Eye surgery has ‘potential,’ risks

Press, 15 July 1983, Page 4

Eye surgery has ‘potential,’ risks

Surgical techniques to improve eyesight cold be perfected within five years, says Dr Perry Binder, a prominent American eye surgeon. He is in Christchurch to attend the twenty-fifth conference of the New Zealand Contact Lens Society. Dr Binder is the director of opthalmic surgery and research at the Sharp Cabrilla Hospital in San Diego. He is also an associate clinical professor at the University of California. Although the surgical techniques had “great potential,” Dr Binder believes they should be approached critically. No patient should go straight into surgery without first having considered the options offered by contact lenses, he said. Patients should also be fully informed of the risks involved in such an operation, and should meet certain psychological and physical criteria. Two types of surgery were available, radial keratotomy and myopic keratomileusis. Under radial keratotomy, eight incisions were made in the cornea, radiating from its centre. This

changed the shape of the cornea. Myopic keratomileusis involved slicing a section off the tops of the cornea. The piece was then frozen and gradually shaved to change its shape. The curvature of the cornea was changed when the shaved section was replaced. This method carried a greater risk of the patient losing his vision and was more expensive—s3ooo to $4OOO an eye compared with $lOOO to $2OOO an eye for radial keratotomy. A few patients had lost vision under both techniques, said Dr Binder. Although both methods would improve the patient’s vision without the aid of spectacles or contact lenses, their best potential vision could be reduced. Either method could correct a defect too much or not enough. Patients could suffer from glare and feel dazzled by bright light. Radial keratotomy was the most likely method to be perfected, and become widely used round the world. It was already widely practised in Russia and the United States. Myopic keratomileusis was used

less frequently. No-one was sure what the long-term effects of such surgery would be. It had only been in use in the United States for a few years. Few, if any, such operations had been performed in New Zealand. “If New Zealand was to start off today, it would benefit from 10 major changes in the techniques,” said Dr Binder. The reason for the wide acceptance of the methods in the United States probably lay with people. “American people are very demanding. They are cosmetically aware of their surroundings and are no longer willing to just accept what God has given them. “There are also a lot of eye doctors and a lot of competition between them,” he said.

Most of the operations were performed on younger people wanting improved vision for their careers.

People aged more than 40 had a greater chance of having a successful operation. Dr Binder said the structure of the cornea became more malleable in people over 40.