Interesting improvements in eye surgeries give hope to countless

Cataracts

Protein that constitute the eye’s light-focusing lens start to clump with years, gradually making vision clouded, blurry and sensitive to glare. The Symfony lens is just one of the recent advancements.

New hope

Post-op adjustment: During 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 allows doctors alter its power 2 to four weeks after surgery, when the eye has healed and refraction has stabilized.

A correction for old replacement lenses: If you’ve already had cataract operation, you may one day be able to upgrade your existing lens. A system in the pipeline by Perfect Lens uses a laser to change the correction on a standard lens already in your eye. If your eyes change over time, you could keep adjusting precisely the same lens without resorting to another surgery.

Bad night vision along with sensitivity to glare may indicate the beginning of cataracts.

Glaucoma

Fluid circulating in the eye maintains healthy pressure levels because the surplus drains through a meshwork of outflow canals. If this meshwork falters and fluid builds up, pressure level in the eye can harm the optic nerve and lead to eyesight loss. Not every patient responds to existing medications, however, and traditional glaucoma surgeries are major procedures with rare but potentially serious side effects.

New hope

Advancement meds: Vyzulta, approved by the Food And Drug Administration 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 surgery (MIGS) is a relatively new development that, although it is not always as good as traditional glaucoma surgery, causes less trauma and has fewer side effects. The FDA-approved iStent, a small tube that restores 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 variant, the iStent inject, has recently received Federal Drug Administration approval.) The similar CyPass Micro-Stent opens up a fluid pathway through a different passage. Both are installed at the moment of cataract surgery, so the extra procedure risk is even smaller. Loss of peripheral vision is a key sign of glaucoma.

Macular Degeneration

Age-related macular degeneration (AMD) has a genetic component, but weight gain, smoking and never wearing sunglasses tend to be among the lifestyle elements that increase your possibility for the disease. It takes place when the macula — the middle portion of the light-sensing retina at the back of the eye — becomes damaged, causing distortion and vision loss in the middle of your field of view. In the “wet” type of the disease, leaking blood vessels and scar tissue can severely speed vision loss. Taking AREDS2 supplements (a combo of vitamins C and E, zinc, copper, lutein and zeaxanthin) may slow the disease’s advancement. For wet AMD, scheduled injections of drugs into the eye can suppress a protein named vascular endothelial growth factor (VEGF), which promotes the growth of abnormal blood vessels. Additionally, there are surgical solutions available. But these treatments can just slow, not end, the advancement of AMD, which can end up in severe loss of vision.

New hope

Gene therapy: We’re approaching the time when genetic causes of conditions such as AMD can be prevented or cured with gene editing. “A deactivated virus loaded with a corrected gene would penetrate cells and put new code into your DNA like a cut-and-paste on your computer,” Haller explains. Around December 2017, the FDA approved this method for a disease that leads to loss of vision in children — the first gene treatment for any inherited disease. Specialists foresee major progress in the following ten years, possibly even programming the body to create its own ­anti-VEGF medication.

Next-gen stem cells: You’ve heard of embryonic stem cells — and the controversies about using them. Now there’s a different classification of cells that can be derived from your own body and used to develop a wide array of brand new cells and tissues, such as particular retinal cells that go bad in macular degeneration. A commercially obtainable treatment might arrive within ten years.

An eye telescope: This may be the very first and exclusively FDA-approved operative device for individuals that have end-stage macular degeneration. One eye’s lens gets replaced with the compact Implantable Miniature Telescope, which magnifies the field of view and boosts central vision. The device is presently limited to people who haven’t undergone cataract surgery, but a brand new study is examining whether swapping the telescope for a previously installed intraocular lens might safely help patients.