A cataract is a clouding of the natural lens in the eye and can affect your vision in a manner akin to "looking through a dirty window". Cataracts occur as a result of the natural aging process of the body and, while typically associated in patients over the age of 60, can also be found in individuals younger than 35! The goal of improving visual performance of the eye has been simply to remove the cloudy cataract lens which, for centuries, was the only cure. Unfortunately, visual outcomes from these early surgical procedures were not very good. With the development of modern intraocular lenses, Ophthalmologists are now able to restore vision performance in eyes and allow patients to resume lifestyles that might have been curtailed because of poor vision. While the development of these original lenses has been good, modern science has now resulted in lenses that allow patients to see both far AND near and not require any glasses AT ALL! For a patient to achieve this “spectacle-free vision”, the doctor must get the proper measurements of the length and curvature of the eyeball and use specially derived mathematical formulas that determine what power intraocular lens should be used. These careful measurements are needed for both the standard intraocular implants and the more sophisticated multifocal lenses like “Restore” or “Crystalens”.
The human body is an amazing thing. This certainly applies to the eye and how predictable the overwhelming majority of surgical cases are in terms of outcome. However, the effect of wound healing in the eye is not 100% predictable which can sometimes mean that an occasional patient will need spare glasses after their surgery. In these special cases, the doctor can do a “touchup” LASIK procedure to repair the power variation and optimize vision. The results with LASIK after cataract surgery are generally excellent. Other alternatives to the LASIK touchup include lens exchange for the original implants. While this would most likely work, most patients and doctors are not excited about the idea of having another surgical procedure to exchange the lens implant since this can increase the risk of complications. So, an idea was proposed and researched. What if we could change the power of the existing lens implant externally without further surgery or LASIK? The first concept for an IOL that would work like this was proposed in 1996 and involved the use of magnets. This proved to be cumbersome and not consistently accurate. In 2003, development of a lens implant that could be adjusted through the use of an ultraviolet (uv) light delivery system was begun. The uv light would cause a photochemical change in the plastic that the IOL was made of and cause a change in the prescription power. Recently an 18 month follow-up study done in Germany on this IOL was published and the results were very promising. Complications from this lens implant both during and after surgery were very rare and only 2 eyes out of 122 in the study had changes in the prescription after the IOL power was adjusted with the uv light. However, 50% did require 2 treatments with the uv light to get the proper lens power.
While all the final results are not in, this study does show that this technology will definitely work. In the future it may provide surgeons with a greater confidence in providing their cataract patients a touchup procedure via a non-surgical means and thus offer better vision without spectacles after surgery. We eagerly await the day this lens implant is FDA approved and available in the United States.
Dr. Steven Corwin is a Board Certified, Corneal Fellowship trained Ophthalmologist. Dr. Corwin has been with Marietta Eye Clinic since 1997, and practices at our Powder Springs, East Cobb, and Main office locations.
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