Pioneering laser treatment could prevent blindness

A senior ophthalmologist at King's College, London has developed a revolutionary laser treatment which could help prevent blindness in millions of older people. Leading eye expert, Professor John Marshall is the pioneer of laser surgery to treat short-sightedness or 'myopia'.  His groundbreaking work has resulted in freedom from wearing glasses or contact lenses for thousands of people.

Laser eye surgery has become a very popular form of treatment and countless numbers of patients are very happy with the results. This is surgery usually undertaken to correct what are known as 'refractive errors': this is the medical term for a problem with the focusing power of the eye which shows itself as myopia (short sight), hypermetropia (long sight) or astigmatism.

Here, Professor Marshall has developed a short pulsed laser procedure which can delay the start of AMD or 'Age-related

Macular Degeneration'. AMD is strongly related to the ageing process and is the commonest form of blindness in people aged 60 or over. It is important to note that it does NOT cure blindness: rather it can stop the onset of this debilitating condition. It can prevent the condition from becoming worse in patients with AMD, and can treat patients with a family history of AMD.

Age-related Macular Degeneration

This is the medical term for the condition in which a membrane at the back of the eye becomes 'clogged up' with waste products as a result of ageing. As this does so it causes our vision to become cloudy and so leads to blindness.

There are two types of AMD:

  • 'Dry' AMD
  • 'Wet' AMD

Wet AMD is the more aggressive out of the two and can be treated with drugs. Up until now there has been no treatment for those patients unfortunate enough to have the 'dry' version.

But that appears to have changed with the advent of this exciting new treatment.

What causes AMD?

Our ability to see is controlled by the optic nerve. The optic nerve is contained within the retina – the nerve rich membrane at the rear of the eye. Images are formed onto the retina which then sends these via the optic nerve to the brain.

The retina contains a thin membrane called 'Bruch's Membrane' which provides the retina's light sensitive cells (rods and cones) with essential nutrients. It also removes waste products which have formed from the constant renewal of the cells of the retina. But what happens with AMD is that, over time, this process slows down which allows these waste products to build up. This then causes damage to a small section across the centre of the retina called the 'macula'. This can lead to the destruction of the light sensitive cells of the retina itself which causes a loss of vision.

What this treatment does is to 'rejuvenate' these ageing cells which cause enzymes to be released and so remove those waste products.

This does not cause any damage to the retina, the eye or vision itself.

How does this treatment work?

This 15 minute procedure involves the use of a pulsed laser to target those tired cells within the membrane. It sends short bursts of light into this membrane which stimulates its cells to start removing waste deposits again. In effect, the membrane gets a new lease of life.

Early trials have shown that this can lead to a dramatic improvement in sight. These tests were carried out on patients with diabetic eye disease rather than AMD. The reason for this being that diabetic related eye disease develops faster than AMD.

The second set of trials will involve treating people who have AMD in one eye. Once a patent has contracted AMD in one eye then they usually find that this affects their other eye 18 months to 3 years later. Professor Marshall's aim is to prevent AMD developing in their remaining good eye. If this can be held off for a long period of time, say, up to 10 years then it will be considered to have been a success.

When is it likely to become available?

He is hoping that this treatment will become available within 5 years. It is early days yet but this innovative treatment gives hope to many sufferers of 'dry' AMD.

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