many concerns and movements to change the way the LASIK industry operates." and "It is often argued that patients are not given sufficient information regarding the possible complications, their side effects, and final outcomes.[attribution needed] A survey in the United Kingdom indicated that most LASIK patients expected their vision to become at least 20/20 after surgery and few knew it could potentially be worse.[citation needed]" I find myself asking "By whom?" I do not think that these particular admonishments are appropriate. However, a medical paper that cites complications is appropriate here. A well written medical article should provide readers with balanced view, containing references to scientific studies. Although personal experiences and outcome have their place, a summary of results from these studies should be based upon published articles in peer-reviewed journals. Neurodoc 20:11, 19 January 2007 (UTC)

External links and USA Eyes material

Someone keeps surreptitiously replacing the weblink to "LASIK Consumer Report" from my original posting of link to www.lasikconsumerreport.com to their own link www.lasereyesurgeries.org. This is not ethical. Is there a way to have this website www.lasereyesurgeries.org blacklisted from Wiki? user:71charger 14:15 Nov 10 2007 —Preceding comment was added at 00:17, 11 November 2007 (UTC)

I'm uncomfortable with some recently-added material (see diffs). An example of what I'm talking about is this addition:

Patients wearing hard contact lenses should stop wearing them for a minimum of six weeks plus another six weeks for every three years the hard contacts had been worn. [11]

Quoting from the referenced USAEyes (CRSQA) page, emphasis mine:

There is not universal agreement on how long someone should be out of contacts before surgery. Some surgeons will say a few days, others weeks or even months. Different procedures are more critical than others. We are a bit more conservative than most... We suggest that if you wear soft contacts, you should not wear them for at least two weeks before final measurements are taken to determine refractive error... If you wear hard contacts, you should not wear them for six weeks for every three years you have worn hard contacts, up to six months out of contact.

Obviously CRSQA needs to have its guidelines on this point, and if they choose to be more conservative than the industry norm I can hardly fault them for that. I have no particular problem with CRSQA; the edit history will show that I've used their material in this article myself, to flesh out the discussion of complication rates. This particular issue is interesting and relevant to the article, and offering CRSQA's guidelines by way of illustration seems reasonable to me. But Wikipedia should not present those guidelines as if they were the industry norm.

By my understanding, the editor who added this material is the founder of CRSQA. I have no objection to him adding content to this article, but that needs to be done carefully in order to avoid giving undue weight to one organisation. This also applies to the number of references to USAEyes; there are good reasons why WP:EL discourages editors from adding links to their own sites, and I'm not convinced this article needs quite as many usaeyes.org links as it currently has. --Calair 01:28, 19 April 2006 (UTC)

My optometrist recommended I keep my RGP contacts out for a month before I had Lasik. Worked like a charm. —Joseph/N328KF (Talk) 01:49, 19 April 2006 (UTC)
I am the Executive Director of CRSQA. re: The item regarding how long to be out of contact lenses. The notation as presented here in its edited form is artfully written and mitigates our organization's more conservative bias and that there is no industry consensus. Bias and lack of consensus are evident in the full article at our website, but would not be so evident in the citation originally presented here.—The preceding unsigned comment was added by Ghagele (talk • contribs) 07:30, 27 May 2006(UTC).

The link to the LASIK Consumer Report is a fact-based, consumer-oriented piece that accurately summarizes and simplifies for consumers what they need to understand when considering having LASIK surgery. 71charger 15:38, 29 September 2007

I've removed the link to LASIK Consumer Reports since it is clearly an advert for Boxer Wachler. It is his site, maintained by his staff, and shows his name on the linked page. This is leads to the impression that it is an ad, not an unbiased help site. I also removed a link to PRnewswire, since it is, by definition, PR and cannot be considered unbiased. Delicious carbuncle (talk) 16:26, 14 January 2008 (UTC)


If one takes the time to read the LASIK CONSUMER REPORT, it will become clear that this is strictly an information-based report that aids consumers in their research about LASIK. Just because Dr. Boxer Wachler's name is on the site does not mean this is a marketing piece. It is no more a marketing piece because his name as author appears there as Sanjay Gupta's book "Chasing Life" is a marketing piece just because his name is on the book (in addition Dr. Gupta's picture is on the whole front cover I might add). So the author's name is ALWAYS expected to be on the written work, otherwise who would know who wrote it?? It is customary and expected to have the author's name on their work. Scubadiver99 (talk) 23:26, 17 January 2008 (UTC)

