In the news:

PRK Versus Thin-Flap LASIK

Investigators enrolled 50 patients (100 eyes) at two sites for this contralateral eye pilot study. Their aim was to determine the differences in the visual results, pain response, biomechanical effect, quality of vision and higher-order aberrations, among other parameters, in eyes undergoing either photorefractive keratectomy (PRK) or thin-flap LASIK/sub-Bowman keratomileusis (SBK; intended flap thickness of ±100 µm and 8.5-mm diameter) at 1, 3 and 6 months after surgery.

The mean preoperative spherical refraction was -3.66D and the mean cylinder was -0.66D for all eyes. Eyes in the PRK group underwent 8.5-mm ethanol-assisted PRK, whereas in eyes in the SBK group, an 8.5-mm (intended) 100-µm flap was created with a 60-kHz femtosecond laser. Additionally, all eyes underwent a customized laser ablation using an excimer laser. Main outcome measures were preoperative and postoperative tests that included best spectacle-corrected visual acuity, uncorrected visual acuity (UCVA), corneal topography, wavefront aberrometry, retinal image quality and contrast sensitivity. At each visit, patients completed subjective questionnaires.

According to investigators, 1- and 3-month UCVA results showed a statistically sig nificant difference: SBK, 88% 20/20 or better vs. 48% 20/20 or better for PRK. At 6 months, UCVA was 94% 20/20 or better for PRK and 92% for SBK. They also found that at 1 and 3 months, the SBK group had lower higher-order aberrations (coma and spherical aberration; p≤0.50), but noted no statistically significant difference at 1, 3 and 6 months in spherical aberration and vertical and horizontal coma between the two groups.

 

Vast majority of patients who undergo LASIK appear satisfied with results, research suggests.

MedPage Today (4/2, Smith) reported that, according to a study published in the April issue of the journal Ophthalmology, 95.4 percent of patients who undergo laser-assisted in situ keratomileusis (LASIK) "eye surgery are happy with the results." For the study, researchers from the Medical University of South Carolina "researchers reviewed published articles covering procedures performed between 1995 and 2003," 19 of which "reported on patient satisfaction." The investigators found that p atient-satisfaction rates "ranged from 87.2...to 100 percent." The majority of the studies "focused on treatment of myopia, and in those, 1,811 of 1,901 patients (93.5 percent) said they were satisfied. In studies of treatment for hyperopia, 286 of 297 patients (96.3 percent) said they were happy with the results." Among "the most common reasons for dissatisfaction were residual refractive error, dry eyes, older age, or night-vision symptoms, such as halo or glare." The authors concluded, "LASIK has provided consistently high rates of patient satisfaction, regardless of when the surgery was performed."

 

 

Vigorous exercise may help prevent AMD, cataracts, studies suggest.

Writing in the Los Angeles Times (2/10) Booster Shots blog, Jeannine Stein observed that, according to two studies published in the Jan. issue of Investigative Ophthalmology & Visual Science, "vigorous exercise...may help prevent age-related macular degeneration (AMD) and cataracts." Both "studies looked at data from almost eight years of follow-up from the National Runners' Health Study. In one, 110 men and 42 women received a clinical diagnosis of" AMD "during the follow-up." But, "running an average of two to four kilometers a day reduced the risk by 19 percent, and running more than four kilometers per day reduced the risk by 42...to 54 percent, compared with those who ran less than two kilometers a day." The second study found that men who "ran 64 or more kilometers a week had a 35 percent lower cataract risk than those who ran less than 16 kilometers per week," and "those with better cardiovascular fitness w ere also at less risk than men who were less fit."

 


Dr. Den Beste loves his baseball team !!!

 

Coach Den Beste and his son Reid pictured on the far right.

 

 

Lasik Patients Satisfied Despite Concerns

FDA hears surprising data on Lasik patient quality of life.

