Eyeworld Supplements

FOCUSING ON THE THREE PILLARS OF THE SOCIETY 32 | SUPPLEMENT TO EYEWORLD Again on the cuing edge First excimer laser procedure and rise of reactive surgery Dr. McDonald is no stranger to innovative and con- troversial work. She performed the world's first laser vision correction procedure (the procedure that became known as PRK) on a human eye in the world. She, Stephen Trokel, MD, and Charles Munnerlyn, PhD, were the development team behind the procedure, which she said was considered very controversial at the time. ey had received a grant from the NIH to pursue the procedure, and many people were angry that money was being spent on this work, she said. "ey thought we were dangerous because we were fir- ing an industrial laser right at the line of sight of people who simply didn't like their glasses," she said. Dr. Mc- Donald faced significant criticism and personal attacks; some accused her of lying about her data. "e three of us kept putting one foot in front of the other," she said. Dr. McDonald and her team persevered and saw posi- tive results aer initially doing research on plastic discs, animal and human cadaver eyes, and finally living sub- jects (rabbits and monkeys, then humans). Dr. McDonald doing a retinoscopy on one of many monkey patients that had PRK at the Tulane National Primate Research Center in Covington, Louisiana, in the mid- to late-80's. Source: Marguerite McDonald, MD Dr. McDonald, Stephen Klyce, PhD, and a lab tech- nician standing in front of a sign on their trailer hon oring Alberta Cassady, the world 's first living human subject to receive laser vision correc- tion, a PRK. Mrs. Cassady died of metastatic cancer 6 months aer her PR K. Dr. McDonald and her team insisted on naming their trailer for her. Source: Marguerite McDonald, MD is is an early VISX prototype that Dr. McDonald and her team used, starting with the partially sighted study (patients with 20/50 or worse best-corrected vision). Dr. Klyce served as the team's corneal physiologist and topography expert, as well as Dr. McDonald 's assistant during all the surgeries, from the very first cases. Source: Marguerite McDonald, MD At first, the results in living rabbits were terrible. "I was firing the laser at the rabbit 6 feet away, and we would fire for a few seconds. en I would crank down the diaphragm by hand, fire for a few more seconds, and crank it down again. ere were only five steps to the original myopic ablations," she said. e rabbits quickly developed thick, hyperplastic white corneal scars. De- spite poor initial results in the living rabbit model and two team members quitting, they continued to refine and make the ablation smoother until they came up with a procedure that was appropriate for living rabbits and monkeys, then human patients.

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