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----- Original Message -----From: Larry LoweSent: Friday, May 10, 2002 9:39 PMTo: Brian Howard; email@example.comSubject: [Acro] Re: LASIK Screening Caution
Brian Howard wrote:
> The following is a link to a story in
> today's Tucson paper regarding an airline
> captain who lost his night vision and
> therefore his job because he wasn't
> properly screened for the procedure:
This is very timely. I am in the process of evaluating doctors and
facilities to perform LASIK on my 20/1200 eyes.
I cannot stress how important it is to take your time, learn all you
can, and get multiple opinions before committing to get this done. Two
weeks ago, I had eliminated one vendor (Swagel&Wooten -> don't use in
any case.) and was balancing between the remaining two.
Barnet,Dulany had recommendations from this list, the best national
reputation, by far the most experience and wanted to charge me the
highest price for the latest equipment to be able to burn the largest
area on my cornea.
Schwartz gave me what I felt was more concerned personal treatment, made
a case for burning a smaller area and thus preserving some of the cornea
for a later correction that could very well be needed. I felt Schwartz
had been more patient with me while I worked my way through the "better
here? or here?" process of arriving at a prescription. They had an
older model machine, but showed me a study in the medical journals which
concluded that the automatic tracking feature of the new equipment was
not resulting in any better results (or to be more precise, any less
errors/failures) than the current generation manual tracking. And their
process was cheaper by about $1000, although that was the least of the concerns.
I was convinced that Schwartz gave me more personal treatment than the
much larger Barnet,Dulany, but could not reconcile the different
approaches proposed by the two eye centers, based on BDP's measurement
of my pupil at 5.5 mm and 6.0 mm respectively compared to Schwartz's
measurement of my pupil at 4.5 mm. The difference was at the heart of
the different treatment, Schwartz proposing to take a smaller cut for
the flap and burn a smaller area of my cornea because they said I did
not need to burn excess cornea because I had an unusually small pupil
when measured in the dark.
At the heart of the problem discussed in the article on the Tucson
airline captain's case was a misreading during the evaluation of his
I went back to S&W and found out their measurement of my pupil matched
Barnet,Dulaney's, which began to make me question my inclination to
select Schwartz because of their better prescription.
I will undergo at least one, possibly two more evaluations from other
reputable eye centers (I've washed out at the onset all these cash and
carry $300/eye chop shop folks who flood the Tuesday junk mail and TV
commercials with ads for cheap good eyes.) and will correlate the
results before making my final selection.
At the moment, I think Barnett, Dulaney is the best choice, although I
will go to them and ask to see the prescription numbers arrived at by
Schwartz through the BDL eyeglass simulator and compare that view to the
prescription BDL arrived at, and discuss the differences with the BDL technician.
I am convinced that Schwartz did exactly what the UofA technician
did--misread my pupil dilation in darkness, and that the result would be
bad night vision.
Meanwhile, it is interesting to note the Doctor's defense, which said
that LASIK changed the "spherical aberrations in the eyes" of the
patient and that misreading the pupil size had nothing to do with it. I
don't know if the doctor is just grasping at a straw to try to defend
himself, but I will discuss the possibility with my doctors until I
understand whether or not it is relevant.
I recommend anyone considering getting LASIK to get no less than three
different evaluations from three highly reputable eye care centers
before doing anything, paying close attention to two factors besides the
prescription-- the width of your pupil in darkness (smaller is better,
but give it time to open as far as it wants to) and the depth or
thickness of your cornea (thicker is better, if you are nearsighted and
need to burn off cornea to adjust the light properly.)
More on all of this as I progress.