Five years ago, glasses or contact lenses were the only choices available in the United States to correct extreme nearsightedness. Today, more permanent options are available through laser surgery.

The Federal Drug Administration did not approve laser surgery for vision until 1995, although it has been investigated since the ‘80s, according to Dr. Kevin Lui, an optometrist at MidPacific Eyecare, laser surgery consultants.

Before 1995, laser surgery was available only outside the United States, specifically in Canada and Columbia. In 1997, the FDA expanded the range of treatment available. Since then, the number of U.S. ophthalmologists offering laser surgery has grown.

The main goal of refractive surgery is to reshape the eye’s cornea—the clear outer surface of the eye—so that glasses or contacts are no longer needed to correct nearsightedness, technically known as myopia. Two methods are common today, and both use an ultraviolet excimer laser: photorefractive keratectomy (PRK) and the newer Laser Assisted in-Situ Keratomileusis (LASIK). PRK works best for low to moderate myopia, while LASIK can correct low, medium, or high levels.

PRK sculpts the front surface of the cornea by removing the thin surface layer (which will regenerate within a few days). Then computer-controlled pulses vaporize tiny amounts of the remaining surface to change the cornea’s shape. Deeper layers of the eye are untouched. A clear contact lens is placed on the eye to act as a protective bandage while it heals. This procedure takes about five minutes, but it may take three to five days for the eye to heal and vision to clear.

LASIK also reshapes the cornea, but goes deeper than PRK. The surgeon uses a specialized knife to slice from the surface of the eye a flap, which remains attached by a hinge of tissue. The laser reshapes the layer of tissue below the flap and the surgeon then replaces the flap. The flap is held in position by the eye’s natural suction. After a week, the flap is mostly healed, but patients should not rub their eyes hard for a month and it may take as long as a year for the eye to heal completely. This procedure takes less than 10 minutes, and clear vision can occur after 24 hours.

After either procedure, it may take up to three months for vision to stabilize. Recovery is usually faster with LASIK, however, and stability can occur in as short a period as two weeks. Once vision has stabilized, the treatment is permanent and usually means less dependence and perhaps complete freedom from glasses or contacts.

Although neither method guarantees 20/20 vision, Hawaii’s results are higher than the national average. About 95 percent of patients achieve 20/40 vision across the nation. In Hawaii, the average is about 97 percent, said Lui.

As with any surgery, risks are inherent with both methods, but incidents are less than 1 percent, said Lui. Infection is the most feared risk, but is extremely rare, less than 0.1 percent according to an information pamphlet on laser surgery. If it does happen, it usually occurs in the first 48-72 hours. Patients receive antibiotic drops after the surgery to prevent infections.

Another risk is the gradual loss of some visual clarity. This can be caused by irregular healing or an irregular flap, but it may improve during the first year, and it can be corrected by glasses or contacts.

Regression, which is the tendency for the eye to go back toward the original vision, can also occur. This happens more commonly in patients with greater myopia.

Three main criteria ensure better results and help lower the risks, according to Lui. First is a careful medical history of the patient. Conditions like diabetes, rheumatoid arthritis, herpes, and pregnancy can greatly affect results because these all affect visual stability.

Second is the skill of the surgeon, especially with regard to LASIK. The surgeon is responsible for both creating a good flap and laying it back down with no wrinkles or distortions. Look for facilities that maintain high standards: those that track post-operation results carefully, invest in new technology, provide regular and continuing education for doctors, and keep up with the newest equipment.

Someone interested in laser surgery may find it difficult to choose a doctor. The best thing to do, Lui said, is to ask you own eye doctor, or a doctor you can trust. Most doctors are aware of which surgeons are more experienced and have had the best results. If you cannot get advice from a doctor, then, Lui suggests, attend one of seminars offered by different eye institutes and get a feel for the staff and facilities.

Last is the pre-operative assessment. The results of this assessment determine what data is programmed into the computer, which controls the laser. The assessment includes measurements of both vision and diameter of the eye. Since contacts can temporarily reshape the eye, this usually means that a patient who normally wears contacts would wear glasses for about a month. Rushing through this assessment may lead to less then desirable results.

Surprisingly, besides having better results in Hawaii, the average cost is also lower. On the East Coast, laser surgery for both eyes costs about $5,000; here it is about $4,000. Lui sees only a small reduction in price because of the growing competition.

MP3.com is the website of a music company started late in 1997 that distributes music freely to all web users and music fans. The company has been controversial due to fears of music industry giants that their products might be pirated.

On an average day, MP3.com has about half a million visitors, which makes their webpage the most popular globally. At the same time, at least 100 artists sign up with MP3.com on a typical day.

MP3 stands for "Moving Picture Expert Group 1, Layer 3" and refers to a new technology that can compress CD quality sound to about the twelfth of its original size and reproduce it with sound quality just as good as a CD. Currently, the company’s website contains songs from about 25,000 artists, and the songs are offered freely to anyone who has access to the Internet.

The MP3 format is so revolutionary that it will forever change the way people listen to and buy music.

A five-minute long song compressed with an MP3 format will use about four megabytes of space and will take slightly more than ten minutes to download. The small size of the compressed file compared to the memory-demanding music files on an ordinary music CD (48 megabytes for an equivalent song) makes MP3 files suitable to store in a computer hard drive. The MP3 format helps users manage the large amount of musical data in their computer, so they won’t need a super computer at home just to listen to music.

MP3 reduces the file size by eliminating extraneous data during the compression process. While occasionally some of the sound quality is lost, this data, often known as "noise," is rarely even noticed by most listeners.

Small file sizes are crucial for Internet delivery, where smaller sizes mean less download times and faster speeds.

Still, size is not the real reason MP3.com is so popular with the Internet using public. Free music online is what attracts most people. So, how does MP3.com make a profit if it gives music away free? Part of the answer is that the music given away does not cost anything to MP3.com. The artists give their songs to MP3.com for promotional purposes, just as once they sent copies to the radio DJs and re-

viewers. MP3.com is one more way to get their product before the public as a way recruiting fans and generating CD and concert ticket sales.

The other part of the answer is that most of MP3.com’s profits are from advertisments aimed at browsers on the MP3.com website. According to MP3.com spokespersons, this is a win-win situation for both the artist and the public as well as for the company.

Most of the CDs that MP3.com sells through it’s ads are around $7, or about half the regular market price, so both customers and artists benefit from this as well. And the high volume generated by the popularity of the site makes it possible for MP3.com to provide music artists with higher profits as well as more control over their music.

In October 1998, Rio Diamond Multimedia Systems of San Jose, California, put a small "walkman-style" MP3 portable player onto the market with the price tag of $199. The Rio PMP300 plays MP3 "audio files" that can hold a number of songs, and it can provide about one hour of listening pleasure. The player will work without your computer, or you can copy the music to a compact flash memory card that you can insert into the player. Playing time is expandable with an additional memory card.

Additionally, the MP3 player does not have any moving parts such as a motor or gears, so a single AA battery can provide up to 12 hours of playtime. With all these advantages, Rio Diamond has sold more than 150,000 MP3 players and cannot keep up with the demand.