Zembla Documentary on Lasik, Pain, and Suicidality

This Lasik documentary was created by investigative journalists in Holland. The language is mostly Dutch, with English subtitles. The documentary focuses on corneal neuropathic path after Lasik and the suicidality it creates. Dutch physician Dr. Michael Brouwer and other Lasik sufferers in Holland are interviewed, as is Dr. Edward Boshnick in the United States (see EyeFreedom.com). The investigators ask: Is the experience of pain after Lasik really uncommon? What are the consequences when it occurs? Also interviewed are Dr. David Barsook and Dr. Morris Waxler. Dr. Barsook is Director of the Pain and Imaging Neuroscience (P.A.I.N.) Group at Boston Children’s Hospital, MGH ,and McLean Hospital at Harvard University. Dr. Barsook maintains that corneal pain after Lasik follows an established model of neuropathic pain. Dr. Morris Waxler is the FDA's former chief research scientist on Lasik. Dr. Waxler maintains at his website HelpStopLasik.com that "The FDA does not want to admit that millions of people have now had a surgery that never should have been approved by its own rules. The FDA is now engaged in covering-up a scandal and an epidemic, and its own corrupt practices. This should be exposed, and LASIK should end." He revisits these conclusions in the video.

Transplant

Cornea Transplants and GVR Scleral Lens

Be very careful about rushing into a cornea transplant (see images of failed transplants at bottom of this page). About 50,000 corneal transplant surgeries are performed every year in the United States. The purpose of this procedure is to replace diseased corneal tissue with a healthy cornea from an organ donor. Corneal eye disease is the fourth most common cause of blindness (after cataracts, glaucoma and age-related macular degeneration) and affects more than 10 million people worldwide.

There is no way to determine the final outcome of a corneal transplant as far as the curvature of the new ocular surface is concerned. Almost all of the post-corneal transplant patients who we have seen over the years have significantly distorted corneas. This is due to the suturing and healing process that every transplanted cornea needs to go through with the recipient eye.

In our specialty practice, all of this special patient population is wearing a GVR Scleral lens over the transplanted cornea. The reasons we use these unique lenses are:

1. There is a life long risk of rejection of the donated cornea. Any contact lens that rubs against the donor cornea could cause irritation and infection to the host eye. It is conceivable that this could lead to rejection of the donated cornea. The GVR Scleral lens vaults over the donor cornea and is supported by the white portion of the eye (the sclera). It does not rest on or touch the donor cornea. Saline solution fills the space between the back surface of the lens and the front surface of the donor cornea. Vision and comfort are almost always excellent.

2. As stated above, there is no way of knowing what the final corneal curvatures of the donor cornea will be after the healing process takes place which could be many months. It has been our experience that almost all of the transplanted corneas we have seen have significant distortions and irregularities after the healing period has taken place. Vision with eyeglasses is usually very poor. Conventional contact lenses such as soft lenses or conventional gas permeable lenses are either not comfortable or provide very poor vision. A scleral lens is the only technology that will replace the irregular transplanted cornea as an optical surface.The GVR Scleral lens along with the liquid interface behind the lens will provide clear comfortable vision once again to the great majority of this patient population.

At the present time, many eye doctors are still telling their patients that they will need a corneal transplant, or to wait until the eye gets bad enough and then they can have a corneal transplant done. These doctors will not inform their patients about non-surgical alternatives such as the GVR Scleral lens which is a non-invasive and yet a very safe alternative when compared to corneal transplant surgery. Many of these eye doctors will never discuss the risks of corneal transplant surgery.

Below is an image of the GVR scleral lens over cornea transplant


Below is the image of a patient's 4th cornea transplant.


Here are other images of failed transplants





Below is an image of a failed cornea transplant resulting in complete blindness.

