From: "Kent Wellish" <wellish@lvcm.com>
To: "ISRSNet" <isrsnet@list.isrs.org>
Subject: [isrsnet] Re: malpractice "experts"
Date: Thu, 24 Oct 2002 06:19:41 -0700

I would also sign such a petition. I'm curious to know who these people are, so I too can boycott their talks. Could someone send me a private e-mail with the names of these "hired guns"

Thanks!

Kent Wellish
Las Vegas
-----Original Message-----
From: JoeDelloRussoMD@aol.com [mailto:JoeDelloRussoMD@aol.com]
Sent: Wednesday, October 23, 2002 4:32 PM
To: ISRSNet
Subject: [isrsnet] Re: malpractice "experts"



To prevent expert whores from appearing on the podiums of our national meetings, we can complain directly to the organization running the meeting and protest. If you want to formulate a complaint to the Academy, I would be happy to co-sign it. There may be other 'netters who would sign as well. Count me in. How can you trust what a whore will say on a podium if his "expertness" can be bought. His credibility is in question. Of course they should be allowed to defend themselves in a public manner.

Joe




Date: Wed, 16 Oct 2002 17:41:35 -0700 (PDT)
From: kenneth lipstock <kdloph@yahoo.com>
Subject: [isrsnet] Re: Laser vision correction public relations
To: "ISRSNet" <isrsnet@list.isrs.org>

"Richard L. Lindstrom" <rllindstrom@mneye.com> wrote:
ASCRS has a current program funded by the society, its Foundation and a group of Manufacturers including Visx,Alcon,B&L and TLC to do exactly what you are requesting, advocate for the Lasik procedure and Lasik surgeon. It is called the Eye Surgery Education Council. You can get more information from ASCRS or look it up on their web site. You can also support it by making a donation to the ASCRS Foundation. Manufacturer contributions to date are near $700,000 and Ophthalmic Surgeons have pledged over $3,000,000 to the Foundation. Best: Dick Lindstrom
-----Original Message-----
From: kenneth lipstock [mailto:kdloph@yahoo.com]
Sent: Monday, October 14, 2002 8:49 PM
To: ISRSNet
Subject: [isrsnet] Re: Laser vision correction public relations


Yes, I guess it would be a long shot. It would certainly take some leadership on the part of an isrs or ascrs. Why couldn`t they together just set up a fund for a national PR campaign; a portion of every physician member`s yearly dues would go towards it as well as a portion of the cost of advertising for refractive surgery related companies. Certainly the devil is in the details. It just seems to me that sometimes a unified and united effort can sometimes raise the level of all the ships in the sea. So I put the onus on our professional societies and not necessarily on the manufacturers. Ken JLGayton@aol.com wrote:
In a message dated 10/14/02 9:04:33 AM Eastern Daylight Time, JoeDelloRussoMD@aol.com writes:


It would seem like a reasonable strategy to have an organization to bring industry together and promote LVC. However , as you may have experienced in the past, it is difficult to get even surgeons to agree on a single adenda.

Secondly, marketing the whole country is probably not cost effective. There was a laser company a year or so ago which launched a $ 750,000 PR campaign without any results. It would take millions of dollars to even raise public awareness even a smidgen {?} You can just imagine trying to get the heads of all the companies together in one room and try to hammer out an agreement that they would feel is just and equally beneficial to all.

. There would ego incidents. How much would each kick in ? Who would benefit the most ? The small or the large companies ?. And all of this would take a lot of time. The idea is good but I doubt that it is workable. Sorry, but that's the wauy I see it.

Joe
---



I agree. You bring up excellent points that would probably make cooperation on public relations efforts impossible.
Johnny Gayton
---

From: "Herman Sloane" <hds@drsloane.com>
To: "ISRSNet" <isrsnet@list.isrs.org>
Subject: [isrsnet] Re: Laser vision correction public relations
Date: Sat, 12 Oct 2002 14:42:56 -0500

Ken,

You have touched on a critical issue. Thus far, with the exception of a brief campaign by VISX, manufacturers have been content to sit back and collect their royalties. As a result, bad press has come our way with no good vibes to balance it.

Only the manufacturers have the funds to mount a national campaign. Perhaps if we all speak to this issue with them it can be effective. Will you be lobbying next week at Academy? I will, and I'm glad to see others have considered it. Let's be politely heard!

