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Your Health & Happiness: SuperSight Surgery – the new breakthrough?

Dr. Iain Corness
Are you over 50 and using spectacles to read this article? Do you hate your reading glasses? If so, keep them on and keep reading, help may be at hand!
Unfortunately, the need for reading glasses is a natural progression of aging. The first signs are the fact that you have to hold this magazine further away to be able to read it, and you also find that you need a good light to be able to see the words clearly. Eventually you run out of arms, and you succumb and buy reading glasses. This means that you have become a slave to your spectacles. Like the Amex card, at your own risk, never leave home without them! Eventually you keep one pair at home, another in the car and another in the office. And your nose gets funny indentations either side of the bridge, where the spectacles settle.
It is important that you understand just why this happens. As you get older, all the ‘elastic’ tissues in your body become less pliable. Knees, lower back, fingers, neck, the list is endless. However, you have to add to that list, the lens in your eye.
The fiddly little lens, supplied at birth as a standard feature, does not have a fixed focus, but under your control you can make it focus close up (to read) and then also focus at a distance, such as when you are following your golf ball as it slices into the water hazard. The way you do this is by ‘bending’ the lens to be able to focus on near objects. Unfortunately, as the lens becomes less pliable, the muscles in your eye become unable to bend the stiffening lens enough to produce the near point focus. The near point moves further away, until you have run out of arms, as described previously. We medico’s call this condition ‘Presbyopia’.
Unfortunately there is yet another result of aging that occurs in the lens of the eye. This is a gradual cloudiness which lowers the visual acuity, slowly lowers your ability to see colours, and eventually brings on blindness. So not only can you not see well enough to read the magazines, but you also begin to lose your distance vision. Welcome to the wonderful world of white sticks and woofing Labrador dogs. If you think this is an exaggeration, currently between 12 and 15 million people are estimated to be blind from cataracts, according to the World Health Organization, and by the year 2020, this will be 54 million people.
The initial method of treating this was by removal of the now optically inefficient natural lens, and attempting to return some usable vision through the introduction of very thick and heavy spectacles placed before the eye. These glasses looked as if the lenses were made from the bottom of Coca-Cola bottles (registered trade mark and all), and were just as heavy. The patient could see again, but reading required even thicker lenses, or hand-held magnifying glasses. Not all that comfortable, but beat the alternative.
However, in 1949, a Dr. Harold Ridley noticed that pieces of shattered Perspex after a penetrating eye injury in aircraft crashes did not produce a reaction within the eye. This was the first step towards production of the Intra-Ocular lenses (now referred to as IOL’s as we medico’s love acronyms). It became possible for us to replace the cloudy hard lens with a clear lens. This too was a hard lens, but optically clear. The patients could see again, but did need reading glasses, as the lens had a fixed focus.
So we come to the latest development in IOL’s. The focusable lens, under the control of the patient’s own intra-ocular (ciliary) muscles. With these lenses you can read your golf scorecard with your near vision, focus on the ball on the tee with your intermediate vision and then using your distance vision watch it gently arcing into the water hazard. (These new IOL’s can improve your sight, but not your golf, I am afraid.)
One of the leaders in this field is the German Akkommodative 1CU lens which represents the latest development in artificial lenses and can provide patients with a better quality of life. This is a lens which is designed to change shape, providing similar functions to a natural healthy lens. These IOL’s meet all the European requirements for implantable medical devices.
We also have Dr. Somchai Trakoolshokesatian who practices at the Bangkok Pattaya Hospital, who is one of the world leaders in inserting these new lenses. His figures after two years of using these IOL’s show a patient satisfaction level after surgery of 94 percent. In addition, 95 percent said they would have the surgery again if it were necessary. 94 percent no longer needed reading glasses, and 97 percent did not need glasses for distance vision. In medicine, we can never give 100 percent guarantees, but 94 percent represents not bad odds, in anyone’s language.
The results have been so outstanding, that medical ‘tours’ are coming to this country to have this operation. Word of mouth and 94 percent satisfaction rates, have been bringing people to Thailand for the operation that can return their sight to what it was when they were 20 years old.
In the words of Dr. Somchai, “SuperSight Surgery is exciting, but it isn’t for everyone. We would like to assure that everyone undergoing a procedure has healthy eyes. However (generally speaking) anyone who is farsighted and unable to see up close, or is now beginning to notice their vision isn’t as good as before, will probably be a good candidate for SuperSight Surgery.”
SuperSight Surgery works best in what are technically known as hyeropic presbyopes, meaning those individuals who are farsighted and have lost the optimal close up focusing ability of their eye’s natural lens. Presbyopes typically wear glasses for close-up work or reading, however because each individual’s situation is different, a consultation with Dr. Somchai is the only way to definitely determine if you are a good candidate for the procedure.
Dr. Somchai again, “We can’t offer guarantees. While SuperSight Surgery does not promise perfect vision, it does hold the promise of reducing one’s dependence on contact lenses or glasses. However, after your initial consultation, we will be able to give you a clear indication as to what you should expect and the likelihood of your achieving it.”
So what does it cost? The current fees for the procedure are USD 4,500 or 3,600 Euro, which include surgery fees, the special lenses, implantation for both eyes and medicines on the day of surgery and one night stay in hospital.
Dr. Somchai can be contacted through his website www.doctorsomchai.com.