For reasons already explained, it is inappropriate for Wikipedia, even if it is otherwise a useful site. Please see Wikipedia:Spam and Wikipedia:Conflict_of_interest. (See also Talk:Keratoconus#Corneal_Collagen_Crosslinking_with_Riboflavin_Section_and_Boxer_Wachler) Delicious carbuncle (talk) 14:11, 18 January 2008 (UTC)

Good Article nomination has failed

The Good article nomination for LASIK/Archive 1 has failed, for the following reason:

I don't think it's well written. Specifically, 'complications' has a lengthy list that should be made into prose or omitted, and there are several one-sentence paragraphs. There's not really much linking going on at all which is a very bad thing. The 'satisfaction' section is very poor - it could be dealt with in one sentence. Also some heading don't conform to the MOS - normal sentence capitalisation is used. Worldtraveller 21:10, 26 April 2006 (UTC)


Pro and anti LASIK

There are some people who are very unhappy with the procedure and some doctors that screwed up.. There are also a lot of success, of course the unappy folks tend to be mor vocal. I came across this list this anti list, seems valid enough.

To ballance this list I will have a equal list of PRO LASIK websites very shortly. But This is harder than I thought, seems that more people put out their complaints than their successes, and many of these seem to come from the doctors's sites... But I will endevour - and will ballance this. Either way it will give pointers and to more information. Bdelisle 00:37, 16 May 2006 (UTC)

One of the reasons you are finding so many anti-LASIK websites is because multiple websites are operated by the same people with similar or identical content.
lasiksucks4u.com and flawedlasik.com are operated by the same person.
lasikdisaster.com and lasikmemorial.com were created by the same person.
lasik fraud.com and lasikflap.com were created by the same person.
lasikflap.com is framed in the homepage of lasikdisaster.com.
surgicaleyes.org as an organization no longer exists, it has been replaced by visionsurgeryrehab.org
dryeyezone.com is a commercial website selling eye lubrication drops by the owner of lasermyeye.com
I agree with your opinion that people who had successful Lasik do not create websites. They achieved what was expected. I find that not too many people create websites about getting what they expect..—The preceding unsigned comment was added by Ghagele (talk • contribs) 07:47, 27 May 2006(UTC).

Anti-LASIK websites

Pro-LASIK websites


Anthropomorphism

"Performing the laser ablation in the deeper corneal stroma and under the Lasik flap fools the cornea into not knowing that it has had surgery." I'm not knowledgeable in this subject, but clearly the cornea does not "know" anything, and the statement confuses me. Could it be phrased more specifically and accurately? 86.131.92.62 17:27, 16 June 2006 (UTC)

Done. -AED 22:26, 16 June 2006 (UTC)

Good article nomination

I stumbled across this article and thought it was good, so I nominated it for good article promotion. It was only AFTERWORDS that I realized it had just recently failed another good article nomination (back in April). Looking at the edit history, it seems that there have been changes since then... though reading the rational for it failing to achieve GA status, it seems that more improvement is needed. The Complications section seems to be mostly prose to me; with the list providing a nice synopsis of the prose. The one-sentence paragraphs could probably be expanded upon, as could the satisfaction section. The headings could be easily fixed. At any rate, it doesn't seem like anything that would be too difficult to do in order to bring this up to GA status. If I've unwittingly re-nominated too soon, I apologize. ONUnicorn 19:30, 30 June 2006 (UTC)

I just cleaned up some of the headers, and pruned the satisfaction section. That ought to just about take care of the objections that killed the last GA nomination. ONUnicorn 19:42, 30 June 2006 (UTC)
GA on hold for 7 days for these reasons: lead is too short--expand to summarize the article and refs are inconsistent--all the external jumps should be turned into cite php. Also, footnotes go at the end of a sentence or clause, not in the middle of it. Rlevse 00:08, 12 July 2006 (UTC)

LASIK@home

Is lasikathome.com a joke or not? If it is not, I think it should be included here.

The doctor23 17:19, 2 September 2006 (UTC)

It doesn't appear to meet the guidelines at WP:EL. -AED 17:29, 2 September 2006 (UTC)
It's a fairly obvious joke. I'd love to see how many t-shirts they're selling, though. Kuru talk 18:00, 2 September 2006 (UTC)
The doctor is wearing glasses. 137.229.70.176 (talk) 22:48, 8 December 2008 (UTC)
That's hilarious. 67.241.72.20 (talk) 21:25, 19 December 2008 (UTC)

Overcorrection

It lists overcorrection as a complication. What exactly does this mean? There are some people who have better than 20/20 vision, such as elite military pilots. If a LASIK candidated is overcorrected, I'm sure he'd be more than satisfied.—The preceding unsigned comment was added by 12.75.199.119 (talk • contribs) 08:00, 24 September 2006 (UTC).

