I-Brite Eye Whitening with Dr. Boxer Wachler

[Charon]

Hi everyone,
I have seen a few archived threads about this procedure but I wanted to see if anyone had anything to add. Here is an overview of the procedure: http://www.boxerwachler.com/whiteeyes/ It consists of the doctor, um, peeling off your sclera (clear membrane over eyes). Supposedly a "crystal clear memberane without red blood vessels, yellow or brown spots grows back in its place."

I asked my opthamologist about this procedure. He had never heard of it and said it sounded dangerous. What concerns me is that there is no peer-reviewed study on this procedure and I am having a hard time finding some unbiased feedback on personal experiences. I sent in my pictures, and I was told I would be a "great candidate." The cynical side of me thinks that they say that to everyone who sends in pictures. Anyway, I was told it would cost me $4,650 PER eye for the procedure. I live in the midwest so it would be a big commitment to fly all the way out there for a consultation.

Has ANYONE here had this surgery? What was your experience like? How long did recovery take? Are your eyes better than before, or about the same (or worse)? If you could do it again, would you?

Here's some background on me and why I am considering taking such drastic measures:

I am 26 years old, and my eyes have always been sensitive--they would get red after I wore my contacts all day. But once I moved across the country, they got even worse and now they are red all the time, even though I completely stopped wearing my contacts (and eye makeup) about 5 months ago. I use preservative-free eye drops regularly, and I have seen 3 different opthamologists who have given me varying diagnoses from "you have rosacea-associated blepharitis, that's why your eyes are red" to "you wore your contacts too long, so now you have these veins and the blepharitis is continuing to irritate them." The one constant feature is that there is nothing I can do except try to keep my lids clean and take fish oil.

My doctors have said things like "it's not THAT bad" and "oh nobody's eyes are perfectly white, what they do in the movies is all faked." That may be true, but I do know that when I see other people's eyes, they look much healthier than mine. And when I look at old pictures of me (even from just a year ago, before my move) my eyes are so, so much healthier-looking.

I want to get back to "normal" and not feel trapped in my own body behind these "dirty" eyes, but I also realize that this is a serious surgery that hasn't been proven safe (or even effective), and it will cost me $9,300, plus a round-trip plane ticket and hotel (and I'd have to take at least 3 days off from work). So I REALLY would appreciate ANY feedback, good or bad, about your thoughts and/or experiences with this procedure.

Thank you and take care.

[PotatoCakes]

I understand your desire to consider this procedure; I've thought about it myself. What stops me, is that so few people and virtually no one I trust with my eyes have even heard of this surgery. Given the severity of lasik-problems (many seen on this website), I can't help but think that the potential for problems, particularly with a population like us (those with chronic issues already) would be extremely high.

Have you tried serum drops? They won't do away with the redness but I do find that my eyes seem a little less red when I've been using my serum drops regularly. This is an old thread and there are more recent ones but I like it because it covers some of the basics about serum drops http://www.dryeyezone.com/talk/showt...ht=serum+drops

[Rebecca Petris]

In a word: scary.

I haven't been on that website in a long time but I thought they used to have prominent information saying something about it being unsuitable for anyone with dry eyes. Or something along those lines. Couldn't find it today.

But what I did find that really disturbed me:

ARE YOU A CANDIDATE? You can e-mail a close-up picture of your eyes to find out if you appear to be a candidate for I-BRITE® Eye Whitening. Simply e-mail to Jen at info@boxerwachler.com and request a "photo review for I-Brite Eye Whitening."

Seriously? I can find out whether I'm a candidate by sending them a PHOTO? As opposed to all my medical records??? Of course they'll presumably require that too later, but I'm sorry, I have real difficulty taking seriously a doctor who advertises a surgical procedure this way.

[robster]

I've never had this procedure done but I've had LASIK and am now dealing with dry eye. If you have sensitive eyes any potential refractive surgery will only make them worse and lead to more sensitivity issues.

[Charon]

I don't think this is considered a refractive surgery, though. That's not to say that it isn't just as dangerous. It would be helpful to hear from someone who has had the procedure done and whether they suffered any side effects.

