Cataract News

Six-Month Neuroadaptation Period Found for Tecnis Multifocal IOL

MADRID, Spain, November 2009 — In a 250-eye study of the Tecnis multifocal intraocular lens (IOL) by Abbott Medical Optics, results were measured at three days, 30 days, 90 days, 150 days and 210 days after cataract surgery. Most of the study participants achieved their best vision after 180 days (six months), which the researchers called a neuroadaptation period.

During the last checkup, 96.8 percent of eyes could read at 20/20 (J2) without correction, with 83.2 percent reading at 20/15 (J1). More than 90 percent of the participants ranked their near, distance and overall vision as good or excellent, with 88.4 percent not needing eyewear.

The study report appeared in the September/October issue of the European Journal of Ophthalmology.

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New LenSx Femtosecond Laser Designed To Increase
Accuracy of Cataract Surgery

ALISO VIEJO, Calif., November 2009 — You may have heard of femtosecond lasers before. They are the ones used in all-laser LASIK, in which the corneal flap is cut with a laser instead of a mechanical blade.

Now a femtosecond laser has been FDA-approved for cataract surgery. In an initial clinical evaluation, the LenSx femtosecond laser produced a laser capsulotomy diameter that was more uniform and reproducible. It achieved intended diameters in all the procedures, while manual cutting methods achieved intended diameters in only 10 percent of the procedures.

Richard L. Lindstrom, MD, who practices in Minneapolis, commented in a news release that accurate size and shape of the capsulotomy is critical to centration of the intraocular lens (IOL) and the correct performance of an accommodating IOL for presbyopia.

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Bausch & Lomb Surgical Launches Akreos MICS Lens
for Cataract Patients

ROCHESTER, N.Y., September 2009 — The new Akreos MICS lens, already on the market in other countries, is now available for U.S. cataract patients. The lens can be inserted through a tiny, 1.8mm incision, for better wound sealability, reduction in below-the-surface cell loss and reduction in surgery-caused astigmatism, according to the company.

"This is what we've been waiting for," said John Hunkeler, MD, a cataract surgeon in Overland Park, Kan., in a company release. "A crystal-clear acrylic lens with no yellow tint, vacuoles, or glistenings. I am yet to have any patient complain of edge glare or temporal darkness syndrome that has been reported with other acrylic IOLs. The four-point fixation offers unparalleled centration."

The Centers for Medicare and Medicaid Services granted the New Technology Intraocular Lens (NTIOL) designation to the lens for its design that reduces spherical aberration. NTIOL status means Medicare reimbursement to surgery centers increases by $50 for cataract surgery performed with the lens, compared with regular intraocular lenses.

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AcrySof IQ Toric IOL Now Eligible for $50 More
in Medicare Reimbursement

HUENENBERG, Switzerland, September 2009 — Alcon's AcrySof IQ toric IOL is now in the Reduced Spherical Aberration class of New Technology Intraocular Lenses for cataract surgery.

The Centers for Medicare and Medicaid Services issued the designation, and it means that Medicare adds $50 to every reimbursement to surgery centers for implanting this lens, and the cost reduction can be passed on to patients.

The AcrySof IQ Toric has an aspheric design meant to improve distance vision and night vision for people with astigmatism.

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With This Implanted Lens, Your Vision May Be Adjustable After Cataract Surgery — Using Light!

TIJUANA, Mexico, September 2009 — In a prospective clinical study, researchers implanted a light-adjustable lens (LAL) in 14 eyes of 14 cataract surgery patients.

Special LALs were used to cause mild nearsightedness of up to -1.5 diopters. Using a light delivery device developed by Calhoun Vision (Pasadena, Calif.), the surgeons treated the LALs with a certain wavelength of light.

The treatment converted certain biocompatible materials called "macromers" in the LAL to polymers, in such a way that the lens curvature was changed to correct the nearsightedness. Then the LAL was treated again, to "lock in" the new lens power.

The patients' vision was tested during follow-up periods of up to nine months. One day after the lens powers were locked in, 13 eyes were within a quarter diopter of the target vision. None of the eyes showed a change of greater than a quarter diopter over the following nine months.

Although this was a small study in terms of participants, in the report the researchers noted that the stability of this procedure was six times higher than that of corneal laser vision correction. The LAL is not yet FDA-approved for use in the United States, but it is available in some other countries.

The study report appeared in the journal Ophthalmology in August.

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Cataract Surgery: When Is It Time To Take the Leap?

SAN FRANCISCO, August 2009 — If you live long enough, it's almost inevitable: You will get cataracts. The question is, should you have cataract surgery as soon as they are diagnosed? Or is it more prudent to wait a while?

