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Update in the treatment of cataracts

Updated: March 7, 2011 10:32AM



Q: I recently read somewhere that there is a new cataract treatment that uses an infrared laser to bleach the age-induced yellowing of the lens — as opposed to lens-replacement surgery. Would you please discuss this in your column?

A: In March 2010, The New York Times science section discussed this very subject. Cataracts are commonly treated by removing the damaged lens and replacing it with a synthetic version; however, the procedure is invasive and costly. As an alternative, an ophthalmologist and his colleagues at the Glostrup Hospital at the University of Copenhagen in Denmark came up with what they believe is a promising alternative — bleaching the yellowed lens with a laser. The research team uses infrared light delivered by an extremely fast-pulse laser — so fast, in fact, that two photons hit a target molecule simultaneously with the same effect as if UV light were used.

The newly discovered treatment reduces light absorption and helps restore lens proteins to their proper structure. At the time of the writing, a great deal more research and development was necessary before the procedure could become routine. It is a similar technique to Lasik.

Then a Nov. 17, 2010, pilot study report from Stanford University covered in the journal Science Translation Medicine indicated an image-guided laser technique is 10 times better than that achieved with current manual methods and could truly change the way cataract surgery is performed. Experts say guided lasers will allow eye surgeons to perform surgery in far less time with greater precision.

Statistics indicate that more than 1.5 million cataract surgeries are performed in our country each year. An astonishing one in three Americans, primarily senior citizens, will undergo cataract surgery at some point in their lives. The natural lens of the eye will be surgically removed and replaced with an implanted, permanent artificial lens. Today, the initial incision is performed manually and the breakup and removal of the clouded lens is performed with ultrasound. With the new technique, however, this will all be done with a special laser guided by 3-D imaging.

While it has been made very clear the new technique and imaging will improve the precision and allow for better control, it hasn’t been fully determined whether the method will result in a better outcome for the patient against a known current procedure that already has a high success rate with few complications.

With refractive repair, many patients will have 20/20 vision without the need for glasses or contact lenses. Images of the eye are taken to determine the thickness of the cornea and distances from the back of the cornea to the front of the lens and back again. The information garnered can be used to program the image-guided laser so a surgeon can determine the precise cut to make.

In response to your question, newer research remains ongoing and extremely promising. I cannot determine whether infrared laser (or other procedures) is for you. That decision is best left to your ophthalmologist. As with any procedure, make sure that you consult with a specialist you have complete confidence in and be guided by what he or she has to say.

To provide related information, I am sending you a copy of my Health Report “Medical Specialists.” Other readers who would like a copy should send a self-addressed stamped No. 10 envelope and a $2 check or money order made payable to Newsletter and mailed to Newsletter, P.O. Box 167, Wickliffe, OH 44092-0167. Be sure to mention the title or print an order form off my website at www.AskDrGottMD.com.



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