November 2005
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New procedures preserve, improve vision
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Douglas Koch, MD |
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Ophthalmologists at Baylor College of Medicine are using new procedures to help sharpen and improve their patients' eyesight.
"The goal of these eye procedures is to preserve or improve the quality of vision while minimizing or eliminating patients' need to wear glasses or contact lenses," said Douglas Koch, MD, professor of ophthalmology and the Allen, Mosbacher, and Law Chair in Ophthalmology. "While these procedures are sometimes considered to be 'cosmetic,' they in fact improve one's ability to function and live full and active lives."
A cataract is a clouding of the eye's natural lens, which lies behind the iris and the pupil. The lens works like a camera lens, focusing light onto the retina at the back of the eye. The lens also adjusts the eye's focus, letting us see things clearly both up close and far away.
Koch said that, while a cataract can progress to a point where there's a total loss of vision in the eye, the vast majority of individuals seek surgery at an earlier phase when the cataract interferes with the performance of normal daily activities.
New intraocular lens
Cataract surgery has advanced tremendously in technology and effectiveness in recent years. Now, said Koch, a new intraocular lens called the AcrySof ReStor IOL, is helping restore the vision of many cataract patients.
"ReStor allows patients to read the newspaper and to see clearly at all distances without the assistance of contacts or glasses," Koch said.
For this procedure a tiny incision is made in the eye and the cloudy lens or cataract is broken up and aspirated from the eye. Once the cataract is removed, the ReStor intraocular lens is inserted into the tiny incision and set into position.
Koch says the ReStor IOL lens is not for everyone. Patients must have a very healthy eye. One common side effect is occasional haloes around lights at night.
A new technique has been created to allow doctors to personalize laser vision correction. Wavefront technology has been adapted to measure optical distortions or aberrations in the eye. These aberrations, like fingerprints, are unique to each individual eye and characterize focusing error well beyond the conventional methods that are used to prescribe eyeglasses.
"This technology known by its commercial name as VISX CustomVue measures light reflected off the inner surface of the eye to generate a map of the eye's optical aberrations. These measurements are much more precise than the standard methods used, " he said.
The information is then used to generate a customized laser treatment based on the optical properties of the patient's eyes.
Keratoconus
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Mitchell Weikert, MD |
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Another disorder than can adversely affect vision is called keratonconus. This problem is a degenerative disease of the cornea that causes it to gradually thin and protrude into a cone-like shape, causing vision to become blurred and distorted. (The cornea is the outermost surface of the eye – a clear, dome-shaped covering.)
Because of the cornea's irregular shape, patients with keratoconus are often very nearsighted and have a high degree of astigmatism that can't be corrected with glasses or soft contact lenses. They typically require rigid gas permeable contact lenses to achieve their best vision. As the disease progresses, they may become intolerant to contact lenses, or their vision may become uncorrectable.
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"The only option that we had a couple of years ago to treat keratoconus was a corneal transplant," said Mitchell Weikert, MD, an assistant professor of ophthalmology. "Recently ophthalmologists have begun using intracorneal ring segments to treat this condition. The ring segments were originally implanted within the cornea to correct low levels of nearsightedness, but they didn't work as well as LASIK surgery."
In keratoconus, the rings help re-establish a more normal corneal shape and may help to stabilize the cornea.
The primary goal is to give the patients useful vision back in their glasses and contact lenses, says Weikert.
To undergo the procedure, keratoconus patients must be at least 21. Their vision cannot be corrected with glasses and they cannot wear contact lenses. They must also have no significant scarring in their cornea. The minimally invasive procedure takes 15 minutes and the only anesthesia needed is eye drops.
Weikert says that this procedure is less invasive with significantly less risk than a corneal transplant, another solution to this problem.
| A Matter of Health | |
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Healing an ailing system |