Herman
----- Original Message -----
From: kenneth lipstock
To: ISRSNet
Sent: Saturday, October 12, 2002 1:46 PM
Subject: [isrsnet] Laser vision correction public relations


Why doesn`t an organization such as ISRS get the various competing excimer laser manufacturers together (or at least those that might be able to afford it) to start a PR campaign in favor of laser vision correction. It could be something like the dairy industry has done with the Got Milk? ads. I think most of us would agree that the penetration of lvc in the general population could and should be way higher. We all could list lots of reasons why it isn`t, but I`d just like to know what you all think about this suggestion? I personally feel that lvc is very affordable and extremely safe when performed by a skilled and conscientious surgeon; I think a "non-partisan" ad campaign could help to clarify an incredible amount of misinformation out there. Ken Lipstock Richard Foulkes MD <foulkes52@mac.com> wrote:
Randy is the patient symptomatic of the displacement? With the softness of
the placement of the IOL in this deep myope that is sulcus fixed and yaged
you may be after your tail! If they were not symtomatic the simple and
perhaps safest fix would be the use of your 217. If you were squimish
about the keratome do PRK. My experience here has been excellent. Rick
Foulkes

---
You are currently subscribed to isrsnet as: kdloph@yahoo.com
*******************************





Date: Wed, 2 Oct 2002 07:37:28 -0700 (PDT)
From: Francisco Sanchez <pacornea@yahoo.com>
Subject: [isrsnet] Re: Hansatome flap complication
To: "ISRSNet" <isrsnet@list.isrs.org>

Movement of the ring during the microkeratome pass Francisco Sánchez MD Insituto de la Visión Cd. de México Matthew Sanderson wrote:
This is often related to a large corneal diameter and a thicker cornea.
The suction ring cannot accommodate the large rigid cornea and often
slides around when building suction. If the ring is somewhat on the
sclera, this will be sucked into the ring preferentially as it deforms
more easily. Try centering the ring not on the pupil in these cases but
on the cornea. Usually this means more temporally.

Matt Sanderson MD

-----Original Message-----
From: Stefan [mailto:stef@stefklopper.com]
Sent: Monday, September 30, 2002 9:29 AM
To: ISRSNet
Subject: [isrsnet] Re: Hansatome flap complication

Flat K's and/or poor vacuum suction could do it.
----- Original Message -----
From: ziad alzubaidi
To: ISRSNet
Sent: Sunday, September 29, 2002 10:42 PM
Subject: [isrsnet] Hansatome flap complication

Anybody got and/or could explain the reasons behind small
eccentric flap with the hansatome?



_____

Join the world's largest e-mail service with MSN Hotmail. Click
Here
---
You are currently subscribed to isrsnet as: stef@stefklopper.com

From: JoeDelloRussoMD@aol.com
Date: Sat, 6 Jul 2002 14:44:04 EDT
Subject: [isrsnet] Re: hansatome
To: "ISRSNet" <isrsnet@list.isrs.org>


These are all very good suggestions, which I used to observe while doing over 27,000 hansatome flaps. In my experience, I still got abrasions too often. After 2,000 Intralsik,flaps ther are no abrasions.
Joe Dello Russo ---

From: "Brad Spagnolo" <bspagnolo@bweyecenter.com>
To: "ISRSNet" <isrsnet@list.isrs.org>
Subject: [isrsnet] Buttonhole
Date: Mon, 20 May 2002 11:29:07 -0400

To the group:

49 yo male underwent Lasik as follows:

OD: +2.00 +1.00 x 150 SIM K's: 46.16/46.74 @ 105
OS: +2.25 +0.50 x 25 SIM K's: 46.61/47.73 @ 068

Pach: 530's OU

Surgery:
Visx S3 with Hansatome 160 plate

OD uneventful and -0.50 +0.50 x 86 20/20 @ 1 month
OS buttonhole paracentrally and no laser performed


Now 1 month and OS BSCVA 20/30+ with 1 mm area of raised, epithelial
ingrowth paracentrally, inferiorly with several smaller areas of
subepithelial change trailing temporally from main lesion.

Given the loss of VA and irregular topography, would be inclined to perform
PTK over ingrowth, let heal, and then attempt recut with deeper plate. How
about manual removal instead of PTK? Would anyone attempt PRK given that
flap was created, but no ablation, or does risk of haze preclude this
option? Had seen mention of report concerning PTK over buttonhole. JCRS
1998?

Appreciate any and all thoughts.

Thanks very much.

Brad Spagnolo, M.D. for A. E. Betancourt, M.D.

From: JoeDelloRussoMD@aol.com
Date: Sat, 6 Jul 2002 14:49:52 EDT
Subject: [isrsnet] Re: hansatome
To: "ISRSNet" <isrsnet@list.isrs.org>


With low compression heads , I still got abrasions. I loved the hansatome, but I do hate abrasions even more.
Joe Dello Russo ---


From: JLGayton@aol.com
Date: Mon, 22 Jul 2002 09:36:29 EDT
Subject: [isrsnet] Re: Skydiving and acute refractive change
To: "ISRSNet" <isrsnet@list.isrs.org>
In a message dated 7/19/02 8:55:33 AM Eastern Daylight Time, pannulaserinstt@msn.com writes:



we are all becoming aware of late dislocations of the flap following air bag injuries ,sky diving,swimming etc.fortunately most of the reported cases were treated successfully with complete visual recovery.as more and more patients have lasik their will be cases where recovery may not be satisfactory.the flap could be the achilles of the lasik.should we revisit our friend prk?


