THE LONG-TIME EVOLUTION OF RADIAL KERATOTOMY
An obstetrician-gynecologist practicing in Nashville, Tennessee, Jill F. Chambers, M.D., had both high myopia and astigmatism before undergoing radial keratotomy, but following the operation she reports vision improvement to 20/15.
"My vision was 20/200 preoperatively," said Dr. Chambers. "My glasses were a problem when I was performing microscopic surgery or using a laparoscope. (A laparoscope is a surgical instrument comprising an illuminated viewing tube that is inserted through the abdominal wall to enable the surgeon to view the organs in the abdomen.) The obstetrician-gynecologist recalled that she could not tolerate hard or soft contact lenses, and skin lesions were forming under the rims of her heavy glasses.
"It was a big decision to let someone operate on my eyes for an investigational operation," Dr. Chambers admitted. "I really had it with corrective lenses, though. I felt that I had tried every kind of contact lens made. One thing that appealed to me was learning that the operation came about from the observation that trauma to the eye that flattened the cornea could reduce nearsightedness."
Dr. Chambers first read of surgical correction for myopia and astigmatism in newspapers and then asked for more information from Spencer P. Thornton, M.D., her Nashville ophthalmologist. "Dr. Thornton gave me information on the operation," she said, "and also allowed me to watch him perform the surgery."
Eight-incision radial keratotomy was done on her left eye in August 1982 and on her right eye in October 1982. "I was pregnant at the time, so I did not allow Dr. Thornton to use any sedation, just local anesthesia," she noted. During the eight weeks between the procedures, she unsuccessfully tried wearing glasses with a piano (flat and uncorrected) lens over the operated eye.
"I had my surgery on a Friday; I went back to work on Monday; and I was performing surgery the following Wednesday," said Dr. Chambers. During this period, she did have some eyestrain and headaches, "but not enough to keep me from working." However, with only one corrected eye, she found she could not read. These difficulties were eliminated when the second eye was operated on. Glare and photosensitivity were minor problems while the incisions healed, she pointed out, but these resolved within a few weeks after surgery. "My vision is now 20/15 in both eyes, with no astigmatism."
Postoperative results have been especially gratifying for Dr. Chambers, in part because her astigmatism has been completely corrected. "I see details now that I had never seen with contact lenses or eyeglasses. I had never seen each leaf on a tree before, for instance," she said. Surgery has also become easier for her to accomplish for her patients. "I am able to perform more detailed surgical techniques because my astigmatism is corrected. I would recommend the procedure almost without reservation."
In fact, she did recommend RK to a colleague and he had it done. Dr. Spencer Thornton also performed radial keratotomy for the second physician, John Witherspoon, M.D., an otolaryngologist in private practice, also in Nashville, Tennessee. Vision for Dr. Witherspoon was about 20/400 before RK, and he mentioned that he had worn eyeglasses since early childhood.
Originally, this ear and throat specialist heard about RK at an outpatient surgery clinic where he performed surgery in his specialty. He then talked to Dr. Chambers, who told him of her successful experiences with undergoing the eye correction. Dr. Thornton performed eight-incision RK on Dr. Witherspoon's left eye in March 1983 and on the right eye in May 1983. "My vision is about 20/20 in the left eye," he reported. "My right eye was recently tested, and the vision is now fairly close to that in the other eye." No problems with excessive glare or fluctuation were evident, he said.
Both Dr. Chambers and Dr. Witherspoon, as knowledgeable patient-physicians, have recommended the procedure to friends and other physicians.
*50/127/5*
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