August is Cataract Awareness Month, and the American Academy of Ophthalmology is taking the opportunity to remind us about what increases our risk for cataracts: family history, diabetes, smoking, sun exposure, eye injury, eye inflammation and prolonged steroid use.

The AAO also advises that the choice of when to have cataract surgery is a very individual one, based on what you do every day and how you use your eyes. If you have blurred vision, glare, halos and/or poor color perception, and you're having trouble driving, working, reading and just living your life because of these vision problems, then it's time to schedule your cataract removal.

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Study To Measure How Cataract Surgery Can
Improve Lives of Alzheimer's Patients

CLEVELAND, July 2009 — A five-year, $2.9 million study will look at the lives of people who have both cataracts and Alzheimer's disease (AD), to understand how people with dementia may benefit from vision restored by cataract surgery.

In the study, half of the 210 participants will receive cataract surgery right away, and the other half will receive it after a six-month delay. The patients' primary caregivers will provide information about their quality of life and activity levels.

"This project addresses a major social justice issue in the disparity in vision care of persons diagnosed with Alzheimer's disease," said Grover Gilmore, dean of the Case Western Reserve Mandel School and principal investigator of the study, which will be funded by the National Institutes of Health.

Another researcher, Thomas Steinemann, MD, noted that the study is important because our world is visual. He added that some AD patients who were combative before cataract surgery became more cooperative afterward, and he said that better vision may even help AD patients recognize others.

Alan Lerner, also on the research team, said, "Ultimately, if you can't perceive something, it is hard to remember it." He noted that cataract surgery can improve quality of life, "which is a major aim in AD therapeutics overall."

The researchers will also measure changes in the thickness of the retina over the six-month period; it is thought that a connection may exist between retinal thickness and AD, which may lead to better prediction of AD and early treatments to delay memory loss.

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Male Prostate Drug May Cause Cataract Surgery Complications

TORONTO, May 2009 — Using tamsulosin (brand names include Flomax, Flomaxtra and Urimax) for urination difficulty caused by an enlarged prostate increases the risk of adverse events during or after cataract surgery, such as a detached retina and intraoperative floppy iris syndrome (IFIS).

Cataract surgeons said in a 2008 survey that they had encountered IFIS in men taking these alpha-blocking drugs. But a new, population-based analysis of 96,128 men aged 66 or older showed that those who had received tamsulosin in the two weeks before surgery had a 2.3 times higher risk of a serious complication.

Patients in the study who had had previous exposure to tamsulosin and those who took other alpha-blockers didn't show a higher risk for complications. Still, researchers said it was unclear as to whether discontinuing tamsulosin before surgery would definitely reduce the risk of complications.

Study results appeared in the latest issue of the Journal of the American Medical Association.

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Small Study Compares Blue Light-Filtering IOL
With UV Light-Filtering IOL

VIENNA, Austria, March 2009 — Using intraocular lenses manufactured by Hoya Medical Europe, surgeons implanted a blue light-filtering IOL in one eye and a UV light-filtering IOL in the other eye of 24 people during cataract surgery.

Post-surgery testing showed that the blue light-filtering IOLs provided significantly worse contrast sensitivity and blue-yellow foveal threshold than the UV light-filtering IOLs, especially in low light.

The fovea is in the central macula area of the retina and provides the sharp central vision needed for seeing detail, such as when you read, do close work or watch television. The foveal threshold is the smallest detectable level of vision that the fovea can achieve.

The study found no differences in color vision and high-contrast visual acuity.

Previous studies have not found significant differences between these two kinds of intraocular lenses, but the researchers in this study used more sensitive tests. Actually, on a questionnaire only three of the 24 people noted differences between the IOLs.

The study report was published in January in the journal Ophthalmology.

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FDA Approves New Cataract Lens for Astigmatism

HUENENBERG, Switzerland, March 2009 — The newly FDA-approved AcrySof IQ Toric intraocular lens (Alcon) for cataract surgery contains a special design to improve image quality in the correction of astigmatism.

The newest version of the toric intraocular lens (IOL) contains an advanced aspheric optic, which can help offset certain types of vision aberrations that decrease vision quality.

The newer, thinner IOL also can be inserted in the eye through a smaller incision during cataract surgery, said Edward Holland, MD, University of Cincinnati ophthalmology professor and director of cornea at the Cincinnati Eye Institute.

Alcon company officials said the aspheric design has been associated with increased contrast sensitivity and better distance vision.

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Running May Boost Eye Health

BERKELEY, Calif., February 2009 — Vigorous exercise such as running seems to stave off both cataracts and age-related macular degeneration.

After evaluating 41,000 runners for seven years, researchers at the U.S. Department of Energy's Lawrence Berkeley National Laboratory found a significantly reduced risk among runners of having these two common, age-related eye diseases.

