Latest improvements in eye surgeries render hope to countless

Cataracts

Protein which constitute the eye’s light-focusing lens learn to clump with years, slowly making vision clouded, fuzzy and sensitive to glare. The Symfony lens is just one of the recent breakthroughs.

New hope

Post-op adjustment: throughout cataract surgery, your ophthalmologist has to calculate the correction your replacement lens needs, but shifts that occur with healing can throw the correction off, resulting in less than optimal results, says ophthalmologist Nick Mamalis, codirector of the Intermountain Ocular Research Center at the University of Utah. The RxSight Light Adjustable Lens lets doctors alter its power 2 to four weeks following surgery, when the eye has healed and refraction has stabilized.

A correction for old replacement lenses: If you’ve currently had cataract surgery, you may one day be able to update your existing lens. A system in the pipeline by Perfect Lens uses a laser to alter the correction on a standard lens currently in your eye. If your eyes alter over time, it is possible to keep adjusting the same lens without needing another surgery.

Poor night sight together with sensitivity to glare might point to the beginning of cataracts.

Glaucoma

Liquid moving in the eye maintains healthier pressure levels because the surplus drains through a meshwork of outflow pathways. When this meshwork falters and fluid builds up, pressure in the eye can damage the optic nerve and lead to vision loss. Not every patient reacts to existing medications, however, and conventional glaucoma surgeries are serious procedures with rare but potentially serious side effects.

New hope

Breakthrough meds: Vyzulta, approved by the FDA in November 2017, is a property of an existing class of medication called prostaglandin analogs and operates by releasing nitric oxide, providing a dual action to lower pressure in the eye. Rhopressa, recently approved, belongs to a new class of medicines called Rho kinase inhibitors; they target cells in the eye’s drainage meshwork to restore outflow.

Microinvasive glaucoma procedures (MIGS) is a somewhat new development that, while not always as good as conventional glaucoma surgery, causes less trauma and has fewer side effects. The FDA-approved iStent, a small tube that sustains the traditional outflow of fluid through the eye’s drainage meshwork, is inserted using an incision so small that doctors view it through a microscope. (An even smaller variation, the iStent inject, has newly obtained Federal Drug Administration approval.) The similar CyPass Micro-Stent opens a fluid pathway through a different passage. Both are put in at the time of cataract surgery, so the added procedure risk is even lesser. Loss of peripheral vision is a key sign of glaucoma.

Macular Degeneration

Age-related macular degeneration (AMD) has a genetic element, but weight gain, cigarette smoking and not wearing sunglasses tend to be among the lifestyle elements that increase your risk for the condition. It takes place when the macula — the central component of the light-sensing retina at the backside of the eye — gets damaged, resulting in distortion and vision loss in the center of your field of view. In the “wet” form of the disease, leaky blood vessels and scar tissue can considerably increase vision reduction. Using AREDS2 health supplements (a combo of vitamins C and E, zinc, copper, lutein as well as zeaxanthin) may slow the disease’s advancement. For wet AMD, regular injections of drugs into the eye can inhibit a protein named vascular endothelial growth factor (VEGF), that promotes the development of abnormal blood vessels. Additionally, there are surgical options available. However these treatments can only slow, not stop, the advancement of AMD, which can end up in severe loss of vision.

New hope

Gene therapy: We are approaching the time when hereditary causes of conditions such as AMD can be prevented or remedied with gene editing. “A deactivated virus loaded with a corrected gene would penetrate cells and insert new code into your DNA just like a cut-and-paste on your computer,” Haller describes. In December 2017, the FDA approved this approach for a condition that leads to loss of vision in children — the first gene treatment for any sort of hereditary condition. Experts anticipate major progress in the next decade, perhaps even programming the body to create its own ­anti-VEGF medication.

Next-gen stem cells: you have been told about embryonic stem cells — and the controversies around using them. Now there’s a different classification of cells that can be derived from ones own body and used to grow a variety of new cells and tissues, such as particular retinal cells which go bad in macular degeneration. A commercially obtainable treatment might arrive within ten years.

An eye telescope: This is the first and exclusively FDA-approved surgical device for individuals that have end-stage macular degeneration. One eye’s lens gets exchanged with the tiny Implantable Miniature Telescope, that magnifies the field of view and heightens central sight. The device is presently restricted to people who haven’t undergone cataract procedures, but a new study is examining whether exchanging the telescope for a previously installed intraocular lens might safely assist sufferers.