Daily Mail 12/05/09
Cataract op that means I can throw my reading glasses away
How pioneering ‘double lens’ surgery transformed one woman’s life
Every year 400,000 Britons undergo cataract surgery, having the damaged lens in their eye replaced with a plastic one.
However, they often need reading glasses afterwards. Ann Edworthy, 50, a lecturer from Swansea, was one of the first to have a new ‘piggyback’ lens, which restores sight completely.
She tells Daily Mail’s CAROL DAVIS her story, and her surgeon explains the procedure.
As a student, I used to suffer from really sore eyes after long spells of reading. My optician diagnosed congenital cataracts – a partial clouding over of the lens in both my eyes since birth. While I didn’t need any treatment then, he warned me they could cause sight problems later in life.
Two years ago, I noticed that when I looked at distant objects, it was as though there was a milky film on my left eye – I couldn’t see clearly, and it felt as if it was covered in cling film; I wanted to rub it all the time.
By chance, one of my students mentioned she’d been really happy with the treatment from a local eye surgeon. So, as I had private health insurance, I asked my optician for a referral to him. The surgeon, Mohammed Muhtaseb, explained that as well as the cataracts I’d had from birth, there was another cataract growing in my left eye, something that tends to happen with age.
He said he could operate to remove them, replacing each cloudy lens with a clear, artificial one. I’d have to choose which kind of replacement lens I wanted – one for reading or one for seeing at a distance. Whatever I chose, I’d have to wear glasses for the other. I couldn’t bear the thought of wearing glasses for the rest of my life. But I had no choice, as the cataracts meant I was now struggling to read, while in dim light I couldn’t see at all.
So last April I had operations to remove the cataracts and replace them with artificial lenses. Afterwards, I could see for miles because the cloudiness in my vision had gone. But I hated the reading glasses I had to use: when I was lecturing, I’d have to put them on to read, and then take them off to look at the students. Changing focus all the time made me feel queasy. Then, in October, Mr Muhtaseb told me about a brand-new lens – the piggyback, so-called because it is implanted on top of, and works in tandem with, existing artificial lenses, meaning I would be able to focus on both distant objects and close print.
Just before Christmas, I became the second person to undergo the procedure. As with all eye operations, there is a tiny risk of blindness, so I had one eye done at a time; this way Mr Muhtaseb could check my sight was fully recovered. An hour before the operation, a nurse put drops in my eye to dilate my left pupil and create a gap in front of the artificial lens. After anaesthetic drops were put in my eye, Mr Muhtaseb pulled my eyelid back and shone a bright light into my eye. The new lens was furled up in a syringe to be injected into my eye. I felt a slight tug as the syringe went in, but no pain. My eye was then covered with a clear plastic shield to stop me rubbing it while the lens settled into place. An hour later the shield was removed and Mr Muhtaseb handed me a medicine packet to read. It was extraordinary – I could read all the small print, even down to the tiniest full stop. My restored vision made my Christmas wonderful. Suddenly, I didn’t need to find glasses to read cooking instructions. Even though my right eye had yet to be done and was still blurry, I just closed or covered it and read with my left. That, too, was corrected five weeks later and my sight is now perfect. I can use the computer and read without glasses, and see for miles, too. I don’t notice when I move from lens to lens. And I’ve given away those glasses I hated so much, because I’m thrilled to know I’ll never need them again. The Surgeon Cataract operations are the most commonly performed surgery in Britain – we remove a lens which has clouded over as the patient ages and replace it with a clear implant. But patients almost always still need glasses because their own lens has been replaced by an artificial one, which does not change shape to focus as their own did. This is very inconvenient, particularly for people such as Ann who need glasses for work or for everyday activities including driving and computer work – they have to take their glasses on and off many times a day. Although you can implant a multi-focal lens, which focuses on both distant and close objects, these are not widely available on the NHS because of the cost – and you can’t add one after regular cataract surgery, as there is not enough space in the eye. Ann had been unsuitable for a multi-focus lens because she had previously had laser eye surgery, which changes the shape of the eye. But a new lens, the Sulcoflex Multi-focal piggyback, is much thinner, which means we can slide it in front of the single lens. This new type, which was invented in Britain, could help hundreds of thousands of people who have had cataract or other artificial lens implants by restoring their ability to see long-distance and read without glasses. The operation takes about ten minutes. After clipping open the eyelids, I slide in a small blade through the side of the cornea – the transparent dome on the front of the eyeball – to form a tunnel to reach the natural space between the iris and the pupil; this is where the new lens will be inserted. To prevent the eye from collapsing if it loses fluid, I inject a jelly-like substance to maintain pressure in the eye. I load the piggyback lens into a plunger – like a syringe – so it rolls the lens in half. I then inject the rolled lens into the space, where it unfolds itself in front of the existing artificial lens. I then check it’s correctly centred over the other lens so the patient can see through its different zones of focus – near and far. I use a syringe to suck out the jelly, and inject saline to maintain the shape of the eye. Pressure from the eye means the tunnel seals itself up. Ann will have a check-up in a few months, and then regular checks over the next few years. But because this plastic lens will not degrade, it should last a lifetime.