An innovative form of eye surgery is offering hope to the estimated three million sufferers of age-related macular degeneration (AMD), the most common cause of blindness in people over 55 in the UK.
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The technique, known as IOL VIP – Intra-Ocular Lenses for Visually Impaired People, is similar to cataract surgery. Developed in Milan by low-vision specialists and ophthalmologists, it was first made available in the UK about 18 months ago and is now performed in private hospitals, although it isn’t currently available on the NHS.
AMD damages the macula – the central part of the light-sensitive retina at the back of the eye – causing scarring, and preventing images being sent to the brain. This damage causes the gradual deterioration, or even loss, of central vision used for activities such as reading, writing, driving and recognising faces.
Hope: Treatment is now available for ‘dry’ AMD
There are two types of AMD: ‘dry’, the most common form, in which the cells of the macula disintegrate gradually; and the more aggressive ‘wet’ form. The latter is caused by the growth of new blood vessels behind the retina, which can leak, causing scarring and leading to loss of sight.
About ten per cent of people with AMD develop the ‘wet’ form, which can be treated with eye injections. But, until recently, there has been no effective treatment for the majority, who suffer from ‘dry’ AMD.
In the pioneering IOL VIP procedure, two artificial lenses are inserted into the eye. The natural lens behind the iris is removed and replaced with an artificial one, which diverts images from the scarred macula to healthy retinal tissue.
A second lens is then placed in front of the iris. Together, the two lenses act as a telescope, allowing the images to be focused and processed to the optic nerve and sent to the brain. The procedure can last as little as 30 minutes. It then takes approximately 12 weeks for sight to stabilise.
After the operation, computer vision training is vital to train the eye and get the best possible outcome.
Richard Newsom, a consultant ophthalmic surgeon, says: ‘The IOL VIP procedure is an exciting new innovation. It’s not appropriate for every patient with AMD and further studies are required but when it works, it works well and for some patients it can make a significant improvement to their vision.’
Brendan Moriarty, consultant eye surgeon at Leighton Hospital in Crewe, Cheshire, who was the first to perform the operation in the UK, says: ‘If you select patients correctly, the vast majority will at least double their near and distance vision.’
The Royal College of Ophthalmologists agrees further studies are required, stating that it is difficult to determine who will benefit and by how much.
The Macular Disease Society says it is not ‘a miracle cure’ and ‘has worked successfully for some but can’t be regarded as a regular new treatment for widespread use in MD patients’.
One patient who has benefited from the pioneering procedure, however, is 68-year-old Evelyn Dean.
Having suffered from ‘dry’ AMD for two-and-a-half years, Evelyn’s sight had deteriorated so much that she couldn’t read a book or newspaper-without a strong magnifying glass. To her dismay, it also got so bad she was told that she could no longer drive.
But, following an IOL VIP operation in November 2008 at Spire Hull and East Riding Hospital, Evelyn has been given the all-clear to get back behind the wheel.
She says: ‘ I can even read the labels on supermarket shelves properly, which I couldn’t before. I still wear glasses for long distances and reading but the best thing is being able to drive again after almost 15 months.
‘I feel like I have my freedom back.’