News About Cataracts, Cataract Surgery
and Lens Implants

Women's Hormone Replacement Therapy Linked to Cataracts-Ophthalmology: March 2010

Swedish researchers conducted an 8 year prospective study of more that 30,000 postmeopausal  women and found that those who were using or had used HRT had significantly higher rates of Cataract removal, compared with women who had never used HRT. Alcohol consumption seemed to increase HRT's harmful effect. The HRT study was led by Birgitta E. Lindblad, MD, Sundsvall Hospital, Sweden as part of the Swedish Mammography Cohort (SMC), established to study lifestyle factors and chronic diseases.  More than 4,300 Cataract Surgeries were performed in participants between 1997 and 2005. The risk for Cataract removal was increased by 14 percent in women who had ever used HRT and by 18 percent in current HRT users, compared with women who never used HRT. Longer duration of HRT use correlated with increased risk. Current HRT users who also reported having more than one alcoholic drink per day had 42 percent increased risk, compared with women who used neither HRT nor alcohol. Smoking status did not significantly affect risk. "Cataract is more prevalent in postmenopausal women than in men at similar ages; this implies that hormonal differences are involved and suggests a possible role for estrogen," Dr. Lindblad explained. She described how HRT may act to promote Cataracts and also compared her project's findings with earlier studies.

Estrogen receptors have been detected in the eye's lens, the area that becomes cloudy and inflexible when a Cataract develops. Naturally occurring (endogenous) estrogen appears to protect the eye from Cataract, along with guarding cardiovascular and other body systems before menopause. Exogenous estrogens like those used in HRT do not function the same way. For example, HRT increases C-reactive protein levels, associated with cataract development in other studies. Dr. Lindblad's study also describes how alcohol and HRT may interact to raise estradiol levels, which appears to affect cataract risk.

In contrast to the SMC, earlier large HRT and Cataract risk studies in the United States, Australia and Europe reported mixed results. Importantly, some of these studies included women who were premenopausal and so possibly protected by endogenous estrogen. Results of the Swedish study may have been impacted by factors unique to this population, for example, nearly all participating women shared the same ethnicity, and all had equal access to care. The study did not identify type of HRT, type of cataract, or measure exposure to excess sunlight, a risk factor for cataract, although unlikely to impact residents of northern Europe.

Statins Reduce Cataract Risk in Patients Under 75 Years Old-Annals of Epidemiology: February 2010

Statins are widely used by patients to reduce cholesterol. There is evidence to suggest that Statins also have anti-inflammatory and anti-oxidative effects and thus may prevent the formation of Cataracts. Researchers examined the charts of 180,291 patients who initiated Statin use and were examined between 1998 and 2007 and the incidence of Cataract and Cataract Extraction was evaluated. The study results showed the development of 27,301 cataracts and 6,976 cataract extractions performed in this group. The data demonstrated that the consistent use of Statins had a statistically significant association with diminished risk of cataract in male and female patients aged 45 to 74 years (P < .001) with men ages 45 to 54 years having a 38% lower risk of developing cataracts and women of the same approximate age reduced their risk by about 18%. However, the data showed no significant association between consistent Statin use and risk of Cataract in elderly patients above 74 years of age. Thus, the consistent use of Statins appears to lower the risk of Cataract formation in patients 45-75 years of age.

Vision Problems & Dementia in the Elderly
American Journal of Epidemiology: February 2010

Elderly people with untreated poor vision are significantly more likely to suffer from Alzheimer’s disease and other forms of Dementia than their clear-sighted counterparts, according to a study published online by the American Journal of Epidemiology. The study suggests that vision problems may be a contributing factor in the development of dementia, rather than a symptom of it.

The study found that when elderly people with poor vision went to an Ophthalmologist even once, their risk of Dementia was reduced by 64 percent and that people who had undergone eye procedures such as to treat Glaucoma and remove Cataracts they were also less likely to develop Dementia.