 
WASHINGTON, DC- April 25, 2008 - More than 99% of patients report their quality of life after laser vision correction surgery is as they had expected or better, even though 2% report complications that are frequently or always problematic, according to a national patient survey conducted by the nonprofit Council or Refractive Surgery Quality Assurance (USAEyes, http://www.USAEyes.org). Preliminary results of the USAEyes Competence Opinion Relative to Expectation (CORE) patient survey are being presented to the US Food and Drug Administration during a special hearing today.
 
"The USAEyes CORE survey is designed to determine if patients are getting what they expect from Lasik and similar eye surgery," says Glenn Hagele, Executive Director of the nonprofit patient advocacy that conducted the study. "Relevant questions ask if the patient's results were 'as expected', or degrees of 'better than expected' or 'worse than expected'." The survey is used to screen Lasik doctors for certification by USAEyes.
 
The survey was mailed to 1,800 vision correction surgery patients of six doctors throughout the US, with a 31% response rate.
 
"It is not surprising that the vast majority of Lasik patients are satisfied with their results, but what was unexpected was that many would have the surgery again despite reporting complications," reports Hagele.
 
Of those who reported complications that were "seldom problematic", 91% would have the surgery again. A surprising 22% of patients who reported complications that were "frequently" or "always" problematic would have the surgery again, according to patients who responded to the survey. "Clearly some patients find the convenience of a reduced need for glasses and contacts worth occasional problems," says Hagele.
 
Additional results of the USAEyes CORE patient survey:
  • 99% report quality of life as expected, better, or much better after vision correction surgery
  • 98% state day vision as expected, better, or much better
  • 98% report no complications or complications that are seldom problematic
  • 98% would recommend surgery to family and friends.
  • 97% would have surgery again, knowing what they know now
  • 96% wear corrective lenses as often as expected, less than expected, or much less than expected
  • 96% report postop vision without lenses as expected, better, or much better than expected when compared to preop vision with lenses
  • 96% report overall quality of vision as expected, better, or much better than expected
  • 91% report no complications at any time
  • 91% state night vision as expected, better, or much better than expected
  • 7% report complications seldom problematic, however 91% of these same patients would have surgery again
  • 2% report complications frequent or always problematic, however 22% of these same patients would have surgery again

Research explores visual impairments in elderly drivers.

Canada's Gazette (7/7, Derfel) reported that "[e]lderly motorists with cataracts are 2.5 times more likely to cause a car crash than seniors whose eyesight is not impaired," according to a study presented on Monday at the International Conference on Low Vision. Cynthia Owsley, Ph.D., of Alabama's University of Birmingham, and colleagues, found that "when drivers with cataracts have them surgically removed, they no longer pose an increased risk."

Therefore, "Owsley recommended that ophthalmologists and optometrists start taking a more aggressive approach in referring elderly patients for cataract surgery." At the same conference, researchers from the Schepens Eye Research Institute at Harvard Medical School "revealed that some elderly drivers who are visually impaired continue to drive, even though they wouldn't pass an eye exam."

The Harvard study indicated that "24 percent of people with age-related macular degeneration...continue to drive. Out of that number, 77 percent would not meet vision requirements to drive."

Eye experts stress importance of consumer research before undergoing LASIK.

In continuing coverage from previous editions of First Look, California's Alameda Times-Star (7/8, Morrill) reports that while the majority of patients who undergo laser-assisted in situ keratomileusis (LASIK) surgery are pleased with the outcome, "still a small percentage...are less than satisfied." Approximately "five percent of them have unsatisfactory results," and "about one percent, or less, have serious consequences, such as loss of vision.

More common risks include dry eye and a halo effect." Therefore, "credible eye doctors advise the importance of doing thorough research and talking to several doctors before" undergoing "any kind of eye procedures." Eye experts point out that not all patients are good candidates for the procedure. Some even "worry that patients who don't really need the corrections are being steered in a direction they don't need to go."