Alternative Medical Therapy Guide From The FDA

Real Alternatives
"It is best not to abandon conventional therapy when there is a known response [in the effectiveness of that therapy]," says Joseph Jacobs, M.D., former director of the National Institutes of Health's Office of Alternative Medicine, which was established in October 1992. As an example he cites childhood leukemia, which has an 80 percent cure rate with conventional therapy.

But what if conventional therapy holds little promise?
Many physicians believe it is not unreasonable for someone in the last stages of an incurable cancer to try something unproven. But, for example, if a woman with an early stage of breast cancer wanted to try shark cartilage (an unproven treatment that may inhibit the growth of cancer tumors, currently undergoing clinical trials), those same doctors would probably say, "Don't do it," because there are so many effective conventional treatments.

Jacobs warns that, "If an alternative practitioner does not want to work with a regular doctor, then he's suspect."

Alternative medicine is often described as any medical practice or intervention that:

1. lacks sufficient documentation of its safety and effectiveness against specific diseases and conditions
2. Is not generally taught in U.S. medical schools
3. Is not generally reimbursable by health insurance providers.

According to a study in the Jan. 28, 1993, New England Journal of Medicine, 1 in 3 patients used alternative therapy in 1990. More than 80 percent of those who use alternative therapies used conventional medicine at the same time, but did not tell their doctors about the alternative treatments. The study's authors concluded this lack of communication between doctors and patients "is not in the best interest of the patients, since the use of unconventional therapy, especially if it is totally unsupervised, may be harmful." The study concluded that medical doctors should ask their patients about any use of unconventional treatment as part of a medical history.

Many doctors are interested in learning more about alternative therapies, according to Brian Berman, M.D., a family practitioner with the University of Maryland School of Medicine in Baltimore. Berman says his own interest began when "I found that I wasn't getting all the results that I would have liked with conventional medicine, especially in patients with chronic diseases.

Laser Scalpel Improves Popular Eye Surgery

The laser technology and surgical procedures were developed at the University of Michigan by a joint team of physicists and ophthalmologists from the National Science Foundation (NSF) Center for Ultrafast Optical Science (CUOS) and the university's Kellogg Eye Center. The team reports on the procedure in the June 2001 issue of Ophthalmology Clinics of North America.

"The collaborations were very important in this project, which allowed us to apply the precision of physics and materials science to a medical application that benefits a large number of people," said CUOS Director G"rard Mourou.

LASIK surgery, or laser in situ keratomileusis, has revolutionized vision correction surgery. In traditional LASIK surgery, a mechanical blade called a microkeratome is used to cut a flap of cornea, an excimer laser is used to reshape or remove a portion of the cornea, then the flap is repositioned. Now, surgeons can use the very precise femtosecond laser to create the initial flap. The laser emits light in extremely fast pulses, each pulse roughly a billion times faster than an electronic camera flash.

Use of the femtosecond laser to cut corneal flaps is more precise than previous methods, reduces the chance of uneven cuts or collateral tissue damage, and improves clinical safety.

"The path from an NSF Science and Technology Center to the marketplace is an excellent example of how federal funding of basic research can lead to new technologies with broad social benefit," said Robert Eisenstein, NSF's assistant director for mathematical and physical sciences. "The cross-disciplinary effort of the team was an important factor in this research."

Lasers with ultrashort pulse durations--a femtosecond is one millionth of a billionth of a second--have been researched extensively for the machining of materials on the micrometer-scale, but they are new to medicine. In attempting to harness their tremendous intensity, the scientific team discovered they were able to cut tissue with unsurpassed precision. The laser's intensity is thousands of times greater than are those of conventional lasers used in medicine.

Two members of the Michigan team, Tibor Juhasz and Ron Kurtz, founded the IntraLaseTM Corporation to commercialize the new laser, with support from NSF, the National Eye Institute of the National Institutes of Health, and the Department of Defense in the form of Small Business Innovative Research (SBIR) grants. The IntraLaseTM product, the Pulsion FSTM laser, was introduced at the American Society of Cataract and Refractive Surgery meeting in San Diego, Calif., in April 2001. It is expected to be widely available in the United States within a year.

Researchers are now exploring the possibility of extending this technique to other eye procedures, such as cornea transplants or glaucoma treatment. One potential application is creating new drainage systems in the eye when those systems are not functioning adequately.

