New Procedure May Transform Treatment of Cataracts

Dr. Timothy B. Cavanaugh sat at a small table in the San Juan Capistrano office of Optex Ophthalmologics Inc., a detached pig eye staring up at him through the microscope. With deft movements he cut a small slit in the periphery of the eye, punched a hole in the lens and sucked out its jello-like contents using a newly developed probe--all in less than five minutes.

"That was the easiest cataract I've ever removed," said Cavanaugh, an experienced surgeon from the Hunkeler Eye Centers in Kansas City, Mo.

Next was Dr. Michael E. Sulewski of the University of Pennsylvania Medical Center, who repeated the process on another eye. "This is the most important advance in ophthalmology since the development of laser keratotomy," he said after finishing.

The object of their admiration was a new Optex instrument for performing cataract extractions that, even though it has not yet been tested in humans, holds promise for revolutionizing cataract surgery.

The new procedure, called Catarex, is not only quicker, cheaper and less traumatic than phacoemulsification, the current gold standard for cataract removal, it also requires far less skill on the part of the surgeon, said chemical engineer John T. Sorenson of Optex, one of its inventors.

Surgeons generally practice on at least 50 animal eyes before they are comfortable performing phaco, as it is generally called, on patients. Cavanaugh and Sulewski mastered Catarex the first time with just a little coaching, although both said that they would want to try it a few more times before operating on a patient.

"This is going to take cataract surgery from the hands of the most skilled surgeons and allow everyone to do it," Sulewski said. Optex hopes to have completed clinical trials and have it on the market by the end of next year.

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Cataracts occur when proteins inside the normally clear lens begin to clump together, becoming opaque and blocking vision. The most common cause is simple aging, but they can also be produced by long-term exposure to ultraviolet light in sunshine, by diabetes, steroids and injuries to or surgery on the eye.

More than half of all Americans older than 65 have a cataract, and untreated cataracts remain a leading cause of blindness.

The only treatment for cataracts is surgery, which entails removing the cloudy lens. Vision can then be restored by inserting a foldable plastic lens in its place or with special glasses or contact lenses.