February 21, 2003

University Partners with Industry to Assist Patients Injured by LASIK

Wendy Lyons Sunshine 
Special To Houston Business Journal

In the hopes of tossing away their glasses and contact lenses forever, nearly 3 million people have flocked to have LASIK and other vision-correcting procedures done since they first became available in the mid-1990s. Last year alone, over 700,000 people in the United States underwent LASIK says David Harmon, president of Market Scope, a refractive industry tracking newsletter.

While the majority of patients report a positive outcome and say they would choose LASIK again, U.S. Food and Drug Administration experts admit that up to 10 percent of patients come away from the surgery with less than satisfying results. Complications range from glare and star-bursting to profoundly fluctuating vision, multiple images, and lack of depth perception.

Working directly with both patients and the industry, the University of Houston's College of Optometry has become a key player in the nationwide effort to bring relief to these injured patients. A self-supporting research arm of the school, the Texas Eye Research and Technology Center now garners nearly a quarter of a million dollars a year for eye-related studies. Among those studies are research into rehabilitation for poor laser surgery results, and data collection for FDA approval of post-LASIK contact lenses.

Refractive surgeries such as LASIK laser-assisted in situ keratomileusis reshape the cornea to improve the focusing mechanism.

A normal eye is steepest at the center of the cornea, but refractive surgeries tend to flatten the center. After unsuccessful LASIK, contact lenses are frequently the best option, according to Jan Bergmanson, O.D., Ph.D., a professor at the College of Optometry and founder of TERTC.

"The surgically altered cornea has a different shape than a normal cornea," he says. "These patients almost invariably need gas-permeable, rigid lenses."

The stable shape of these hard lenses can mimic a normal contour for disrupted corneal surfaces, stabilizing and improving vision as a result. The difficulty, however, lies in finding a suitable lens design. Post-surgical patients have unique vision aberrations and tissue conditions that make treatment a challenge.

"If you put a standard contact lens on a surgically altered cornea, it's not going to fit very well," Bergmanson says.

He also notes that, following LASIK, a condition called "dry eyes" typically occurs due to disrupted eye lubrication nerves.

"We use some of the most recent materials that have the most favorable wetting angle and the most favorable oxygen transmission," he says. "I'm a big believer that a contact lens should have an ultraviolet radiation blocker, a filter formulated into the lens material."

The goal is to make the patients' eyes as comfortable as possible.

The steady stream of patients seeking treatment at the college's University Eye Institute helps fuel TERTC research. Bergmanson, who launched TERTC at the University of Houston in 1996, says that one study conducted with post-LASIK

patients revealed the limitations of the eye chart for identifying poor vision quality.

"People who came to see us had vision good enough to drive a car, but there were quality issues. They had shadowing and duplication of vision," he says.

Many of these patients were since treated successfully with contact lenses.

Currently in the planning stages at the research center are tests of an innovative contact lens design by Austin-based manufacturer, MetroOptics. These tests will gather data about the firm's specialized reverse geometry, rigid gas permeable lenses as part of the FDA approval process. Already prescribed to post-LASIK patients by doctors, these lenses now need FDA approval to be marketed for that specific indication. TERTC's findings will play an important role in the FDA's evaluation.

At the University Eye Institute, about six to 10 patients each month are fitted with custom contact lenses specially designed for their surgically-altered corneas.

Norman Leach, O.D., chief of the Cornea and Contact Lens Service, says, "We have a considerable bank of diagnostic lenses of different designs."

This allows doctors to demonstrate the potential for improved vision during a patient's first visit.

Some patients return for ongoing follow-up at the university, others return to their own local optometrists as far away as San Antonio and College Station who don't have the expertise to do initial fittings.

"We work out the fit, design, and power of the lenses, and when all that is done, we send the lenses to the local doctors to save the patient a trip," says Leach.

The University Eye Institute has a variety of fee reductions available to qualified patients, including a 30 percent discount for same-day payment.

"It's very cost-effective for a patient to come here," says Bergmanson. "We're one of the best-kept secrets in Texas."

Wendy Lyons Sunshine is an Arlington-based freelance writer.

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Posted by Admin at February 21, 2003 04:50 PM