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Asking for less than perfect IOL in Cataract Surgery
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Neil Brooks
medicine forum Guru


Joined: 24 Mar 2005
Posts: 1148

PostPosted: Tue Apr 04, 2006 5:40 pm    Post subject: Re: Otis Reply with quote

Now THAT's funny!
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Scot
medicine forum beginner


Joined: 18 Jan 2006
Posts: 18

PostPosted: Wed Apr 05, 2006 2:21 am    Post subject: Re: Look how good orthoK sounds. I want!!! Reply with quote

Bass: max that my OD currently knows about (and I am using) is 7mm
correction zone with standard lenses. There are some experimental
lenses out there but he does not work with them. I still have some
night vision issues (hence the 7mm correction zone), otherwise perfect
vision through the day with some research being done by the
manufacturer and some special topography reports being taken and
evaluated later this month. My pupil size is 4.5-5mm..

Scot




Bassslapper wrote:
Quote:
My expertise on ortho-K is limited by my own personal experience. A
statistical population of one. I get the impression that ortho-K is
considered a utopian alternative to corrective eyeware and corrective
surgery. Like any other treatment modality it has it's pros and cons
and it's risks. Anyone considering ortho-K needs to gather as much
information as possible so they can make an informed decision and
understand what to expect. No dfferent an approach then if considering
corrective surgery or other forms of corrective eyeware.

If anyone has any questions about ortho-K I'd be happy to elaborate on
my experiences with it.
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Dr. Leukoma
medicine forum Guru


Joined: 30 Apr 2005
Posts: 1283

PostPosted: Wed Apr 12, 2006 1:07 pm    Post subject: Re: I predict orthoK and corneal molding will displace lasik soon! Reply with quote

doctor_my_eye@msn.com wrote:
Quote:
Glenn is right on this one. Ortho-K was "under the radar" for 30 years
because the fitting of rigid lenses with the intent to mold the cornea
was an off-label use for contacts. It wasn't until Paragon Vision
Sciences went through an elaborate protocol to obtain FDA approval for
CRT (Corneal Refractive Therapy) a couple of years ago that made
ortho-k go mainstream. Many of us who fit thousands of contact lenses
per year on eyes for daily vision correction (without ever advocating
sleeping in them) view CRT as a novelty, but far from a safe
alternative for millions of wearers.

What do you mean "thousands of contact lenses per year"? Don't be so
modest. I'm sure you meant "billions."

But, to the point, which is that Paragon didn't just casually decide to
obtain FDA approval. The fact is that the FDA came down hard on
orthokeratology and decreed that overnight OK lenses needed safety and
efficacy studies. Why? Because of the occurrence of those pesky eye
infections, that's why. RGP lenses for overnight wear had been
approved by the FDA a loooong time before.

DrG
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Dr. Leukoma
medicine forum Guru


Joined: 30 Apr 2005
Posts: 1283

PostPosted: Wed Apr 12, 2006 1:13 pm    Post subject: Re: I predict orthoK and corneal molding will displace lasik soon! Reply with quote

Bassslapper wrote:
Quote:
I found ortho-K to be an effective treatment modality but I was not
overly wowed by it. It became a hassle putting lenses in before bed and
removing them upon waking up. I am one of those people that doesn ot
like to take and hour to prepare for bed or an hour to prepare to get
out the door in the morning and ortho-K just added to that
inconvenience.

Doctors, please chime in and correct me if I am wrong in what I am
about to say. One other thing about ortho-K is that it takes a period
of time to tweak them to where the corneal remodeling will give you
clear distance vision. I returned for multiple appointments during the
original delivery of the lenses for rechecks and refits. It is not a
one time thing, like corrective lenses or Lasik. It is a progressive
therpay that has to be tweaked. It adds another dimension to the issue
of convenience we touched on earlier.

Grant will jump all over me for answering this because I don't do much
OK, but yes, Basslapper, OK lenses do require tweaking. Otherwise the
patient will end up with something quite similar to bad LASIK where the
optical zone is decentered, too small, or both. The good thing is that
"it is reversible."

