Wednesday, April 21, 1999

Eye implant provides new vision

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Cataract surgery can improve close-up sight

BY TIM BONFIELD
The Cincinnati Enquirer

Dr. Robert H. Osher talks with Jada Gamble after surgery. (Tony Jones photo) | ZOOM |

        Jada Gamble isn't quite ready to throw her reading glasses away. But after receiving an improved type of implanted lens during cataract surgery Tuesday, she vows to push those glasses “way back in a drawer.”

        Mrs. Gamble, a retired kindergarten teacher living in Colerain Township, became one of a few hundred Tristate patients so far to get the Array Multifocal Intraocular Lens, made by Allergan Inc.

        The device is the first to be approved in the United States that can give some, but not all, cataract patients the ability to see both long and short distances. Traditional lens implants can restore long-distance vision, but the vast majority of patients still require reading glasses.

        “This is the future of cataract surgery,” said Dr. Robert Osher, an ophthalmologist with the Cincinnati Eye Institute in Montgomery. “Not only can patients see to drive, they can also see to play cards or thread a needle at the same time.”

        Cataracts — a gradual clouding of the eye's lens that blurs vision and causes light sensitivity — is the most common vision problem for elderly Americans. Cataracts affect about 42 percent of people between the ages of 52 and 64 — and about 73 percent of people between 65 and 74.

        The Array lens isn't widely known but it isn't brand-new either.

        The lens won U.S. Food and Drug Administration approval in September 1997 and hit the national market in March 1998. However, Allergan has been gradually rolling out the product while more doctors get training to use the product. This week, Cincinnati became the latest stop on Allergan's city-by-city marketing campaign.

        Mrs. Gamble, 67, has worn glasses since college and was diagnosed with cataracts about three years ago. She got the Array lens in her left eye in January. After healing, she had her right eye done in a 20-minute procedure Tuesday.

        Even with just one lens placed, Mrs. Gamble said she has been able to read cooking recipes, play the piano and enjoy gardening without wearing glasses. “I can even read the phone book now,” she said.

        The Array lens works like a complex set of bifocals. The tiny silicone lens, just 13 millimeters in diameter, has five built-in rings that provide differing levels of long-range and short-range focus. Traditional cataract implants have only one focal power.

        While the new lenses may be exciting, they won't work for everyone, Dr. Osher said.

        In U.S. clinical trials in 1997, 41 percent of patients with the Array lenses never needed glasses for any reason compared to 11 percent with monofocal lenses.

        Among the other restrictions and side effects:

        • Patients must fit criteria for pupil size.

        • Patients must have healthy eye tissue.

        • Patients cannot have significant astigmatism problems.

        About 15 percent of patients getting the Array lens report seeing halos around lights at night; about 6 percent of patients getting monofocal lenses report seeing such halos. More than 10 percent of Array patients report problems with glare, vs. 1 percent of those with monofocal lenses.

        Dr. Osher does not recommend the lenses for people who drive a lot at night or work in low-contrast lighting.

       

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