Published in The Islander
July 16, 1991
Contact: Michele Hay
The Eye Clinic of Texas

60 Patients Prepare For New Surgery – Excimer Laser Corrects Poor Vision
by Joel Kirkpatrick

Star Wars surgery, using “cool” laser beams and microscopes, may provide light for poor eyes in Galveston.

The surgery, called photorefractive keratectomy (PRK), will be performed on 60 Galveston area patients during the month of July, using a new excimer laser at St. Mary’s hospital purchased by a grant of $289,000 by the Moody Foundation of Galveston.

What the surgery does is provide patients another way to see without wearing glasses or contact lenses.

For now, the patients, part of a nationwide study being conducted at 20 sites in the United States, can only have nearsightedness corrected by the procedure. But surgeons who have already done it say it can be modified to treat farsightedness and astigmatism as well.

Dr. Bernie Milstein of Galveston, and Dr. Daniel Gold, will be performing the surgery.

There were 30 patients undergoing baseline preparatory studies for the surgery Friday at Milstein’s clinic at 2302 Avenue P, Galveston.

Those will report for the laser surgery on July 9. Another group will get the procedure on July 23.

Milstein said laser surgery currently in use uses photorefractive, acoustic, and chemical means to remove tissue.

In excimer laser surgery, the laser is a computer-controlled “cool” laser beam which emits short, high energy pulses to vaporize microscopically thin sections of the eye’s cornea, the clear tissue covering the eye’s pupil.

The pulses of cool ultraviolet radiation breaks the chemical bond between molecules, without harming adjacent tissues.

The procedure at St. Mary’s hospital will be performed using a local anesthetic.

Milstein said the procedure is far more sophisticated and offers far more promise than the procedure called Radial Keratotomy (RK), first attempted in Japan and refined in the Soviet Union during the 1970′s. The new procedure is being used on patients who do not have extreme myopia (nearsightedness). In some earlier uses, patients achieved 20/20 vision.

Dr. Milstein said the reason it is not being used with extreme myopia is because extensive removal of tissue might induce scarring in a more aggressive healing of tissue.

The patients who go to St. Mary’s Hospital will be given a topical anesthetic, then their eyes will be held open while the procedure, which takes about 10 minutes, is performed.

The patient wears an eye patch for several days after the surgery, then must use eye drops for two to three months until the eye is completely healed.

The Moody Ophthalmic Laser Center at St. Mary’s was chosen by the U.S. Food and Drug Administration to participate in the clinical studies program involving the excimer laser. The idea was to study its application for both glaucoma and refractive surgery patients.

Members of the Moody Ophthalmic Laser Center team, in addition to Milstein and Gold, are Dr. Allan H. Fradkin, and Dr. Thomas Schwartz, all ophthalmologists. Milstein is director of the center.

What ophthalmic lasers do is convert a powerful electrical current passing through a tube into a narrow light beam. The specific wavelength of the light determines whether the laser will be used to produce coagulation with heat, cutting, or dissolution of tissue.

The wavelength of the laser is determined by the contents of the tube the light passes through. A gas like argon, krypton, or argon fluoride, or a solid material like neodymium in the YAG laser, produces a specific wavelength.

Lasers, like those used at the Moody Ophthalmic Laser Center at St. Mary’s Hospital, are truly a light for sore eyes.

They can be used to smooth out superficial abnormalities of the cornea. They can remove calcium deposits from the eye, and polish the eye’s surface after the surgical removal of wedge-shaped growths called pterygiums.

Even glaucoma patients benefit from the lasers. There is a procedure called a partial excimer trabeculectomy which reduces pressures in the eye through formation of a partial window allowing excess fluid to escape from the eye.

Truly, the new laser procedure will give many a new outlook on life.

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