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New implant for AMD

Report on a new implant that can help all types of AMD sufferers was published on the Daily Mail Online Today


11th August 2009

The report stated that this new implant is one of the most exciting advances for AMD patients in many years. There was no treatment for dry AMD, but wet AMD can be slowed down using laser treatment or drugs known as anti-vascular endothelial growth factor medications (one of the best known is Lucentis) to tackle the damaging blood vessels.

Now, for the first time, sight can be restored for patients with either the wet or dry form of AMD.
Known as the Lipshitz Macular Implant (LMI) after its inventor, it magnifies images by 2.5 times, rather like a telescope. The blind spot is still there, but magnifying the image means it can be picked up by the healthy outer parts of the macula, too, which can send a message to the brain to tell the patient what they are looking at.

Patients can read more easily, watch a game of cricket, or see the details on faces - things that most people with AMD had given up on ever being able to do again.

Mr. Andrew Luff is a consultant ophthalmic surgeon at Optegra eye hospital, Guildford, and a consultant at the NHS Southampton eye unit and he explained the process:

The eye is given a local anaesthetic injection, and held open with tiny clips.
An incision was made into the white of the eye and tunnel from here into the front of the eye behind the cornea (the transparent part of the eye covering the pupil). The implant - which is about 1.3cm in diameter - is then inserted through this tunnel and rotated into the correct position. Two tiny plastic feet keep it held securely.
The tunnel is sealed using two invisible microscopic stitches. Then the eye is covered with a pad and shield to protect it overnight.
After 24 hours the padding can be removed.

Patients will be able to see better from then on. Because the lens in the implant is a one size fits all, patients will still need spectacles for previous eye problems, such as long-sightedness, but they will be a weaker prescription than before surgery.

As with all eye surgery, we only ever operate on one eye at a time because of the rare chance of infection. All cases are different and some eye may be too poor to benefit from the new lens - sometimes sight has degenerated so much that even magnifying things doesn’t help.
The patient who underwent the operation was the first person to have the surgery outside India, where the initial trials were conducted.

Only a dozen patients have had the operation so far, but results are extremely encouraging. It’s now being introduced to selected hospitals in Europe for treating people with severe macular disease and very poor central vision. But as it’s perfected, it will be offered to people with better vision.

Mr. Luff continued,”No doubt this technology could help tens of thousands of people with AMD, and I hope it will soon be available on the NHS.”

• The procedure costs £7,500 privately. Optegra Eye Care is on 0800 358 0825, www.optegra.com.

An explanation of how AMD occurs

Mr. Luff explained that AMD occurs because of wear and tear in the retina, the part of the eye that converts light into messages that go to the brain. At the centre of the retina is the macula, which gives us the straight-ahead vision necessary for everyday life such as reading and seeing fine details.

Usually, waste products from cells in the eye are carried away in the bloodstream, but this mechanism declines with age and the waste products then build up. Over time, this waste damages the delicate cells of the macula, eventually causing vision loss. This is known as dry AMD and affects 90 per cent of sufferers.

The ‘wet’ form occurs when tiny blood vessels start to grow under the macula in an attempt to remove the waste products - these blood vessels can leak beneath the macula, causing a sudden and dramatic decline in vision.

Because the macula is only responsible for ‘straight-ahead’ sharp vision, you can usually still see things with the edge of your eyes - your peripheral vision, as it is known.

 
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