Adjustable Lens May Help Customize Vision for Cataract Patients

June 02, 2002
News Office: Maureen McInaney (415) 502-6397

A new light-sensitive lens is being developed -- using technology invented by a doctor at UCSF Medical Center and researchers at the California Institute of Technology -- that can be adjusted to improve vision in cataract patients after the lens is implanted.

Nearly 3 million cataract surgeries are performed every year in the United States and the majority of patients must wear presciption glasses after the procedure to see properly. This new lens may eliminate the need to wear glasses.

The lens, being developed by Calhoun Vision Inc., is a photosensitive silicone intraocular lens that can be adjusted with a low-power source of light to customize lens power and correct vision.

Preliminary findings were presented at the American Society of Cataract and Refractive Surgery in Philadelphia on June 1 to 5.

Currently, patients experience refractive errors or imperfect vision after cataract surgery because of unpredictable wound healing, inaccuracies in pre-operative measurements of the eye or pre-existing cornea disorders such as astigmatism.

Dr. Daniel Schwartz, an ophthalmologist at UCSF Medical Center and co-inventor of the Light Adjustable Lens (LAL), said, "With this technology, we can make power adjustments after the lens is in place, wound healing has occurred and the eye is stabilized.

"As currently envisioned, the procedure will be relatively simple. The surgeon would implant the lens using standard surgical techniques. When the eye has healed after two to four weeks, the patient returns to have the lens customized. By directing a cool, low intensity beam of light onto the lens, the surgeon would precisely adjust the lens power to the patient's specific needs," Schwartz, director of the UCSF retina division and a professor of ophthalmology, said. "The lens material is photosensitive and designed to respond in a predictable manner according to the duration and intensity of light delivered."

Initial human trials are expected to begin in the summer of 2002. U.S. clinical trials will follow if they receive FDA approval. It is anticipated that the lens will be available commercially in Europe in late 2003 and in the United States by 2006.

The in vivo fine-tuning is based on the interaction of light and photosensitive materials, called macromers, that reside doctor directs the beam of light to the center of the lens. This causes the macromers in the irradiated area to bind together to form a polymer. The unreacted macromers in the non-irradiated area then move toward the center to equalize their concentration throughout the lens. This movement of material causes a swelling in the irradiated area -- and an increase in lens power. The physician locks in the optimized lens power by treating the entire lens with light, thereby consuming all remaining macromers.

For the opposite effect -- a reduction in lens power -- the physician would treat the periphery of the lens, driving unreacted macromers to that area. The treatment of astigmatism, a commonly occurring irregularity of the cornea that causes blurred vision, could be accomplished in a similar fashion, by suitably orienting the light beam.

In another presentation, Dr. Nick Mamalis, professor of ophthalmology at the University of Utah, will summarize research from animal testing of Calhoun Vision's light adjustable lenses. Research on rabbits has shown an absence of inflammation or other adverse effects, predictable power changes after irradiation, and high optical quality, according to Mamalis and Calhoun Vision scientists.

The researchers note that this technology may have applications beyond correcting vision problems in post cataract surgery patients. Schwartz said the lens potentially could be used as an alternative to LASIK surgery for severe myopia or nearsightedness. He explained that LASIK surgery for severe myopia has resulted in complications including glare, halos and unpredictable refractive outcomes. The light adjustable lens also may be effective in treating farsightedness, which often cannot be treated optimally with LASIK surgery. The ability to implant and precisely adjust lens power after surgery offers farsighted patients a wider range of correction and potentially more predictable outcomes than LASIK.

Funding for the initial research was provided by That Man May See, Inc. Additional researchers working with Calhoun Vision include Robert Grubbs, PhD, professor of chemistry at Cal Tech; Julia Kornfield, PhD, professor of chemical engineering at Cal Tech, and Jeffrey Hubbell, PhD, formerly of Cal Tech and now professor of biochemistry at the University of Zurich.

Calhoun Vision is a privately held company engaged in developing and commercializing novel technology combining advanced principles in chemistry and optics. The company, founded in 1997, is headquartered at 2555 East Colorado Blvd., in Pasadena, Calif.

Schwartz has a proprietary interest in the company as do all the Cal Tech researchers. Mamalis has no proprietary interest.

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