Poor vision often prevents people from participating in the types of activities thought to reduce Alzheimer’s risk, such as socializing, reading and physical activity. Early treatment of vision disorders, the authors suggest, could delay the onset of Dementia, and of Alzheimer’s disease in particular.

Thirteen million Americans are expected to have Alzheimer’s disease by 2050, according to the U.S. Centers for Disease Control and Prevention. Treating vision problems early may make that number less daunting. “If we can delay the onset of dementia, we can save individuals and their families from the stress, cost and burden that are associated with Alzheimer’s disease,” the authors relayed.

Bausch & Lomb Introduces Crystalens® Aspheric Optic (AO) Accommodating Lens Implant (IOL): January 2010

Bausch & Lomb has received Food and Drug Administration (FDA) approval for and has released the Crystalens® AO, the first aberration-free accommodating intraocular lens (IOL) with aspheric optics, to Cataract Surgeons worldwide. Aspheric Intraocular Lens Implants (IOL)s are widely used during Cataract Surgery as patients report that they are able to achieve a better overall quality of vision and especially in dim or low light conditions. The Crystalens® AO has prolate aspheric surfaces and is designed to be free of spherical aberration. This design feature is intended to improve retinal image quality without compromising depth of field and therefore provides greater quality of distance and intermediate vision as well.

Cataract Surgery and Progression of Macular Degeneration
Archives of Ophthalmology: November 2009

There has been some concern among Cataract Surgeons and Retina Specialists that Cataract Surgery may predispose patients to a quicker progression of Age Related macular Degeneration (ARMD). Researchers enrolled 108 patients in a study who were awaiting Cataract Surgery to see if over time they were more likely to develop wet macular degeneration. They were studied with Fluorescein Angiography before their Cataract Surgery and were followed carefully for up to one year after their eye surgery. They concluded that there was a very low incidence of neovascular of wet macular degeneration and that Cataract Surgery did not hasten the progression of Age Related Macular Degeneration.

Adaptation to the Tecnis® Multifocal Intraocular Lens (IOL) Implant
European Journal of Ophthalmology: September/October 2009
Researchers reported on a clinical study of 250 eyes having the Technis® Multifocal Intraocular Lens (IOL) implanted. As part of the study they examined and reported on patients who were examined for as long as 7 months after surgery. The researchers found that 96.8 percent of eyes could read at 20/20 without eyeglass correction or reading glasses correction and that more than 90 percent of the participants ranked their near, distance and overall vision as good or excellent, with 88.4 percent not needing eyewear for seeing well at any distance. However, they did find that in order to obtain the best overall vision it required an adaptation period of about 6 months for most patients. This "neuroadaptation" period is common and has been reported previously with other types of near vision presbyopia correcting multifocal intraocular lens (IOL) implants as well as accommodating and diffractive lens implants for the correction of near vision and presbyopia after cataract Surgery.

Patients With Age-Related Macular Degeneration Benefit From Cataract Surgery - Ophthalmology : November 2009
Emily Chew, M.D. of the National Eye Institute reported on data from  the Age-Related Eye Disease Study (AREDS), which was organized primarily  to evaluate the effects of high-dose vitamin and mineral supplements on  Cataract and AMD. She reported on the results of 1,939 eyes of 1,244 patients  with AMD and evaluated their visual acuity after Cataract Surgery. The results  showed that on average, patients with AMD, ranging from mild to advanced,  gained visual acuity after cataract surgery; with the best gains were in  patients with vision worse than 20/40 before surgery. There was no difference  in improvement between patients with Wet Macular Degeneration as compared to  Dry Macular Degeneration. The results remained significant at one year after  their surgery as well.

