Implant, Laser Eye Surgery Frees British Mother of Dual Vision Woes
A London accounts manager is among the first in Britain to receive a combination of corrective laser eye surgery and an implant to treat both presbyopia and short-sightedness – in one sitting.
Almost two million Australians and more than a billion people worldwide suffer from presbyopia, deterioration in the lens of the eye that causes reading difficulties to start for us in our 40s.
When forty-six-year-old Ruth Smith was diagnosed, it was explained that presbyopia is natural part of aging. ”Like all people who work in an office, I have to focus on lots of things close at hand: my computer screen, paperwork, telephone numbers and newspapers. But four years ago I realised reading any small print was becoming a struggle,” she told London’s Daily Mail newspaper.
Also short-sighted since the age of 13, she was already wearing contact lenses during the day. However, her optometrist told her reading glasses were required for presbyopia and advised against continual removal and insertion of lenses. As a result, she had to tolerate a constant exchange between prescription glasses and particular glasses for reading or driving – a real hassle. She also didn’t like how she looked with glasses on.
So Ruth returned to her optometrist earlier this year and asked about eye laser surgery for her myopia and was pleasantly surprised to hear she could undergo a new laser eye surgery procedure to solve both her short-sightedness and presbyopia.
The optometrist laid out the course of treatment. Traditional laser eye surgery would smooth the corneas of both eyes, flattening them for distance vision. Then a plastic implant like a very small Life Saver would be inserted into a single eye. He told her the implant would cause her to see just narrow beams of light because the brain registers these much more acutely, and that then she could read printed material once more without spectacles.
Excitedly she agreed and was referred to an ophthalmologist, who also reminded her that laser eye surgery can cause dry eyes, and recommended taking 400mg of flaxseed oil daily for a month before the operation and for a minimum of three months after the surgery. Flax seeds contain omega-3 fatty acids, which prevent the eyes from drying out.
”A month later, I had the procedure. Mr. [David] Allamby placed anaesthetic drops in my eyes, which kicked in quickly so I couldn’t really see what was going on. I lay flat on a bed as both eyes were lasered – I could feel the pressure of the laser, although it wasn’t painful,” she told the newspaper.
The implant was then placed in her left eye. It’s required in only one eye, because the brain judges the image as though it is seen via both. The implant’s position was checked, some drops inserted, and Ruth went home, all in about 30 minutes. She said she could see flawlessly the moment the procedure ended.
The ability to see clearly again however did bring tears to Ruth’s eyes. ”When I think this has restored my sight to how it was at 13 — more than 30 years ago — I feel a bit emotional,” she told the Daily Mail.
And she said she’s thrown away all her old glasses: ”I can read a book easily, and work at my desk, taking everything in at once.”
Her ophthalmologist told the Daily Mail: ”Until now, we tended to offer patients reading glasses or, if they also had an existing prescription problem such as long or short-sight, bifocal or varifocal glasses and contact lenses.”
Laser surgery can also be mixed for a variety of needs, including making one eye a little short-sighted and the other somewhat long-sighted; the brain adapts the image so that recipients can see as usual.
This new ”Z Kamra” method is based on a dissimilar but straightforward idea. Working just like the early Camera obscura, the tiny donut-shaped wafer the size of a pinpoint is placed on the pupil, reducing the amount of light allowed to reach the retina, where it is transformed into pictures. By letting light enter via central beams, the insert can return one’s vision to the acuity of a teenager.
The procedure is recommended only for those with a prescription between minus 6 and plus 3. However, astigmatism – a defect caused by an unusually shaped cornea that makes the eye unable to focus an object into a sharp image on the retina – can be handled. The method is also suitable for people with normal vision merely seeking to throw away their reading glasses.
Tests are done to ensure patient suitability. This includes gauging the pupil in the dark; if it opens too widely at night, light can slip round the implant and give rise to halo effects or glare. Patients with such problems are advised to avoid the treatment.
Lenses are also held in front of the eye to imitate the effect of the implant to see if the brain is sufficiently flexible to adjust to the new conditions. Ninety-eight to 99 per cent of patients are suitable.
On the day of Ruth’s procedure, her eye surgeon took only about 20 seconds with an excimer laser to shape the cornea and remedy the short-sightedness in her right eye. With a laser, he then opened a sliver of a space on the front-most layer of the eye and again laser-shaped the cornea. The implant was then manually slipped into the space of around one centimetre.
The disc is manufactured from special plastic that the body won’t reject and is so slight that it adheres to the eye tissue. The section is closed and the flap heals without stitches. A scan was done to make sure the disc was placed correctly and Ruth was sent home with eye drops.
Check-ups were carried out and Ruth’s progress was supervised closely. Post-op patients have to wear sunglasses outside and shields at night so they can’t rub their eyes. After a couple of months, the enhanced vision will last a lifetime, Ruth’s doctor said.
Hazards compare to those of any laser eye surgery, such as dryness and sensitivity to bright light, but the insert is not known to expose recipients to any extra dangers.
Z Kamra is a significant advance in eye rejuvenation, allowing clear distance sight and reading ability. It works well for people between 45 and 70 years old, and there are no reports of the positive results fading as recipients get older.
Brian Saxon, a contributing editor for PersonalEyes, writes about the latest developments in ophthalmology.
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