Blunt Trauma to Right Eye with Hemorrhage and Partial Transplant, Vitrectomy, and Cataract Surgery. Now 20/60 with GVR Scleral Lens

One year ago this patient suffered a blunt trauma to his right eye. This resulted in a severely damaged cornea and a hemorrhage within the eye. Shortly thereafter, his right eye underwent a partial corneal transplant known as a DSEK. In addition, a vitrectomy was done which involves the surgical removal of the vitreous gel within the eye (done to clear away the blood). This was followed by cataract surgery several months later. Due to the ocular trauma and the multiple eye surgeries that were done, this eye was left with no iris and therefore no pupil. In addition, the transplanted cornea while healthy and clear was extremely distorted. Several weeks ago, in an effort to restore vision to this severely damaged eye, we fit this eye with a GVR Scleral lens. Before placing the scleral lens on this eye, it became necessary to provide this eye with a new pupil. This was done by first placing an opaque black soft lens with an 8 mm pupil on the damaged eye. Over this blackened soft lens we placed our specially designed scleral lens. Without this soft/scleral lens combination, this patient's best corrected visual acuity is less than 20/200 with significant distortions. With this specialty lens combination this patient is able to see 20/60 without any distortions. The purpose of fitting this eye with a scleral lens was to correct the distorted vision created by the distorted transplanted cornea. The photo below is of me along with this very special patient. Below left is a photo of his right eye without any corrective lens. Note that there is no iris and no pupil. The lower right photo is of the blackened soft lens with the clear pupil. Over this lens can be seen the gas permeable scleral lens. This patient is able to wear the lens combination comfortably with all day wear.

RK Over Transplant Equals Constant Pain. Vision Clear and Comfortable with GVR Scleral Lens

The 3 images below are of the same eye. 20 years ago this eye underwent corneal transplant surgery. For many years this patient was unable to obtain functional vision with this eye due to a high degree of corneal distortion. 3 years ago, in an effort to make the corneal more spherical, her corneal surgeon decided to perform a modified RK surgery on the transplanted cornea. The result of this RK procedure was continuous pain along with a decrease in the patient's visual acuity. In the first image below, you can see the open RK incisions. A special green dye and filter were used to make this easier to see. In the 2nd photo, which is a profile view, you can see the open RK incision in the lower portion of the transplanted cornea. The 3rd image is a cross section of this cornea taken with a technology known as "Optical Coherence Tomography". The top 2 curved lines represent the front and back surfaces of the scleral lens. The thick curved grey structure below the scleral lens is the transplanted cornea. Look carefully to the left side of this image and you can see the open RK incision that extends half way through the cornea. With this scleral lens the patient is able to see clearly and comfortably for the first time in 20 years.

Patient with Multiple Cornea Transplant now 20/25 and 20/30 with GVR Scleral Lens

This patient had corneal transplant surgery in both eyes a number of years ago. For many years he was unable to see clearly with either eye glasses or contact lenses. Two years ago his left eye rejected the transplant and he needed to undergo another corneal transplant operation. Earlier this year we fit this patient with GVR gas permeable scleral lenses which are allowing him to see 20/25 in his right eye and 20/30 in his left eye. He is able to wear both lenses comfortably all day with stable vision. Because his left eye underwent 2 corneal transplant surgeries, he will need to be monitored very carefully with periodic examinations for several years to come.

Transplant in Process of Being Rejected

What you are seeing in this photo is the third corneal transplant that this eye has had to endure. There is an ulcer in the center of this cornea that has not healed despite many weeks of treatment with antibiotics and other medications. You are viewing a corneal transplant that is in the process of being rejected. The purpose of posting this photo is to enlighten those viewing this image that rejection and infection will always be a risk factor in corneal transplant surgery. This type of eye surgery should never be taken lightly. All non-invasive technologies should be considered before corneal transplant surgery is done.

Patient with Corneal Transplant now 20/20 with GVR Scleral Lens

This patient visited our specialty practice from Aruba seeking help for his vision loss. 8 years ago he underwent corneal transplant surgery in both eyes. He was fit with scleral lenses in Europe which were unable to provide him with good vision along with good comfort. 2 years ago we examined him and fit him with GVR Scleral lenses. For the first time since his corneal transplant surgeries he is able to see clearly and comfortably with all day lens wear. The photo below shows a GVR Scleral lens on one of his eyes with a corneal transplant underneath. For the past 2 years his corneal transplants have been stable and clear and the original GVR Scleral lenses look like the day he first received them.