Prior Cataract Surgery Affects Results of VEGF Injections for  Wet Macular Degeneration - Retina Congress : 2009
Ayala Pollack M.D.,  Department of Ophthalmology, Kaplan Medical Center, Rehovot, Israel reported  on a review of patients who had prior Cataract Surgery and found that those  patients who have new blood vessel growth secondary to age-related macular  degeneration (AMD) and are treated with VEGF injections do not respond as well  to treatment if they have had prior Cataract Surgery. The analysis found that  patients who had not had prior cataract surgery fared slightly better than  those who had had their cataracts removed and had intraocular lenses  implanted. Dr. Pollack said further prospective studies are needed to confirm  these results. When initiating patients on VEGF injections, consideration  should be given to whether these patients have intact crystalline lenses. A  more aggressive therapeutic regimen may be warranted if patients have had  prior Cataract Surgery, and in particular, if they had their surgery  within the 2 years immediately preceding the diagnosis of wet  AMD.

FDA Approves Aspheric AcrySof IQ Toric Intraocular Lens: March 2009
Alcon announced that the FDA has approved the AcrySof IQ Toric Intraocular Lens Implant for the correction of astigmatsim during Cataract Surgery.This new lens offers an enhanced aspheric optic that improves image quality and increases contrast sensitivity in cataract surgery patients with astigmatism. The innovative lens design offers these patients the best opportunity for quality distance vision without glasses.According to company officials, the first AcrySof Toric lens was introduced in 2005 and quickly became the leading toric lens on the market, due to its predictable power outcomes and excellent rotational stability. These benefits are largely realized due to the strengths of the AcrySof IOL material and proprietary single-piece design. As the first acrylic single-piece lens, AcrySof provides unequalled stability in the eye. This is especially important when correcting astigmatism, which occurs due to an irregular shape of the eye.

Cataracts & Age Related Macular Degeneration (ARMD) Ophthalmology: February 2009
There has been concern that having Cataract Surgery might accelerate ARMD and increase the potential for vision loss in aging patients. As reported in the publication of the American Academy of Ophthalmology, Ophthalmology, in February 2009, researchers from the National Eye Institute reviewed 5 years of data on the progression of AMD after Cataract Surgery as part of the Age Related Eye Diseases Study (AREDS) which a large scale clinical study. Their conclusion was that having Cataract Surgery did not increase the risk for the onset of advanced ARMD and that patients should be reassured by this.

Exercise & Cataracts February 2009
Researchers from the U.S. Department of Energy’s Lawrence Berkeley National Laboratory tracked approximately 41,000 runners for more than seven years, and found that running reduced the risk of both cataracts and age-related macular degeneration. Their study suggests that vigorous exercise may help prevent vision loss and offers hope for people seeking to fend off the onset of certain age related eye diseases.“In addition to obtaining regular eye exams, people can take a more active role in preserving their vision,” says Paul Williams, an epidemiologist in Berkeley Lab’s Life Sciences Division who conducted the research. “The studies suggest that people can perhaps lessen their risk for these diseases by taking part in a fitness regimen that includes vigorous exercise.”

New Technique for Early Detection of Cataracts: National Institute of Health January 2009
Researchers from the National Eye Institute (NEI), part of the National Institutes of Health, and the National Aeronautics and Space Administration (NASA) collaborated to develop a simple, safe eye test for measuring a protein related to cataract formation. If subtle protein changes can be detected before a cataract develops, people may be able to reduce their cataract risk by making simple lifestyle changes, such as decreasing sun exposure, quitting smoking, stopping certain medications and controlling diabetes. The new device is based on a laser light technique called dynamic light scattering (DLS). It was initially developed to analyze the growth of protein crystals in a zero-gravity space environment. NASA’s Rafat R. Ansari, Ph.D., senior scientist at the John H. Glenn Research Center brought the technology’s possible clinical applications to the attention of NEI vision researchers when he learned that his father’s cataracts were caused by changes in lens proteins.

Cataract Gene Located by Swiss Researchers: February 2008
Swiss Researchers from the University of Zurich will report information in the American Journal of Human Genetics regarding the location of a gene that is responsible for the formation of juvenile Cataracts.  The researchers have identified the chromosomal location and exact molecular defect in the coding region of the gene responsible for a juvenile Cataracts. They were able to accomplish this through the detailed study of a large Swiss family wherein the members had autosomal dominant juvenile Cataracts.It is believed that a transporter protein may exist that moves small molecules acoss cell membranes and damages the Crystalline Lens causing a Cataract . Age-related cataract patients are now being screened to find mutations in this gene. Understanding the exact function of this transporter may open new approaches for preventiona and non-surgical treatment of Cataracts.

