New technology an option for severe nearsightedness

A new surgical procedure that has improved eyesight in people who have severe nearsightedness and face a dearth of treatments has made its way to western New York.

Ophthalmologist Scott MacRae, M.D.,director of the Strong Vision Refractive Surgery Center at the University of Rochester Eye Institute, this week treated a patient’s severe nearsightedness – vision of approximately 20/3,400 compared to a healthy 20/20 – by outfitting her with a permanently implanted lens, a procedure that was approved two months ago by the U.S. Food and Drug Administration.

The surgery gives an option besides life-long thick glasses or contact lenses to patients legally blind, whose vision problems go far beyond simply not seeing the large “E” on a standard eye chart.

“This surgery produces one of the most dramatic improvements in quality of life that I have seen in my 20 years as a corneal surgeon,” says MacRae. “These are patients who really are blind without glasses. If they knock their glasses off the nightstand, they’re blind – for many, their greatest fear is to be caught in a situation like a fire in a hotel where they could lose their glasses and not be able to find their way out.”

Most such patients aren’t eligible for procedures like LASIK because their eyes simply are too bad to benefit from the procedure, and so they’ve been left behind as their friends and colleagues have ditched their glasses and contacts in recent years.

The key to the new procedure is a plastic lens that is implanted into a person’s eye permanently to correct for the person’s abnormal vision. The technology was included in Time Magazine’s list of top medical developments in 2004.

The lens is implanted just behind the cornea and in front of the iris and the eye’s natural lens during an outpatient procedure that lasts about an hour. It’s the first time the FDA has approved a permanently implanted lens to correct nearsightedness. In studies of the device, 84 percent of patients with vision 20/400 or worse improved to at least 20/40.

MacRae, a professor of Ophthalmology and Visual Science, helped guide the new technology through its final phases in the United States, working closely with California-based American Medical Optics until the device’s approval by the FDA in October 2004. AMO distributes the device, which is called the Verisyse Phakic Intraocular lens and is made in the Netherlands. The lens has been used in Europe since 1990, and so far more than 100,000 people worldwide have had the procedure.

“These are usually people who have worn glasses – super-thick glasses – or contact lenses their whole lives,” says MacRae, “and they get a great deal of distortion or glare from their glasses. We’re glad we can finally offer them an alternative. Back in medical school, we never dreamed that improving vision so dramatically would even be possible.”