The patients I have in OK really like it. They tolerate the lenses
well and the results serve their needs. But, they don't sleep in their
lenses.

DrG
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LarryDoc
medicine forum Guru Wannabe


Joined: 29 Apr 2005
Posts: 262

PostPosted: Wed Apr 12, 2006 5:38 pm    Post subject: Re: I predict orthoK and corneal molding will displace lasik soon! Reply with quote

Does anyone know what happened to what was to be called "Precision
Cornea Moulding", a more permanent CRT procedure using a hyaluronidase
solution along with the RGP lens? It was under development by ISTA
Pharm with trials in Mexico and Italy a couple of years ago. Last I
heard they were readying USA trials and then all signs of it vanished.
It was supposed to be the "Lasik killer". Perhaps it worked the other
way around?

LB, O.D.
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Dick Adams
medicine forum Guru


Joined: 12 Oct 2005
Posts: 300

PostPosted: Wed Apr 12, 2006 8:22 pm    Post subject: Re: I predict orthoK and corneal molding will displace lasik soon! Reply with quote

I predict that it will soon be impossible to obtain eyeglasses and
that the fancyass stuff that supercedes 'em will blind us one and all.

--
Dicky
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Bassslapper
medicine forum addict


Joined: 21 Jan 2006
Posts: 52

PostPosted: Thu Apr 13, 2006 12:44 am    Post subject: Re: I predict orthoK and corneal molding will displace lasik soon! Reply with quote

If your patients in ortho-K do not sleep in their lenses, please
enlighten me on your standard potocol for ortho-K. Mine was to wear
them at night when I slept. No daytime wear.
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Dr. Leukoma
medicine forum Guru


Joined: 30 Apr 2005
Posts: 1283

PostPosted: Thu Apr 13, 2006 12:55 am    Post subject: Re: I predict orthoK and corneal molding will displace lasik soon! Reply with quote

One day on and one to two off. Or half day on, half day off.

What you are doing is overnight OK, which is a fairly recent invention,
but also more risky, IMO.

DrG
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Bassslapper
medicine forum addict


Joined: 21 Jan 2006
Posts: 52

PostPosted: Thu Apr 13, 2006 2:04 am    Post subject: Re: I predict orthoK and corneal molding will displace lasik soon! Reply with quote

By one day do you mean all day suring the waking hours? Also, is that
the maintenance phase or also the same protocol during the initial
phase? I am assuming you feel it is riskier because the lense is in
direct contact with the eye more ofrten, which can lead to a myriad of
problems.

I did ortho-K for about 2 years with no problems. I could go a night
without wearing them but then I would notice my vision getting blurry.
Overnight ortho-K parallels with orhodontic retainers. You wear both at
night to maintain the new positioning of the teeth or cornea.
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TG
medicine forum beginner


Joined: 29 Dec 2005
Posts: 28

PostPosted: Thu Apr 13, 2006 7:27 am    Post subject: Re: I predict orthoK and corneal molding will displace lasik soon! Reply with quote

If you weaar the lens during sleep, you will have significantly less tear
flushing, so any nasty bugs will have more of a chance of establishing
themselves. Some researchers also advocate placing the lenses onto the eye
about an hour or so before sleep, so that any nasties transferred from the
finger will get flushed off

BM


"Bassslapper" <dr_george@prodigy.net> wrote in message
news:1144892015.422848.316230@u72g2000cwu.googlegroups.com...
Quote:
By one day do you mean all day suring the waking hours? Also, is that
the maintenance phase or also the same protocol during the initial
phase? I am assuming you feel it is riskier because the lense is in
direct contact with the eye more ofrten, which can lead to a myriad of
problems.

