Dr. Alice Epitropoulos is pioneering new corrective procedure

Text: local eye specialist is helping patients see better with a new twist on an old procedure. Upper Arlington resident Dr. Alice Epitropoulos took a new astigmatism-correcting device many ophthalmologists use in the operating room, and brought it into a new light in her office. About 25 million people have astigmatism, a condition in which the cornea of the eye is irregularly shaped like a football, rather than round like a basketball. It can cause distorted or blurred vision and often makes fitting contact lenses difficult, Epitropoulos said. The new take on the procedure might be less nerve-wracking for patients than its operating room cousin.  Epitropoulos lets patients sit up in a chair, rather than lay down like they would have to do if they went the operating room route. To correct or reduce the astigmatism, Epitropoulos first numbs the patient's eyes with drops and then props the lids open with a small plastic device, she said. Then, she inserts another plastic piece numbered with precise 10-degree increments into the eye. "This instrument tells us exactly where to place the incision," she said.  The tool is called a Terry astigmatome, named after the doctor who created it. Before the tool was developed, doctors had to correct the astigmatism by judging with their own eyes where to make the incisions. The cornea tended to buckle and the length of the cuts were inconsistent, Epitropoulos said. "The traditional method is more of a freehand method and technically more difficult in my opinion," she said. "I found that this (new) procedure has effectively reduced astigmatism in a more accurate and controlled manner," she said. Epitropoulos noted having the procedure done in the office is also cheaper since the patient does not need to pay a facility fee for the operating room. Epitropoulos said she developed the idea of bringing the procedure into the office setting when she was teaching students to work on animal eyes during a "wet lab" at Ohio State University, where she is a clinical assistant professor. She tried it on a few practice eyes before beginning to use it in her practice at Grant Medical Center, where she specializes in cataract and refractive surgery. "I've tried it on 12 patients so far," she said. "We've had good results with it." Mark Anderson, a national sales manager for Oasis, the company which produces the astigmatome, said Epitropoulos was the first doctor to try out the tool in an office setting. "Nobody's had the guts to step up and do it. She was the first one," Anderson said. "Based on her success, I have other physicians who are planning to do it," he said. In January, Epitropoulos spoke to colleagues about her views on the astigmatism procedure during Hawaii 2000, the third largest annual ophthalmologist meeting in the country. "The course was closed out. There were so many people who wanted to try it," she said of her presentation. Other ophthalmologists said they were interested, but as far as Epitropoulos knows, she's the only doctor in the country using the revised procedure. Anderson said he didn't know of any others who have brought the procedure out of the surgery center and into their offices. Epitropoulos said the astigmatome method is safe and precise. The method has few risks, she said, but noted any time someone operates on an eye, risks are involved.