Ophthalmologist Scott MacRae, M.D. treated a patient last week for extreme nearsightedness with a recently U.S. Food and Drug Administration approved breakthrough procedure.

This procedure, rated in Time magazine’s top medical advancements for 2004, corrects nearsightedness by implanting a lens behind the cornea and in front of the iris and natural lens.

This procedure lasts about an hour and is capable of permanently improving extreme nearsightedness.

“This surgery produces one of the most dramatic improvements in quality of life that I have seen in my twenty years as a corneal surgeon,” MacRae said. “The cost is about $3,900 an eye and there is financing available.”

Geared to treat patients with extreme vision impairment, this procedure allows patients to replace their thick glasses and contact lenses.

Many of these patients are legally blind without their glasses. “If they knock their glasses off the night stand, they’re blind,” MacRae said. “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.”

The patient most recently treated by MacRae suffered with eyesight of 20/3,400. MacRae treated the patient with permanently implanted lenses. This is the first time lens implants have been approved by the FDA.

Studies of this surgery have shown 84 percent of patients with vision 20/400 or worse improved to 20/40 or better.

MacRae explained why some of these patients are not completely cured. “Sometimes the patients have small amounts of residual nearsightedness or farsightedness. Sometimes they have some residual astigmatism, but overall, their vision is dramatically improved without glasses,” MacRae said.

This procedure opens doors for such extreme cases. In the past, patients with extreme nearsightedness have been forced to wear thick glasses or contacts. LASIK surgery has not been an option for them because their eyesight is simply too poor to profit at all. They are now able to ditch the glasses and contacts due to the permanently implanted plastic lenses. “This group represents approximately five percent of the total nearsighted population, so it is not a large group but a group that is severely affected by their nearsightedness,” Dr. MacRae said.

“Glaucoma, infection and cataract can occur in about one percent of cases,” MacRae said. The procedure, however, is permanent. “The procedure is not reversible but the implant is removable if there is a problem,” MacRae said.

Few improvements can be made on this procedure, according to MacRae. “The procedure has been done since 1991 in Europe, so most of the improvements to the procedure have been implemented. There is currently a trial that uses a lens that also corrects for significant nearsighted with larger amounts of astigmatism that is ongoing.”

MacRae is a professor of ophthalmology and visual science and has helped guide the new technology through its transition into the United States. He was working closely with American Medical Optics while the procedure was awaiting FDA approval. MacRae commented on his opinion of this procedure.

“Back in medical school, we never dreamed that improving vision so dramatically would even be possible,” MacRae said.

Ricketts can be reached at aricketts@campustimes.org.

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