Part of me wonders if I am a less than ideal candidate because my eyes used to be relatively clear (as of a year ago)--it's not as though this is a permanent condition I've dealt with my whole life. Additionally, I think my redness is caused by rosacea/blepharitis/allergies, so who knows if it would even make a difference? Maybe after the procedure my eyes would go back to being red again. I just wish there was a way to get feedback from those who have had the procedure!

However, I haven't seen any negative postings from people who had the procedure. The only negative feedback I hear is speculation. Which makes me wonder...after all, if people had a bad experience, don't you think they'd be running to the message boards to get their story out? (See, e.g., LASIK patients who now suffer from dry eye).

[Rebecca Petris]

Which makes me wonder...after all, if people had a bad experience, don't you think they'd be running to the message boards to get their story out? (See, e.g., LASIK patients who now suffer from dry eye).

The reason you don't see stories online from I-Brite patients is because so few have had it done. For example:

Suppose there are 20 million people in this country who have moderate to severe dry eye. Only about 5,000 people have joined DryEyeTalk in its 7 years of existence. That's 0.03%. The percentage of LASIK complications patients is probably even smaller I would guess based on my experiences with refractive surgery forums over the years.

Suppose 10,000 people have had I-Brite. 0.03% of 10,000 is 2.5. That's about how many people have posted about it on DryEyeTalk after having it done, I think.

[google me]

[Removed by moderator]

I debated for months before having the procedure and like many of you I was searching for direct patient references. If you go to the I-Brite website and look on the right side there is a link to click to view patient videos. You can see testimonials from people who had the procedure done. Let me know if you have questions.

[alisonW]

google me - what was your diagnosis before the procedure? Dry eyes, allergies, MGD, ocular rosacea, etc. I'm curious about what was causing your redness since mine are always red too. Thanks!

[Rebecca Petris]

I gather you had it very recently. I will be interested to hear how you are in 6 months.

[google me]

google me - what was your diagnosis before the procedure? Dry eyes, allergies, MGD, ocular rosacea, etc. I'm curious about what was causing your redness since mine are always red too. Thanks!

I went to a lot of different doctors and they said it was due to dry eyes. I took that test that measures your tear production and my tears were very low so they suggested the plugs, flax seed oil and restasis. I tried it all but it didn't help I was still left with bloodshot eyes that got progressively red throughout the day. I was using Opcon A 4-6 times a day and yeah I know there is a rebound effect but what could I do..I had lasik a few years back which may have contributed to the dry eyes.

I had bloodshot eyes from morning to night it was a nightmare until I found this procedure.

[alisonW]

Thanks for answering. Same here as far as a "dry eye" diagnosis and having tried everything and the eyes still being red. I will take a look at the site.

[Rebecca Petris]

Funny, all this time and I never actually read a description of what I-Brite actually IS. This time I got curious.

Based on what I read here it's manually excising the scleral conjunctiva and applying MMC, then letting the conj grow back.

Something to keep in mind about this approach (especially if you're considering the, cough, $6k variety) is: What caused, or is causing your redness in the first place? Is the cause ongoing or not.

For those who want to know more about this general type of surgery, please search on conjunctivochalasis. We have had several members over the years who have had surgery for conjunctivochalasis in hopes of dry eye symptom relief (with or without amniotic membrane transplantation). But as far as I know they only had it recommended if they actually had chalasis.

[google me]

I think conjunctiva surgery has been around a long time. Doctor Boxer Wachler has perfected the technique or maybe he has just repackaged what was there all along and specifically marketed it as a white whitening procedure. In any case I think getting rid of that layer with all the yellow or brown spots from sun damage along with those nasty red veins make sense. The membrane is going to regrow itself providing a new healthier looking sclera. I agree the cost is high and everyone has to due their own research and make their own decisions.

Just wanted to offer some insight for anyone considering the procedure. I am here to help.

