DR. JOSEPH DELLO RUSSO

A new study was presented on November 16, 2006 at the annual meeting of The Academy of Ophthlamology in Las Vegas, Nevada. The study affirms that laser vision correction, LASIK and PRK are both safe and effective. Last month Dr. Dello Russo presented a study indicating that LASIK is so safe that it is actually safer than using contact lenses. Now Dr. Maloney of Los Angeles presented a study that indicates the same. The study compared 100 patients having LASIK verses 100 patients having PRK. They both had the same safety results.

Dr. Dello Russo: “It continues to astound me how good this surgery has gotten. From when I first helped to study the laser in 1990 as an FDA researcher to the present high tech safe technology.” The story was just covered by ABC News – click here to watch the video.

For many years, a $69/dose medicine has been widely used to treat ARMD, an aging degeneration of the retina. Although it is not a definitive cure it does seem to arrest the progress in a significant percentage of people and some even gain some lost vision back.

The drug is called Avastin, originally developed and approved for colorectal cancer. It has also been used by eye doctors for ARMD, although it is not approved by the FDA for that purpose. It is called being used “off-label”. Nobody has objected using this cancer drug for another unapproved use since it benefits people.

Now a new but related and more costly drug has been approved by the FDA for treating ARMD with similar results as Avastin, except that Lucentis costs about $1,950 per dose.

So here is the dilemma: if the results of both drugs are similar, but the cost is so dramatically different, which should a doctor use?

If the eye doctor chooses to use Avastin to save patient or insurance carrier money, is the doctor exposing himself to then being sued?

Although Avastin has been recognized and widely used for the eye for so many years it is still an “off-label” use. Now that Lucentis is available, is in unethical to continue to use Avastin regardless of costs?

The problem is basically that in case a patient complains the results of Avastin, would an attorney use this “off-label” use to be a claim of malpractice, assault and battery.

Editor’s Comment:
A simple example of another “off-label” drug is the use of Aspiran Prohylactcly as a heart medicine in older persons. Aspiran has never been approved by the FDA for a cardiac use. Believe it or not.

News from the Journal of the AMA: FUSARIUM KERATITISOUTBREAK IN CONTACT LENS WEARERS.

In a series of hospital-based wearers of 66 patients from March 2004 – May 2005 which translated into an incidence of 2.3 / 10,000. Poor hygiene and contamination of Fusarium in the cleansing solution seemed common.

Editor Dr. Joseph Dello Russo comments: “Fusarium appears to be latest  germ to plague wearers. Again poor hygiene does seem to play a part.”