The Doctor's Consultation: Passive smoking – should we take it passively?

by Dr. Iain Corness

For the past two issues I have concentrated on smoking and its effects, and how to stop. It requires dedication and commitment, and I congratulate all people who have given up smoking. You have done your health profile in the future a great service. While smoking cigarettes does not mean you will automatically get lung cancer, or other smoking related illnesses, by becoming a non-smoker does guarantee that your chances of getting the above conditions are very much less. And before the cigarette smokers out there start waving their arms (or cudgels), the evidence is in the arena of public knowledge. Read it.
However, there is one more aspect of smoking, which I should mention. That is “passive” smoking. So what exactly is passive smoking? In essence, it is breathing in other people’s cigarette smoke, which the scientists break up into two parts – “sidestream” smoke from the burning tip of the cigarette which the scientists say accounts for 85 percent of the smoke in an enclosed area, and “mainstream” smoke that has been inhaled and then exhaled from the lungs by the smoker. I usually refer to this 15 percent as “second-hand smoke”.
The situation associated with passive smoking has been well investigated by the scientific communities of the world, and the following information was extracted from the Scientific Committee on Tobacco and Health (SCOTH) in the UK. For example, is tobacco smoke a simple compound? No, tobacco smoke contains over 4000 chemicals in the form of particles and gases. The particulate phase includes tar, nicotine, benzene and benzo(a)pyrene. The gas phase includes carbon monoxide, ammonia, dimethylnitrosamine, formaldehyde, hydrogen cyanide and acrolein. It has been estimated that tobacco smoke contains as many as 60 substances which cause - or are suspected of causing - cancer. And many irritate the tissues of the respiratory system. The Environmental Protection Agency (EPA) in the USA has classified environmental tobacco smoke as a class A carcinogen - ranking it alongside asbestos and arsenic. You don’t need to be an academic toxicologist to understand that formaldehyde and hydrogen cyanide are hardly amongst the compounds that are “good” for you!
SCOTH looked at the situation and concluded that passive smoking can cause eye irritation, headache, cough, sore throat, dizziness and nausea. Just 30 minutes exposure can be enough to reduce blood flow through the heart. If your blood supply to the heart is only just sufficient under normal conditions, this could be enough to tip the scales. More than slightly worrying! There is also evidence to show that people with asthma can experience a significant decline in lung function when exposed.
The advantage of well based scientific study is that large groups of people can be examined and findings collated. When large exposed groups show a preponderance of any sign or symptom, compared to a group not exposed, then you can place some credence on the findings. Here are some of them. Non-smokers who are exposed to passive smoking in the home have a 25 percent increased risk of heart disease and lung cancer. Researchers from London’s St. George’s Medical School and the Royal Free hospital have recently found when you include exposure to passive smoking in the workplace and public places the risk of coronary heart disease is increased by 50-60 percent. A major review in 1998 by SCOTH concluded that passive smoking is a cause of lung cancer and ischaemic heart disease in adult non-smokers, and a cause of respiratory disease, cot death, middle ear disease and asthmatic attacks in children. Children in smoking households have a much higher risk of respiratory problems (72 percent) than those raised in non-smoking households. The UK Government’s Committee on Carcinogens concluded that environmental tobacco smoke is carcinogenic, and responsible for several hundred deaths a year in the UK.
I do not need further proof. Do you?

