Blind World


Implant could improve vision and independence.
Procedure done on first person in Middle Tennessee.





June 7, 2003.

By SAMEH FAHMY,
Staff Writer.
The Tennessean.




Jerry Torgersen and his wife, Bonnie, have been married for 46 years, but he hasn't seen her face clearly for the past five.


The 69-year-old has macular degeneration, a condition that damages the macula, or central area of the retina. His side vision is fine, but anything directly in front of him appears washed out.


If he and Bonnie are separated while shopping, he distinguishes her from the crowd by her shoulder-length blonde hair.


''He says I can't ever change my hair,'' Bonnie Torgersen said.


''I might run up and grab the wrong woman,'' Torgersen explained, chuckling. ''I might get my face slapped.''


Thanks to an experimental surgery performed yesterday at Vanderbilt University Medical Center, Bonnie Torgersen might be able to get a new 'do. And Jerry Torgersen might regain some of the independence that, like his central vision, has slowly faded away.


In a procedure that took about 45 minutes, Vanderbilt assistant professor of ophthalmology and visual sciences Dr. Jeffrey D. Horn implanted a telescope smaller than a pea into Torgersen's right eye. If it works like it is supposed to, Torgersen will use his untreated left eye for peripheral vision, while his right eye will magnify his central vision 2.2 times.


The IMT, or implantable miniature telescope, is being tested at 30 hospitals nationwide, and Torgersen is the first person in Middle Tennessee to have the surgery. The first Tennessee recipient was in Memphis, said Chet Kumar, director of business and market development for Saratoga, Calif.-based VisionCare Ophthalmic Technologies, which makes the device.


Kumar would not say how much the telescope costs or speculate on how much it might cost if it ever comes to market. For now, the 200 patients the company plans to enroll into the study will receive free medical and follow-up care related to the telescope.


If the telescope is approved by the Food and Drug Administration, it could be widely available in two or three years, he said.


Torgersen's surgery was performed under general anesthesia. Shortly after the surgery, he was propped up on his gurney drinking a cup of coffee and chatting with Bonnie. He wore an eye patch all day and is scheduled to have it removed today.


Horn hoped Torgersen would notice an improvement in his vision immediately after the removal of the patch, but because Torgersen is his first patient, he was not sure what to expect.


In preliminary studies, 77% of patients were able to read two additional lines on the standard eye chart. and the vision of 62% improved by three lines. The most common complication was temporary inflammation.


Implanting the IMT, which has two glass lenses housed in plastic, requires a 10- to 11-millimeter incision and five to eight stitches, Horn said.


More than 1.6 million Americans older than 60 have advanced macular degeneration, according to the National Eye Institute.


The IMT is designed to treat vision loss caused by both types of macular degeneration, dry and wet.


In dry macular degeneration, the tissue in the central area of the retina thins, causing vision loss.


In wet macular degeneration, abnormal blood vessels develop under the macula and leak fluid and blood, causing scar tissue to form.


Laser surgery can stop the leaky vessels from spreading in the wet form of macular degeneration, but there is no accepted treatment for the dry form, although zinc supplements may slow its progression, according to the National Library of Medicine.


The IMT does not cure macular degeneration, but it does offer hope where there once was little.


''For most of the patients with macular degeneration … often there's not much you can do for them,'' Horn said.


Patient qualifications


Prospective patients for the clinical trial of the implantable miniature telescope must:


• Have macular degeneration or Stargardt's macular dystrophy and cataract in the eye scheduled for surgery. If they have the wet form, it must be stable and have not been treated in the past six months.


• Have between 20/80 and 20/800 vision.


• Have good peripheral vision.


• Be at least 55 years old.


For more information, call Sandy Owings, clinical trials specialist for ophthalmology at Vanderbilt University Medical Center, 936-2020, or VisionCare Ophthalmic Technologies, www.visioncareinc.net or 1-888-528-0006.



Sameh Fahmy covers consumer health for The Tennessean. Reach him at sfahmy@tennessean.com or by phone at 259-8072.


© Copyright 2002 The Tennessean.






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