The ‘wide-screen’ eye implant giving hope to millions

THE first lens implant to offer ‘wide-screen vision’ is set to transform the lives of millions of Britons suffering a debilitating eye condition. Age-related macular degeneration (AMD) is the leading cause of sight loss in the over-55s. It involves the gradual deterioration of the macula, a 5mm oval area in the centre of the retina – the light-sensitive cells in the back of the eyeball that enable detailed sight.

The disease gradually robs people of their central vision, and about four million Britons have it, including 500,000 with late-stage AMD in which there are significant problems with sight. Although drug treatments can slow the disease’s progress, there is no cure.

Previously, implants corrected this problem by redirecting light rays to another part of the macula, but restoring the centre of vision came at the expense of peripheral vision. In contrast, the new lens is curved in such a way that projects images across the entire macula, offering unparalleled allround vision.

The ten-minute procedure is suitable for those with intermediate-stage and advanced AMD. And in another first, it is also suitable for those who have had a lens replacement due to cataracts, which was previously impossible.

The EyeMax implant was developed by surgeon Bobby Qureshi and Professor Pablo Artal, an optics expert at the University of Murcia in Spain.

‘This has opened up the potential for clear vision to AMD sufferers who have been told they had no option but to eventually lose their sight,’ says Mr Qureshi, chief medical officer and founder of the London Eye Hospital Pharma.

EyeMax, like some other lens implants (collectively, they are known as IOLs, or intra-ocular lenses) actually comprises two lenses. They are inserted into the sulcus – the space below the cornea, or curved front of the eye, and above the lens – via a tiny incision in the front of the eye.

One IOL is convex, or angled outward, and the other is concave, which curves in toward the patient’s own lens.

‘Asymmetric, microscopic waves in the face of each lens refract light and allow the eye to focus not just straight ahead but also across the whole field of vision with high resolution, like a wide-angled camera lens,’ says Mr Qureshi.

‘Traditional IOLs work by diverting light to a single point elsewhere on the macula, but this means patients only have high resolution vision in the central field. And as the disease progresses and more of the macula dies, this area of vision can be lost too.

‘Because the EyeMax diverts light across the entire macula, not just one point on it, vision is preserved for as long as possible.’

The other crucial advantage of this treatment, which costs £9,000 per eye, is that the lens is smaller than conventional implants and can be inserted into the eye in front of an existing implant.

This means that patients who have had cataract surgery can now undergo AMD treatment.

This was not possible before because they already had a lens in place of the cataract so there was no space to insert two additional lenses to treat their vision.

The alternative would have been to take out the cataract lens, but this can cause complications.

‘It’s not easy to take out an implant,’ explains Mr Qureshi. ‘We have got around this issue through the shape of the implant and by making them small enough to fit in the space alongside an existing lens – whether that is the patient’s own lens, or an implant given to correct cataracts.’

The downside, admits Mr Qureshi, is that the macula will continue to degenerate, as the implant does not cure the condition. ‘But it does prolong eyesight for as long as possible,’ he adds.

Anne Sackwood was one of the first UK patients to benefit from the new procedure. The great-grandmother was diagnosed with AMD in 2002 after having cataract surgery.

Recently, the 89-year-old’s sight deteriorated and she feared this would rob her of the ability to recognise family members. Unable even to read bus signs, Anne could no longer go out alone and had to give up her hobbies including reading, knitting and sewing.

With no NHS options available, her children went to see Mr Qureshi and she underwent the EyeMax procedure last summer.

Her daughter, Fiona Sackwood, says: ‘It was heartbreaking to see Mum slowly losing the independence she had fiercely fought to protect. It was such as relief when Mr Qureshi said that she would be suitable for the AMD lens despite having undergone cataract surgery previously.

‘Mum has gone from being unable to read the optician’s vision chart to reading practically down to the bottom of it. She can also watch television, read the newspaper, knit and, even more importantly, focus on faces, meaning she can now recognise family and friends without having to hear their voices.’

The procedure is currently available only privately.

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