Researchers said more than half of people 65 or older have cataracts, and about 25 percent of people 75 or older have macular degeneration, which potentially can lead to blindness.

"In addition to obtaining regular eye exams, people can take a more active role in preserving their vision," said epidemiologist Paul Williams of the Laboratory's Life Sciences Division. "The studies suggest that people can perhaps lessen their risk for these diseases by taking part in a fitness regimen that includes vigorous exercise."

Researchers said more investigations are needed to identify specific links between exercise and eye health.

"We know there are important health benefits to walking, including lowering heart disease risk," Williams said. "It is quite likely that the studies' results might apply to a lesser extent to smaller doses of more moderate exercise."

Study results were published in the January issue of Investigative Ophthalmology and Visual Science.

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Test Detects Early Signs of Cataracts

BETHESDA, Md., January 2009 — An "early warning" testing system that can alert eye doctors to the first signs of cataracts may become an important diagnostic tool, according to National Eye Institute (NEI) and NASA researchers who developed the device.

Low power laser light is aimed into the eye to detect early signs of damage to certain proteins found in the natural lens, which helps intercept and focus light rays.

This damage eventually leads to clouding of the lens and advanced cataracts that, when left untreated, can cause blindness.

Researchers say early intervention can lead to lifestyle changes to help prevent cataract advancement, such as controlling diabetes or avoiding sun and UV exposure.

"By the time the eye's lens appears cloudy from a cataract, it is too late to reverse or medically treat this process," said NEI medical officer Manuel B. Datiles III, MD, lead author of the clinical study. "This technology can detect the earliest damage to lens proteins, triggering an early warning for cataract formation and blindness."

Study results were reported in the December 2008 issue of Archives of Ophthalmology.

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FDA Approves Tecnis Multifocal Cataract Lens

SANTA ANA, Calif., January 2009 — The FDA has announced approval of the Tecnis Multifocal IOL (Abbott Medical Optics or AMO), the newest presbyopia-correcting intraocular lens for cataract surgery.

Company officials say clinical trials demonstrated that most people implanted with the Tecnis no longer needed any glasses. In conventional cataract surgery, artificial "single vision" lenses usually provide good distance vision but require reading glasses for near vision.

New-generation multifocal or accommodating intraocular lenses for cataract surgery potentially can restore vision at all distances, but require extra out-of-pocket payment from patients who want this benefit.

"The Tecnis Multifocal IOL delivers a predictable and consistent full range of vision," said Ralph Chu, MD, founder and director of Chu Vision Institute in Bloomington, Minn. "The U.S. clinical study shows that more than 94 percent of patients function comfortably without glasses for all distances, including intermediate."

The Tecnis lens also corrects certain higher-order aberrations beyond usual vision errors to help eyes focus better.

Shipments to U.S. surgeons will begin early this year.

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New Version of Alcon AcrySof Cataract Lens Approved

HUENENBERG, Switzerland, December 2008 — Alcon Inc. has announced FDA approval of its newest version of the AcrySof IQ ReStor intraocular lens (IOL) that replaces the eye's natural lens during cataract surgery.

The IQ ReSTOR lens is considered a "premium" IOL that potentially can restore vision at all distances, unlike conventional lenses typically requiring reading glasses for near vision.

The newest version of the IQ ReSTOR has a +3.0 add power, which company officials say has increased by fourfold the number of people able to see 20/20 at near, intermediate and distance ranges. This compares with the earlier version of the ReStor, which has a +4.0 add power.

In clinical trials leading to approval, 95 percent of patients said they liked the lens and would have it implanted again if given a choice, according to Alcon.

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Photochromic Cataract Lens in Development

IRVINE, Calif., November 2008 — Medennium plans to introduce a one-piece, aspheric version of the Aurium photochromic intraocular lens to Europe in late 2009, at which time it will seek FDA clearance for U.S. clinical trials.

Used as an artificial lens (IOL) in cataract surgery, the Aurium is unique because it automatically acquires a yellow tint in sunlight to block harmful UV and blue light. But unlike other tinted cataract lenses, the Aurium IOL automatically becomes clear in low light.

Studies indicate that other IOLs with a fixed tint can help protect eyes from sun damage, but also reduce color vision and clarity in low lighting.

The Aurium takes about 10 seconds to acquire a yellow tint in sunlight and about 30 seconds to become colorless in low lighting.

In sunlight, the Aurium blocks about 50 percent of UV and blue light.

The current three-piece version of the Aurium photochromic IOL has been approved and is marketed in Europe, but not in the United States.

Two C-shaped extensions hold the lens in place.

