New technology offers better, more versatile vision

Rayman Solomon went to Wills Eye Hospital and cataract surgeon Mark Blecher hoping for just a sip of the fountain of youth.

A 69-year-old dean emeritus at the Rutgers-Camden Law School, Solomon isn't one to indulge in fantasy.

But Blecher says a recently developed lens he surgically implanted in Solomon's left eye less than two weeks ago could bring him closer to the vision he had as a youth than anything previously available.

"We're using very fancy tricks of optics to re-create the physiology of a 20-year-old," said Blecher, who has been practicing for almost 30 years. "We haven't quite re-created what God was able to do, but we're taking steps in that direction."

The day after the operation, Solomon already noticed significant improvement. "I can see lines more sharply," he said. "I see colors more vividly."

The Symfony Intraocular lens, developed by Abbott, was approved for use in the United States by the Food and Drug Administration only in July. Solomon was the first patient to get one at Wills Eye and one of the first in the country, although others followed at Wills days later. It was previously approved in 50 other countries worldwide, starting in 2014.

"Patients will have the chance to see close up, from a distance, and in between and in some cases may be able to get out of glasses altogether," Blecher said.

The surgical procedure and the recovery period for the Symfony lens are essentially the same as with traditional monofocal lenses. But the Symfony uses diffractive optics, more akin to that of telescopes than that of eyeglasses or conventional cataract lenses.

For example, an FDA review of a clinical trial showed that although the Symfony and conventional lenses produced comparable improvements in distance vision, patients using the Symfony had better vision at intermediate distances and were able to read two lines lower on an eye chart. In addition to correct near-sighted and far-sighted vision, the plastic lenses also correct astigmatism, and should never need to be replaced.

The Symfony also showed lower incidence of glare and haloes than other lenses.

"It's an exciting leap forward," said Blecher. "My colleagues in Europe are telling me that it changes the way they do cataract surgery."

A cataract is a condition in which the lens inside the eye becomes cloudy. Almost four million cataract surgeries a year are performed in the United States, and the number is growing as the population ages.

Solomon is probably typical of this group.

He has worn glasses since he was 12 or 13, but he had an increasing need for changes in his prescription as cataracts developed. He found that he couldn't read the "crawl" below the main screen on TV newscasts and had increasing trouble following the flight of a golf ball.

"When the last prescription only helped a couple of months I knew I had to do something," he said. "I wanted the latest technology and I didn't see any reason not to try it."

Blecher says that the Symfony comes along at an ideal time. The demand for cataract surgery naturally increases as the population ages, he says, but more and more people are developing cataracts early.

He says he doesn't know why but suspects that exposure to ultraviolet light, the use of certain medications, mostly steroids, and the increase in diabetes and its adverse effects on eyesight all play a role. He is planning a research study in the fall on that subject.

Blecher cautions that the Symfony isn't for everyone. Certain eye conditions, including macular degeneration and advanced glaucoma, can prevent it from being effective, he says.

Then there is the cost.

The lens is more expensive than conventional lenses, and Medicare and private insurance plans don't pay for the difference, he said, leaving patients paying about $2,500 more than for conventional lenses, per eye.

But for those who can afford it, he said, "It's a sea change." As for Rayman Solomon, he's just waiting for the left eye to heal before he gets another implant in his right eye.

pjablow@comcast.net