No, it's not what you think. It really was…MY visit to the
eye doctor's. Actually I was more of an observer, as Dr. Kaufman
(a friend and colleague) and I visited the offices of Dr. Stephen
Slade and Dr. Richard Baker. They were opening a new office near
the Summit in Houston. Dr. Slade has been one of the leading corneal
surgeons in the country for years and Dr. Baker, an optometrist
and associate for as many years, is one of the most knowledgeable
surgical co-management doctors in the country. The division of
"duties" in this optometrist-ophthalmologist setting
allows each doctor to perform at his highest level of skill, and
most importantly, allows for the most thorough patient care available
today. I am pleased to be associated with such a fine surgical
center.
One of the more striking and unique concepts of their new office
is the "Laser Theater". An appropriate term, theater,
as you immediately notice the large TV that is positioned just
above the patient's head and in easy view of the reception area.
You may WATCH the entire laser-surgical procedure through a glass
partition! This glassed-in arena seems to say: "watch how
simple this procedure is, and how confident we are in the results".
Both Dr. Slade and Dr. Baker commented on the significant improvements
in the second generation lasers. The excimer laser manufactured
by Summit Technologies and approved by the FDA just last October,
is a first generation excimer. The improvements seen in the 2nd
and 3rd generation lasers have allowed for more precision
in the result and more predictable healing. Dr Slade's 2nd
generation, Chiron excimer laser can treat patients with higher
degrees of astigmatism and myopia (nearsightedness) without the
"haze" problem characteristic of the first excimers.
The Laser Center will soon acquire a 3rd generation
laser that promises even more precision.
During my visit to the Center, a referring doctor had made arrangements
to be present during his patients' surgery. The pre-op and post-op
care is performed by the referring doctor, so the onsite observation
of the actual laser treatment on his patients is very useful,
and also encouraged by The Laser Center. His three patients were
there to have their "other" eyes treated, having had
their first eyes "zapped" about 2-3 weeks ago. The particular
procedure that drew most of my interest was one called LASIK,
which is an acronym for "laser in-situ keratomileusis",
or "laser intrastromal keratomileusis". Affectionately
called "Flap-N-Zap", this technique involves a precision
cutting device that is used to temporarily remove the top layer
of the cornea, exposing the deeper "stromal" layer.
That's the flap. Now the laser goes to work and "reshapes"
the curvature of the cornea based on computer calculations. That's
the zap. The flap is then repositioned over the zapped area and
within minutes you have a nearly normal looking, "quiet"
eye. There are no sutures or pressure patches used after the procedure,
just a clear shield to protect the eye for a day or so, or nightly
for a week. The patient is sitting up and ready to go home within
20 minutes.
I guess you can tell that I was impressed by "my visit to
the eye doctor". So much, in fact, that I went back earlier
this week for another "performance". As with ANY surgical
procedure, there are some risks, and realistic patient expectations
are vital to a successful outcome. I will discuss some of these
risks as well as the role of your primary care optometrist in
surgical co-management, in another column.