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The Eyes Have It
Laser procedures change the shape of optical surgery in Connecticut
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Business New Haven
8/10/98
By: BNH
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BNH interviewed Shachar Tauber, M.D., assistant clinical professor and director of the Section of Refractive Surgery at Yale University's Department of Ophthalmology and Visual Science School of Medicine about one of the newest forms of eye surgery. Tauber is also medical Director of Yale-New Haven Eye Laser Center on Temple Street.
How does this procedure work?
Myopia [nearsightedness]occurs when the eye that is too long or the cornea is too steep, for a person to see clearly, the length or steepness needs to be changed. Since we are unable to change the length of the eye, we use the excimer laser, to shave off microscopic layers of the cornea to change the shape of the eye. There are two types of refractive surgery: photo-refractive keratectomy (PRK) and laser in-situ keratomileusis (LASIK). PRK involves changing the shape of the cornea. LASIK involves making a flap in the cornea that is returned to its natural anatomical position. The entire procedure including preparation takes about 20 minutes, while the actual surgery lasts about 15 to 20 seconds.
Who might benefit most from this procedure?
This procedure benefits a great deal of people. To give an extreme example, police officers and firefighters may lose their glasses in an emergency situation and may become a danger to themselves and others.
Are there any dangers or side effects?
Complication rates are very low. No one has gone blind from PRK in this country. Under-correction is one side effect that may occur, but the re-operation rate for this is under ten percent - I would say around six to eight percent. Over-correction is rarely seen, and scarring may be seen in PRK, but never in LASIK. There is no pain during the procedure and minimal pain in the recovery stage. PRK has varying degrees of discomfort for three or four days afterward. There is no pain after having the LASIK treatment because the eye does not realize that it has undergone surgery. People are apprehensive because the eye is a very special organ; sight is one of the most precious gifts we have been given. This procedure has been shown to be safe and effective, and the results are very impressive.
How long has this been performed and what is the interest level?
I have been involved in poover 600 procedures. There was only one active laser and one partially used laser in Connecticut two years ago. However, two more lasers have been brought in and another is coming, so the interest is growing. There was a laser available in New Britain, but very few people wanted to make that trip from Fairfield County, which is a big reason for the three new lasers being brought in. This laser was first used by IBM in the early '80s to take care of their microprocessors. Ophthalmologists looked at it and found it could be used to treat disease because it precisely sculpts the cornea. It was first used in the late 1980s, but it really got started in 1992.
How much does the procedure cost, and is it covered by insurance?
The surgery varies from $1,800 to $2,600 in CT. Very rarely is it covered by insurance because they consider it an elective procedure. We are actively involved with many companies to see if we can offer this as a vision-correction option.
What lies in the future for eye surgery?
Research and surgical techniques involved in cataract surgery and glaucoma, including new medications and detection of glaucoma, as well as the treatment of other diseases, hold great promise for the future. One up-and-coming thing is teleconferencing. This will possibly eliminate doctors overseas having to travel to other countries to learn new surgery.
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