[Charon]

google me, that's a good point. I have no idea why my eyes suddenly became red, but no treatment is working. I'm guessing it's the result of sun damage (I always wear sunglasses, but I am very fair). My eyes are always red, even when they don't feel dry or hurt. I came on this board because there is no "red eye zone" or anything, and I figured my red eyes were the result of some dry eye problem. I know I have blepharitis, but I have had that for years. Either way, I think I will get the surgery. I know there is a risk that the redness will return, but I want to get a fresh "baseline" because honestly, going through a lifetime of red eyes (I am 26 now) with no hope for a cure is extremely depressing. At least if I do this surgery I'll have a shot at clear eyes again, and I won't spend the rest of my life wondering "what if" the surgery had worked.

I am still a little wary of the procedure, but I am becoming more comfortable with it. It seems like the biggest risks are A) a prolonged recovery, B) lack of results or results that don't last. As far as I know, there are NO patients who reported vision loss or other serious complications. If I got the surgery and suffered awful side effects, you can bet I'd be out there spreading the word.

[Charon]

Also, I'm not so worried about the dry eye side effect. I really don't have "dry eye." My eyes hurt sometimes because of the redness (or they hurt because of something else that causes the redness...) but they really don't feel very dry at all. Healthy tear production most of the time. That's why I think this procedure is a good fit for me. My eyes are more or less healthy (except for the blepharitis that makes my eyelids a bit swollen) but yet they are still red.

[darkhorse81]

Hi Charon, I used to be on the old red eye thread on wrongdaignosis before it got bought out, and many of the people who got the procedure did seem to be satisfied. However, one girl who went to Dr. BW did complain that she had burning, irritated eyes after the surgery that made life very difficult/painful and I don't think she was ever able to get it resolved. Also, I did check yelp for Dr. BW's reviews and while all of his reviews for his Lasik and other traditional eye surgeries were glowing, there were 2 reviewers who got ibrite who both complained that it did have bad, lasting side effects like impaired vision and light sensitivity and were very mad. I think while most people do get good results without serious complications/side effects, you should still be aware that some people do experience side effects to their eyes to the point where they wish they hadn't undergone the procedure.

I myself am still torn whether I'd like to risk the procedure for a shot at normal looking eyes again. If it works, then it's like hitting the lotto but if not; you just have to make sure you're will to live with the consequences of if you are one of the unlucky ones.

[google me]

where are you seeing these reviews? if you go to the i-brite website you will see a link to the right to view patient stories. there is a little tiny arrow where you click through dozens of patient stories. make sure you are viewing the i-brite testimonials

[dutcheye]

Googleme, maybe I am on the wrong page, but I don't see an arrow, neither can I find specific iBrite patient stories.

[dutcheye]

Googleme,

would it be possible for you tot post before and after pictures?

regards, Dutcheye

[Charon]

where are you seeing these reviews? if you go to the i-brite website you will see a link to the right to view patient stories. there is a little tiny arrow where you click through dozens of patient stories. make sure you are viewing the i-brite testimonials

Yes, but those are the testimonials that Dr. BW has approved. It's not exactly an objective source of information.

[darkhorse81]

if you google "boxer wachler yelp" there are two yelp links. the first one is of the actual doctor brian, which has some great reviews from patients of his other surgeries but two very bad reviews of 2 former ibrite patients of his. the 2nd link, which is the review of his practice, has a great review from a successful ibrite patient. i'm not saying that there aren't a lot of success stories, but i do think people have to be aware that things can go wrong and what the consequences are when they do. clearly it's already gone wrong for a few patients; although we don't know the ratio of successful, happy patients to unsatisfied and angry ones. i'd still like to get the surgery myself but would like to proceed with caution.

[debbiemrosa]

I was thinking of doing the I-Brite procedure. I have a pterygium in one eye and a ping in the other eye, plus blepharitis. My kaiser eye doctor told me that she would not do the follow up on my eyes if I have the procedure done. She said that 100% of the corneal specialists do not advocate for this surgery. Kaiser will do the pterygium surgery if it grows big enough but I would like to get it done now. I'm seeing a local doctor tomorrow to get a second opinion.

