How much safer are contact lenses and orthoK than lasik or laser surgury?

Some people(wont be giving names) have stated the risks of contact
lenses. They are correct but I argue that the risks are tiny compared
to the risks of lasik. Both options will reduce your dependancy on
glasses but contacts, including orthoK will achieve the goal safely,
effeciently and with much less risks. I dont think they should even be
arguing against contact lense based correction when its the far safer
and also non-permaent choice of vision correction. If something goes
wrong with contacts, you can go back to glasses with no ill effects, no
permaent effects. With lasik, there is no going back to your
pre-operative pescription. You are stuck with whatever lasik gives you.
Of course glasses is the safest but contacts are safe enough that many
millions wear them, even 12 year olds have been known to wear them! Of
course children are more likley to get complications because they dont
take as much responsability. There will be reports of complications
from contacts and orthoK because so many people wear them that a few
will turn up with bad luck. I see much more reports of lasik
complications. Life is all about risks and how you manage them. I am
going to take the very small, calculated risk with orthoK to reduce my
dependancy on glasses.

(E-Mail Removed) wrote:
> Some people(wont be giving names) have stated the risks of contact
> lenses. They are correct but I argue that the risks are tiny compared
> to the risks of lasik. Both options will reduce your dependancy on
> glasses but contacts, including orthoK will achieve the goal safely,
> effeciently and with much less risks. I dont think they should even be
> arguing against contact lense based correction when its the far safer
> and also non-permaent choice of vision correction. If something goes
> wrong with contacts, you can go back to glasses with no ill effects, no
> permaent effects. With lasik, there is no going back to your
> pre-operative pescription. You are stuck with whatever lasik gives you.
> Of course glasses is the safest but contacts are safe enough that many
> millions wear them, even 12 year olds have been known to wear them! Of
> course children are more likley to get complications because they dont
> take as much responsability. There will be reports of complications
> from contacts and orthoK because so many people wear them that a few
> will turn up with bad luck. I see much more reports of lasik
> complications. Life is all about risks and how you manage them. I am
> going to take the very small, calculated risk with orthoK to reduce my
> dependancy on glasses.
>

Sounds like you've answered your own question.

Dom

Dear All,
I`m writing to You, in the name of our club, hoping that You will join
us in humanitarian action "RIDE BICYCLE AGAINST DRUGS, ALCOHOL AND
VIOLENCE". After January 1., 2006. this action will become program
named "WHEEL OF ENJOYMENT". This program is supported by Ministry
of health Republic of Serbia, Ministry of labour, employment and
social policy Republic of Serbia and Ministry of education and sport
Republic of Serbia.
Program "WHEEL OF ENJOYMENT" also includes actions "Cancer is
hard, Friendship is easier" and "Diabetes has its enemy"
dedicated to people with cancer and diabetes.
Bicycling club " SIRMIUM BIKE INTERNATIONAL" from Sremska Mitrovica
is promoter and initiator of this program. Beside bicycling
promotion, this program`s goal is to build Rehabilitation center for
addiction diseases, too.
After January 1., 2006. our multiethnic bike team will ride again
across Serbia and districts of Kosovo.
In Jun 2006. we will ride trough Europe with same goal to pay
attention on existing problems of addiction diseases, cancer and
diabetes.
We invited great number of economic subjects in country and abroad, to
join us in this program giving their support.
We asking You, too, to join us and to give us your support or to
direct us to competent humanitarian, financial and medical
institutions.

Sincerely,


President of bicycling club

"SIRMIUM BIKE INTERNATIONAL"

and program`s coordinator
Mr. Kamenko Vladisavljevic

Dear All,
I`m writing to You, in the name of our club, hoping that You will join
us in humanitarian action "RIDE BICYCLE AGAINST DRUGS, ALCOHOL AND
VIOLENCE". After January 1., 2006. this action will become program
named "WHEEL OF ENJOYMENT". This program is supported by Ministry
of health Republic of Serbia, Ministry of labour, employment and
social policy Republic of Serbia and Ministry of education and sport
Republic of Serbia.
Program "WHEEL OF ENJOYMENT" also includes actions "Cancer is
hard, Friendship is easier" and "Diabetes has its enemy"
dedicated to people with cancer and diabetes.
Bicycling club " SIRMIUM BIKE INTERNATIONAL" from Sremska Mitrovica
is promoter and initiator of this program. Beside bicycling
promotion, this program`s goal is to build Rehabilitation center for
addiction diseases, too.
After January 1., 2006. our multiethnic bike team will ride again
across Serbia and districts of Kosovo.
In Jun 2006. we will ride trough Europe with same goal to pay
attention on existing problems of addiction diseases, cancer and
diabetes.
We invited great number of economic subjects in country and abroad, to
join us in this program giving their support.
We asking You, too, to join us and to give us your support or to
direct us to competent humanitarian, financial and medical
institutions.

