Fatal Focus, a novel by Jonathan Maxx

The long-term effects of photorefractive eye surgery remain unknown. It’s clear that LASIK and other forms of eye surgery using the excimer laser are not as promised –“quick, painless and effective.” And we know that some people will never recover their vision, lost as a result of this next “miracle of modern medicine.” If, after ten years, we look back and see that laser eye surgery was simply a mistake, a risk-prone procedure imprudently pushed for the sake of the money to be made, it will indeed be a sad day for the medical profession. However, might there be an even greater evil lurking?

The excimer laser is a source of ultraviolet radiation, a form of energy closely associated with mutagenicity and carcinogenesis. For more than a decade, researchers have questioned whether this laser-generated radiation might trigger the growth of cancer in human tissues. A clear-cut answer has never been obtained.

While some researchers proclaim that the 193 nanometer argon-fluorine laser does not produce radiation in the known mutagenic wavelengths, (the blanket statement that even the primary radiation from the 193 nm laser is entirely safe is not presently accepted by all researchers), and therefore cannot be mutagenic, others have pointed out that the interaction of human tissues with laser radiation causes the radiation to change— changing its wavelength into the mutagenic ranges. What is the effect of this “secondary radiation?”

Consider the facts. Last year over 800,000 people underwent laser refractive eye surgery. In each instance the patient’s eye was irradiated with ultraviolet radiation. The secondary radiation produced during the photoablative process has the potential of scattering into the surrounding tissues. Since this secondary radiation falls into the known mutagenic ranges, these tissues may be genetically altered by this radiation, and some cells may become malignant. If only one-half of one percent of those 800,000 patients sustained DNA damage—that may be as many as four thousand people whose lives are NOW threatened by the onset of cancer.

There is practically no research being conducted into the long-term effects of laser eye surgery. Is there a lack of interest? Or, is it more a matter of the ostrich hiding its head in the sand? At this time more than 1 million people have been prompted to undergo laser eye surgery. If laser radiation triggers cancer it may become apparent soon. (Alternatively, the histopathological effects may mimic the effects of x-ray exposure, and become apparent after several years.) However, determining the existence of a correlation between photorefractive surgery and cancer depends entirely on whether or not researchers are looking for it.

Jonathan Maxx is the author of the fictional novel entitled, “FATAL FOCUS”, which follows the lives of two physicians attempting to publish research about the potential deadly effects of the excimer laser. A portion of the proceeds from this book will go to long-term reseach concerning laser eye surgery.

Available by e-mailing the author, Jonathan Maxx.

Bibliography

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Green, H., Boll, J., Parriesh, J.A., Kochevar, I.E., Oseroff, A.R.

"Cytotoxicity and mutagenicity of low intensity, 248 and 193 nm excimer laser radiation in mammalian cells.” Cancer Res. 1987 Jan. 15, 47 (2) : 410-3

Kochevar, I.E. (Wellman Laboratories, Mass. General Hosp., Boston) “Cytotoxicity and mutagenicity of excimer laser radiation.” Laser Surg. Med 1989; 9(5): 440-5

Lubatschowski, H., Kermani, O. (Institut fur Anewandte Physik, Universitat Bonn.) “193 nm Excimer laser photoablation of the cornea. Spectrum and transmission behavior of secondary radiation.” Ophthalmologe 1992 Apr: 89(2): 134-8

Muller-Stolzenburg N., Schrunder S., Helfmann, J., Buchwald, H.J., Muller, G.I. “Fluorescence behavior of the cornea with 193 nm excimer laser irradiation.” Fortschr Ophthalmo; 87(6): 653-8 1990

Phillips, A., McDonnell, P.J. (Doheny Eye Institute, Los Angeles) “Laser-induced fluorescence during photorefractive keratectomy: A method for controlling epithelial removal” Amer. Jour. Opht. 1997 123; 42-47

Seiler, T., Bende, T., Wincker, K., Wollensak, J. “Side effects in excimer corneal surgery. DNA damage as a result of 193 nm excimer radiation” Graefes Arch Clin Exp Ophthalmol, 1988; 226(3): 273-6

Trentacost, J., Thompson, K., Parrish, R.K., Hajek, A., Berman, M.R., Ganjei, P. “Mutagenic potential of a 193 nm excimer laser on fibroblasts in tissue culture: Ophthalmology; 94(2): 125-9 1987