March 8, 2005
Having cataract surgery? New accommodating lens restores youthful vision
People who have cataract surgery may not have to worry about misplacing their reading glasses any longer, thanks to a new implantable lens that moves like the eye’s natural lens. The new lens is designed to shift its position within the eye, allowing both near and far vision.
Everyone loses the natural elasticity of the lens with age. This creates a loss of accommodation, or ability to see at different distances without glasses. The condition is known as presbyopia, and, as a result, most people need bifocals or reading glasses beginning around age 45.
Michael Smith-Wheelock, M.D., ophthalmologist at the University of Michigan Kellogg Eye Center, now offers a new accommodating intraocular lens (IOL) to some individuals undergoing cataract surgery. He has been pleased with the results, noting that it provides his patients with functional vision, or, as Dr. Smith Wheelock says, “good walking around vision.” While individuals may still need eye glasses for extremely small print, for example in medicine inserts, most regain the ability to read a newspaper and see into the distance without glasses.
Robin Dudley, among the first to have the surgery at Kellogg, says the new lens has changed his outlook on life. An auto mechanic and teacher of the trade, he was beginning to experience double vision due to cataracts. “Imagine looking at a running engine and not knowing whether a sharp object is nearby,” he said. “I thought about retiring, but now, why should I?” He jumped at the chance to try the IOL because it would give him the range of vision he needed for his work.
The lens exceeded Mr. Dudley’s hopes. He easily adapted to it, using eye drops for only a short period after surgery. Two weeks later, Mr. Dudley threw away his reading glasses. “It’s beyond great. I wish this had been available five years ago,” he said.
“A clouding of the lens inside the eye, known as a cataract, will affect just about everyone sooner or later,” says Dr. Smith-Wheelock. When visual quality is sufficiently impaired, cataract surgery is performed to remove the cloudy lens and replace it with a fixed artificial clear lens.
The new lens, Crystalens™, includes hinges that work with the eye’s focusing muscles so that the lens can move forward or backward as needed for near, intermediate, and distance vision. “The lens mimics the natural action of the eye, which has its own auto-focus function,” explains Dr. Smith-Wheelock.
The lens device was approved by the FDA in November, 2003. Of the 324 adults over the age of 50 who had the new IOL inserted as part of a clinical trial, the majority had markedly improved vision. With the Crystalens implanted in both eyes, 98% had vision good enough to pass a driver’s license exam, 98% could read print the size of stock quotes in the newspaper, and 93% said they could perform most daily activities without glasses.
Although the device has FDA approval, the federal government and commercial insurance carriers have placed some restrictions on its availability. *Patients must be under the age of 65, because, for the moment, those on Medicare are not eligible for the surgery. Patients with insurance must pay part of the cost of the IOL.
Dr. Smith-Wheelock sees the new accommodating IOL as a terrific alternative for the right person. “Our patients say they come out of cataract surgery with the eyes of a 30-year old. Now, their world is clear and in focus when they read, watch television, or drive down the highway. The future of this lens is very promising.”
* As of May 10, Medicare changed its policy and now allows its beneficiaries to have the new lens. Medicare covers the surgery and the cost of inserting a standard IOL. Patients pay the additional costs for the accommodating IOS.
Contact: Betsy Nisbet, 734.647.5586, bsnisbet@umich.edu or Aimee S. Bergquist, 734.763.4660, aimeesb@umich.edu.
