| BUSINESSWEEK ONLINE : MARCH 1, 1999 ISSUE | ||||||||
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| PERSONAL BUSINESS
Surgery to Scrap Those Specs When noises roused Catherine Schmeltz in the middle of the night, she used to fumble for her glasses before checking on her kids. So when the 41-year-old Kansas City oncology nurse heard about a clinical trial for corneal implants to correct mild nearsightedness, she signed up. Today, her vision is 20/12. Until recently, eye surgery could correct only a limited range of vision problems. But technological advances are making it possible for more people to trash their glasses. ''We can now treat almost every level of near- and farsightedness,'' says Dr. Daniel Durrie, director of refractive surgery at the Hunkeler Eye Centers in Kansas City. Patients who suffer from mild to moderate myopia may benefit from corneal implants. Newly approved by a Food & Drug Administration advisory panel, these tiny pieces of curved plastic are placed on the edges of the cornea like parentheses. The implants flatten the cornea, which is too curved when you are nearsighted. Unlike laser surgery, the procedure does not require cutting into the central part of the eye. And it is reversible. A 24-hour recovery period is the same for both procedures. Not everyone believes the implants are worry-free. Some experts are concerned about the long-term effects of having a foreign object in your eye. But Dr. Penny Asbell, director of cornea services at NYU Mt. Sinai Medical Center, says such fears are mitigated by the fact that ''the implants are made out of the same material that we've been safely using in replacement lenses after cataract surgery.'' The implants are made by KeraVision in Fremont, Calif., and should receive full FDA blessing by yearend. A corneal operation will cost $2,000 to $2,700, or about the same as laser surgery. As with other eye care, it probably won't be covered by insurance, unless you have a special vision plan. A fix for farsightedness may also soon be available. The Holmium YAG laser, developed by Sunrise Technologies of Fremont and awaiting FDA approval, disperses into 16 rays of low-intensity energy, which strike the cornea in a circular pattern. This steepens the cornea, which is too flat when you're farsighted. ''It's much safer than other lasers because you are not vaporizing or removing tissue,'' says Dr. Douglas Koch, a professor of ophthalmology at Baylor College of Medicine in Houston. One advance that could improve the accuracy of all laser surgery is so-called tracking systems. Based on military technology, tracking lasers lock on to the eye during surgery the way a missile locks on to a target. This minimizes error caused by a patient's involuntary eye movements. Autonomous Technologies in Orlando received FDA approval to market a tracking laser last November, though it is not yet in commercial use. Other companies have similar products in the pipeline. LONG-TERM RISKS? Patients with vision problems too severe for laser surgery may benefit from implantable contact lenses. These virtually permanent lenses come in two varieties, both widely available in Europe, though still under review in the U.S. Ophtec USA of Boca Raton, Fla., produces a lens that goes on top of the iris. A competitor, STAAR Surgical of Monrovia, Calif., makes a lens that slips behind the iris. Clinical studies of both versions have been positive, but as with corneal implants, experts wonder about the long-term repercussions. ''There are risks of developing serious problems'' such as glaucoma and cataracts, says Dr. Leo Maguire, an ophthalmology professor at the Mayo Clinic in Rochester, Minn. Help may also be on the way for patients who experience presbyopia, a problem that forces many people to read things at arm's length when they reach middle age. Researchers have shown promising results with an experimental procedure in which plastic bands are surgically implanted to expand tissue surrounding the lens and eye muscles that has stiffened over the years. ''The hypothesis is that the procedure gives muscles in the eye more room to move'' and thus improves the ability of the lens to focus, explains Dr. Richard Yee, a professor of ophthalmology at the University of Texas-Houston Health Science Center. Dallas-based Presby Corp., a maker of the bands, hopes the FDA will begin clinical trials in March. That could be an eye-opener. By Kate Murphy _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ BACK TO TOP |
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