A Review of the History of Customized Corneal Ablation Custom LASIK

With the recent announcement by Technolas Perfect Vision of the FDA approval of its iris-tracking laser to improve LASIK outcomes, it reminded me that I was among the first to report on customized ablation (or Wavefront Driven LASIK), from its birth at the 1998 AAO Meeting, and subsequent blossoming at the 1999 ASCRS Meeting.

I was also the first to write about LASEK, the technique of pushing aside the epithelium and performing PRK on the surface of the cornea – as opposed to first making a flap with a microkeratome or laser, and then zapping the cornea to reshape it.

Here, in chronological order, is a series of writeups on these techniques that were first published in Ocular Surgery News, under my “Technology Update” byline:

1. I’ve Seen the Future....and its Custom Cornea, OSN, June 15, 1999.

I first learned about custom ablation at the 1998 AAO meeting, but it was at the 1999 ASCRS meeting that I came to realize that it was the future of refractive surgery.

2. Customized Ablation: the Future is Close, OSN, February 15, 2000.

Here is my report on my first encounter with wavefront and ray tracing diagnostics as a pre-cursor to customized ablation.

3. Customized Ablation: Getting Closer Yet, OSN, August 1, 2000.

At the 2000 ASCRS meeting I learned first-hand of the early results on the initial human clinical trials using wavefront combined with LASIK.

4. Customized Ablation: The Wave Moves Forward.....but Keep an Eye on a Newly Developed Technique....LASEK!, OSN, January 1, 2001.

My first exposure to LASEK – laser epithelial keratoplasty, as I explained it in detail.

5. AAO Report: LASEK, Customized Ablation Draws Interest, OSN, January 1, 2002.

More results from the ongoing custom LASIK trials and a new technique for performing LASEK.

6. AAO Refractive Pre-Meeting Focuses on LASIK, LASEK, OSN, January 15, 2002.

An overview of what was reported at the 2001 Refractive Surgery pre-AAO meeting.

7. ASCRS Report: Customized Ablation, Hyperopia & More, OSN, August 1, 2002.

An overview from the 2002 ASCRS meeting.

8. An AAO 2002 Update: Classic vs. Custom LASIK -- The Battle Continues, OSN, January 1, 2003.

And finally, my last report for OSN, reviewing the latest developments occurring at the 2002 AAO meeting.

9. Custom Ablation #9: Questions......and Answers

An update and answers to the question – Custom vs Classic Lasik.

Along with its April 2006 issue, CRS Today published a supplement (sponsored by an unrestricted grant from Advanced Medical Optics) that answered the questions I had raised in previous columns on customized ablation concerning whether wavefront-optimized LASIK was as good as wavefront-guided ablation. (And, were either better than conventional LASIK?)

OCD A Guide for the Newly Diagnosed Review of Michael Tompkins Book for Consumers

When New Harbinger Publications asked if I would consider reviewing Michael Tompkins book, OCD: A Guide for the Newly Diagnosed, I was heartened to know that there was a new book on this topic. The introduction is by Jeff Bell, who wrote an insightful memoir about OCD called Rewind, Replay Repeat, which I took to be a good sign.

The book fits nicely in the hand, and adds to the approachability for those who have just found out they have OCD. Actually, Tompkins starts with describing the process of getting a diagnosis, and I'm glad he addressed the difficulty of finding mental health professionals who are actually familiar with the many forms OCD can take. I would argue that the comprehensive diagnostic process described in this book really only happens with therapists who are specialists in OCD, or who have trained in Exposure Therapy, and have treated a lot of people with OCD. The therapist who diagnosed me basically said, yes, it sounds like you have OCD.

Tompkins does an overview of Exposure and Response Prevention Therapy(ERP), Cognitive Therapy, and medication as well as other treatments, as well as what questions to ask a potential therapist, and how to get the most out of sessions.

I particularly liked the chapter on developing a "Recovery Attitude" including accepting such things as uncertainty, imperfect outcomes, imperfect knowledge, learning to approach discomfort in order to get through to the other side, turning away from debate with your OCD, seeking support, not reassurance, and practicing everyday. As someone who has struggled with perfectionistic OCD, I constantly battled with the fear that I wasn't doing my treatment perfectly or that I didn't have perfect knowledge of my OCD. Tompkins points out that "good enough" treatment is indeed "good enough," and OCD is demanding perfection that doesn't exist.

The book closes with information about unhealthy coping, school and work issues, a list of treatment centers, and recommended reading. It's difficult to fit everything into an introductory book, an at times I wanted more detail, or found too much squeezed into a section, but overall this book would be an excellent addition to a public library's mental health collection, as well as college libraries and hospital consumer health libraries.

Michael Tompkins, PhD, is a licensed psychologist at the San Francisco Bay Area Center for Cognitive Therapy.