I did ortho-K for about 2 years with no problems. I could go a night
without wearing them but then I would notice my vision getting blurry.
Overnight ortho-K parallels with orhodontic retainers. You wear both at
night to maintain the new positioning of the teeth or cornea.
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CatmanX
medicine forum Guru


Joined: 17 May 2005
Posts: 367

PostPosted: Thu Apr 13, 2006 1:32 pm    Post subject: Re: I predict orthoK and corneal molding will displace lasik soon! Reply with quote

Actually, OK didn't and doesn't require FDA approval, but to market a
system does. Paragon got to market with a system they could market to
both optoms and the public. The iinfection stuff didn't come till
later, and still mostly relates back to poor compliance, not OK per se.
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Neil Brooks
medicine forum Guru


Joined: 24 Mar 2005
Posts: 1148

PostPosted: Thu Apr 13, 2006 4:07 pm    Post subject: Re: DARWIN SAID A MOUTHFUL -- OR: eye, Eye, EYE Reply with quote

"Ed Conrad" <edconrad@verizon.net> wrote in message
news:q31r32dnhs4049k6m2d9cfikqo8rubdm4e@4ax.com...
Quote:

(On Sat, 11 May 1996, Ed Conrad wrote to talk.origins, etc., in
response to Michael Clark's accusation that he had used only
a portion of Charles Darwin's quote in which he expressed
serious doubts about the evolution of the eye:

=======================================================

The Ed Conrad Hurry-Up-I-Have-to-Catch-a-Train Version:

``To suppose that the eye (with so many parts all working together) .
.. .
could have been formed by natural selection seems, I freely confess,
absurd in the highest degree."

=======================================================

The Charles Darwin Let-Me-Put-You-To-Sleep Version:

"'To suppose that the eye with all its inimitable contrivances for
adjusting the focus to different distances, for admitting different
amounts of light, and for the correction of spherical and chromatic
aberration, could have been formed by natural selection, seems, I
freely confess, absurd in the highest degree. When it was first said
that the sun stood still and the world turned round, the common
sense of mankind declared the doctrine false; but the old saying of
Vox populi, vox Dei, as every philosopher knows, cannot be trusted
in science. Reason tells me, that if numerous gradations from a simple
and imperfect eye to one complex and perfect can be shown to exist,
each grade being useful to its possessor, as is certainly the case; if
further, the eye ever varies and the variations be inherited, as is
likewise certainly the case and if such variations should be useful to
any animal under changing conditions of life, then the difficulty of
believing that a perfect and complex eye could be formed by natural
selection, though insuperable by our imagination, should not be
considered as subversive of the theory. How a nerve comes to be
sensitive to light, hardly concerns us more than how life itself
originated; but I may remark that, as some of the lowest organisms, in
which nerves cannot be detected, are capable of perceiving light, it
does not seem impossible that certain sensitive elements in their
sarcode should become aggregated and developed into nerves,
endowed with this special sensibility."
[Darwin, 1859, _The
Origin of Species

==========================================================

I thought I said what Darwin had said but Dave Iain Greig at
Ediacara U., a colleague of mine at Ediacara University,
said what I said wasn't what Darwin said because he said Darwin said
something more than what I said he said, then Steve Vickers of UK
sends an E-Mail and said he knows what Darwin said, which is not
entirely what I said he said, so I said to myself, ` I'll say what
he said Darwin said even though I don't know if he really said it,
since this is what he said he had said.

Nice little song and dance, there, Zippy. Can you balance
a ball on your nose? ---- Michael Clark

Actually, Michael, it doesn't really matter what Darwin said or what
these fellas said he said -- or what they said I didn't say -- since
what I said, whether Darwin said it or not, isn't something that was
vital to say, and I'm sort of saying he had painted himself into a
corner and said what he thought he'd better say, else critics would
say he really had nothing to say, even though he had said it.