[Charon]

My kaiser eye doctor told me that she would not do the follow up on my eyes if I have the procedure done. She said that 100% of the corneal specialists do not advocate for this surgery.

Woah. That raises major red flags for me. It's one thing if the doctor won't do the procedure herself (many are cautious, an understandable approach with the eyes) but for her to say that she wouldn't even do the follow-up and 100% of corneal specialists are against surgery?

I still am interested in this procedure because (like everyone else) I want normal-looking eyes that aren't red all the time. But I think I'll stick with a more cautious approach right now and just keep trying to treat my stupid stubborn blepharitis/ocular rosacea. Opthamologists can be pricey and frustrating but at least they aren't dangerous.

I will need a lot more evidence of good results form this procedure before I consider it again. First of all, it's VERY expensive (around $9,000). That's a TON of money to me (and to most people, I would think). Second, it requires a long recovery time. Apparently after you get it, your eyes are BRIGHT red (like scary-looking) for at least a week, and possibly up to 18 weeks (this is what their client consultant told me). Here is one of the few pictures I have been able to find of what an actual patient's eye looked like soon after the procedure. NOTE: This is from Dr. Klein's isowhite procedure. So different doctor, but similar procedure. And this patient is extremely happy with his overall results. But here is what he looked like a full 7 days after the procedure. http://myeyesurgery.blogspot.com/201...hite_8204.html
There is absolutely no way I would go to work looking like that!

So means, in addition to taking time off to fly out to California for the procedure, I'd have to take at LEAST another week off (and possibly more, if my eyes are hurting or terrifyingly bloody-looking). And who knows how long the recovery would be after that...and there's always the chance that you get bad results. Here are some pictures I saw of a surgery gone wrong. NOTE: These are not pictures of a patient of Dr. BW's, but it is from someone who does a similar procedure. As you can see, if something goes wrong, it has serious consequences.
http://redeyezone.4umotion.com/t7-re...ani-and-dr-kim

I wish it was as simple as, say, getting a nose job...if you want one, you find a good doctor, pay the expensive price tag, and recover in a set amount of time. Some might debate the merits of doing it, but overall it is a safe choice that gives effective results if you are smart about it and have a good doctor. I guess the eyes are different because if you mess up an eye, you can permanently ruin someone's vision. So that means the best and brightest opthamologists won't be clamoring to do this surgery any time soon. Sigh. Fingers crossed for better blepharitis/ocular rosacea treatment!

[Rebecca Petris]

My kaiser eye doctor told me that she would not do the follow up on my eyes if I have the procedure done. She said that 100% of the corneal specialists do not advocate for this surgery.

Doubt it's 100% but probably not too far off either - assuming we're talking about excision for cosmetic reasons only. Lots of surgeons do conjunctivochalasis surgery (with or without AMT) when they feel they have a compelling reason to.

I think that Charon is right on about red flags though. For me the red flag in your situation would be this: Your Kaiser doctor sounds conservative. Someone who is protective of your eyes is an asset I would not want to lose in this world of heavily commercialized consumer ophthalmology (bearing in mind that cornea/anterior segment subspecialty has changed fundamentally, not for the better, since the advent of elective vision correction surgeries). I have no doubt that if you go out and shop around, you'll find a plethora of doctors willing to do what you want. Their offices will be more lavishly furnished, and you'll probably get a nice T-shirt and mug to take home And you may do fine. But will they be competent to go to bat for you if anything should go wrong? Or will they tell you before surgery that they've never had a serious complication? (Bright crimson flag if so.)

I wish it was as simple as, say, getting a nose job...if you want one, you find a good doctor, pay the expensive price tag, and recover in a set amount of time. Some might debate the merits of doing it, but overall it is a safe choice that gives effective results if you are smart about it and have a good doctor.

Bet the people who had complications debate the merits and I bet they have a newfound appreciation for their noses... just like all the LASIK patients here who rue the day that they believed being smart and having a great surgeon was enough to expect an excellent result. Sigh. Ain't no free lunch anywhere in surgery. Buyer beware.

