November, 2003 the FDA approved the use of the first method
of surgically correcting presbyopia. The eyeonics (formerly
C and C vision) Crystalens is a posterior chamber lens implant
that is used to replace the human lens. Its approval was granted
for lens replacement during cataract surgery. The surgery
for Crystalens implantation is similiar to cataract surgery
and must be done in a sterile operating room. This lens is
hinged to take advantage of the eye's musculature changes
that occur with natural focus. Click
here for more Crystalens info.
of correction of presbyopia is with Refocus (formerly Presby
Corp) presview scleral implants for scleral spacing to potentially
reverse presbyopia in the human eye. In younger patients with
clear lenses this method provides restoration of near focus
in presbyopia with small plastic inserts in the white part
of the eye to restore the space needed for focus. Scleral
spacing is still under FDA investigation. Phase II clinical
trials have started with FDA and New York Eye and Ear Infirmary
IRB approval in December 2003 with Dr. Soloway serving as
the Medical Director of Refocus, the Medical Monitor for the
clinical trials and continuing his roll of principal investigator
from the phase I clinical trials. Click
here for more Scleral Spacing info.
WHAT IS PRESYOPIA?
Presbyopia is the normal process of aging. The natural lens
in the human eye continues to add layers like rings on a tree
or the layers of an onion as we grow older. This causes the
lens to become larger. As the lens grows, it enlarges into
the area where the focusing muscle needs to flex when it works.
We become unable to focus things up close because of this
loss of room around the lens. This usually occurs between
the ages of 40 and 50.
Everyone experiences presbyopia, some sooner, some later.
Because of this normal process, nearsighted people begin to
wear bifocals in their forties, and those who never needed
glasses before may require reading glasses. The one advantage
to mild myopia is the ability to remove your glasses after
age 40 and continue to read (your myopia effectively counteracts
After having the excimer laser procedure to correct for better
distance vision without glasses in each eye, you will lose
this ability. You will need reading glasses for small print,
like every other normally sighted person between the ages
of 40 to 50. The excimer laser has no effect on your focusing
muscles. Patients who are experiencing the effects of presbyopia
cannot be helped directly by the excimer laser, however, there
are new surgical techniques for this condition.
In March 1999, Dr. Soloway was the only doctor granted an
exemption by the FDA and the Institutional Review Board at
the New York Eye and Ear Infirmary to perform this surgery
in the United States during clinical trials. Ask us at the
time of your evaluation if you are a candidate for this method
of correcting presbyopia, or click on surgical
reversal of presbyopia for more information.
In November 2003, the FDA approved the first (and only) implantable
lens that can restore far and near focus after cataract surgery.
The eyeonics AT-45 Crystalens is able to perform this feat
by using microhinges to allow it to be moved forward and back
slightly in the eye by the eye muscles that are used for focusing