"We have barely begun to explore the myriad of uses that the femtosecond laser offers in the clinical management of glaucoma," said Paul Lichter, director of the Kellogg Eye Center.

With eye drops the cornea is easily numbed with eye drops during the procedure. You may feel a slight pressure sensation for 15 - 20 seconds. But they have little to no discomfort during LASIK surgery.

LASIK eye surgery is a surgical procedure to reduce a person’s dependency on contact lenses and glasses. LASIK stands for Laser-Assisted In Situ Keratomileusis. This procedure permanently changes the shape of the person’s cornea.

LASIK surgery treats nearsightedness, farsightedness and astigmatism. The surgeon cuts a flap in the stroma, and then uses a special laser to remove material under the flap. LASIK surgery usually takes less than one minute per eye.

LASIK eye surgery is a great soluion to your vision problems but is not for everyone. A couple of examples why LASIK surgery may not be for you is if you are breastfeeding or pregnant and if your perscription changes frequently and in your early 20's.

• LASIK Surgery Expectations
• LASIK Surgery Cost
• Nearsightedness
• Frsightedness
• Stigmatism
  

How is the recovery from LASIK surgery?

Recovery is very fast. The eye will feel irritated for the first couple hours after surgery and may have some tearing. Vision is typically blurry during this time. A nap 3-4 hour nap is usually suggested during this time. The day after surgery most irritation will be gone and your vision will be remarkably clear.

What If I’m really nervous?

Mild sedative is available prior to surgery to encourage you to be relaxed. The surgeon and technicians talk throughout the procedure to put you at ease.

How much does LASIK surgery cost?

The FDA regulates the safety and effectiveness of medical devices but not their marketing or fees associated with LASIK surgery. So prices will vary between each LASIK surgeon.

How do I find out about a particular laser being approved?

You can find out about approved devices and their approval dates and more from the FDA approved lasers page.

Which laser is best for treating my refractive error?

You need to have your eyes examined and then the doctor will discuss what is in your best interests and which lasers will show you the best results.

LASIK Procedures

LASIK procedures are one of the most common and popular ways to help correct an individual’s vision.  The term “LASIK” stands for laser in-situ keratomileusis.  With a state-of-the-art laser, an experienced LASIK surgeon changes the curvature of the cornea to treat issues such as astigmatism, nearsightedness, and farsightedness.  Having an experienced LASIK professional guide you through the various procedures and process can allow you to gather all the necessary information you need before you decide if LASIK surgery is right for you.

Do you want to learn more about LASIK procedures? Contact our experienced and knowledgeable LASIK professionals to advise you on a LASIK procedure today!

Below are some of the most common LASIK surgery procedures performed:

• Laser in-situ keratomileusis (LASIK)
• Epithelial Laser In Situ Keratomileusis (Epi-LASIK)
• Custom LASIK
• Laser Epithelial Keratomileusis (LASEK)
• Presby LASIK

With today’s technological advancements in LASIK surgery procedures and techniques, a wide range of choices gives patients the opportunity to significantly reduce and/or eliminate their dependency on the use of contact lenses and glasses. Millions of patients throughout the world have experienced positive results from their LASIK surgery procedure. It is important to speak with a LASIK professional to understand which LASIK procedure is right for you based on your individual needs. This will allow the best treatment be offered and available to you and provide the best results.

Do you want to learn more about LASIK procedures? Contact our experienced and knowledgeable LASIK professionals to advise you on a LASIK procedure today!

LASIK Surgery Expectations

For many people, the expectations of undergoing a LASIK surgery revolve around obtaining very positive results.  One of these results is the reduction of patients’ dependency on visual aids such as contact lenses or glasses.  With their improved vision, common things like reading, driving, and other everyday activities are much easier for most all LASIK patients.  It is important to communicate your needs and expectations to a LASIK professional prior to your surgery.

Do you want to learn more about LASIK surgery expectations?  Contact one of our experienced and knowledgeable LASIK professionals in your area today!

Below are some temporary symptoms that may occur following LASIK surgery:

• Glaring effect in vision
• Redness in the eyes
• Decreased nighttime vision
• Haloes around lights
• Starbursts

In many cases, the success rate for LASIK surgery can depend on a patient’s prior medical history and existing medical condition.  Depending on a patient’s current level of vision, it can have a potential factor on the expected result.  After undergoing a LASIK surgery, a patient’s eyesight may take some time to become adjusted; and will not completely stabilize right away.  In most cases, a person can expect their eyesight to become more adjusted and stable between three to six months.  However, the expectations of a LASIK surgery procedure can result in considerable and in positive improvement in a person’s vision regarding distance nearly instantly.