"Overcorrection of your prescription is when the correction has gone too far, sometimes resulting in a patient going from nearsighted vision to farsighted vision, and vice versa "[12]. Notinasnaid 12:19, 24 September 2006 (UTC)

Other Reference Sites

If anyone knows of other good reference sites, this would be the place to put them. Remember, it could always be worse. 13:00, 26 September 2006 (UTC)

Statement removed

I have removed the following:

An American study shows that on a population of 6 millions surveyed that had Lasik eye surgery, a third were unsatisfied with the results wherther it be bad correction or surgery-related sighting problems such as loss of quality, fluctuation in quality of sighting or poor vision in the dark.[7]

First of all, the fraud.com/news/archives/000138.html citation provided does not support that statement. It does not state that 6 million were surveyed or that they were unsatisfied. It states that they reported certain conditions. Secondly, this infor was a PR release by NeuroVision who funded the study and is marketing their vision therapy product: full context. -AED 23:02, 8 November 2006 (UTC)

Please clean up my entry

I have just posted 'Informal advice for persons considering lasik treatment', based on my own experience and research of the subject.

I apologise but my contribution looks quite messy. I do not understand the syntax required to make neat new entries.

If someone could clean up the entry, starting with capitalizing the 'I' in 'Informal', I would appreciate it!

Thanks very much,

jeffg@pacific.net.hk

Further to above:

My entry has beeen removed. I understand the high standards required for this site, and my entry was very carefully written and objective. Could the person who deleted my entry please explain why it was removed, and where I can find the text?

Thank you

Jeffg@pacific.net.hk

You can find your text by browsing the history tab. I can't help you otherwise. --Scot.hale 03:03, 7 May 2007 (UTC)

Release of molecular bonds?

In the procedure it said:

The laser vaporizes tissue in a finely controlled manner without damaging adjacent stroma by releasing the molecular bonds that hold the cells together.

This is ambiguous however. Does the laser release the bonds, which otherwise would harm nearby cells, or does it prevent such a release? Mikael Häggström 19:13, 24 August 2007 (UTC)

Effective range

What is the typical range of correctable eyesight? The articles mentions that both shortsightedness and farsightedness are correctable, but within what (diopter) ranges? — Loadmaster 23:07, 13 October 2007 (UTC)

questions...

The article said 'During the second step, the patient's vision will become very blurry once the flap is lifted. He/she will be able to see only white light surrounding the orange light of the laser. This can be disorienting.' My question is that won't he see only black all the time, as the eyes have been locally anasthesized?? —Preceding unsigned comment added by 68.41.8.89 (talk) 05:25, 11 May 2008 (UTC)

External Links -- Substantive, Reliable, Informative, Balanced

I am responding to the removal of an external link to LASIK Surgery Watch from Wikipedia's LASIK page. The justification for the removal of this link is that LSW is a "non-notable site according to WP:EL".

This link can be justified under Wikipedia's External Links guidelines: this site contains neutral and accurate material that cannot be integrated into the Wikipedia article due to the amount of detail involved.

Some background information may be helpful here.

Before April 25, 2008, the LASIK industry was able to market LASIK surgery as a safe and effective alternative to glasses largely unimpeded by reports of poor outcomes. LASIK surgeons, as independent professionals, operate with little oversight. LASIK surgery, like other patient-financed elective surgeries, does not benefit from the actuarial oversight provided by health insurance companies. Some LASIK practioners engage in aggressive marketing practices [13] [14] and some have also engaged in aggressive attempts to silence criticism, especially on the Internet, using spam techniques targeted at patient forums and bulletin boards.

One example will give you a good idea of the kinds of strategies employed to promote LASIK: Dr. Richard L. Lindstrom, President, American Society of Cataract and Refractive Surgery, responding to an article entitled "Some Link Depression, Failed LASIK" [15] in The News & Observer (NC) said "Those considering LASIK surgery should responsibly research it and can find more information at these Web sites: www.fda.org; www.eyesurgeryeducation.org; www.aao.org; and www.allaboutvision.com." [16] To the uninformed reader, www.fda.org might look like a good way to reach the site of the U.S. Food and Drug Administration. But that site, of course, is www.fda.gov.[17] The site recommended by ASCRS' president is a commercial site masquerading as a government sanctioned site. [18]

