The idea started out as an accident.
In 1972, a young boy fell off his bicycle in Moscow and
cut his eye with the broken glass from his lenses. The cuts were radial,
like the spokes of a bicycle wheel. A Russian doctor named Svyatoslav
Fyodorov found that the boy could now see without his glasses. Fyodorov
went on to develop a technique of making four to eight incisions in the
cornea (the transparent part at the front of the eyeball) with a
diamond-tipped blade -known as the radial keratotomy operation. Just
like the broken glass in the Moscow boy's bicycle accident, these
incisions caused the steeply sloping cornea of the shortsighted person
to flatten, and the patient's vision would improve.
This operation was first performed in Montreal Canada at
St. Mary's Hospital in 1979 by Dr. Kwitko after studying with Dr
Fyodorov.
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Approval Status of the Excimer Laser
in
Canada and the United States
CANADA
The Department of Health and Welfare regards the use of the excimer laser in
photorefractive surgery as an experimental device but has permitted unlimited
utilization in treatment of myopia. Unlike the United States there is no limit
on the degree of myopia treated. Myopic patients with refractions of -20.00
diopters have been successfully treated at the University of Ottawa Eye
Institute and across the country. In the United States approval has only
recently been given (see below) for myopes up to -7.00 diopters.
The University of Ottawa Eye Institute has completed the first trial of the
VISX STAR for hyperopia from +1.00 to +4.00 Diopters. The results have been
excellent with stability now to 12 months. Additional studies are in progress.
Based on these results, hyperopia on the VISX laser was released internationally
in July 1996.
UNITED STATES OF AMERICA
Only recently has approval been given for photorefractive surgery in the
United States. Prior to this approval each site was limited to 50 patients per
laser. This restriction did not apply to Canadian physicians in Canada, some of
whom have now performed thousands of laser procedures with this new technology.
The approval of excimer laser photorefractive surgery in the U.S. applies
only to the Summit laser and the VISX laser system. The FDA approved the laser
for treatment of mild and moderate myopia on October 20, 1995. The FDA however
has set some limits on the technical components of the procedure until further
data can be collected. No such treatment restrictions exit in Canada.
The laser can only be used in the United States on myopes requiring -1.0 to
-7.00 Diopters of myopic correction with less than 1.5 Diopters of astigmatism.
Those American patients that fall outside the parameters limiting the use of
the excimer laser in United States can seek treatment at a Canadian site.
Link
to FDA laser
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