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Debate rages over who can wield laser to improve your eyesight
July 31, 1996
Web posted at: 12:20 a.m. EDTFrom Correspondent Linda Ciampa
ATLANTA (CNN) -- In just a few minutes and with a few zaps of a laser, photorefractive keratectomy, or PRK, corrects nearsightedness, having better vision for close objects than distant ones.
It is a popular new surgery, and fairly lucrative. A controversy surrounds the surgery, not over whether it should be performed, but by whom.
Ophthalmologists are "eye doctors" who have earned their medical degree; optometrists are clinicians who have studied the eye in at least four years of postgraduate work. Right now, only ophthalmologists are allowed to perform the procedure.
But across the United States, optometrists are starting to push for the right to perform PRK as well.
Several optometrists in Idaho are already doing it, but five medical organizations have filed a lawsuit. They say PRK is surgery, and only medical doctors can perform surgery.
"You are cutting tissue out of the eye with a laser, just like we use lasers to cut endometriosis out of the belly of people who are sick," said Dr. George Waring, an ophthalmologist.
Furthermore, Waring says, PRK patients can see complications that a medical doctor is qualified to treat. Chris Wilkinson had an allergic reaction to eye drops after PRK.
"It was so painful that from the moment I put the drop in my eye, I had to cover my head with my coat and I couldn't stand any light," she said.
Wilkinson's ophthalmologist treated her, and today her eyes are fine.
Optometrists counter that they have the right to prescribe certain drugs in most states, and they too would have been able to handle such a complication. They also argue that PRK isn't really surgery because there is no detectable cutting involved.
If you're starting to suspect that the debate is really over money, optometrist Paul Ajamian is with you.
"I think there is an economic aspect to this issue, for sure," he said. "Optometrists over the years have expanded their scope as their training has improved ... laser is kind of the last frontier."
Reaching the last frontier isn't cheap. PRK costs about $2,000 per eye, and the newest use of the laser, known as LASIK surgery, costs about $400 more.
The surgery involves first cutting the cornea, then using the laser to reshape it; Emory University in Atlanta is one of the FDA test sites for LASIK.
Waring believes that because this is clearly surgery, when LASIK replaces PRK as the preferred way to correct nearsightedness, the debate over who should perform PRK will disappear.
Most optometrists and ophthalmologists hope that's the case, because as many point out, when it comes to eye surgery, the patient's welfare should be the only driving force.
Related story:
- PRK can improve nearsighted vision - Dec. 26, 1995
Related sites:
- PRK Today Eye Site
- Ocular Surgery News
- Journal of Refractive Surgery
- American Academy of Ophthalmology
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