One Hundred Percent Success

BY JOSEPH T. BARR, O.D., M.S., EDITOR
JUNE 1997

Last month, we published a report about the new, mobile excimer laser clinic. For years, many have talked about this concept. Now, a tractor-trailer with an excimer laser enclosed will be arriving at a shopping center near you. Certainly, you'll know when it's coming from the advertising that's sure to precede it.

Now, people in rural America can have access to laser refractive procedures without having to drive to a larger city for this type of care. It sounds so easy. Send the truck to town, level it, align and recalibrate the laser and fire away. Drive off into the sunset and let the local surgeon or the local O.D.s who will comanage take care of the aftermath.

But, how will success be judged? By the initial outcome before the truck leaves town or by the long-term outcome for the patient?

This reminds me of a story a wise sage in the contact lens field told me about a famous contact lens practitioner, far, far away who was an early pioneer in the field. Many patients would fly in from all over the world to get contact lenses from this practitioner and experience the thrill of vision without eyeglasses. The practitioner would fit the lenses using topical anesthetic, dispense the lenses having topically anesthetized the eyes again, and then send the patients on their way after assuring a good fit and satisfactory vision. He could boast of perfect success. After all, when patients left his care, they were very happy and probably even paid the fee, satisfying two common measures of success.

Other stories of perfect succcess include the old myths in the PMMA lens days when practitioners would claim "my patients never have any edema" or "my patients never have any peripheral corneal 3 and 9 o'clock staining." These 100 percent success rates are usually explained by the old WNL abbreviation. Of course, WNL stands for "within normal limits" but in the context of 100 percent success, it's often defined as "we never looked."

It will be interesting to see if the mobile excimer laser clinics have these 100 percent success rates like the contact lens fitters of old who fit their patients and sent them away, rarely if ever to see them again. CLS