This article appeared in the May 13, 2004 Jewish Advocate.

LASIK helps people see with the naked eye

By Susie Davidson

Advocate Correspondent

40-plus years of severe myopia was more than enough for this writer, who likely came out squinting at birth and soon graduated to turquoise glasses with sparkles on their pointy corners. It never got better, even when new technologies finally did away with the coke-bottle thick numbers, and gas-permeable contacts proved tolerable for over 20 years.

But that’s tolerable given endless cleaning, soaking and enzyming with expensive solutions, ill-fitting replacement pairs, scavenging hunts down drainpipes, dry eyes, runny mascara, embedded sand and dust particles, and then there was traveling with them, all of which often led to resorting to glasses, and then (horrors!) being caught bespectacled in public.

Following extensive research into both the procedure and top local practitioners and a ten-year wait observing long-term results in patients, relief was finally realized in the office of Ernest Kornmehl, M.D., F.A.C.S., who runs one of the generally recognized top five LASIK centers in the Boston area. Kornmehl personally developed specialized instruments which are used internationally by refractive surgeons; he also co-developed the Swinger-Kornmehl solution which reduces corneal swelling.

A Best of Boston LASIK practitioner in Boston Magazine’s “Top Doctors” issue, Kornmehl, who was director of the Novatec Laser Surgery Program for Nearsightedness at Mass. Eye and Ear and is a clinical instructor at Harvard Medical School, an associate professor of ophthalmology at the Tufts School of Medicine and a research associate at MIT, grew up in an observant and altruistic home in Buffalo. “My father served on the Board of Directors of his conservative synagogue for many years, and my mother strongly believed in directly helping those in need,” he recalled. “She would often send me to deliver homemade care packages to those less fortunate.” Kornmehl was bar mitzvahed and went to weekly Shabbat services. “My parents, Nathan and Frances Kornmehl, taught me that being a physician is a privilege and position of trust that can never be violated,” he added.

Kornmehl, who received his education at the Yale Eye Center and the Mass. Eye and Ear Infirmary of Harvard Medical School, is a past Vice President and current member of the Board of Directors of Congregation Mishkan Tefila and serves as the Chair of the Health Professions Team of Combined Jewish Philanthropies. His wife, Ellen Kornmehl, M.D., a Radiation Oncologist at the Brigham Farber Center in Fall River, also serves as a Co-Chair of the Community Shabbat program at CMT. “Ellen is my role model for a caring, compassionate physician,” said Kornmehl. The couple has a two-year old daughter, Lia.

Kornmehl provides initial information, videos, and an extensive eye examination, recommending outside ophthalmology appointments if needed. While he turns away some cases, he also works with potential candidates. (In this, case, contacts had to be abandoned for two months to allow for a corneal warping to correct.)

“My early research work focused on the healing mechanisms of the front part of the eye (the cornea) and how certain plastic materials could influence the process,” says Andrew Garfinkle, M.D., Ph.D., of Laconia Eye Associates, which is located at 85 Spring St. in Laconia, New Hampshire.

Garfinkle’s knowledge fit with the new technology of PRK and LASIK laser refractive surgery, which emerged in the early 90's in Canada, and he was soon busy doing surgery and other clinical work. “I was able to participate in the refinement of the laser surgical technique and the continued growth in popularity which was supported by the excellent and lasting visual results,” he explains.

Garfinkle, a Newton native, also received great family support. “Respect, responsibility and the will to compromise are the values that my parents and grandparents reverberated while I grew up in my Jewish household,” he recalls. Education was highly regarded as well; Garfinkle spent 15 years in university and training after graduating from Newton South High School in 1973. He studied chemistry as an undergrad at McGill University, which led to an interest in Biomedical Engineering and a combined M.D.-Ph.D. program at the University of Washington in Seattle. Garfinkle returned to McGill University for specialty training in Ophthalmology and subspecialty work as well, which resulted in his appointment as an Assistant Professor in Ophthalmology at the school.

“Laser refractive surgery still forms an important component of my general ophthalmology practice, as it should after some 8,000 surgeries,” he says. Refractive laser surgery, he explains, can best be understood by using the analogy of a camera to the eye. “The “lens” of the camera is like the clear window at the surface of the eye where a contact lens would be placed (the cornea). In the back part of the eye, the “film” (the retina) transmits the visual image to the brain, so that we can see.” In order that the picture is seen clearly, he continues, the shape of the cornea must result in a focusing strength that is just right for the size of the eye. “This is likened to the correct camera lens which can perfectly focus your picture on the film. The laser can reshape the cornea to give us this perfect focus without glasses.”

What is LASIK, which runs about $2,500 per eye, like? For four days prior to this writer’s surgery, antibiotic eye drops were applied. The surgery, endured cold-turkey following a seemingly ineffective Valium, took place in a reclining medical chair, and was far more strange than uncomfortable. A squeeze bear was handed out as both eyes were taped back to prevent blinking and a propping device kept them open. Drops anesthetized the area so that the integral eye flap-cutting was barely noticeable. He and his aides called out numbers, and following a minute or so (divided into three segments) of staring into the pulsating light with each eye, plastic shields were taped on to prevent rubbing while sleeping. The worst part was the anticipation that something was going to go wrong, and after being led into a waiting room to relax, the only inconvenience was extreme sensitivity to daylight on the ride home. So with eyes covered, it was naptime as advised, with vision decent, albeit blurry, upon awakening. Kornmehl called, wondering if perhaps he had undercorrected, but despite this anxiety-provoking possibility, things began to clear and the newspaper could be read unaided. Taking the T there alone the next day wasn’t a problem; Kornmehl performed a scraping type of procedure to help improve vision.

For the first few days, the goggles were worn at night, and antibiotic and anti-inflammatory drops continued for another week. At the first week follow-up, it was possible to read Line 6 when Line 3 was requested, reading glasses weren’t needed, halos or starbursts were never seen, and night vision posed no problem. Upon leaving, Kornmehl was heard raving “She was a minus 10! 20/2000!” in the office. At the second follow-up, 20/20 for reading and 20/30 for distance was declared, with occasional natural tear eye drops (and being able to wear fashion sunglasses) the only residual factor. Wow. But to Kornmehl, his clients are the miracle-workers. “I am grateful to the thousands of patients, and the doctors who referred them, for entrusting me with their most precious sense, the gift of sight,” he said.

Based on the experience, LASIK, and Dr. Kornmehl, cannot not come more highly recommended. But don’t go to a hack. Don’t expect 20/20 for life, as scant few normal, and up to 8 percent of severely myopic patients can possibly regress within the first 3 months or very rarely, later in life, requiring an “enhancement” procedure. Do everything advised. And then, give the contacts solutions to your siblings, toss the glasses into the post office charity eyewear bin, and enjoy waking up to the priceless pleasures of immediately seeing the time on the wall clock, the numbers on the coffeemaker, the buttons on the radio.

For more information on Korhmehl Laser Eye Associates, please call 877-870-2010, email info@visionboston.com or visit visionboston.com. Dr. Andy Garfinkle can be reached by calling 603-528-2606 or emailing eyelaser@metrocast.net.