On April 25, 2008, after reports of suicide by LASIK patients were presented to the FDA, the Opthalmic Devices Panel of the FDA's Medical Devices Advisory Committee held a public hearing. [19] The hearing was well attended by civilian and military proponents of LASIK surgery, medical professionals, patients and family members of LASIK patients, as well as other interested parties. The hearing received wide spread media coverage. [20] [21] [22] [23] [24] [25] [26] [27] [28]

The hearing was instrumental in bringing to light problems with LASIK surgery that were previously unrecognized by the American public. [29]

Following the hearing, a group of patients, family members, and medical professionals formed LASIK Surgery Watch to continue the effort to raise awareness about this important public health issue. Although the non-profit organization is only a few months old, it has been very successful in this regard. More media attention has been focused on the practice of LASIK surgery, and the industry is responding to these reports in their trade journals. [30] They no longer describe patients with poor outcomes as having unrealistic expectations or prior histories of psychological problems. But there remains much to be done. At this point we only have estimates of the number of patients affected. No one has been counting them. But anecdotal evidence suggests that as many as three out of four patients with poor outcomes are considered successes by their surgeons.

There is currently no reference to the FDA hearing in the Wikipedia article on LASIK. It would be very difficult to integrate information about the reasons for the FDA hearing and the results and impact of this hearing into the article due to the amount of detail involved. Yet it is important that this information be easily available to anyone interested in reading about LASIK surgery. All of the information provided on the LASIK Surgery Watch website is reliable and backed by scientific peer-reviewed studies. The information is presented in a neutral way. The website states: "For many people the information provided here might be surprising. Most people are not aware of the amount of controversy concerning LASIK that exists in the medical community. Spend some time on our site and form your own opinion."

A link to LASIK Surgery Watch would provide easy access to accurate information not readily available elsewhere. Such a link would also provide balance to the Wikipedia article on LASIK. The external links section in this article currently includes a link to the Eye Surgery Education Council, an initiative established by the American Society for Cataract and Refractive Surgery (ASCRS). Lsw webmaster (talk) 01:54, 22 October 2008 (UTC)

If you could boil some of this down into three sentences it might be worth adding to the text. It seems unlikely that LASIK Surgery Watch would deserve *its own article* at this point. If no separate article is justified, I question whether an uninterpreted external link to LASIK Surgery Watch is justified. Better take some striking bit of information that was found by your group, and integrate it into the text. The FDA hearing that you speak of sounds like it was inconclusive. If a group is just trying to 'raise awareness', we might allow our readers to find it on the web in the normal course of events, rather than point to it from Wikipedia. EdJohnston (talk) 14:40, 7 November 2008 (UTC)
----
The FDA hearing was conclusive in the sense that it unequivocally demonstrated the reality, nature, and impact of poor LASIK surgery outcomes. The FDA hearing was inconclusive in the sense that it revealed a great deal of controversy over why and how often these poor outcomes occur. Given the degree of contention and what is at stake, it is especially important that the article on LASIK surgery adhere to the Wikipedia standard for presenting information fairly, proportionately, and without bias. The internal and external links sections of the article are very important in this regard. These links currently fall into four categories: related topics, academic and government websites, industry websites, and nonprofit websites. Can you elaborate on the specific criteria by which the particular links to industry and nonprofit websites were justified? Lsw webmaster (talk) 20:03, 8 November 2008 (UTC)
Your website is not going to meet WP:RS, but I hope you will heed EdJohnston's advice. Adding the FDA information sourced to news articles meeting Wikipedia sourcing policy would provide the valuable information you want to provide to Wikipedia readers. Flowanda | Talk 04:24, 29 November 2008 (UTC)
----
Big money breeds corruption. The LASIK industry is big money. The FDA is responsible for protecting the American public from unsafe medical devices, but it is under fire for allowing itself to be corrupted by the influence of big money.(Ailing FDA May Need a Major Overhaul, Officials and Groups Say Washington Post, Wednesday, November 26, 2008; Page A02) , (CDRH Weaves ‘Tangled Web’ on LASIK, MD&DI, November 2008) None of this is evident from the description of LASIK surgery on the Wikipedia page. Instead, the reader is presented with a bland overview that gives the impression that, if the surgery goes as planned, the patient can expect a satisfactory outcome. Attempts have been made by others to add balance to the page. But their edits have been reversed and their suggestions ignored. Is the Wikipedia model of collaborative editing up to the challenge of balancing competing points of view here? It does not appear to be.
--Lsw webmaster (talk) 12:31, 3 December 2008 (UTC)
--Lsw webmaster (talk) 16:43, 1 February 2009 (UTC)
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