- Email: [email protected]
Multifunction Endolaser Probe: Reply
648
November, 1992
AMERICAN JOURNAL OF OPHTHALMOLOGY
tumor or dies, I hope the authors will write a note to THE JOURNAL to keep us up to date. DAVID H. ABRAMSON, M.D.
New York, New York
Reference 1. Van Eys, J.: Malignant tumors of the central nervous system. In Fernbach, D. J., and Vietti, T. J. (eds.): Clinical Pediatrie Oncology, ed. 4. St. Louis, C. V. Mosby, 1991, p. 424.
Reply EDITOR:
Dr. Abramson raises several points with re gard to our successful treatment of trilateral retinoblastoma. He concludes that it was the stage of the disease rather than the therapy that allowed successful treatment. We have no way of knowing whether this is true. Previous investigators have not been able to prevent a fatal outcome in patients with trilateral retino blastoma regardless of the stage of the tumor when first symptomatic. Although treatment before cerebral spinal fluid dissemination may make a cure more likely, there is currently no evidence that diagnosing trilateral retinoblas toma before neuroaxis spread will result in a cure. We hope that further investigation will allow us to answer this question. Although our patient with the longest fol low-up never had histologie documentation, it is difficult to fathom that a patient with bilat eral retinoblastoma and a tumor in the pineal region does not have trilateral retinoblastoma. We have not encountered any report of another type of tumor in the pineal region in a patient with retinoblastoma. We will certainly continue to follow up these patients, because we believe they represent a unique group that will advance our under standing of trilateral retinoblastoma. STEPHEN C. NELSON, M.D. HENRY S. FRIEDMAN, M.D. W. JERRY OAKES, M.D. EDWARD C. HALPERIN, M.D. ROBERT TIEN, M.D. GREGORY N. FULLER, M.D. BEVERLY HOCKENBERGER MARK W. SCROGGS, M.D.
Durham, North Carolina
MARK MONCINO, M.D.
Louisville,
Kentucky
JOANNE KURTZBERG, M.D. EDWARD G. BUCKLEY, M.D.
Durham, North Carolina
Multifunction Endolaser Probe EDITOR:
In the article, "Multifunction endolaser probe," by G. A. Peyman and K. J. Lee (Am. J. Ophthalmol. 114:103, July 1992), the authors describe this laser probe as their design with out acknowledging that it is a modification of an endolaser probe developed and already marketed by Infinitech, Inc. (St. Louis, Mis souri). In the spring of 1991, I initiated collabora tion with the engineering staff at Infinitech, Inc., to develop an aspirating laser probe. The probe was subsequently marketed by In finitech, Inc., beginning in January 1992, un der the name "Chang aspirating laser probe." This probe has all of the backflush, aspiration, and infusion capabilities described by Peyman and Lee, neither of whom was involved in the design of the instrument. The probe design was modified later to incorporate a light fiber when Dr. Peyman requested the addition of fiberoptic light as an added function. While the instrument described by Peyman and Lee is a modification of the probe that carries my name, the appearance and laser, aspiration/infusion capabilities are identical to the Chang aspirating laser probe. The casual reader might even be led to believe that I have plagiarized the ideas of Drs. Peyman and Lee, because the probe sold under my name has the same appearance. I simply would like to set the record straight by clarifying the history behind the development of this instrument. STANLEY CHANG, M.D.
New York, New York
Reply EDITOR:
In April 1988, Dr. Raichand, and one of us (G.A.P.) visited Advanced Surgical Products, Inc. (St. Louis, Missouri), to discuss develop ment of various surgical instruments with this company. Among the items discussed with Mr. Gregg Serieller, Vice President-Marketing, Mr. James Easley, and Mr. Todd Hessel was the development of an endolaser system with multifunction capabilities. On April 29, 1988, Mr. Gregg Serieller (written communication) confirmed their commitment to the develop ment of various products and went on to speci fy the concept of "combined laser, illumina tion, and suction in the same instrument." He wrote: "This correspondence will serve as le gal evidence that the innovative ideas above, with the exception of the scissors handpiece, were supplied by you."
