Surgically Implanted Lenses Shown Effective for Improving Nearsightedness
Nearly 30% of the population has some degree of nearsightedness. Nearsightedness usually develops before the age of 20 and stabilizes between the ages of 20 and 40. The easiest—and most common—method of correcting nearsightedness is to wear eyeglasses or contact lenses. But for people who want a more permanent fix, LASIK and similar surgeries, is currently the only options.
However, now there may soon be another option for people with moderate to severe nearsightedness. At least two different companies are currently awaiting approval from the Food and Drug Administration for their implantable contact lenses. Implantable contact lenses are corrective lenses that are surgically implanted in the affected eye to correct vision.
One maker of these implantable lenses has just released the follow-up results to its previous study on the use of their collamer lenses for treating moderated to severe nearsightedness. The study, which appears in the September 2004 issue of Ophthalmology , suggests that implantable collamer lens (ICL) surgery is a safe and effective method for treating nearsightedness.
About the Study
This study included 526 eyes of 294 people with nearsightedness between -3.0 and -20.0 (average –10) diopters from multiple clinics throughout the US. The majority of participants were female (60%) and Caucasian (85%); participants ranged in age from 22 to 45.
The researchers inserted the lenses through a tiny incision in the eye and placed them in front of the eye’s natural lens. The implantations took place at fourteen different clinics between between November 1998 and December 2002. Then they compared vision before and after lens implantation, specifically looking at:
Uncorrected visual acuity (UCVA)
Refraction (degree to which light is bent as it passes through the lens)
Best spectacle-corrected visual acuity (BSCVA)
Operative and postoperative complications
Lens opacity (degree to which light is obstructed as it passes through the lens)
Other symptoms (e.g. glare, halos, night vision)
Prior to their surgery, 68% of participants had 20/20 or better with glasses (BSCVA). Three years after lens implantation, 41% of participants had 20/20 or better without glasses (UCVA) and 81% had 20/40 or better.
Average UCVA three years after lens implantation:
|Vision at Baseline||20/20 or better||20/40 or better|
|-3 to –7 diopters||68%||98%|
|-7 to –10 diopters||49%||87%|
|-10 to –20 diopters||22%||70%|
The risk of complications—which occurred in 9.5% of the eyes—increased as nearsightedness increased. Complications included a decline in vision, having to replace the implantable lens, and retinal detachment. While some of the complications occurred early on, a few did not occur until between the second and third year after surgery. The incidence of glare, halos, double vision, or night vision problems improved or remained the same after implantation.
Only 0.6% of participants reported being dissatisfied with the results. And 97% said they would choose ICL implantation again.
How Does This Affect You?
This study suggests that implantable contact lenses are a safe and effective method for treating moderate to severe nearsightedness. Although the results are impressive, they should be interpreted with some caution since the research was funded entirely by the lens manufacturer. Additionally, because this study ended at three years, the long-term effects and potential complications of implantable lenses are not yet known.
Nevertheless, based on these study results it is likely that the FDA will approve the implantable collamer lenses sometime in the near future. So is this procedure an option for you? If you are moderately to severely nearsighted (-3 to –20 diopters) and your vision has remained stable over the last several years, it may be. The study authors point out that implantable lenses appear to be more effective for those with more severe nearsightedness than LASIK surgery.
Before deciding to throw away your glasses or contacts once and for all, be sure to evaluate the risks and benefits of corrective eye surgery with your doctor. The more nearsighted you are, the more likely it is that you will not end up with perfect 20/20 vision—whether you are having LASIK or implantable lens surgery.
American Academy of Ophthalmology
American Optometric Association
ICL in Treatment of Myopia (ITM) Study Group. Ophthalmology . 2004: 1683-1692.
Myopia. American Optometric Association. Available at: http://www.aoa.org/eweb/DynamicPage.aspx?site=AOAstage&WebCode=Myopia . Accessed on September 2, 2004.
Last reviewed September 2004 by ]]>Richard Glickman-Simon, MD]]>
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