Sincerely,


President of bicycling club

"SIRMIUM BIKE INTERNATIONAL"

and program`s coordinator
Mr. Kamenko Vladisavljevic

I think the only statistics that matter are those dealing with visual
morbidity, i.e. what is the probability that wearing a contact lens, or
undergoing LASIK will cause permanent decrease in visual function.
Traditionally, this has meant loss of visual acuity on the Snellen
chart.

We know what those numbers are for contact lenses, because the subject
has been studied exhaustively for years, with several large-scale
population studies. Currently, there are ongoing post-market studies
involving the new silicone-hydrogel lenses. We do not have information
of the same quality for LASIK or for orthokeratology. We do NOT have a
good handle on the infectious keratitis rate for overnight OK.

DrG

In article <(E-Mail Removed) .com>,
"Dr. Leukoma" <(E-Mail Removed)> wrote:

> Currently, there are ongoing post-market studies
> involving the new silicone-hydrogel lenses. We do not have information
> of the same quality for LASIK or for orthokeratology. We do NOT have a
> good handle on the infectious keratitis rate for overnight OK.

Ace--did you read this?

--
~RT

I assume infectious keratitis is treatable (and cureable) with
antibiotics. A poor LASIK result is something you'll have til you die.

crvc wrote:

> I assume infectious keratitis is treatable (and cureable) with
> antibiotics. A poor LASIK result is something you'll have til you die.
>

True, although the keratitis often leaves you with a nasty (and vision
robbing) scar that will also be with you forever (or until you get a
corneal transplant).

I'd guess that more serious damage, as measured by loss of acuity, has
occured from such ulcers than has occured from LASIK. But one thing is
for sure, far more LASIK patients are glad they had it than not. And I
must add that most post-ortho K people I've seen think they wasted their
money, and I've agreed with that assessmment in every single case.

To be balanced, I admit I have one patient who wishes he'd never had
LASIK. Although he went from -8.00 to 0.00 and gets 20/20 after standard
LASIK then wave front secondary, he hates his night vision and claims he
is now a hazard driving at night. I'm counting on his pupils get smaller
as he ages (yes he has used Alphagan, but still is not a happy camper).

w.stacy, o.d.

William Stacy wrote:
> crvc wrote:

> True, although the keratitis often leaves you with a nasty (and vision
> robbing) scar that will also be with you forever (or until you get a
> corneal transplant).

But, this happens in only 13% of ulcer cases. Probability dictates
that they will occur peripherally and off-axis most of the time.
Without taking you through the calculations, the probability of vision
loss from sleeping in a conventional hydrogel lens is 0.026% per year.
>
> I'd guess that more serious damage, as measured by loss of acuity, has
> occured from such ulcers than has occured from LASIK. But one thing is
> for sure, far more LASIK patients are glad they had it than not. And I
> must add that most post-ortho K people I've seen think they wasted their
> money, and I've agreed with that assessmment in every single case.

Sure wish you had numbers to back-up your guess, Dr. Stacy. Looking at
the clinical trials, we might come up with an educated guess of from
0.5% to 1%. If you divide 0.5 by 0.026, you get something like 20
years. But, even this statistic is moot, because most patients don't
sleep in their lenses, in which case the probability of an infection is
reduced by a factor of 5 or 10, in which case 20 patient years becomes
100 or 200 patient years.

No contest. Contacts win.

DrG

Dr. Leukoma wrote:

>
>>True, although the keratitis often leaves you with a nasty (and vision
>>robbing) scar that will also be with you forever (or until you get a
>>corneal transplant).
>>
>>
>
>But, this happens in only 13% of ulcer cases. Probability dictates
>that they will occur peripherally and off-axis most of the time.
>Without taking you through the calculations, the probability of vision
>loss from sleeping in a conventional hydrogel lens is 0.026% per year.
>
>

Only 13%? That's quite a few. I wasn't trying to blame them all on
contact lens wear for sure.

>No contest. Contacts win.
>
>

I think there are a few million LASIK recipients who might argue with
you on that, as most of them went to LASIK because they didn't like
contacts for one reason or another. But you're right, I have no numbers
to back me up, just my patient base which includes 40 or 50 LASIK
patients and a couple thousand CL wearers.

w.stacy, o.d.