Agony Column

Camera Class:  Weird photographers - Edweard Muybridge

by Harry Flashman

Photography can certainly bring out some of the real characters in this world. A few months back I brought Weegee to your notice, the man I like to call the father of photojournalism. He was the chap ready to photograph a body on the pavement, but I doubt if he would ever have been involved in holding a blanket to catch the jumper! No, the photo came first. So to another for whom photography came first – weird Edweard Muybridge was another of these ‘characters’ and while decidedly eccentric he did further scientific knowledge and in fact made the first cinema projector, so should be remembered fondly.
Edweard was born plain Edward Muggeridge in the UK in 1830 but emigrated to America in the early 1850’s and changed his name (as did a lot of other people emigrating in those days – and even these days to places like Thailand). Edward’s reasons for emigration were not stated.
In the 1860’s he took up photography and gained some fame as a topographical photographer and even published a book, “Scenery of the Yosemite Valley” in 1867, so Ansel Adams was not the only one to see the possibilities in the majestic landscapes.
However, it was the photography of motion that attracted Edweard. In 1872 he finally managed to successfully photograph a horse in motion showing that at certain times all four hooves are off the ground simultaneously, this fact being one of much controversy and wagers. Unfortunately, immediately after proving his point, he was tried for murdering his wife’s lover but was acquitted. He was then sued for divorce by the distraught lady and finally widowed. All this kept Edweard away from his photography of motion for four years.
Returning to photography, with the millionaire railroad builder, Leland Stanford as his sponsor, Edweard developed a unique system in 1878 which was in reality 12 cameras mounted side by side and operated by trip wires. By the following year he had expanded this to 24 cameras and could thus take very short time interval photographs of horses, dogs, pigeons and goats in motion. This in turn led to photographing moving humans, despite enormous problems in getting people to walk past his battery of 24 cameras in the nude! However, by 1881 he published these in a book.
His next objective was to show these as motion and he invented the “Zoopraxiscope” which projected sequences of these photographs mounted on a glass disc to give the impression of true motion. This was in fact the worlds first cinema projector and preceded Thomas Edison’s “Kinetoscope” by some twelve years.
In 1882 Edweard went to Europe, hopeful of raising sponsorship to continue his photographic study of movement, but returned to America with empty pockets. He was then lucky enough to get backing from the University of Pennsylvania. They kept him alive while he photographed 2000 models, male and female, clothed and nude, as well as wild animals. When he ran out of models, he even used himself, taking his serial shots of himself walking up and down ramps. 20,000 photographs of almost 800 different subjects were published in a book called “Animal Locomotion” in 1887.
Once again, he was to run out of money for his grandiose schemes and tried selling the “Animal Locomotion” book at $100 a book. Needless to say it was not an overnight best seller.
This led our Edweard to new heights. He built a hall to demonstrate the Zoopraxiscope, called the Zoopraxographical Hall in the 1893 Chicago World’s Colombian Exhibition. This was the world’s first movie theatre and predated the Lumiere brothers “Cinematographe” presentations by three years.
Despite his inventiveness, the world did not beat a path to his studio and Edweard decided he had enough of this photography lark, returning to the UK, where he bequeathed all his photographic equipment to the local library. At the turn of the century he reprinted his original books, earning enough to eke out his last four years of life.
Of course, what Edweard did not realize was that almost 100 years later the scientific community would find that he had left them the most complete records of animal motion ever produced and in fact in 1979 his books were republished. It’s a (Ed)weird world we live in!

Money Matters:  How past can affect present and future, continued…

Alan Hall
MBMG International Ltd.