Patient Age 93 Improves to 20/50 from 20/800 with GVR Scleral Lens

Below is a photo of me, our student extern Jennifer Vicente and our patient Gonzalo, age 93, who visited our practice from Lima, Peru. In 2014, Gonzalo's right eye suffered a retinal detachment. Following the retinal repair surgery, a corneal infection and inflammation took place in this eye which required corneal transplant surgery. Following the corneal transplant surgery, a severe defect in the outer layer of the transplanted cornea occurred which never healed. Gonzalo traveled to Miami to have us fit his right eye with a scleral lens. Upon seeing this defect we decided to use stem cell technology to speed the healing process before attempting to fit this eye with a scleral lens. 4 days ago, a therapeutic device known as the Prokera lens was placed on Gonzalo's right eye and remained on this eye without removal until this afternoon. This device is made from amniotic tissue which is the tissue closest to the baby throughout development in the womb. In addition to helping the baby develop, this tissue has healing properties that aid in ocular surface repair with less pain and scarring and less inflammation. The photos below were taken of Gonzalo's right eye when he first visited us 4 days ago and also today when the Prokera Amniotic Membrane was removed. All of the ocular photos seen here are of the right eye. In the first 2 photos can be seen the large, deep, triangular defect. Fluorescein dye along with a special filter was used as a visual aid to better view the cornea in greater detail. The 2nd set of photos were taken today immediately after the Prokera lens was removed. The large epithelial defect which was present for many months is completely healed. To write that we were surprised would be a gross understatement. 4 days ago, the visual acuity in Gonzalo's right eye was less than 20/800. This afternoon we went through with a scleral lens fitting. With the scleral lens Gonzalo will be able to achieve 20/50 vision. Gonzalo and his family who traveled from Lima to visit us were extremely happy with the rapid healing of his right eye and with his greatly improved vision.

Transplant Following Injury by Sharp Blade Equals 20/800 Vision, now 20/40 with GVR Scleral Lens

In 2012, this patient's right cornea (the front surface of the eye) was perforated by a sharp blade and had to be sutured in order to avoid corneal transplant surgery. The suturing left this cornea with a scar and a very irregular surface. In addition, internal ocular trauma took place which required cataract surgery and a vitrectomy which involves removal of the interior gel within the eye and replacing it with saline solution. All of the trauma and surgeries left the right eye with a blurred, distorted image which could not be corrected with eyeglasses or contact lenses. Last year we fit this patient's right eye with a GVR Scleral lens which has corrected the vision in this eye from 20/800 to 20/40. He has been able to wear his GVR lens comfortably all day with excellent comfort. When this patient recently returned for a follow-up visit, his vision was stable and his eye was healthy and clear.

Documentary on Keer Deng

This past week we had the opportunity to participate in a documentary filmed at our office about Keer Deng's visual journey from Africa to America. The subject matter of this documentary is gratitude. I am certainly grateful to have played a part in Keer's visual rehabilitation. Information about Keer's special story has been previously posted in January and earlier this month. Our hope is that in the coming months Keer's vision will continue to improve so that he can become visually independent.

Update on Keer Deng

This is an update on Keer Deng's eyes and vision. As I posted earlier, Keer is the young man who was blinded in Sudan. Keer underwent a corneal transplant in his right eye. He left eye was destroyed and is incapable of any vision. Up until last week, Keer was only able to tell night from day and make out some shapes. Today, Keer was able to see his teeth when brushing for the first time since childhood. He can also see the food on his plate and identify colors and shapes. A long healing period lies ahead for Keer. I expect his vision to improve in the months to come. Keer's positive outlook on life has been an inspiration for all who have been privileged to meet him including me.

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EyePrint Pro

EyePrintPro technology creates a scleral lens based on a mold of the cornea. The molding is accurate to 1 or 2 microns and fits perfectly because it exactly mirrors the irregularities of the individual corneal surface. The technology is well suited for post-Lasik, Keratoconus, RK, eye injury, and corneal transplant patients. Read More in this PDF about EyePrintPro Scleral Lens Technology