[Charon]

Right, I guess what I meant was I wish this was a procedure that had more transparent results, I.e., with before after photos and testimonials that weren't regurgitated from the doctor himself. And nose jObs (and other plastic surgeries) do have complications but generally you are fine. And eye surgery is in a different league.

[darkhorse81]

in the other thread they did have different posters who gave accounts of their experiences with dr. bw and dr. kim. mostly it was positive; i don't even think there was any bad accounts with dr. kim and apparently dr. kim is very selective with the people he performs surgery on but now he's not allowed to practice that surgery in korea. but there were a few people who had the surgery and didn't have good results; it's just so new that there really isn't a way to count the people who had good results vs. those who had complications. and even if there were, the numbers are too few to really give the scope of how bad and prevalent the complications can be.

ugh...my biggest regret in life is that if i didn't rub my eye that one day, my eyes would be totally normal still. one silly action can totally change your entire life...

[dutcheye]

Darkhorse,

I don't believe it is true that the number of surgeries are too few to count people with good and bad results. There should be a few thousand people who had it done, since the surgery is being done for many years. I recall I read somewhere Dr. Kim helped over 1400 people already.

It would be helpful if patients would give a clear follow-up of their experience after they had it done. But in many cases, you don't read anything anymore from them afterwards. Please people, give details, post pictures etc..

[darkhorse81]

There's also an abstract about a study a group of Korean doctors did on 48 patients who had the eye whitening surgery. I don't know if they were patients of Dr. Kim but it's here and they had some pretty bad findings in that there were complications in 44 of the 48 patients. I don't know if that means the patients had additional surgery and were fine or if that means there was irreparable harm to their eyes but it's here:
http://www.ncbi.nlm.nih.gov/pubmed/22269679

Dr. Kim did release his own study as well where he says he studies 1815 patients. Postoperative complications included intraocular pressure elevations (98 of 571; 17.2%), development of granuloma (153 of 1815; 8.4%), transient subjective visual decreases (43 of 571; 7.5%), pigment deposition (96 of 1815; 5.3%), scleral calcification (70 of 1815; 3.9%), and diplopia because of adhesion esotropia (9 of 571; 1.6%)

So it'd be nice if they did more studies because I don't know if Dr. Kim would actually follow or could keep track of 1815 patients. I think Dr. Kim regarded the complications as treatable whereas the other doctors regarded them as dangerous. To my mind, these are the only studies that have been made available concerning this procedure but I'd love to see a more extensive one where they really track a few thousand patients (and not the doctor who performs the surgery but an independent group of doctors) to see what complications arise and how safe it is. And hopefully they won't fudge the numbers the way the Lasik surgeons did to get Lasik approved in the US.

[Rebecca Petris]

Nice find darkhorse!!! Many thanks for posting that abstract link. Scary conclusions line:

Cosmetic wide conjunctivectomy, which has been advertised as a simple and effective surgical option for the treatment of conjunctival injection [i.e. RED EYES], has caused disruption in the normal physiology of the ocular surface, which leads to various devastating complications."

I appreciate also now having a name (other than a 'brand name') for the procedure: Cosmetic Wide Conjunctivectomy Combined With Postsurgical Mitomycin C Application. Personally I would not let anyone put MMC on my eyes.

[darkhorse81]

I'd love for there to be more of these studies since we don't know the history of those they tested. They only did 48 patients and I'd be happier if they tracked 1000 or so to really get a better idea of the stats for this surgery. Since I do know of quite a few people who did get the surgery and were happy with their results over a year later, so the 90% complications rate is high for me. Once again, more independent studies would be great since the doctors normally don't keep track of their patients afterwards, and it'd probably require another full time team to really be able to do that effectively.

I'm going to try the no dairy/less meat diet and see if that could possibly help some; it's really the only thing I haven't tried besides this procedure. Then maybe I'll try one eye and pray to God none of these bad side effects happens to me. That'll probably be another year or so down the line though since in the beginning there were a ton of great stories, and now a few bad stories have come out as well, so trying to weigh the potential good vs the bad, both of which would be dramatically life changing, will take time.