Safety and Effectiveness of Smooth Incision Lenticular Keratomileusis (SILK™) Using the ELITA™ Femtosecond Laser System for Correction of Myopic and Astigmatic Refractive Errors [Letter]

Dear editor

I was interested to read the paper by Sachdev et al on the safety and effectiveness of the ELITA™ femtosecond laser for astigmatic corrections.¹ It was gratifying that they used the technique that I developed and innovated in a paper published in the Journal of Cataract and Refractive Surgery in 1993,² since described as The Alpins Method, now widely used in treating and analyzing astigmatism as well as in the formal reporting of the results of such treatments. Overall, the study demonstrated that the ELITA laser can remove the lenticule successfully with smooth apposing surfaces.

However, the paper raises an important concern related to the terminology and referencing the authors chose to use. The vector analyses of astigmatism used in the paper follow techniques and nomenclature recommended by the Astigmatism Project Group of the American National Standards Institute (ANSI). The ANSI paper, by Eydelman et al (JRS 2006), was later shown to reproduce the method I published in 1993.² Yet Sachdev et al reference only the ANSI paper, which other authors have noted^3–5 copied my technique without adequate acknowledgement. Sachdev et al cite two references, 31 and 32, both of which employ The Alpins Method and cite my seminal paper. It makes little sense for the authors to confuse readers by using different terminology than the references they employ, putting obstacles in front of readers to understand an already complex subject.

As BJ Dupps stated in his editorial,⁴ “citation is intimately linked to the birth of new disciplines”, and proper referencing of source material is an essential process in the advancement of scientific knowledge. For whatever reason, Sachdev et al were negligent in this regard. The editors of the Journal of Refractive Surgery (JRS), in their 2014 editorial,⁵ were clear about the duplication of my approach and went to great length to defend their preference for the seminal terms that I originally employed to describe the method I invented 13 years earlier.

It is clear that J&J funded this study in order to promote the general adoption of their recently introduced laser, and that several of the authors are J&J employees. I believe that the principles of ethical publication may have been overlooked to serve a commercial agenda, where original sources and intellectual property are disregarded. This paper’s use of inadequate referencing and widely abandoned terminology will confuse knowledgeable readers and disappoint innovators in the ophthalmic field.