Comments & Feedback

Dr. Bazell,

I was very confused by your report on the PSA test (March 18, 2009) I have additional questions:

Biopsies on the prostate are done when the PSA level is elevated. So if the patient has the test, they're 47 times more likely to be harmed? On the other hand, if you discourage patients from getting the PSA test aren't you raising the possibility that someone with cancer may not be screened and could therefore die of prostate cancer?

Is the problem with the test, or the problem with the biopsy? And what's the alternative here if the PSA is unreliable?

Thanks, James

— nightlyfan

Dear Mr. Bazell:

Congratulations on your story last night. As a lens and laser based refractive surgeon who had LASIK on my own eyes over 11 years ago, I would hope that the news media would also choose to focus on the positive aspects of refractive surgery. It has been my experience that the vast majority of patients who undergo refractive surgery, myself included, have a positive life-changing experience as a result of laser vision correction. I have performed over 20,000 laser vision procedures since 1993, and can count on one hand the number of patients who wish they did not have the procedure done.

While my heart goes out to the patient that you focused on in your news story, my guess is that this patient had surgery by a relatively inexperienced, non fellowship-trained surgeon who did not properly test for dry eye prior to LASIK. Typically, patients like the one who you described have underlying dry eye prior to the procedure. Patients like this should be properly screened prior to surgery and offered alternative procedures such as PRK or Visian ICL to minimize the risk of tragedies like you described.

As a refractive surgeon who has experienced the postive life-changing experience of LASIK, I would hope that the news media would depict a balanced view of refractive surgery for their audience. As such, I would like to request that you consider giving some news coverage to a 6 year old little girl that I will be performing Visian ICL on in the next few weeks. The patient has unilateral high myopia, and is intolerant of contact lenses and is unable to wear glasses because of her anisometropia (difference in power between eyes). In the past, this eye would simply have been left alone to reamain blind for the rest of her life. As a result of a refractive surgery procedure called Visian ICL, combined with patching of her good eye, this patient has a significant chance of obtaining more normal vision in this eye that would previously have been considered blind.

Again, thank you for your interest in educating the public about refractive surgery.

Regards,

Paul J. Dougherty, MD
Medical Director
Doughety Laser Vision
Los Angeles, CA
www.doughertylaservision.com
cell 805.444.2015

— Paul Dougherty, MD

I read recently where the trend in LASIK eye surgery nowadays is away from
cutting a flap and just reshaping the eyeball with the laser beam. Reportedly,
this is a safer procedure than cutting a flap and avoids problems like "dry eye."
Is there any truth to this?

— David Ames

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