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For those too myopic for Lasik surgery, clearer vision may be in sight

New to the U.S., the Verisyse procedure implants a tiny plastic lens behind the cornea.

September 13, 2004|Valerie Reitman | Times Staff Writer

About 2 million nearsighted Americans whose eyesight is too impaired for Lasik surgery will now have an alternative to permanently correct their vision.

The procedure, approved by the Food and Drug Administration last week, involves implanting a permanent plastic lens about one-third the size of standard contact lenses behind the cornea and in front of the iris.

It isn't for everybody. For the average nearsighted person, Lasik remains a better alternative than the new procedure, said Dr. Kerry Assil, a Los Angeles eye surgeon who has been involved in clinical trials of the new lens.

But for the 5% to 10% of myopic patients whose eyesight is too poor to be corrected with Lasik, the new Verisyse lens procedure offers the potential for much better vision correction than is possible with corrective contact lenses or glasses.

"If Lasik is like a cure for a migraine, this is like a cure for cancer when it comes to the eyes," Assil said. In contrast to Lasik, in which lasers are used to permanently reshape the cornea, this procedure is reversible; the lens can be surgically removed later.

The procedure is expected to cost about $3,500 to $4,000 per eye. The lens itself costs an additional $1,000. Lasik surgery typically costs $300 to $1,500 per eye.

Unlike Lasik, which can be performed in physicians' offices, the Verisyse procedure, which requires a 6-millimeter incision, must be done in a special, fully sterile hospital operating room. The skill of the surgeon will be even more critical in the lens implantation than in Lasik surgery, which is highly automated. With Verisyse, there is risk of bleeding and potential for increased pressure on the eye.

There is also a risk of infection, which might be more severe than with contact lenses because it could occur behind the cornea.

However, none of these problems were reported during seven years of clinical trials of Verisyse involving more than 1,000 patients in the United States, Assil said. The lens was developed by a Netherlands company and has been available in Europe for about a decade. It is being distributed in the U.S. by Advanced Medical Optics in Santa Ana.

For Saudah Pleasant, 38, of Rancho San Diego, the lens has made the difference between blindness and near-perfect vision. Her vision had been deteriorating since age 10. Contact lenses helped somewhat, but glasses didn't help nearly as much. About three years ago, unable to tolerate contact lenses for more than two or three hours a day -- and with her vision greatly impaired without them -- she was forced to quit her job as a substitute teacher. She had to choose which few hours of the day to wear her contacts -- a difficult problem for a mother with young children. She had to give up swimming because she couldn't see anyone else in the pool.

After having the Verisyse lenses implanted last spring, she has 20/20 vision in her right eye and about 20/40 in her left.

"It's the little things, like being able to see a freeway sign," Pleasant said. "I can read. I changed all the fonts on my computer from the giant ones.... I have a life now."

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