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News
All-Laser Lasik Makes the CutACHES & CLAIMS
January 4, 2005 Dow Jones WebReprint Service®
All-Laser Lasik Makes the Cut
By RHONDA L. RUNDLE
Staff Reporter of THE WALL STREET JOURNAL
Teaser ads promote "all-laser Lasik" as the latest innovation in vision-correction surgery. The pitch is aimed at consumers who fear the riskiest step in the conventional Lasik procedure. But is the new technology really safer? And does it produce better vision?
Laser-assisted in situ keratomileusis, or Lasik, has a good overall safety record. But complications can arise when a surgeon cuts a flap in the cornea before reshaping the underlying tissue with laser pulses. The flap is usually created with a hand-held blade but can be made by a computer-guided laser that is different from the one used to carve the cornea. The flap-making laser costs the surgeon about $375,000, which can be more than six times the cost of the manual tool, called a microkeratome.
The pros and cons of the new laser are being debated by eye surgeons at medical meetings in the U.S. and Europe. Many prominent surgeons say they are satisfied with the microkeratome, which has a decadelong track record. They say the laser's growing popularity is driven by consumer marketing that exploits irrational patient fears of rare flap mishaps. Its use can add a couple hundred dollars or more to the per-eye cost of Lasik, which already ranges from $1,500 to $2,800, including state-of-the-art custom software.
But the new laser, sold by IntraLase Corp. is gaining converts among physicians who were naysayers as recently as a year ago. The shift comes as evidence is mounting that laser-made flaps are more precise and produce better vision—especially contrast sensitivity, a component of vision quality that isn't measured on a standard eye chart. The advantages aren't huge but are enough to sway many ophthalmologists who seek an edge for their patients.
One of the largest studies is being conducted by researchers at the Naval Medical Center in San Diego. They are exploring various technologies to identify the best Lasik treatment options for Navy pilots who perform vision-demanding feats such as landing fighter jets on aircraft carriers at night. The research is funded by the Defense Department and not by IntraLase or its paid consultants.
Preliminary results from a 199-patient Navy study showed that military personnel treated with the IntraLase laser experienced more light sensitivity and had "a scratchy feeling" in the eye on the first day after Lasik, compared with those whose flaps were created using a hand-held blade, said Steve C. Schallhorn, a Navy captain and ophthalmologist overseeing the study. But the IntraLase patients had faster visual recovery, he said.
More important, the IntraLase patients had better contrast sensitivity and acuity "at all postoperative time periods" he said. "The crispness and clarity of vision, especially at night, is a very important outcome for us," he added. The results are preliminary but if confirmed, as expected, "we will likely use IntraLase to cut flaps for our aviators."
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