Michigan Eyecare Institute

As Seen in...

Monday, May 10, 2004

BOON TO BOOMERS: New eye surgery turns back aging
Less-invasive, repeatable procedure fixes
40-somethings' need for reading glasses

BY JEFF BENNETT
FREE PRESS BUSINESS WRITER

Candace Hanna knew she had the "baby boomer disease."

It struck about 10 years ago when she couldn't make out the numbers in the telephone book. She also began holding menus at arms' length and stashed 10 pairs of reading glasses throughout her house so a pair was always within reach.

Fed up, Hanna turned to what is sure to become the next hot hit in cosmetic eye surgery since LASIK, or laser-assisted in situ keratomileusis, burst onto the scene 10 years ago.

J. KYLE KEENER/DFP

Dr. William Myers uses a speculum to hold
Candace Hanna's eye open for her conductive keratoplasty. In what is called blended surgery, one eye is treated for nearsightedness while the other is left to take care of distance vision.

Conductive keratoplasty surgery, known as CK, corrects the baby boomer disease presbyopia. The age-related ailment, the inability of the eye to focus sharply on nearby objects, usually strikes people older than 40.

It forces people like Hanna to use reading glasses although she never had vision problems before.

"It is a nuisance," said the fifty-something West Bloomfield resident. "You are not used to having to use glasses, and then you are relying on them."

The U.S. Food and Drug Administration in late March approved the surgery as safe and effective.

At a price between $1,500 and $2,500, the one-eye procedure could become another cash cow for the eye care industry.

Experts say about 90 million baby boomers are expected to develop presbyopia in the next 10 years, meaning a potential market worth more than $67 billion if half those who get the disease seek CK treatment once at the low-end of the price range.

The cosmetic eye surgery industry has needed a boost of excitement since 1995 when millions of people lined up for LASIK surgery to fix nearsightedness, farsightedness and astigmatism. The numbers began to fade in 2000 with the drop in the economy.

CK is less invasive than LASIK, which permanently changes the shape of the cornea, the clear covering of the front of the eye. CK requires no knives, and no tissue is removed. It also takes less than 15 minutes.

The only downside is that insurance doesn't cover the procedure because it is considered cosmetic and because CK gradually wears off. A patient might need to return for another treatment in three to five years.

"We are not making our patients like they were at age 20," said Dr. William Myers of the Michigan Eye Care Institute. He performed the surgery on Hanna late last month. She was his first CK patient.

"We are allowing them to read a menu in a dimly lit restaurant and do certain things where they once needed magnification. We are allowing them to be much more functional than they were before the procedure."

One CK machine costs about $50,000.

What to expect during CK

Nurses will administer eyedrops before the patient enters the surgical room. These drops numb the eye.
Some patients might be given a mild sedative upon request but must have a person available to drive them home.
Once entering the surgical room the patient reclines beneath the machine.
The surgeon applies a speculum between the eyelids to keep them open and to prevent blinking.
The surgeon will use a rinse-away dye to make a circular pattern around the cornea. The surgeon will use the pattern as a guide to where the radio frequency -- which looks like a flash of light -- should be applied. Seconds of frequency are required for each eye.
The surgeon will write a prescription for eyedrops that help to prevent infection and reduce inflammation. Some surgeons ask patients to wear special bandage contact lenses for a few days to minimize discomfort.
There might be a foreign-object sensation or a slight scratchiness in the eye. This sensation usually subsides within 24 hours.
The patient should be able to function normally during the first week after the surgery but might be slightly nearsighted. These side effects should clear up quickly. Eyes might be sensitive to bright light. Wearing dark glasses for up to one week is sometimes necessary.
CK does not stop the aging of the eye. Patients might have to return for another procedure in 10 years.

Source: Free Press interviews and eye-related Web sites.

For Hanna, not having to rely on her glasses is worth the expense.

"It's been wonderful," Hanna said about two weeks after her surgery. "I can read the newspaper, backs of labels on cans, magazines and price tags. Within the first week I could focus much more easily. I would encourage people to do this."

Dr. Robert Maloney, who practices in Los Angeles and is a spokesman for the American Academy of Opthalmology,said the potential for CK is great because it is the safest surgery yet. He was one of 54 doctors who tested the treatment in FDA clinical trials.

"The limitation to its appeal is that we are only taking one eye and make it nearsighted so people can see up close," he said. "The other eye handles seeing long distance. Some people don't like that and others love it."

How it works
CK uses radio waves shot around the cornea's perimeter to shrink the underlying collagen bands that are found in cartilage, connective tissue and bone.

The surgeon marks the perimeter of the cornea with rinsable dots, then follows the pattern with an instrument that has a small probe and focuses the radio waves.

The radio waves heat the bands until they shrink, which forces the cornea to bulge forward.

"You have a balloon and put a belt around one end of it and tighten, which causes the other end to bulge," Myers said. "That is why people are able to see more closely."

Most patients see immediate improvement in their near vision but it can take a few weeks for both eyes' vision to blend.

"It is mind-boggling," Myers said. "I never dreamed 20 years ago some of the things I am able to do today."

Contact JEFF BENNETT at 313-222-8769 or jbennett@freepress.com.

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