All About Cataracts

Aspheric intraocular lenses (IOLs) used in cataract surgery provide higher quality vision than spherical IOLs, according to a new study.

Researchers at Johann Wolfgang Goethe-University (Frankfurt, Germany) and Cullen Eye Institute, Baylor College of Medicine (Houston) performed bilateral cataract surgery on 26 patients. The patients received an aspheric IOL in one eye and a spherical IOL in the other. All lenses were produced by the same manufacturer (Alcon).

Aspheric IOLs feature a gradually changing curve from the center of the lens outward and are designed to control spherical aberration produced by spherical IOLs. Spherical aberration is one of many higher-order aberrations of the eye, and is believed to cause glare and halos around lights at night.

Six months after surgery, aberrometry and visual acuity measurements showed the eyes receiving the aspheric IOLs had significantly lower spherical aberration, better visual acuity (measured with an eye chart in medium/low lighting) and better contrast sensitivity than the eyes with spherical lens implants.

The researchers concluded that aspheric IOLs produce better retinal image quality and higher quality vision than spherical IOLs.

Note: Aspheric IOLs typically are considered premium lens implants, and choosing this type of intraocular lens may increase the your cataract surgery cost.

Source: Effect of intraocular lens asphericity on quality of vision after cataract removal: An intraindividual comparison. Ophthalmology. Published online July 29, 2009.

Carnosine, a dietary supplement available without a prescription, may be able to prevent or treat cataracts, according to a study published in the July 14 issue of the American Chemical Society journal Biochemistry.

If true, taking daily supplements of carnosine may reduce the risk of developing cataracts, decreasing the need for cataract surgery.

Carnosine is a small molecule composed of two amino acids. It is found in relatively high concentrations in several body tissues, including muscles, nerves and the brain. The exact role of carnosine in the body is not fully understood but it appears to have an antioxidant effect.

The researchers exposed tissue cultures of lenses taken from healthy rat eyes to either guanidine — a substance known to form cataracts — or a combination of guanidine and carnosine. The lens tissue exposed to guanidine became completely cloudy, while the lens tissue exposed to guanidine and carnosine developed 50 to 60 percent less cloudiness. Carnosine also restored clarity to clouded lens tissue.

Cataracts occur when the primary structural protein in the eye’s lens, alpha-crystallin, forms abnormal clumps. These clumps make the lens cloudy and impair vision. Carnosine appears to play a role in blocking the formation of these clumps and/or reversing them.

Though further research is needed, the findings of the study prompted the researchers to suggest that carnosine could potentially prevent and treat cataracts in humans.

Source: Protective effects of l- and d-carnosine on a-crystallin amyloid fbril formation: Implications for cataract disease. Biochemistry. Published online July 14, 2009.

German company S&V Technologies has created custom-made intraocular lenses (IOLs) for animals with cataracts. The acrylic IOLs are implanted in the animals’ eyes during a procedure essentially the same as cataract surgery for humans.

Human cataract surgery is the most frequently performed surgery in the United States, and more than 90 percent of patients achieve good vision. For animals, cataracts usually mean blindness, according to Indgeborg Fromberg, head of the company’s veterinary division. Treating cataracts can improve the quality of life for animals, which have relatively short life spans, Fromberg says.

The company’s lenses have generated interest from around the world, including Sea World in San Diego for a sea lion that performs tricks, an Australian nature park for a blind kangaroo and a Romanian zoo for a visually impaired lioness. Additionally, the World Wildlife Fund has paid for cataract surgery with the lens implants for brown bears in a China nature reserve.

The company’s IOLs have also been used to restore vision for racehorses, circus animals, guide dogs and domestic pets.

Although the surgery is pricey, Fromberg says that many people consider their pets to be part of their family and are willing to pay the cost to restore the vision of their beloved furry friends.

Cataract surgery does not cause a progression of early age-related macular degeneration (AMD) to a more sight-threatening stage of the disease, according to a new study.

Researchers in Australia performed cataract surgery on 27 eyes of 27 patients with early macular degeneration to see if removal of their cataracts would improve the patients’ vision and quality of life without increasing their risk of AMD progression and vision loss from choroidal neovascularization (CNV).

CNV is the growth of fragile new blood vessels in the choroid layer of the eye underlying the retina. In macular degeneration, these blood vessels can leak into the retina, causing “wet” macular degeneration and severe vision loss.

Prior to the phacoemulsification cataract surgery performed in the study, all patients underwent a test called fundus fluorescein angiography (FFA) to make sure no eyes had pre-existing CNV.

Data gathered 6 months after surgery revealed a 2.8-line mean improvement in visual acuity (measured with a standard eye chart) and a 2.1-fold average gain in quality of life scores (measured by a patient survey) after cataract removal. One eye (3.7 percent) developed CNV within 6 months of surgery.

The researchers concluded that there was no significant increase in short-term risk of progression from dry AMD to CNV following uncomplicated phacoemulsification cataract surgery, and that there are distinct benefits of cataract surgery in people with early macular degeneration.

Source: Cataract surgery in high-risk age-related macular degeneration: A randomized controlled trial. Clinical & Experimental Ophthalmology. Published online June 22, 2009.