Kiss Those Glasses Goodbye New Laser Surgery Helps Correct Mild to Moderate Nearsightedness - in a Flash

By Walek, Gordon | Daily Herald (Arlington Heights, IL), May 6, 1996 | Go to article overview

Kiss Those Glasses Goodbye New Laser Surgery Helps Correct Mild to Moderate Nearsightedness - in a Flash


Walek, Gordon, Daily Herald (Arlington Heights, IL)


Byline: Gordon Walek Daily Herald Staff Writer

For the 60 million nearsighted people in the U.S. who can't see their alarm clocks without groping for spectacles, the TV advertisements suggest a dream come true. Stop by the XXX Vision Center, shine a laser beam in your eye for between 15 and 40 seconds and, presto, kiss the glasses and contact lenses goodbye.

It's quick, it's clean, it's simple. It's photorefractive keratectomy (PRK). Depending on who you talk to, the procedure is at best the beginning of a revolution in the eye-care industry and at worst a promising new development.

Heretofore, nearsighted people impatient with glasses or contacts relied on surgery, usually radial keratotomy (RK), to correct their vision. Surgeons made a few slits in the side of the cornea (the clear window on the front of the eye) to flatten it to the desired correction so the eye could focus properly.

This procedure worked well, by most accounts, though some patients experienced a gradual shift toward farsightedness, or hyperopic creep (no, it's not a nerd, it's a condition). Other potential patients took a pass because they didn't like the idea of scalpels in their eyes or feared, with reason, that the surgery would weaken their cornea.

But last fall, after reviewing several years' worth of clinical studies, the Food & Drug Administration approved the use of excimer lasers to treat mild to moderate myopia (nearsightedness). Instead of slitting the sides of the cornea, as in RK, the laser vaporizes a microscopic layer at the center of the cornea, resulting in the desired flatness.

Currently, two companies, Summit and VISX, have received FDA approval for their lasers.

The findings of clinical studies (for the Summit excimer laser, approved last October) in the U.S. were impressive. More than 90 percent of the treatments yielded at least 20/40 vision without correction, meaning those patients no longer needed to wear contact lenses or glasses to pass a driving test or to perform most functions in everyday life. More than 60 percent of the patients saw 20/20 or better without spectacles.

The VISX laser studies (the FDA approved VISX in March) were also excellent. Based on research here and in Europe, PRK offers permanently corrected vision.

A simple procedure

"This is a revolution in vision care," said Dr. Thomas Deutsch, medical director of the Rush Eye Laser Centers-Summit Vision Centers in Schaumburg and Vernon Hills, which recently opened to perform PRK. "This has none of the disadvantages of RK and all of the advantages of laser surgery."

The procedure looks simple enough. After undergoing a thorough eye exam, the patient receives drops to numb the eye. The ophthalmologist then applies a device to keep the eye open and positions the patient on a reclining chair beneath the laser machine. The epithelium, the skin covering the cornea, is peeled off. Depending on the degree of correction necessary, the laser light pulses are administered for between 15 and 40 seconds.

The most difficult task for the patient, who is fully conscious during the procedure, is to keep the eye still by focusing on a fixed green light in a microscope. A computer that operates the laser, using data from the aforementioned eye exam, does nearly everything else.

The laser beam is invisible, but the laser machinery makes a peculiar rumbling sound, as though it is generating lots of energy. When the beam hits the cornea, there are a series of small explosions, complete with puffs of smoke. The smell, says Dr. Robert Mack, staff ophthalmologist at Rush's Schaumburg center, is like burning hair. Patients, though, say they don't feel a thing.

"Ten seconds after leaving the table, I could tell my vision was better," said Charles Leffler, 50, an Arlington Heights resident who had the laser surgery on both eyes earlier this year. The only side effect, he says, is that at night he sometimes has slight double vision in one eye. …

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