EXPERIMENTAL LASER SURGERY HELPS PATIENTS DISCARD GLASSES

Thanks to experimental laser eye surgery Wednesday at St. Francis Medical Center, a Southern Illinois man may be able to discard his eyeglasses.

Dr. Charles H. Cozean, a Cape Girardeau ophthalmologist, used a new Eximer laser to sculpt the surface of Scott Gibbs' eye in an effort to correct his vision problems.

Cozean said Gibbs, 26, of Alto Pass, Ill., should begin seeing an improvement in his eyesight within a week and within a month should see a great change.

Only the right eye was corrected Wednesday. Cozean plans to do the laser procedure on Gibbs' other eye within six months to a year. "In the meantime, he will be wearing one contact (lens)," Cozean said.

Surgical procedures using the Eximer laser, like the one performed Wednesday, are currently under study for approval by the Federal Drug Administration.

Cozean is one of five surgeons in the United States studying the use of laser surgery to correct astigmatic eyesight.

Research surgeons must complete test cases with the Eximer laser before the procedure can be approved by the FDA for more widespread use.

"I expect, based on the other procedures we have done, that Scott will do very well. I think the chances of eliminating his need for eyeglasses are very good," said Cozean.

Cozean said that prior to the surgery Gibbs' eyesight without correction was zero. "He can't see at all without glasses."

Candidates for the laser procedure must be nearsighted and have a significant degree of astigmatism, an irregular surface of the cornea.

The Eximer laser is different than some other surgical lasers in that it uses a chemical reaction rather than heat to remove tissue. As a result, virtually no scar tissue is formed.

The entire surgery Wednesday took about 30 minutes. The laser procedure lasted just 16 seconds. Gibbs was awake during the surgery.

Prior to the surgery, Cozean and his staff had analyzed the surface of Gibbs' eye to determine precisely what changes were needed to correct his vision. That information was programmed into the laser's computer. Once the laser beam was lined up on Gibbs' eye, the laser did the work. The changes are minute.

In 16 seconds the laser changed an area of Gibbs' eye just 5.5 millimeters in diameter. Each laser pulse removed .29 microns of tissue. A micron is one-1,000th of a millimeter.

"Rather than a surgical knife, like other surgical lasers, the Eximer laser is like a lathe. It sands or lathes the tissue. The accuracy is measured in terms of microns," Cozean said.

Prior to his surgery, Gibbs talked about why he chose to be part of Cozean's FDA investigation.

"I've had to wear glasses since I was 16, and they're just about Coke-bottle size now. Just the idea of getting rid of them is reason enough to have the surgery," Gibbs said.

"I work on a towboat and sometimes the glasses get in the way. I've lost them a couple times out on the boat. They fall off and bounce into the river.

"I'm so bad off, they won't let me go out on the tow without glasses."

Gibbs decided to have the surgery because of the danger of losing his glasses while on the river, but he expects other benefits as well.

"I think this will change my life completely," he said. "I'll be able to do things I never could before because my glasses were holding me back."

For example, Gibbs said he was interested in sport shooting and hunting. "I can't hardly shoot a gun because I can't see.

"I never could be good at sports because I was all the time losing my glasses. The idea of waking up and being able to see the alarm clock is great.

"Plus, I will look a hell of a lot better without them; I call them my birth-control glasses, and they work all too well."

Gibbs said many people in his small hometown know about his surgery. "All the neighbors are asking me about it. Most of the older people are kind of curious and want to check into it also."

Cozean will closely monitor Gibbs' progress as his eyes heal.

"We have to document everything for the FDA," Cozean said. "The hard part of the procedure is the paperwork."

Cozean and each of the other researchers will conduct five test cases, a total of 25 in the United States.

Massive documents outlining research information on each case are sent to the FDA for study.

When the test cases are complete, the FDA will compile information about the procedures and decide if they are safe and can be performed in the future. Cozean expects these results in two to five years.

Cozean said he has been told the laser in Cape Girardeau is the only one outside a medical center research center.

He was selected to be a FDA researcher because of his work with astigmatism and bifocal lens implants.

"I convinced the company that the Eximer laser has great potential with the bifocals for touchups.

In fact, Cozean has used the laser already to correct an astigmatism caused by a bifocal lens implant.

Cozean added, "We are trying to involve other ophthalmologists in this new technology. They are asked to refer a patient to us and then urged to attend the surgery."

The referring physician would then be involved in follow-up.

"We want to start the long road of instruction on how to do this new procedure," said Cozean.