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January 31, 2003

Radio wave surgery gives view of life without reading glasses

MILLIONS of middle-aged people with long sight can recover normal vision with a new technique to be used in Britain for the first time today.

Using radio waves to reshape the cornea frees them from needing reading glasses — and remembering where they last put them down.

The technique, conductive keratoplasty (CK), has been approved by the US Food and Drug Administration and is used in about 150 centres in the US. The first procedures in Britain will be carried out today at Horizon Laser Eye Centre in Manchester by the centre’s medical director, ophthalmic surgeon David Allamby.

Laser surgery has proved very successful for short sight, where the need is to reduce the curvature of the cornea and weaken its focusing power. It can also be used for correcting long sight but Mr Allamby said that it is not as effective in that role.

Long sight affects 25 per cent of people aged more than 45, and a half aged more than 60. “Finally we have a technique for those millions of people, including those who only need reading glasses,” he said.

The new technique was developed by the US company Refractec, which says that its purpose is to “turn back the clock” on long-sightedness.

As we age, our eyes inevitably change, which means that long sight may slowly develop. “It is not a lifetime treatment,” Mr Allamby said. “It turns the clock back about ten years. But it can be done again if necessary.

“The average age of CK patients is 55, compared to 38 for laser vision correction,” Mr Allamby said. “We know from research that the 40-60 age group have been much less active in considering laser surgery.

“Yet they are more interested in the safety of CK and they like the fact there is no blade or laser, and the important line-of-sight part of the cornea isn’t touched.”The company does not promise 20:20 vision. “No honest doctor can absolutely guarantee a certain result from any vision procedure,” Refractec says.

Its clinical trials have. however, shown that 92 per cent of patients with low to moderate levels of long sight achieve normal or near-normal vision after one procedure. Among Mr Allamby’s first patients today is Howard Lockett, 53, of Preston, a teacher of science and computer studies. “I find difficuly when marking students’ papers,” he said. “I need reading glasses and I’m always putting them down.

“I hope that the treatment will allow me to get rid of the reading glasses, at least until I retire. After that, I may not mind so much.” The FDA gave the technique its approval in April last year after trials in which more than 400 people were treated, with no serious complications. Mr Allamby will offer the treatment in Manchester and Bolton at first, but hopes that it will be available in Harley Street in London within the next month or so.

£1,000 an eye, no knife, no laser

The treatment works by causing the structural material of the cornea to shink in a controlled way, steepening the curvature of the cornea and increasing its power as a lens.

This is achieved by applying radio waves through a tip as fine as a human hair. The tip is placed successively in a ring of spots around the outside of the cornea, the number of spots determined by the extent of long-sightedness. There may be as few as eight or as many as 32.

The eye is anaesthetised with drops and the pattern of spots imprinted on the cornea with rinse-away ink to guide the doctor. The energy of the radio waves causes the collagen around each spot to shrink slightly. When the ring of spots has been completed, the effect is to create a “belt” of shrunken areas which squeezes the cornea and steepens its curvature.

Unlike laser surgery, the technique does not remove any material from the cornea, nor does it involve any interference with the front on the cornea. The spots are arranged around the edges, an important feature for many users.

The whole procedure takes five minutes, and costs about £1,000 an eye, similar to laser surgery. Refractec say that most patients notice an immediate improvement in their vision, but that it usually takes a few weeks for the eyes to reach the final level.

 

 

 

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