(RK)
One of the major developments in the
medical treatment of poor sight over the last
twenty years has been surgical modification of
the cornea - radial keratotomy.
Originally developed in the USSR, this has been
hailed as a miracle operation, enabling the
normalisation of sight in a few minutes of
surgery.
The technique involves making small incisions in
the cornea, in a radial pattern, which cause it
to flatten slightly under the influence of normal
intra-ocular pressure: hence it has application
mainly to myopia and, to a lesser degree, to
astigmatism.
Photo-refractive Keratectomy
(PRK)
This more recent development uses
computer guided surgical lasers to actually
reshape the cornea, in a process akin to
sandblasting (photoablation). Although more
limited in scope (less good with astigmatism and
suitable for a smaller range of myopic errors)
this has held out the promise of quicker and more
accurate treatment and with fewer complications.
It has also gained greatly in catching the public
imagination from the sex appeal value of the word
laser (have your eyes fixed by James Bond). At
the present time there are a number of clinics
offering one, or both or these techniques.
RS seems to appeal to people who dislike
wearing glasses &c but lack the motivation to
do personal work on their vision. The reasons
given for preferring RS to, say a course of Bates
lessons are generally:
· Bates lessons are expensive
· Bates teachers do not guarantee results
· Bates work demands a certain personal
commitment, practice and so on.
On the other hand:
· RS, although quite expensive, is a 'one off
investment'
· RS is considered to promise a more reliable
outcome
· RS is 'done for you' and does not require the
same personal effort.
Let us examine these questions through the
publications of the people who use and advocate
P.R.K.
"The essential requirements of any surgical
intervention are: safety, effectiveness and
predictability." 1 Quite so.
Opticians in general are fond of reminding their
customers and potential customers of the
preciousness of sight and the need to be
responsible in the care if the eyes; indeed, one
of the standard objections to people working with
medically unqualified vision educators is that
this may, if not directly dangerous in itself,
encourage people not to look after their eyes
properly.
