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hree Farmington Hi lls tents, including some of his fam-
businessmen, including an ily members who've undergone
ophthalmologist, are pla n- the procedure, are "thrilled" with
ning to open 22 clinics n a- the results.
tionwide to offer U.S. residen is
PRK is effective in correcting
what they say is a highly eff ec- astigmatisms, but the FDA has
tive, new procedure for corre ct- not approved it for that use.
Vision Sculpting Inc. is the
Other opthalmologists a re first Michigan company to own
more reserved about excim er and operate the PRK clinics in
laser surgery, also known as ph o- Canada, said Dr. Segel, but he
to radial keratotomy (PRK), c all- isn't sure if other companies in
ing it promising but expensiv e. the United States are planning
Following the recent reco m- clinics here.
mendation for FDA approval of
Dr. Raymond Margherio, the
the VISX laser, Farmingto n medical director of the Beaumont
Hills-based Vision Sculpting In c. Eye Institute in Royal Oak, said
began the process of securing $ 20 he's heard rumors that a dozen
million to finance the clinics fro m excimer laser surgery clinics are
a Toronto-based investme nt planned in the metropolitan area
banking firm with which it h as — too many, in his view.
a memorandum of agreement
When RK came on the scene
Over 500,000 excimer las er in the 1980s, it was touted as
surgeries have been performe d something of a miracle, but the
worldwide since 1988, but in th e number of procedures performed
United States, the procedure can has dropped off, he said.
only be used to treat corneal di 5-
However, according to the
ease, said Dr. David Segel, a fo r- American Society of Cataract
mer podiatrist who serves a s and Refractive Surgery, last year,
Vision Sculpting's chairman.
450,000 RK surgeries were per-
Vision Sculpting has been op - formed in the United States,
erating two clinics in Ontario an d compared to 50,000 in 1990.
one in Vancouver, serving man y
"We're not sure how big the
U.S. residents who have crosse d bubble is going to be with the ex-
the border for the excimer lase r timer because we're so close to
the excimer centers in Windsor
With FDA go-ahead, Dr. Sege 1, that have been functioning for
partner Robert Mackey and oph - years," Dr. Margherio said. "It
thalmologist Alan Spigelma n would seem that, realistically,
plan to open locations in th e this area could support three or
Farmington Hills and Sterlin g four (centers). Rumors have it
Heights areas early next year - there could be as many as 12 or
Other clinics are planned in Al - 14. It'll probably be overkill."
buquerque, Beverly Hills, Chica -
He noted that the excimer
go, New York, Dallas and othe ✓ lasers are quite expensive, they
require high maintenance and
Unlike radial keratotomy (RK) are rather large. Plus, clinics are
surgery, which is widely per - required to send an ongoing li-
formed in the U.S. to correc t tensing fee to the manufactur-
nearsightedness, excimer lase ✓ er of VISX. Beaumont Eye
surgery is safer and more pre - Institute has already purchased
cise, Dr. Segel said.
excimer equipment in anticipa-
"It's generally controlled by a tion of opening its own center, he
computer, so it takes just the said.
right amount of cornea needed •
Dr. Margherio said PRK leaves
In RK, you make spoke-like in - the eye stronger, but the recov-
cisions and cut through 90 per - ery time is longer than for RK.
cent of the cornea. The integrity
Dr. Robert Beitman, an oph-
of the eye seems to be much safer thalmologist with offices in West
with the excimer surgery. Five Bloomfield and Brighton, per-
to 15 percent of the cornea is re- forms between 700 and 1,000 RK
moved with this new surgery," surgeries each year.
He said he's looking into buy-
For RK surgery, the cost per ing a VISX, although he is on staff
eye is between $1,200 and at Sinai and Beaumont hospitals,
$1,500. Excimer surgery is slight- both of which are planning to per-
ly more expensive, at about form excimer laser surgery.
$2,000 to $3,000 per eye. Most
"We're real happy that lasers
insurance carriers don't cover the have come aboard in the United
cost of the surgeries.
States. We've been waiting five,
Dr. Segel said there are no de- six, seven years for (FDA) ap-
finitive studies on the long-term proval, but north of the border ...
effectiveness of PRK, but pa- they've been doing excimer laser