Vol. 114, No. 5
Correspondence
By the end of 1989, Infinitech, Inc., (St. Lou is, Missouri), acquired Advanced Surgical Products, Inc., and all its employees, including Messrs. Scheller, Easley, and Hessel, who be came a part of Infinitech, Inc., until the pres ent. Because of this transition, a number of projects that I had proposed to Advanced Sur gical Products, Inc., were put on hold. Subse quently, in 1990, in collaboration with Donald D'Amico, M.D., and Iris Medical Instruments (Mountain View, California), we developed an endolaser probe with aspiration capability. 1 Knowing that there was still merit to the original concept of multifunction endolaser probe, I contacted Mr. Gregg Scheller from In finitech, Inc., in 1991, and asked if the compa ny could produce this probe for me, which they agreed to do. Dr. Chang may have had the idea of an aspi rating laser probe in the spring of 1991, but certainly it did not predate the probe designed by Dr. D'Amico and me, or my original con cept of a combined laser, illumination, and suction instrument, as described in the Letter to The Journal. GHOLAM A. PEYMAN, M.D KWANG J. LEE, M.D.
New Orleans, Louisiana
649
The Obligation of Ophthalmic Organizations to Report Their Actions EDITOR:
Congratulations for publishing the editorial, "The obligation of ophthalmic organizations to report their actions," by F. W. Newell (Am. J. Ophthalmol. 114:220, August 1992). The issue Dr. Newell addresses is an important one. Ophthalmology is not just fragmented by subspecialty, but by other categories as well: acad emicians, basic researchers, HMO physicians, ambulatory surgeons, general office practition ers, and the like. The more the organizations representing these somewhat different inter ests talk to themselves alone, and the less they talk to others, the more serious their fragmen tation becomes, with the development of un necessary jealousies, resentments, and rival ries. Being open and honest is neither always easy nor without risk. But not to be open and honest guarantees a disconnectedness from each other that results in our losing the collegiality essential for the well-being of ophthal mology as an integral part of the medical pro fession as a whole. GEORGE L. SPAETH, M.D.
Philadelphia,
Reference 1. Peyman, G. A., D'Amico, D. J., and Alturki, W. A.: An endolaser probe with aspiration capabili ty. Arch. Ophthalmol. 110:718, 1992.
Pennsylvania
November, 1992
AMERICAN JOURNAL OF OPHTHALMOLOGY
tumor or dies, I hope the authors will write a note to THE JOURNAL to keep us up to date. DAVID H. ABRAMSON, M.D.
New York, New York
Reference 1. Van Eys, J.: Malignant tumors of the central nervous system. In Fernbach, D. J., and Vietti, T. J. (eds.): Clinical Pediatrie Oncology, ed. 4. St. Louis, C. V. Mosby, 1991, p. 424.
Reply EDITOR:
Dr. Abramson raises several points with re gard to our successful treatment of trilateral retinoblastoma. He concludes that it was the stage of the disease rather than the therapy that allowed successful treatment. We have no way of knowing whether this is true. Previous investigators have not been able to prevent a fatal outcome in patients with trilateral retino blastoma regardless of the stage of the tumor when first symptomatic. Although treatment before cerebral spinal fluid dissemination may make a cure more likely, there is currently no evidence that diagnosing trilateral retinoblas toma before neuroaxis spread will result in a cure. We hope that further investigation will allow us to answer this question. Although our patient with the longest fol low-up never had histologie documentation, it is difficult to fathom that a patient with bilat eral retinoblastoma and a tumor in the pineal region does not have trilateral retinoblastoma. We have not encountered any report of another type of tumor in the pineal region in a patient with retinoblastoma. We will certainly continue to follow up these patients, because we believe they represent a unique group that will advance our under standing of trilateral retinoblastoma. STEPHEN C. NELSON, M.D. HENRY S. FRIEDMAN, M.D. W. JERRY OAKES, M.D. EDWARD C. HALPERIN, M.D. ROBERT TIEN, M.D. GREGORY N. FULLER, M.D. BEVERLY HOCKENBERGER MARK W. SCROGGS, M.D.
Durham, North Carolina
MARK MONCINO, M.D.
Louisville,
Kentucky
JOANNE KURTZBERG, M.D. EDWARD G. BUCKLEY, M.D.
