NO CUT NO TOUCH’ LASER EYE SURGERY COMES TO KENYA

Dr. Joshi performing C-TEN laser eye surgery at his ambulatory clinic at Sarit Centre, Nairobi

By Margaretta wa Gacheru (posted 3.3.2021)

Anyone can make a case for spiffy eyeglasses or colored contact lenses. But most people who wear specs know they look better without them than with. And those who wear contacts are sure of it, but find that dust and pollution make it difficult to wear their contacts full-time.

Corrective eye surgery is what many specs-wearers yearn for, but they either feel laser surgery is too costly or suspect it can endanger their eye sight.

We hear few stories of dismay these days from laser surgery recipients who previously complained about night driving or dry eyes. Their problems usually sorted themselves out after a few days, but some people still believe eye surgery generally can be risky business.

Laser itself stands for ‘Light Amplification by Stimulated Emission of Radiation’ and was invented by Theodore Maiman at Hughes Research Laboratories in California in 1960.

The principle of laser can be traced back to Albert Einstein who in 1917 described the theory of stimulated emissions.

But it wasn’t until 1962 that the first laser eye surgery capable of destroying a retinal eye tumor was being done in the West.

Today, lasers can be found everywhere from bar codes and supermarket scanners to CDs, and diamond cutting drills.

They are best known in Kenya as LASIK corrective eye surgery which seems to be available widely in Nairobi. But LASIK (short for Laser-Assisted in-Situ Keratomileusis) only arrived in Kenya in 2004 with the Uganda-born, India-trained opthalmologist Dr Mukesh Joshi.

Dr. Joshi had come to Kenya after receiving his ophthalmological degrees and went straight to work for the Kenya government for several years before opening his eye correction practice in 1984 in Nairobi.

“It was while attending a conference in Switzerland that I first heard about LASIK and decided to bring it back to Kenya,” says Dr. Joshi who sights Swiss and Norwegian colleagues as those who gave him the most current LAKIK information.

Since laser research and development has been ongoing since the 1950s, Dr. Joshi kept track of new developments in LASIK and so brought EPI-LASIK technology to his practice in 2006.

But what he is most proud of today is the C-TEN laser that he brought home in 2010.

“I was the first to bring this non-invasive ‘no touch – no cut’ laser surgery to Kenya, and we are still the only ones in East Africa to have it,” Dr. Joshi says.

He goes farther and contends that as far as he knows, he is the only ophthalmologist in all of Africa to practice C-TEN. The main reason, he says, is economic.

“Most laser clinics in South Africa are owned by businessmen who have invested heavily in LASIK, so they are not keen to move on,” he says. “The costs are high and the profit margins are low for C-TEN, so it doesn’t make good business sense to invest in the newest technology when clients are still satisfied with LASIK,” he adds.

For him, the advantages of C-TEN far outweigh the costs. This is because it is not only a safer mode of eye surgery, since it is non-invasive. No blade touches the eye, unlike LASIK which physically removes the outer flap of the cornea before applying the laser, after which the flap has to be carefully put back.

In contrast, with C-TEN, all that is done by the laser itself.

And while both LASIK and C-TEN (which stands for Customized Transepithelial no-touch no-cut) apply a topical anesthetic so one is awake during the entire procedure, the high-definition C-TEN procedure takes only 35 seconds at most. What’s more, recovery is much faster and there are rarely problems of dry eyes or night driving.

It is a wonder that more local eye surgeons haven’t moved over to C-TEN, but Dr. Joshi isn’t concerned.

Since 2010 when he first got the latest LASIK technology (for C-TEN is still an advanced form of laser surgery), his satisfied patients number in the thousands. Asked why his advanced technique is not more widely known, Dr Joshi simply says he’s too busy with his practice for self-promotion.

“My patients have learned they didn’t need to fly out of Kenya to get the most advanced laser surgery in the world.”