It’s not that Alan Greenspan was unaware of the developing bubble or even the action that was needed; “By the late 1990s, it appeared to us that very aggressive action would have been required to counteract the euphoria that developed in the wake of ... extraordinary gains in productivity growth spawned by technological change,” he said.
Austerity measures were needed; the punchbowl should have been taken away and corporate, federal and consumer America given the opportunity to drink some black coffee. Instead the party got more and more out of control. Greenspan’s justification for not taking away the punchbowl has been that, “In short, we would have needed to risk precipitating a significant recession, with unknown consequences. The alternative was to wait for the eventual exhaustion of the forces of boom.”
Well that is the job of the chairman of the Federal Reserve System - that’s what all the predecessors had to do and that is what Alan Greenspan has evaded doing. His view is, “We concluded that the latter course was by far the safer.” Our take is that he abdicated all responsibility.
Fleckenstein interprets this as the Fed realized that there was a bubble forming (although as Fleckenstein points out at the time the Fed denied this, but we now know that the Fed speaks with a forked tongue) but didn’t worry because they assumed that they could fix it. The Greenspan view is that, “Relying on policymakers to perceive when speculative asset bubbles have developed and then to implement timely policies to address successfully these misalignments in asset prices is simply not realistic ... It is difficult to suppress growing market exuberance when the economic environment is perceived as more stable.”
Fleckenstein has highlighted a range of measures that the Fed could have introduced (we would have liked to have seen tax hikes - admittedly that would have required Presidential initiative beyond Greenspan’s remit, but he certainly didn’t have to make his policies so accommodating to the suicidal tax cuts of the Bush regime).
Among these are: Regulation T - margin requirements can be raised to reduce risk and change market psychology. Regulation X. Part of the Defence Production Act of 1950, this regulation let the Fed set minimum down payments and maximum mortgage-repayment periods for residential properties. The Fed gave up the authority a few years later, but could have asked Congress to redress this.
Failing that, inflicting short term pain on the economy for longer term gain is what Paul Volker and predecessors have had to do. The 13 interest rate cuts, all the way down to 1%, were irresponsible and have created the greatest bubble that the world has ever seen - the US housing market.
Fleckenstein summarises, “The fallout from the housing boom, the unfinished business from the stock boom and all the derivatives he’s championed for his beloved deregulated financial system will combine to hit with full force somewhere down the road. By then, of course, Greenspan will be long gone.”
Bill Fleckenstein, a hedge fund manager based in Seattle, recently used his daily Market Rap column to unburden himself about the outgoing Fed chairman’s legacy. In this column he is highly critical of the easing of monetary policy in the mid 1990s that created the housing and equity bubbles that we have seen since then. Greenspan has claimed that, “The equity market’s ability to withstand periods of tightening arguably reinforced the bull market’s momentum.”
Fleckenstein believe that it was the Fed bail-outs of the like of Orange County, Asia and LTCM that was to blame - Fleckenstein insists that the “endless bailouts” created the notion of the “Greenspan put.” “Purely and simply, it was his practice of bailouts and market-cheerleading (which reached fevered pitch at the peak) that turned the boom to bubble.”
In his main criticism of Greenspan Fleckenstein said, “Tools were available to choke off the stock-market boom, but those tools would only have been effective if they undermined market participants’ confidence in future stability.”
Fleckenstein on the other hand harks back to the era of former Fed Chairman Paul Volker, who was a big believer that when the party’s gone on too long, you have to take away the punchbowl before everyone over-indulges with unpleasant after effects. Alan Greenspan never believed in taking away the punchbowl but referred to mutter away about irrational exuberance - the Fed Chairman becomes the party guest who opines that he’s stopped drinking because of the lateness of the hour and if you don’t you’ll regret it in the morning. That wouldn’t be so bad if at the same time Greenspan hasn’t been adding his own special recipe to the punch and making it taste better than any other punch that anyone had ever tasted!

The above data and research was compiled from sources believed to be reliable. However, neither MBMG International Ltd nor its officers can accept any liability for any errors or omissions in the above article nor bear any responsibility for any losses achieved as a result of any actions taken or not taken as a consequence of reading the above article. For more information please contact Alan Hall on alan@mbmg-international.com

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