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Bausch & Lomb Launches Akreos AO Aspheric Lens

ALISO VIEJO, Calif., September 2008 — Bausch & Lomb officials say shipments should begin this month of the Akreos Advanced Optics Aspheric Lens (model AO60), which recently received FDA approval for cataract surgery.

The Akreos AO lens is designed as a foldable single piece, with four haptics or extensions that hold it in place in the eye. The lens is made of biocompatible acrylic material.

Surgeons who used the intraocular lens in clinical trials say it reduces visual aberrations, improves contrast sensitivity and allows easy insertion through small surgical incisions.

A special, single-use inserter (AI-28) is devised for use with the lens to help keep incisions smaller during cataract surgery.

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Medicare Awards "New Technology" Designations to
Staar Surgical Cataract Lens

MONROVIA, Calif., August 2008 — Medicare recently awarded a "new technology" designation to two Staar Surgical intraocular lenses used in cataract surgery: the Afinity Collamer Aspheric Single Piece foldable lens and the Elastimide Silicone Aspheric foldable lens.

Medicare pays $50 extra per lens in reimbursements to encourage development and use of newer technology intraocular lenses. These types of lenses have proven, positive characteristics that set them apart from other lenses commonly used in cataract surgery.

The two Staar Surgical lenses received a "new technology" designation because of unique optical design features and ability to reduce a type of vision error known as spherical aberration that can cause focusing problems.

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Resveratrol May Delay Cataract Progression

BALTIMORE, July 2008 — Resveratrol, a chemical found in grapes and red wine, has been shown in mouse studies to delay progression of cataracts, according to study results published in the July 3 issue of Cell Metabolism.

Researchers at the National Institute of Aging (National Institutes of Health) found evidence of numerous, seemingly unrelated potential benefits of resveratrol, including improved bone, heart and vascular health.

Resveratrol also is being studied in clinical trials as a treatment for type 2 diabetes, which can cause eye damage related to diabetic retinopathy.

Scientists found that resveratrol appears to stimulate activity of a specific beneficial protein, SIRT1, which improves cell function.

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FDA Approves Newest Version of Crystalens for Cataract Surgery

ALISO VIEJO, Calif., July 2008 — The newest version of an artificial intraocular lens known as Crystalens HD (Bausch & Lomb) has received FDA approval for use in cataract surgery and other eye procedures.

The Crystalens HD is the only approved accommodating IOL on the U.S. market, meaning that the lens moves within the eye to provide a wider range of focusing ability similar to the action of the eye's natural lens. Company officials say an optical design modification further improves focusing ability of the Crystalens HD.

When a cataract forms, the eye's natural lens grows cloudy. During cataract surgery, the cloudy lens is removed and replaced with a clear, artificial IOL.

Crystalens is one of only three presbyopia-correcting IOLs available in the United States with the ability to provide simultaneous near, intermediate and distance vision. The other two presbyopia-correcting IOLs, ReZoom (Abbott Medical Optics) and IQ ReSTOR (Alcon), are multifocal lenses with different zones for providing vision at varying distances.

Shipments of the new generation Crystalens HD were expected to begin July 7.

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Protein Fragments Linked to Development of Cataracts

BETHESDA, Md., March 2008 — Protein fragments found in the eye's natural lens contribute to development of cloudy vision resulting from cataracts commonly found in older people, according to an article in the March issue of Journal of Biological Chemistry.

Researchers say the highly ordered structure of these proteins (called crystallins) normally allows transmission of light and resulting clear vision.

But when crystallins begin to break down as part of the aging process, light becomes scattered.

Cataracts result when tiny, abnormal protein fragments bind to and disrupt function of normally shaped crystallin proteins.

Researchers believe these abnormal fragments are left over when other proteins attempt to "chew up" and remove damaged crystallin proteins in the eye.

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Lutein and Zeaxanthin May Help Prevent Cataracts

BOSTON, January 2008 — Yellow plant pigments known as lutein and zeaxanthin may help protect eyes against cataract formation, according to a report published in the January issue of Archives of Ophthalmology.

Scientists at Brigham & Women's Hospital and Harvard Medical School examined dietary information provided by 35,551 female health workers who originally enrolled in 1993 in the Women's Health Study. Dietary and other health factors involving participants were analyzed for an average 10-year period. Of this study group, 2,031 developed cataracts.

Investigators concluded that women with the highest intake of lutein and zeaxanthin were 18 percent less likely to develop cataracts. Scientists also found that women with the highest intake of vitamin E were 14 percent less likely to develop cataracts.

Lutein, zeaxanthin and vitamin E are all antioxidants, which help protect against molecules (free radicals) that destroy cells in the eyes and other parts of the body.

Please click here for more cataracts news from 2007.

[Page updated November 17, 2009]