Sentinel - July 11, 1996

The cutting-edge procedure. which doctors say is painless, is offered in Somerset for $2,250 per eye.

   And with a 98 percent success rate, doctors rave that the procedure can alter a person's lifestyle.

   "For some, this is very dramatic." said Dr. Richard Witlin, who performs the procedure at the 20/20 Laser Services Clinic. "Their whole personality changes. You can really improve someone's quality of life."

   But Witlin, who runs a private practice in the Iselin section of Woodbridge, said he does not recommend the laser surgery to all his patients.

   "To have this, I have to have a patient who does not want to wear contact lenses or glasses," he said. "A lot of people just want to get up in the morning and see, and it is very gratifying as a doctor to do this."

   There are more practical reasons, too, Witlin added. Firemen. for instance, can't wear contacts because of smoke. And glasses can get in the way for athletes, such as swimmers or water skiers.

   Sayreville resident Paul Mikolas, a corrections officer at the Middlesex County Corrections Center, North Brunswick, had the procedure done on his left eye.

   "I've been wearing glasses for 40 years. and now it's time to get rid of them," the 49-year-old Coolidge Avenue resident said.

   He said the entire procedure -- during which the patient is conscious, but given a local anesthesia -- lasted a half-hour. and he reported no pain or discomfort.

   "I noticed as soon as I sat up. I could see faces of people in the room," said Mikolas. who never was able to wear contact lenses comfortably.

   A day later. he said he was reading road signs and was able to watch television without his glasses.

   Dr. John Kung, a corneal specialist at Columbia University and a private practitioner in Perth Amboy, conducted Mikolas' surgery.

   "He couldn't read the big E on the chart before (the surgery)," Kung said about Mikolas. "Two days after the procedure. he can read the middle letters on the chart."

   Doctors report patients generally feel some pain the first night after the procedure. Patients are prescribed eye drops and pain pills, and they also wear a soft contact lens that acts as a bandage over the surface of their eyes.

   A study has shown that 66 percent of patients come out of the procedure with 20/20 vision and 98 percent were 20/40 or better, according to Witlin. who is medical director at 20/20 Laser Services.

   In New Jersey, you have to have 20/50 vision to drive without glasses or contact lenses.

   Though the procedure has been available for several years in Canada and countries in Europe and Asia. it was first approved by the FDA in October.

   The sheer expense or the procedure -- it isn't covered by insurance and the technology costs $600.000 to acquire and $50,000 a year to maintain -- makes it difficult for a private practice to operate.

   There are clinics, like 20/20 in Somerset, however, that purchase the technology, and lease it to doctors.

   Of the $2,250 fee, $1.000 goes to the clinic, $1.000 goes to the doctor and a $250 "royalty fee" goes to the company that created the technology, according to Witlin.

   Doctors enter exclusive contracts, and they, agree to use 20/20 Laser Clinic when they use the procedure, according to Joshua Peck, a publicist for the clinic.

   "The center charges a facility charge like a hospital does," Witlin said. There have already been about 50 operations done at the clinic, he added. 

   Witlin said he thinks the number will compound due to word of mouth, but he does not foresee the procedure replacing contact lenses and glasses.

   "Most patients will see with eyeglasses because they are either afraid of surgery or because of the cost," Witlin said. "I wouldn't worry that the Pearle Visions are going to go out of business. Some of them are getting into the laser business because they want to cover the bases and get in on both ends."

   The FDA, which has been studying research and results for years. approved the procedure, but only for certain degrees of myopia or nearsightedness. Extreme cases of nearsightedness, for example, cannot be corrected by the laser at this time, doctors said.

   In the procedure, the laser reshapes the cornea and refocuses the power of the eye, Witlin said. The results of the surgery "should last forever," but this does not prevent the patient from contracting other eye diseases such as presbyopia, which affects the ability to focus and could require the need for reading glasses, Witlin added.

   "When you get older, you may or may not need glasses for reading," he said.

   Also, the surgery is not free of hazards.

   "The complication rate is not zero," said Witlin, who noted that the possibility of scarring or infection exists in any laser procedure. "It's minute. When you get on an airplane, can a pilot promise you that nothing will go wrong? Once in a while, something happens."

   The New Jersey Optometric Association has given cautious support to the procedure.

   "The association has not passed a resolution one way or another," said David Grimm. the association's executive director. "Has there been an indication in the literature of significant problems? No. But what are the long-term effects of a new procedure?"

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