AK>From: ifaq…@ccwf.cc.utexas.edu (Allen Kitchen)
AK> What I know about laser surgery…
AK>The excimer laser is a moderate powered laser that makes much more
AK>precise
AK>incisions than a scalple. By varying the power and length of time on a
AK>point,
AK>you can vary the depth of the cut very accurately. Also because of the
AK>speed
AK>in which such work can be done and the precision of the laser, many
AK>more
AK>adjustment can be made to the lens, which produces more improvements to
AK>vision. The type of laser would be helpful to know, but I speculate it
AK>is
AK>probably the usual Argon or Krypton lasers. The Krypton a friend of
AK>mine
AK>uses for laser shows can be gentle enough to be barely visible, but
AK>powerful
AK>enough to light a cigarette in the audience ( Frightening, by the way
AK>).
I wish that the above was true re the EXCIMER laser and corneal ablation but
the actuality is somewhat less than the theory. Medicine is not practiced by
wish fulfillment.
Leo Bores, M.D.
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GM>From: gmann…@dale.cts.com (Gary Manning)
GM>I am entering the final phase of my Radial Kerotatomy vision correction
GM>procedure. Currently my vision is holding at about 20/60, up from
GM>20/400.
GM>There are two options to fine tune further correction: a few more
GM>incisions,
GM>or using a laser. My surgeon is recommending the laser. If it
GM>matters, my
GM>last surgery was July 90.
GM>I have complete confidence in the RK incision method, but I don’t know
GM>anything
GM>about the laser treatment. I think it is an "exemer" (sp?) laser. It
GM>must be
GM>new, since he is waiting for the "approval" to perform it (2 to 3
GM>months,
GM>he
GM>says). He has been doing RK since it was brought here from Russia.
I’m the doctor who brought the surgery here from Russia and you’re not in my
list of patients. Perhaps your doctor means that he’s been doing it shortly
after it was introduced by me in 1978. Considering that neither Fyodorov nor I
taught this surgery to anyone else until 1979 (and then only 5 guys) – it’s
not likely that he started until we gave our first course in 1980.
The use of the laser to "touch up" RK is certainly an intriquing notion and
has been done. I share your misgivings about it though and for good reason.
Firstly – if your residual myopia is greater than -5 diopters – the laser will
not get it all. Secondly if you residual is less than -5 diopters, it’s
possible that additional incisions or re-cutting of the old (using the
original Russian technique) AFTER 6 months could do the trick. The laser cuts
across the center of vision and leaves you with a corneal haze that takes
months to clear. I’d think about it.
Leo Bores, M.D.
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