==============================================

Wonder what Darwin Would'ver Said About This:

PETRIFIED BONES IN GIANT SLAB OF SLATE (COAL VEINS)I

http://mysite.verizon.net/edconrad/NewFossils/MVC-002S.JPG
http://mysite.verizon.net/edconrad/NewFossils/MVC-003S.JPG
http://mysite.verizon.net/edconrad/NewFossils/MVC-004S.JPG
http://mysite.verizon.net/edconrad/NewFossils/MVC-005S.JPG
http://mysite.verizon.net/edconrad/NewFossils/MVC-006S.JPG
http://mysite.verizon.net/edconrad/NewFossils/MVC-007S.JPG
http://mysite.verizon.net/edconrad/NewFossils/MVC-008S.JPG
http://mysite.verizon.net/edconrad/NewFossils/MVC-009S.JPG
http://mysite.verizon.net/edconrad/NewFossils/MVC-010S.JPG
http://mysite.verizon.net/edconrad/NewFossils/MVC-011S.JPG
http://mysite.verizon.net/edconrad/NewFossils/MVC-012S.JPG


It means the bones have to be older than the material in which
they are encased..

Same as many thousands of other petrified bones, teeth
and soft organs I've discovered between anthracite veins,
they offer the undeniable physical evidence that large land
animals -- man included -- had existed on earth while
coal was being formed some280 million years ago..

PSEUDOS' DENIAL OF PHYSICAL EVIDENCE
(Petrified coal-age bones, teeth and soft organs)

http://www.edconrad.com/ebay/ManasOldasCoal/Discoveries.jpg

http://www.edconrad.com/ebay/FOSSILS/ManasOldasCoal.jpg
http://www.edconrad.com/ebay/FOSSILS/TestResults.jpg

http://www.edconrad.com/ebay/FOSSILS/OldestTool.jpg

==========================================

Ed Conrad
http://www.edconrad.com
Man as Old as Coal

Please feel free not to cross-post this junk.
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saturdayoptical@yahoo.com
medicine forum beginner


Joined: 14 Apr 2006
Posts: 2

PostPosted: Fri Apr 14, 2006 2:06 am    Post subject: Re: I predict orthoK and corneal molding will displace lasik soon! Reply with quote

Never heard of the hyaIuronidase?? ....I was a guniea pig for our
office and tried CRT..I was barely in the required parameters... but
cause of the high cyl in my os I ended up with more cyl instead of
less...plus I never got better than 20/-30 out of them in the od. It's
a great idea unless you already have alot of cyl. Lucky for me I could
sneak into the CL trial room and find a soft lense to get me through
the day so I could at least help my customers,,,but for avg Joe they
don't have the luxury of doing that..I wondered how a patient would
feel if they woke up and were not corrected enough to drive and then
had to wear the CRT lenses to function all day too? Especially after
hearing how great they were? I would have been more disappointed if I
would have had to pay for them. For me lasik is a better choice someday
=) but I gave it a shot!

BB, ABOC
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JamesM
medicine forum beginner


Joined: 23 Jun 2005
Posts: 27

PostPosted: Sat Apr 15, 2006 1:46 am    Post subject: Re: Cadena de la Fortuna Reply with quote

globetroter wrote:
Quote:
Cadena de la Fortuna

¿Por qué diablos se mete en esto foro? ¿No se da cuenta que se trata
de la óptica fisiológica?

¡Lárguese!

--Rich
>
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acemanvx@yahoo.com
medicine forum Guru


Joined: 15 Nov 2005
Posts: 732

PostPosted: Sat Apr 15, 2006 3:23 am    Post subject: Re: I predict orthoK and corneal molding will displace lasik soon! Reply with quote

"Does anyone know what happened to what was to be called "Precision
Cornea Moulding", a more permanent CRT procedure using a hyaluronidase
solution along with the RGP lens? It was under development by ISTA
Pharm with trials in Mexico and Italy a couple of years ago. Last I
heard they were readying USA trials and then all signs of it vanished.

It was supposed to be the "Lasik killer". Perhaps it worked the other
way around?"


I was seriously wondering this too. anyone have any ideas? some say the
lasik companies and surgeons were so scared, they paid to buy out that
corneaplasty idea then bury it forever! Others say corneaplasty had
side effects as dangerous as lasik. I also read about corneal onlay
lenses but it too looks like those will not be a success. There will be
new ideas constantly and I bet within 10 years something will be a
success and replace lasik largely.
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