If you're looking to spark a lively dinner debate among ophthalmologists, I know two excellent topics. One is whether lawyers should be boiled in oil or lashed to an anchor and set adrift. The other involves contact lenses and LASIK.
As with most good debate topics, there are strong cases to be made for either side, and there is, at least as yet, no definitive method to determine the clear superiority of either. Of course, the debate doesn't occur in a vacuum; it's not simply a matter of one choice being better than the other. The complicating factor in the LASIK/contact lenses debate, both a blessing and a curse, is that there is a patient involved, a patient who is hugely important to the ultimate success or failure of the option you recommend.
The patient's age, likelihood of adhering to the recommended wearing schedule, cleaning and replacement regimen, follow-up, are all critical to your decision-making. A recent study reported in October's Ophthalmology dismisses the idea that new lens types, including silicone hydrogel soft lenses and daily disposables, may be by themselves inherently safer. The same lesson, i.e. over-reliance on a "silver bullet" solution to non-compliance, has also torpedoed the idea of "no-rub" cleaning.
On the surgery side, you have an even more complicated challenge: divining the motivation of a patient and the likelihood that this specific patient will adapt to the inevitable trade-offs that are still inherent in refractive surgery of any type.
So the headline above is not really instructive. That is, it's not telling you to decide. It's a statement of the reality that you already make this decision every day. Fortunately, you're choosing between two highly successful and safe modalities. Which is safer? Depends on the patient.
To start your own debate, first see our cover story to find out the latest thinking and some fascinating statistical analysis of the options.
As to the other subject, it's fairly clear that fire hazards and the risk of splash burns associated with deep-frying ultimately make anchors the preferred option.
Have a wonderful holiday season, and here's to a better year for everyone in 2009.
