Could Electromechanical Reshaping Replace LASIK?

HOT TOPIC

Is a Safer, Less Expensive Alternative to LASIK on the Horizon?

Scientists are developing a novel, incision-free alternative to LASIK called electromechanical reshaping (EMR), which uses electricity to mold the cornea rather than cutting it with a laser or scalpel. As we know, in traditional LASIK refractive surgery, a flap is created on the corneal surface. Then lasers remove precise portions of corneal tissue to reshape it—a process that, while common, compromises the eye’s structural integrity and can instigate ocular surface issues.

EMR exploits the chemistry of collagen-rich tissues such as the cornea. Collagen and water within the corneal matrix maintain shape via ionic interactions. When a mild electric potential is applied via specially designed platinum “contact lenses” placed on ex vivo rabbit eyes immersed in a saline solution, the tissue’s pH drops locally. This acidification loosens the ionic bonds, allowing the cornea to be molded. Once the pH normalizes, the tissue retains its new shape—in rabbits, at least.

In tests on 12 rabbit eyes (10 modeled to mimic nearsightedness), the EMR treatment was applied for about 1 minute and successfully corrected the corneal curvature to the desired focus. Cells survived the treatment thanks to careful pH control. The process also showed promise in reversing chemical-induced corneal cloudiness, a condition treatable only with full transplants.

Although EMR offers some advantages (eg, no incisions, simpler equipment, lower cost), it’s still at an early stage. The researchers plan to initiate detailed, live-animal studies to explore its full potential in managing refractive errors such as myopia, hyperopia, and astigmatism. However, progress is limited by uncertainties in scientific funding.

My Two Cents

There’s a lot to unpack here! As someone who works in a cataract and refractive surgery center, this would be a fantastic addition to any practice that performs such surgeries. Think about it: You throw a pair of special contact lenses on the corneal surface, shoot some mild electricity at it, and voila—you end up with perfect corneal shape! Woahhhh. One extremely interesting tidbit embedded in this story is the potential to clear chemical-induced corneal cloudiness. That could be a life-altering option for patients who have no other choice except transplantation!

The study’s authors emphasized that more than 80% of transferred patients lacked pre-transfer eye care provider involvement, likely due to limited specialist availability, inadequate equipment, and rising subspecialization within ophthalmology. They concluded that implementing standardized pretransfer evaluation protocols—and encouraging in-person eye care assessments when possible—could significantly increase diagnostic accuracy and reduce unnecessary transfers and associated costs.

OUTSIDE THE LANE

Study Highlights Value of In-Person Eye Care Assessment

A retrospective cross-sectional study published in Ophthalmology investigated the accuracy and necessity of ocular-related referrals to tertiary care services at Harborview Medical Center in Seattle. Analyzing 685 patients transferred from community hospitals, emergency departments, and urgent care centers between February 2022 and January 2023, the study found only 6.1% of patients underwent an in-person evaluation by an eye care provider before transfer, and 11.3% had consultations with a provider at the originating facility. The most common provisional diagnoses prompting transfers included suspected open-globe injury (14.3%), retinal detachment or tear (11%), orbital fracture (10.2%), and eyelid laceration (8.5%).

Despite these serious concerns, only 48.9% of referrals were ultimately accurate, and just more than half (50.2%) of the transferred patients were discharged from the emergency department without admission or any procedural intervention within 1 month. Notably, those who had an in-person eye care assessment before transfer exhibited much higher diagnostic accuracy (90.5% vs 66.3%) and intervention rates (90.5% vs 46.8%). Trauma-related diagnoses were significantly more precise than nontraumatic ones. Additionally, the study highlighted inefficiencies and escalating health care costs associated with inter-hospital transfers, with many patients transported by ambulance or airlift, which are extremely expensive.

The study authors emphasized that more than 80% of transferred patients lacked pre-transfer eye care provider involvement, likely due to limited specialist availability, inadequate equipment, and rising subspecialization within ophthalmology. They concluded that implementing standardized pretransfer evaluation protocols—and encouraging in-person eye care assessments when possible—could significantly increase diagnostic accuracy and reduce unnecessary transfers and associated costs.

My Two Cents

Nothing here is surprising; however, it’s important to note and remind ourselves just how valuable we are to the health care system. Of all the fascinating information in this study, the comment about the difficulty finding eye care providers was borderline shocking, let alone the fact that the authors point out that rising subspecialization within ophthalmology could cause poor results. Ughhh. The study’s authors also made a point to state, “We were also limited in our ability to conclude differences in accuracy between those evaluated by ophthalmology and optometry due to the low number of patients evaluated by optometry before transfer.” 😐

CAN YOU RELATE

If you’ve been a follower of this newsletter long enough, you know I love reading both business and self-help books. I recently finished Building a StoryBrand 2.0 by Donald Miller. As I continue to refine the messaging and branding for my new company, Eye Derm Cosmetics, this book has been the single most beneficial piece of marketing know-how I’ve ever stumbled across. If you get the chance, I highly recommend you snag a copy for yourself!

To give you a quick summary, Donald Miller provides a basic seven-step guide that uses the power of business storytelling to clarify a company’s message and ensure that customers (or patients) can easily understand what the “brand” offers and why it matters to them. Quite interestingly, it emphasizes that you are not the hero of the story—the customer is! Your business should act as a trusted guide that provides the solutions for the hero. Essentially, you are the Yoda to your patient (Luke Skywalker).

Some of my favorite quotes from this book are: “What we think we are saying to our customers and what our customers hear are two different things,” and “People don’t buy the best products; they buy the products they can understand the fastest.”