Letters in VIEW : Update on Radial Keratotomy

While reading "Eye Surgery Pitch--Is It Hype or Hope?" (by Allan Parachini, March 3), I only found the answer to half of that question. According to Parachini's article, radial keratotomy is an unapproved procedure being hyped shamelessly to the public.

Certainly, there is truth in the idea that some of the marketing pitches for RK go too far. Radial keratotomy is not for everyone who is nearsighted. Not every person undergoing the procedure will be able to "throw those glasses away." Frankly, however, anyone who would consider having his or her eyes operated upon based on the words in an advertisement is either crazy or foolish.

The key to ensuring the best possible experience with radial keratotomy is education--knowing what you're getting into. Patients elect to have the RK surgery and it is, therefore, the patient's ultimate responsibility to understand exactly what is involved and what can be expected, both before and after surgery.

I don't know of any ophthalmologists who would not be willing to discuss the pros and cons of RK with a potential patient. After all, it is to the physician's advantage to have a patient who has realistic expectations and will be pleased with his or her experience. Advertising and marketing may, indeed, be overwhelming the public, but in the long run it will be word-of-mouth that guarantees the public popularity of RK. Doctors know that.

Perhaps what I'm trying to tell Parachini and those who may now be concerned about radial keratotomy as a safe, effective procedure is not to worry. There are very few known risks associated with RK. For most people, the procedure is effective, and for some it is very effective. Many ophthalmologists who two years ago expressed doubts about RK are, themselves, now performing the surgery.

The guidelines for the consumer are to: (a) know your physician and his qualifications; (b) learn about the surgery; (c) ask your physician if he can refer you to patients who have already had the procedure; (d) always be suspicious when you are guaranteed perfect results; (e) don't believe everything you read.

DOUGLAS L. STEEL MD, F.A.C.S.

Ophthalmologist

Los Angeles

As a public-relations practitioner, I was bothered by the implication that the public-relations account executive was at fault for making overzealous claims about radial keratotomy. Unless this situation is highly unusual, it was her client, the ophthalmologist, who initiated the campaign on his own behalf and supplied the information to the public-relations firm. Dr. Paul First and all the other ophthalmologists who are aggressively marketing this eye surgery are responsible for their own actions.

CAROL BROMBERG

Santa Monica

The overall tone of the article conveyed concern about the increased use of marketing in medicine, and restraint in the widespread use of radial keratotomy to correct nearsightedness. However, the article misses the mark on both points.

First, marketing will continue to play an increasingly important role in the rapidly changing face of medicine. This has been legislated by the Congress, and upheld by the courts. Health care is a consumer item, and while a trusting, one-on-one relationship with a physician will remain important, marketing, used properly and professionally, will provide a patient with much information and education formerly obtained through the doctor.

Secondly, while not all nearsighted people are candidates for RK, 80% of the myopic population is, and 90% of those who have the surgery will experience clear vision without glasses or contact lenses, a freedom previously unavailable to them. Perhaps had Parachini interviewed any of the 100,000 people who had RK this past year, he and your readers would learn the impact this surgery had on their lives. Those of us with clear vision take for granted our ability to ski, snorkel, play tennis, watch a movie, drive, or apply makeup with ease. RK gives nearsighted people opportunities to participate in activities, freeing them from dependency on glasses or contact lenses. And yes, I do believe it is not incorrect to say that in many cases, RK "cures" myopia, by altering the focus of light rays.

Whether or not the three reluctant physicians like it, RK is here to stay. I predict that within five years, because of its safety, simplicity, and effectiveness, it will become one of the most commonly performed operations in all of medicine.

ALBERT S. LEVEILLE MD

Los Angeles

I read with dismay the article about radial keratotomy and feel that it is not the whole picture. The article is about two different things, which have no relation to each other. Either you are going to discuss advertising for this operation or whether the operation works. I am in the midst of having it done, one eye has been operated on and when the waiting period is over, the next one will be done. I am thrilled beyond belief--for the first time in more than 40 years, I can see distances without glasses or contacts. I can drive with my good eye now, whereas before I couldn't even see the large E on the charts--much less tell you what it was.

If airline pilots, firemen, etc. are worthy of the operation, why not anyone who doesn't want to wear glasses all the time? I am not having this radial keratotomy for any other reason except that I want it done. The fact that this operation exists, has been infinitely successful, and that it's available to me or just about anyone who wants it--well, those facts were enough for me to find out about it, find a doctor I could trust and have it done.

Myopia isn't any fun. It seems the people who are against this operation don't have myopia and so they think glasses are OK. But knowing this exists, how could anyone not want it, anyone who has had to wear glasses or contacts for most of his life? I never dreamt that in my lifetime I would be able to see distances without glasses. I only wish it happened when I was younger, though now I plan to take up scuba diving, wind surfing and snorkeling--plus I bet my tennis game will improve.

JEAN GENTRY

Oxnard

The article on eye surgery in the View Section of the Sunday edition by Allan Parachini was outstanding. As an ophthalmologist with many years of private practice and several years of teaching at USC, I can truly appreciate the thoroughness and evenhandedness of the writer. He selected experts to interview who really represented all viewpoints.

Articles such as this are extremely beneficial to the public's need, particularly in view of the great amount of marketing of myopic surgery. It is indeed rare for the layperson to have the opportunity to read such well presented material.

ARTHUR E. OBERMAN MD

Whittier

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