ESCRS Homepage

November 2002
IN THIS ISSUE

Wavefront seeks a higher order of vision correction


New laser system for intraoperative measurement of LASIK flap thickness

Visual prostheses use neurotransmitter retinal chips to stimulate retinal function

Wavefront emerges as powerful tool for night vision

Allegretto promising for hyperopia and hyperopic astigmatism

Topography's role in wavefront systems

IOP measurement after LASIK may be unreliable

LASEK may only play support on refractive stage

Solid-state laser PRK yields favourable results for myopia

GTS-assisted DLK useful alternative to PK for keratoconus

Glaucoma common after PK bodes poorly for visual outcome

Classic drawbacks of PRK succumb to new strategies

New insight into LASIK dry eye pathogenesis

Use of anti-inflammatories after capsulotomy questioned

Good quality training leads to good quality cataract surgery

One line of regained visual acuity is a snip at just €120

Mitomycin-C provides effective haze prophylaxis

Long-term concerns linger on safety of Mitomycin-C

German politicos promise health reforms

Honey forms biblical basis for corneal oedema

Routine two-step LASIK after PK unnecessary

Plasma knife provides clean and accurate cut for capsulorhexis

Glaucoma therapy targets apoptosis and trabecular meshwork

Viscocanalostomy viable choice for cataract-glaucoma

Device allows needle-free injections into smallest vessels

New river blindness therapy may provide panacea for 18m people

Daytime running lights may soon be compulsory in all EU states

Intracorneal lamellar implants still a questionable option

Aqualase system viable for small incision cataract removal

Unilateral von-Hippel disease with optic nerve head

FEATURES
From The Editor
Reflections on Refractive Surgery
In Your Good Books
An Eye On Travel
Bio-ophthalmology
Outlook on Industry
Regulatory Matters



Daytime running lights may soon be compulsory in all EU states

By Stefanie Petrou-Binder MD

BERLIN - A special symposium on "Traffic Ophthalmology" at the centennial Congress of the German Ophthalmological Society has revealed that the European Union is now considering making daytime running lights (DRLs) compulsory in all member states.
"Daytime running lights render vehicles more conspicuous, particularly in the twilight hours when poor contrast and inconsistent lighting allow vehicles to escape notice.
"Twenty-five years of Swedish experience indicates that requiring all automobiles to use daytime running lights will reduce daytime traffic accidents," Bernhard Lachenmayer MD reported.
In fact, Swedish safety studies conducted in the 1960s proved that DRLs reduced pedestrian traffic accidents by 21% and cyclists by 17%.

The studies placed cars of different colours on the streets at day and twilight periods. The surrounding colours of woods, fields and neighbourhoods varied seasonally when foliage or snow dominated the background.
Detection of oncoming vehicles was poor when marked by a lower contrast between them and their surroundings - except if the car used lights.
When oncoming vehicles with lights on approached cyclists, pedestrians or other vehicles from different peripheral angles (between 20° and 80°), the study reveals that 9% less accidents occurred.
Compulsory DRLs became a standard feature for Swedish cars in 1967. This was considered a wise safety policy considering the long hours of twilight in Sweden.
This was also the same year that Sweden switched from left to right sided traffic and DRLs provided a new means of alerting vehicles to one another and to other road users.
Other Scandinavian countries soon followed suit. Countries such as Canada, Poland, the Czech Republic and Hungary have made compulsory laws for DRL use on country roads and highways.

In the US, DRLs became optional in the 1980s for use on roads outside built-up areas. They now come as standard on several makes of US cars.
Large US and Canadian fleet studies carried out in the 1950s provided additional data supporting DRL efficacy in reducing traffic accidents.
Greyhound bus fleet studies verified that daytime accidents could be reduced by 10% with DRLs.
A few years later, truck fleets turned out a remarkable 44% reduction in daytime accidents. A New York study showed an 18% drop in daytime collisions involving car drivers.

Although these early studies were not as comprehensive or well thought out as the Swedish safety studies, they too reflect the overall efficacy of DRLs in signalling to other road users the presence of an approaching vehicle, Dr Lachenmayer said.
Daytime running lights are low beamed and smaller than headlights. They are automatically triggered to activate at twilight and can be assembled independently without expensive alteration to the car's light system.
DRLs are directed forward and slightly to the left (or right, depending on which side of the road you are driving on) in order to avoid causing discomfort to oncoming traffic.
The arguments against DRLs centre on increased fuel consumption and pollution. But Dr Lachenmayer stressed that reliable studies have revealed that petrol consumption and pollution are increased by less than 1% with the use of DRLs and so do not constitute a major cost hike or contribute significantly to air pollution.

Nonetheless, some researchers challenge the Canadian and Swedish reports. They assert that new statistical studies are needed to investigate further the effect of real DRLs in varying traffic situations and lighting conditions.
The reason for the scepticism is that all of the studies upon which conclusions have been based were carried out before the introduction of actual DRLs and in fact used car headlights - which are much bigger, brighter and higher-set - to alert fellow road users to the presence of oncoming vehicles. Others object that DRLs are liable to mask brake lights and cause accidents.
The EU has done its own analyses of DRLs. An official review indicates that DRLs reduce the percentage of vehicles' collisions by about 10% and fatalities by 25%. The
EU estimates that mandatory DRLs would prevent 5,500 traffic fatalities per year within member states.

Dr Lachenmayer stressed that non-motorised road users - pedestrians, bike riders, children and the elderly - profit even more from DRLs than car drivers. He said DRLs should be made compulsory for everyone's benefit.


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