"New Technology" Designation Awarded to Staar Surgical Afinity Collamer Aspheric Intraocular Lens and the Elastimide Silicone Aspheric Intraocular Lens by the Centers for Medicare and Medicaid Services: August 2008
The Centers for Medicare and Medicaid Services (CMS) announced that the "new technology" designation for the Afinity Collamer Aspheric Intraocular Lens and the Elastimide Silicone Aspheric Intraocular Lens, used to replace the eye's natural lens during cataract surgery, was effective in August 2008. Because the lens incorporates a special aspheric optical design, it corrects optical aberrations and thus is helpful in decreasing glare under certain lighting conditions by enhancing contrast especially at night and low light conditions.

FDA Approves Crystalens HD™ 4th Generation Accommodating
Lens Implant: June 2008
Bausch & Lomb received approval from the Food and Drug Administration (FDA) to market the Crystalens HD™ in the United States. The Crystalens Accommodating Intraocular Lens (IOL) was first approved by the FDA in November 2003. The Crystalens HD™ is the fourth generation of the only FDA approved accommodating lens. The surface of the Crystalens HD™ has been shaped to enhance the depth of focus with a proprietary optical modification. The enhanced optic provides an increased depth of focus, which is designed to improve near vision without compromising intermediate or distance vision. The HD lens does this without inducing increased undesirable dysphotopsia or night vision symptoms.

Aspheric Lens Implants & Contrast Sensitivity
Journal of Cataract & Refractive Surgery: August 2007
A Canadian researcher reported that by carefully measuring and targeting the amount of spherical aberration to be corrected through Aspheric Intraocular Lens Implants after cataract surgery, it is possible to improve the overall contrast sensitivity achieved. Contrast sensitivity improvements are generally regarded as a way to improve vision in dim illumination and poor lighting conditions such as for night driving. Aspheric Lens Implants are available to patients throughout the United States.

Delaying Cataract Surgery
Canadian Medical Association Journal: April 2007
People who undergo cataract surgery within six weeks of booking their procedure have better visual outcomes, as well as increased quality of life and fewer adverse events such as falling, says research reported in the April 24 issue of the Canadian Medical Association Journal. People who waited six months or longer for their cataract surgery experienced more adverse events.

Cholesterol Drugs Decrease Risk of Cataracts and Macular Degeneration
American Journal of Ophthalmology: April 2007
The class of cholesterol lowering medications called “statins” have been found to reduce risks of developing both cataracts and advanced age-related macular degeneration. Researchers found that statins slowed the development of cataracts by 50%.

ReSTOR® Aspheric Lens Implant FDA Approved: February 2007
The U.S. Food and Drug Administration recently approved a new aspheric version of Alcon's AcrySof® ReSTOR® Intraocular Lens (IOL) for cataract surgery. The lens, known as the AcrySof® ReSTOR® apodized diffractive aspheric IOL, addresses presbyopia by providing different zones enabling vision correction at near to far distances. An Alcon Laboratories statement says the newly approved aspheric optics design is the only one currently available in the U.S. in a presbyopia correcting lens implant.

Researchers previously have produced evidence that aspheric lenses, which are somewhat flattened at the periphery, may help offset aberrations in the eye that can cause vision problems such as reduced night vision and contrast sensitivity.

Medicare Allows Astigmatism Correcting Lens Implants for Cataract Surgery
Centers for Medicare and Medicaid Services: February 2007
Medicare recipients are now able to choose an astigmatism-correcting Intraocular Lens for cataract surgery. While the ruling allows Medicare coverage for basic cataract surgery, patients must pay out-of-pocket for any extra features such as for astigmatism correction. In the past, astigmatism-correcting lens implants were not covered at all.