Do you want to learn more about LASIK surgery expectations?  Contact one of our experienced and knowledgeable LASIK professionals in your area today!

Oxygen Restrictions Can Be Eased for Premature Infants with Blinding Eye Disease

"Up to now, there have been tight restrictions on the amount of oxygen low birthweight infants were permitted to have," said Carl Kupfer, MD, director of the National Eye Institute (NEI), which funded the study in collaboration with the National Institute of Child Health and Human Development (NICHD) and the National Institute of Nursing Research (NINR). "This is because doctors have been concerned about a possible adverse effect of supplemental oxygen on the eyes of infants with ROP. While the benefits and risks of supplemental oxygen must be individually considered for each infant, doctors need no longer worry that supplemental oxygen, as used in this study, will harm eyes with moderate ROP."

Many premature infants need supplemental oxygen soon after birth because their lungs are not sufficiently mature to efficiently transfer oxygen into their bodies. Doctors have long known that supplemental oxygen, while helping infants survive, might increase cases of ROP. They have also been concerned that it might allow the disease to progress from a moderate stage, when surgery is not needed, to a severe stage, which usually requires surgery and sometimes permanently damages sight. However, recent research had suggested that controlled amounts of supplemental oxygen might actually keep ROP from progressing from moderate to severe. If controlled amounts of supplemental oxygen could help prevent the progression of ROP, then infants could avoid this threat to their sight and consequently the invasive surgery for severe ROP, with its possible long-term side effects.

Retinopathy of prematurity develops when abnormal blood vessels grow and spread throughout the retina, the nerve tissue that lines the back of the eye. The scarring and bleeding caused by the excess growth of these blood vessels can lead to retinal detachment, resulting in vision loss. ROP develops in about 14,000-16,000 infants each year who weigh less than 2 3/4 pounds (1250 grams) at birth. In most cases (80 percent), the disease improves and leaves no permanent damage. However, about 1,100-1,500 infants annually develop ROP that is severe enough to require surgical treatment.

The most effective proven treatments for severe ROP are cryotherapy and laser therapy, which usually will stop the growth of abnormal blood vessels and prevent retinal detachment. The effectiveness of cryotherapy--a freezing treatment--was demonstrated several years ago through another NEI-sponsored clinical trial. However, even with these therapies, about 400-600 infants with ROP become legally blind each year. Cryotherapy and laser therapy are considered invasive surgeries on the eye, and doctors don't know their long-term side effects.

"Of the infants in the study with moderate ROP who received the supplemental oxygen, 41 percent progressed to severe ROP," said study chair Dale Phelps, MD, professor of Pediatrics and Ophthalmology at Children's Hospital at Strong at the University of Rochester School of Medicine and Dentistry. "Of the infants with moderate ROP who did not receive the supplemental oxygen, 48 percent progressed to severe ROP. Statistically, there is no difference.

"However, we found something we did not expect," Dr. Phelps said. "The infants in the study fell into two groups - those whose moderate ROP was complicated with dilated eye blood vessels, and those whose blood vessels were not dilated. Modest supplemental oxygen significantly reduced the need for surgery in the second group. This finding needs to be confirmed with additional research before we can recommend modest supplemental oxygen as a treatment for infants with moderate ROP without dilated blood vessels."

Dr. Phelps said there were side effects in some infants who received the supplemental oxygen, including a temporary worsening of their chronic lung disease. "In addition, we examined the infants three months after their due dates, when they were no longer on the treatment," Dr. Phelps said. "We found, at the three-month exam, that the children who received the supplemental oxygen were more likely than those who did not receive the extra oxygen to be either in the hospital, on oxygen, and/or on medications for chronic lung disease. However, these side effects themselves are not life-threatening, and are acceptable risks for infants who require extra oxygen for cardiopulmonary reasons."

The clinical trial, called the Supplemental Therapeutic Oxygen for Prethreshold ROP (STOP-ROP) study, initially enrolled 649 infants; 597 completed the study. The clinical trial was conducted at 30 study centers involving 71 hospitals across the US.