For Immediate Release

11/17/2003

New Procedure On Track To Revolutionize Cataract Surgery

ANAHEIM, Calif. – A revolutionary procedure that would make aging eyes “young again,” by replacing the contents of the eye’s lens with a soft polymer, promises to fundamentally change the way cataract surgery is performed – and to allow middle-aged patients to enjoy life without reading glasses.

The University of Miami’s Bascom Palmer Eye Institute today announced it is developing the new treatment which, when proven safe and effective, should enable cataract patients to see clearly -- and to rapidly focus near and far. Bascom Palmer biophysicist and biomedical engineer Dr. Jean-Marie Parel reported the findings yesterday at the American Academy of Ophthalmology’s annual meeting in Anaheim. He leads the Bascom Palmer team responsible for developing both the surgical procedure and instrumentation for the technique.

“We expect aging patients will feel they are ‘16 again,’ regaining teenage vision,” said Dr. Parel. “This procedure goes beyond the relief from clouding provided by traditional cataract procedures, restoring the ability to quickly shift focus at varying distances. After surgery, patients would be able to focus on a computer screen, look down to read a credit card, and look up again to see a face across the room.”

Initially, researchers expect the technology will be used in cataract surgery – typically performed on elderly patients, and the most common surgical procedure worldwide. It offers further applications to restore middle-aged patients’ ability to rapidly shift focus at varying distances, while ensuring they do not develop cataracts as they age.

Dr. Parel, research associate professor at Bascom Palmer Eye Institute, and his team are collaborating with an international scientific initiative, in which scientists at the Australian government’s multinational Vision Cooperative Research Centre are developing a polymer gel formulation that would chemically reproduce the characteristics of a young adult’s lens.

To focus, the eye’s lens must change shape. It flattens to focus on a distant object, then returns to a wider shape to clearly see closer objects. By about age 40, most people’s lenses have lost three quarters of their ability to change shape, or “accommodate,” according to Dr. Parel. During their 40s, most need reading glasses or bifocal lenses. While the contents of the lens become relatively inflexible and may cloud with age, the lens’ outer coating, or capsule, typically stays clear and flexible.

Dr. Parel said that in cataract surgery, physicians would no longer substitute an intraocular lens implant for the patient’s own lens contents. Instead, the patient’s lens capsule would be retained and its contents removed and replaced with the polymer. UV or visible light would transform the liquid to a gel after injection, restoring the lens’ pliability to quickly adjust shape in focusing.

Dr. Parel’s fascination with the possibility of restoring the eye’s “accommodation” dates back to 1979. In researching accommodation, he found that retired ophthalmologist Dr. Julius Kessler of New York had initiated the theory of replacing lens contents in 1960. Dr. Parel has been researching the procedure for nearly 25 years, and founded the worldwide Accommodation Club of highly specialized scientists and physicians to focus global talent on the investigation. He estimates that currently only about 100 researchers are studying the issue worldwide. Bascom Palmer linked its efforts on accommodation with Vision Cooperative Research Center in a multi-year collaboration agreement launched in 1997. As experts in polymers and optics, the Australian scientists have so far created and tested the properties of over 30 special formulations in the quest for the ideal polymer gel.

Accommodation is just one of many research priorities for the Bascom Palmer Eye Institute’s Ophthalmic Biophysics Laboratory, headed by Dr. Parel. Known as one of ophthalmology’s most accomplished biophysicists, he has overseen the creation of more than 300 instruments, surgical and diagnostic devices since joining the Institute in 1970. Fluent in four languages, he has helped make the Laboratory an international hub for solving patient care and surgical problems through applied technology.

“Here, in Australia, Finland, and India, top research talent is working to perfect and prove that accommodation can be regained in this way,” said Dr. Carmen Puliafito, chairman of the Department of Ophthalmology at the University of Miami School of Medicine and the director of Bascom Palmer Eye Institute. “With so many Baby Boomers and elderly adults affected by loss of the eye’s ability to easily change focus, the advance would be most significant.”

The Bascom Palmer team has been perfecting the surgical technique since 1980. Dr. Parel noted that the extremely high caliber of the Florida Lion’s Eye Bank, located within Bascom Palmer Eye Institute, has been crucial to the work. This spring, his team became the first to restore over 9 dioptres of accommodation – enough to comfortably read small print -- in a post-mortem human eye, as reported at the Association for Research in Vision and Ophthalmology (ARVO) international conference in May. The next steps will be to prove safety and effectiveness and seek FDA (Food and Drug Administration) approval, followed by testing in humans perhaps as soon as 2005, Dr. Parel said.

One of the premier ophthalmic research centers and providers of eye care in the world, Bascom Palmer Eye Institute treats over 200,000 patients each year with nearly every ophthalmic condition, and performs over 10,000 surgeries annually. The largest ophthalmic care, research and educational facility in the southeastern U. S., the Institute has served as the Department of Ophthalmology for the University of Miami School of Medicine since its founding in 1962.