Common Prostate Drug Can Cause Problems With Cataract Surgery
American Academy of Ophthalmology: August 2006
A number of medical associations including the American Academy of Ophthalmology, the American Society of Cataract & Refractive and the American Urological Association have warned patients that the common prostrate drug, Flomax, and similar medications known as alpha-blockers may cause problems during cataract surgery. If you are taking Flomax and plan on having cataract surgery it is important that you alert your cataract surgeon before you have your surgery.

Flomax, commonly used to treat an enlarged prostate, and other alpha-blockers such as Hytrin, Cardura and Uroxatral can cause abnormal movement of muscles controlling the opening and closing of the iris and thus can interfere with pupil dilation, creating a condition known as intraoperative floppy iris syndrome. Your cataract surgeon will take extra precautions including additional eye drops if you are taking these medications in order to prevent unexpected complications during cataract surgery.

Asthma Drugs May Be Linked to Cataracts
European Respiratory Journal: July 2006
Researchers at McGill University Health Centre found that people older than 65 using daily doses of inhaled corticosteroids to reduce risk of attacks of asthma or chronic obstructive pulmonary disease (COPD) increase their risk of developing cataracts by 24%. For that reason older people with asthma who use cortisone-based medications in their inhalers might consider asking their physicians about reducing dosages to avoid cataracts or their progression.

"New Technology" Designation Awarded to Tecnis® Intraocular Lens
Centers for Medicare and Medicaid Services: March 2006
The Centers for Medicare and Medicaid Services (CMS) announced that the "new technology" designation for the Tecnis® Intraocular Lens, used to replace the eye's natural lens during cataract surgery, was effective in late February 2006. Because the lens incorporates an aspheric design, it corrects higher order aberrations and thus is helpful in decreasing glare under certain lighting conditions by enhancing contrast especially at night and low light conditions.

Fruits and Vegetables May Protect Against Cataracts
American Journal of Clinical Nutrition: July 2005
Researcher William Christen of Harvard Medical School and Brigham and Women's Hospital investigated the effects of dietary intake of fruits and vegetables on the occurrence of cataracts. When the study began, none of the patients had cataracts. By the end of the study, those who had eaten the most fruit and vegetables were 10% to 15% less likely to have cataracts than the other patients.

Medicare Allows Presbyopia Correcting Lens Implants for Cataract Surgery
Centers for Medicare and Medicaid Services: May 2005
The Centers for Medicare and Medicaid Services (CMS) have ruled that Medicare beneficiaries may choose Intraocular Lenses (IOLs) that correct presbyopia for an additional fee as part of their Medicare-covered cataract surgery. These newer IOLs correct vision at more than one distance and offer the possibility of little or no dependency on reading glasses. Before the ruling, Medicare patients were limited to receiving the traditional monofocal distance-vision IOLs that don't correct near vision.

ReZoom™ Multifocal Lens Implant FDA Approved: April 2005
The ReZoom™ Multifocal Intraocular Lens is designed to distribute light over five optical zones to provide distance, intermediate, and near vision for cataract patients. The idea is to reduce the need for spectacles, including reading glasses, after cataract surgery.

AcrySof® ReSTOR® Lens Implant FDA: March 2005
The AcrySof® Lens Implant, a type of artificial lens or intraocular lens implant that can restore vision at near, intermediate, and distance ranges following cataract surgery received U.S. Food and Drug Administration approval. The clinical studies supporting the approval showed that 80 percent of patients who received the AcrySof® ReSTOR® lens did not use glasses for any activities after cataract surgery. The AcrySof® ReSTOR® lens provides different ranges of vision based on a lens configuration that enables specific distribution of light in response to how wide or small the eye's pupil might be. Most current intraocular lenses used for cataract surgery are able to restore vision only in limited distance ranges, which means patients often must use eyeglasses or other corrective lenses following surgery.

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AcrySof®ReSTOR® is a registered trademark of Alcon, Inc., ReZoom™ and Technis® are registered trademarks of
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