----- Original Message -----
From: Redeyedoc@aol.com
Sent: Tuesday, July 16, 2002 8:58 AM
To: ISRSNet
Subject: [isrsnet] Re: Skydiving and acute refractive change

I had a patient call me one weekend afternoon with concerns about sudden blurry vision in one eye 5 months after LASIK. She had been swimming with her young son and was kicked directly in the eye. Stating that it was unlikely that it was the flap, more likely edema or contusion of the cornea, I urged her to come in anyway so I could take a look.
Indeed it was a slipped cap that had to be lifted and replaced. After about 3 weeks she returned to 20/20.
I now counsel all patients, serious athletes and weekend warriors to be very careful in any activity for at least 6 months.
Marlane J. Brown, OD, FAAO
---




Amen and amen! Johnny Gayton, M.D.
---

From: JLGayton@aol.com
Date: Thu, 28 Feb 2002 19:11:25 EST
Subject: [isrsnet] Re: PUPIL SIZE
To: "ISRSNet" <isrsnet@list.isrs.org>

In a message dated 2/28/02 9:13:10 AM Eastern Standard Time, omar_eye@yahoo.com writes:


Jim, the other day I performed LASIK on one of the
dental hygienists that worked next door. I did the
usual counseling preop on halo and glare. This lady
came to see me 1.5 years ago and I had noted a preop
pupil of 7.5 and 7.0 mm. She was -7.25 and -7.75
sphere and initially i put her off based on her pupil
size. I thought long and hard about doing her with
increased optical zone but my experience with larger
optical zones based on tissue removal and nomogram
adjustments did not seem to be an optimal solution for
her. Her pach was 510 OU.

2 weeks ago i did her single zone 6.0 with the Apex
and at her 1 week visit she describes drving home in
the dark over 300 miles with no problems and vision
very similar to that provided to her by contacts.

I based my treatment decision for her on thousands of
myopes between -4 and -10 who had pupils between 6 and
8 mm.

For some patients pupil size may be a factor but it is
much less important than you might think. Centration
on the mesopic pupil, single zone versus multizone,
and elimination of the ammetropia are far more
important factors.

I believe you work sometimes as a expert medical
witness (plaintiff side??). If i can get you and other
doctors to understand that the science and personal
experience of many good doctors doesnt support pupil
size dogma we may save lots of doctors unecessary
clinical headaches and litigation.

Sam Omar MD


--- Jjsalzeye@aol.com wrote:
> In a message dated 2/27/2002 2:34:50 PM Pacific
> Standard Time,
> omar_eye@yahoo.com writes:
>
>
> > With modern lasers with optical zones of 6mm or
> > greater, pupil size is a relatively unimportant
> factor
> > in performing lasik or prk.
> >
> > Sam Omar MD
> >
>
> I doubt that the patients with 8 mm pupils, moderate
> to high corrections, who
> had ablations of 6 to 6.5mm would agree that their
> pupil size in unimportant.
> The fact that the obtain considerable relief from
> Alphagan indicates that at
> least for some of them, pupil size can be very
> important.
>
> James J. Salz, M. D.
> 444 South San Vicente, Suite 704
> Mark Goodson Building, Cedars-Sinai Medical Center
> Los Angeles, CA 90048
> Phone 323 653-3800 Fax 323 653-3898
> e-mail jjsalzeye@aol.com Web Page www.drsalz.com
>




Jim, I strongly agree with you. My daughter has terrible night vision problems due to a 5.5 o.z.(done by another surgeon) with her approx 8.0 pupils.
Johnny Gayton
---

From: JoeDelloRussoMD@aol.com
Date: Mon, 7 Oct 2002 09:28:21 EDT
Subject: [isrsnet] Re: malpractice insurance
To: "ISRSNet" <isrsnet@list.isrs.org>

CERTIFICATION
We have a similar law in New Jersey that requires "certification by an expert" before filing a complaint. As you well know there are enough whores around who will certify anyone even without previous records , like Dr Cary Silverman in New Jersey. He seems to be taking over the whore's role for the lately departed Dr Jordan Burke, whose claim to fame was in helping a patient receive that largest award in a catarcat suit. I would hate to leave that as a legacy.

Thera is enough wiggle room in the law to allow the damaged plaintif his just rights, no matter how manmy years have passed or the lack of certification. The law is a good idea but tough to enforce .

Joe ---