From http://www.nylvc.com/html/lasik-experie ... counseling

LASIK Preparation

Next, either Mariebelle or Gabrielle, our laser technicians, will call you into our state-of-the-art laser suite for your procedure. Before you enter the suite, the laser will be calibrated, and all of the tools needed for your LASIK procedure will be prepared. After your name is confirmed, you will take a seat in the laser chair. We will administer a disinfectant preparation to your eyelid area and instill drops to numb your eye. To make the process more comfortable, you will be given a teddy bear to hold and you will hear music in the background (aww how sweet!!!! Has Teddy had this procedure done too?).

Lasik Procedure

Dr. Mandel will ask you to open your eye and focus on a flashing light. A lid holder will keep your eye open, and Dr. Mandel will ask you to tell him when the flashing light disappears. You will feel a vibration for about 10 to 15 seconds, and then the light will reappear. The light will then become blurry. At this point, you will hear the sound of the laser and notice the smell of the laser gases (I didnt' know lasers smelled).

It's the smell of burning corneal tissue.

http://www.eyeworld.org/article.php?sid=662

EyeWorld
June 01









http://www.eyeworld.org/article.php?sid=1121

EyeWorld
Feb 01



http://www.mastel.com/pdf/BO_4951-23.pdf

Oh, I almost forgot... when the flashing light disappears, the patient has gone blind from retinal artery occlusion due to the suction ring used to cut the flap.

http://www.neovisioneyecenter.com/laser ... _faq2.html

http://idinchildren.com/199710/frameset ... =child.asp

"Stuffed animals and blankets are other contrasting ideas between pediatricians and educators. Although educators suggest having these soft items, they only "harbor disease," Poole said, because children rub against them, slobber on and wipe their nose on them making it impossible to keep them clean. If blankets and stuffed animals, are present, they must be washed routinely."

I highly doubt LASIK centers wash their Teddy bears between patients. Good grief, many of them re-use microkeratome blades to save effort and money!

Never trust your precious vision to a corneal refractive surgeon! He or she is placing a higher value on making money than your vision and eye health. No conscientious physician, in my opinion, would perform corneal refractive surgery in the context of literature available today... literature demonstrating that all forms of corneal refractive surgery cause permanent harm to every eye and typically reduce visual quality.

http://www.ophmanagement.com/article.aspx?article=86452

Ophthalmology Management
October 2005

http://www.ophmanagement.com/article.aspx?article=85072
Ophthalmology Management
April 2001
Where There's Smoke . . .
By: Christopher Kent, Senior Associate Editor
Eliminating LASIK laser plume may have a host of beneficial effects -- including improving your outcomes.

and staff.

http://www.revophth.com/index.asp?page=1_833.htm

Is Your Health at Risk?

When laser plume is not contained, individuals present at the surgery are virtually certain to inhale some of the particles and gases being produced. The anecdotal evidence of health trouble—some mild, some serious—is plentiful. Clinical studies, however, have been relatively few. Nevertheless, the existing data does provide reason for concern.

Elements that have been identified in laser plume include the gases benzene, hydrogen cyanide, toluene, formaldehyde, and polycyclic aromatic hydrocarbons.1,2 Studies of excimer laser plume smoke have found that live viruses can be isolated from the plume evacuate.3,4,5 Other laser studies have also shown that bacteria, viruses and DNA can survive laser ablation.6,7,8 (The dermatology literature contains multiple references to the health problems resulting from breathing plume smoke emitted during CO2 laser use.) The National Institute for Occupational Safety and Health and the Occupational Safety and Health Administration have both stated that plume smoke should be evacuated and treated as infectious waste.

Some of the particles created are between 1.0 and 0.4 µm,9 the same size range as coal or asbestos dust, making the particles invisible and lighter than air. Unless contained, they remain floating in the air, as coal dust does. In addition, excimer lasers are often calibrated by vaporizing test plates made of materials such as vinyl, polymethylmethacrylate and aluminum mylar; the consequences of breathing the laser plume from these materials is not known.

About a year and a half ago, Matthew Niemeyer, MD, a resident in ophthalmology under Howard V. Gimbel, MD, at Loma Linda University, conducted a survey of ophthalmology personnel in the United States designed to look at the effects of laser plume on the health of those who are regularly exposed to it. About 250 surveys (out of 500) were completed and returned. The control group (about 125 respondents) consisted of ophthalmologists and technicians who work in the same clinic or building as the people using excimer lasers, but do not use a laser as part of their surgeries or other procedures.

The results showed a highly statistically significant difference between the groups; personnel exposed to laser plume had more symptoms as a group than other doctors working in the same buildings. Those who were exposed to the plume reported a significantly greater amount of runny nose, cough and allergy problems—primarily respiratory symptoms. (Differences in more serious conditions such as autoimmune disease were not significant.)

Like any good scientist, most ophthalmologists prefer to take action only when clinical evidence is substantial and compelling. However, long-term health risks can take years to establish clinically, by which point considerable damage may have been done.

http://www.crstodayarchive.com/03_archive/0603/111.html

"Although there has never been a documented case of an infectious agent transmitted by plume smoke, some surgeons have voiced the concern that they may be at risk. When operating on patients who are unknowing carriers of hepatitis C or hepatitis B or who hail from countries where prions taint the food supply, for example, could refractive surgeons be in danger of contracting infection? During excimer laser ablation, innumerable protein fragments from vaporized keratocytes and perhaps the occasional infectious microbe launch off the patient’s corneal surface at a high velocity. As surgeons, we should consider that we carry all our patients with us in the form of microscopic particulates in our lungs."

http://www.lsms.org/Pubs/Journal/Jan_2007.pdf (this link is not working)

From the full text:

Stage II begins when the corneal flap is reflected (opening the incision) and is completed with the corneal flap returned and sealed in its original position (closure of the incision): surgical incision exposure to surgical incision closure. During this stage invasive solids and fluids can arise owing to the involuntary introduction of infectious organisms, epithelial cells, debris, oils, etc. into the stroma after the corneal flap is reflected back off the corneal surface. Manipulations of the epithelial surfaces, flap, flap bed, introduction and extraneous use of instruments at the interface, flap folding, irrigation and cleansing of the surface, coupled with possible contaminations from the eyelashes, stromal bed tissue, tear ducts, proliferation and/or migration of epithelial cells, and the limbus throughout the second stage of the LASIK procedure may contribute to less than desirable outcomes.

Moreover, splatter from the ablation plume can partially mask the laser beam impairing the laser’s efficiency and could create undesired outcomes that require future surgical correction. Excimer surgeons sometimes have observed the generated plume to carry large particles, which can drop out onto the surgical field creating additional contamination in the region of the incision. These particles also may adhere after splattering onto the laser’s last optic resulting in irregular etching. Both events cause grief for the surgeon and patient and may require complex surgical intervention in an attempt to correct poor outcomes. Additionally, splatter, smoke, and large particles are possible health and safety issues for the surgeon, medical staff, and patient.

PTT