Durham, North Carolina
Multifunction Endolaser Probe EDITOR:
In the article, "Multifunction endolaser probe," by G. A. Peyman and K. J. Lee (Am. J. Ophthalmol. 114:103, July 1992), the authors describe this laser probe as their design with out acknowledging that it is a modification of an endolaser probe developed and already marketed by Infinitech, Inc. (St. Louis, Mis souri). In the spring of 1991, I initiated collabora tion with the engineering staff at Infinitech, Inc., to develop an aspirating laser probe. The probe was subsequently marketed by In finitech, Inc., beginning in January 1992, un der the name "Chang aspirating laser probe." This probe has all of the backflush, aspiration, and infusion capabilities described by Peyman and Lee, neither of whom was involved in the design of the instrument. The probe design was modified later to incorporate a light fiber when Dr. Peyman requested the addition of fiberoptic light as an added function. While the instrument described by Peyman and Lee is a modification of the probe that carries my name, the appearance and laser, aspiration/infusion capabilities are identical to the Chang aspirating laser probe. The casual reader might even be led to believe that I have plagiarized the ideas of Drs. Peyman and Lee, because the probe sold under my name has the same appearance. I simply would like to set the record straight by clarifying the history behind the development of this instrument. STANLEY CHANG, M.D.
New York, New York
Reply EDITOR:
In April 1988, Dr. Raichand, and one of us (G.A.P.) visited Advanced Surgical Products, Inc. (St. Louis, Missouri), to discuss develop ment of various surgical instruments with this company. Among the items discussed with Mr. Gregg Serieller, Vice President-Marketing, Mr. James Easley, and Mr. Todd Hessel was the development of an endolaser system with multifunction capabilities. On April 29, 1988, Mr. Gregg Serieller (written communication) confirmed their commitment to the develop ment of various products and went on to speci fy the concept of "combined laser, illumina tion, and suction in the same instrument." He wrote: "This correspondence will serve as le gal evidence that the innovative ideas above, with the exception of the scissors handpiece, were supplied by you."
Vol. 114, No. 5
Correspondence
By the end of 1989, Infinitech, Inc., (St. Lou is, Missouri), acquired Advanced Surgical Products, Inc., and all its employees, including Messrs. Scheller, Easley, and Hessel, who be came a part of Infinitech, Inc., until the pres ent. Because of this transition, a number of projects that I had proposed to Advanced Sur gical Products, Inc., were put on hold. Subse quently, in 1990, in collaboration with Donald D'Amico, M.D., and Iris Medical Instruments (Mountain View, California), we developed an endolaser probe with aspiration capability. 1 Knowing that there was still merit to the original concept of multifunction endolaser probe, I contacted Mr. Gregg Scheller from In finitech, Inc., in 1991, and asked if the compa ny could produce this probe for me, which they agreed to do. Dr. Chang may have had the idea of an aspi rating laser probe in the spring of 1991, but certainly it did not predate the probe designed by Dr. D'Amico and me, or my original con cept of a combined laser, illumination, and suction instrument, as described in the Letter to The Journal. GHOLAM A. PEYMAN, M.D KWANG J. LEE, M.D.
New Orleans, Louisiana
649
The Obligation of Ophthalmic Organizations to Report Their Actions EDITOR:
Congratulations for publishing the editorial, "The obligation of ophthalmic organizations to report their actions," by F. W. Newell (Am. J. Ophthalmol. 114:220, August 1992). The issue Dr. Newell addresses is an important one. Ophthalmology is not just fragmented by subspecialty, but by other categories as well: acad emicians, basic researchers, HMO physicians, ambulatory surgeons, general office practition ers, and the like. The more the organizations representing these somewhat different inter ests talk to themselves alone, and the less they talk to others, the more serious their fragmen tation becomes, with the development of un necessary jealousies, resentments, and rival ries. Being open and honest is neither always easy nor without risk. But not to be open and honest guarantees a disconnectedness from each other that results in our losing the collegiality essential for the well-being of ophthal mology as an integral part of the medical pro fession as a whole. GEORGE L. SPAETH, M.D.
Philadelphia,
Reference 1. Peyman, G. A., D'Amico, D. J., and Alturki, W. A.: An endolaser probe with aspiration capabili ty. Arch. Ophthalmol. 110:718, 1992.
Pennsylvania