Medicine: Bright Vision of the Future

A cure for myopia, lasers for cataracts, bifocal contact lenses

In his 1973 film Sleeper, Woody Allen awakens from a deep-freeze snooze and finds himself in the 22nd century, surrounded by doctors. Peering through his glasses, Allen locks eyes with a doctor who is similarly bespectacled. Svyatoslav Fyodorov, an eminent Soviet eye surgeon, saw the film while visiting New York, and was disturbed by this myopic vision of the future: "It's not logical, I thought. So I wondered how we could avoid wearing glasses." That concern led Fyodorov to develop a radical new treatment for nearsightedness called radial keratotomy, or R/K.

In San Francisco last week, the Soviet doctor, now director of the Moscow Research Institute of Eye Microsurgery, reported on his eight years of experience with R/K surgery. More than 19,000 doctors and technicians from 81 countries had gathered at a joint meeting of the International Congress of Ophthalmology and the American Academy of Ophthalmology (A.A.O.) to hear about Fyodorov's controversial technique and scores of other important innovations in eye care.

The presentation on R/K by the gregarious Fyodorov was eagerly anticipated, especially by those U.S. doctors who practice his technique in the face of skepticism from their colleagues. The procedure takes only 15 minutes. First, the patient's eyes are anesthetized with eyedrops. Next, the cornea, the clear outermost portion of the eye, is marked with six to 16 lines radiating outward from the pupil, like spokes of a wheel. Finally, careful incisions are made along each line, altering the shape of the cornea and changing the spot at which light is focused inside the eye. In nearsightedness, light is focused in front of the retina instead of on it. An R/K corrects this condition by flattening the cornea so it bends light in such a way that images are more properly focused on or near the retina.

As his audience of 500 specialists listened closely, Fyodorov, speaking in a thick Russian accent, described how his clinic does 20 to 25 operations a day. Fyodorov has performed more than 3,000. In 96% of his patients with moderate myopia, Fyodorov claimed to have improved vision to somewhere between 20/15 and 20/40, obviating the need for glasses. In patients with more severe myopia, he reported an Fyodorov 84% success rate. The surgeon declared that he had never lost an eye and had encountered complications in only three cases (two patients with excessive scarring and one with infection).

In 1976, Dr. Leo Bores, a Phoenix eye surgeon, traveled to Moscow to learn the technique. Some 400 U.S. doctors, mostly in private practice, have since been trained in R/K in two-day courses here and abroad. American surgeons have performed the procedure more than 20,000 times, charging between $1,000 and $2,000. Complications have been reported in only three U.S. cases.