Medicine: Shaping Up the Blurry Eye

• Share

(2 of 2)

A still newer and more controversial corneal operation was developed by Soviet Ophthalmologist Svyatoslav Fyodorov. In 1973 he examined a nearsighted 16-year-old youth whose glasses had been smashed in a fight. The shards had cut the cornea of one eye. Three days later the boy could see perfectly out of the eye—without glasses. The injury had inadvertently flattened the cornea.

In the operation that was inspired by the accident, a procedure called radial keratotomy (a cut or slice into the cornea), the surgeon makes 16 or so incisions into the cornea. The cuts, varying in length and depth, extend from the outer edge of the cornea toward the center like spokes of a wheel. The internal eye pressure will stretch the nicked regions, thus flattening the center of the cornea.

Fyodorov and his colleagues have performed more than 2,000 "radial ks" with, they claim, most of the cases improving to at least 20/25 vision. So far, about 2,000 operations (average cost: $1,000) have been done in the U.S., but the procedure, which takes between 15 and 45 minutes and can be performed under local anesthesia, is so simple its popularity is increasing among doctors and patients alike. Some people, like pilots, policemen and firemen, are clamoring for the surgery to pass required visual tests. Others are seeking it for reasons of vanity.

Nonetheless, many ophthalmologists believe the enthusiasm is premature. Aside from Fyodorov's claims, which some Americans find suspect, there is little solid information on long-term benefits or problems. Though limited studies confirm that radial ks improve vision at least temporarily—although not to any great extent—many patients seem to be bothered by glare at night. Also, as much as half of the initial improvement vanishes within three months. Moreover, because the surgeon is cutting through almost nine-tenths of the cornea's thickness, there is the risk of perforation, an injury that could lead to blindness. Declaring that the operation is still experimental, an advisory body to the National Eye Institute has urged doctors to avoid this surgery until its results have been fully evaluated.

—By Anastasia Toufexis.

Reported by Adrianne Jucius/New York