Vision Health
(Globe & Mail insert)
Innovative technology revolutionizing surgery
Innovations in eye surgery have been remarkable in the past decade, none more so than for cataracts.
Once an arduous undertaking, cataract surgery is now one of the most efficient and successful operations in all medicine.
"Cataract surgery is easily the most frequently performed operation in Canada," notes Dr. Lawrence Brierley, a specialist in Victoria, B.C. "It used to be a leading cause of blindness in this country and still is elsewhere in the world."
Often age-related, a cataract is the clouding of the natural lens of the eye, increasingly distorting and reducing vision. Cataracts were previously removed with large incisions that had to be sutured and were the source of many complications. Hospital recoveries of more than a week with the patient's head totally immobilized were once standard, and the cataract patient subsequently needed thick glasses that were themselves the cause of numerous problems.
Today with intraocular lens technology, says Dr. Brierley, "a number of changes have occurred that are allowing us to achieve results that more closely approximate what was present when we were young people." Moreover, those results are coming with unprecedented levels of safety and minimal complications.
"Probably the biggest development," explains Dr. Brierley, "is the ability now to do this surgery through small wounds."
Astoundingly small: today, a 1.2-mm incision is enough to insert an ultrasonic needle, described by Dr. Brierley as "a microscopic jack hammer," that breaks up and aspirates the clouded lens and allows a scrolled-up synthetic lens to be inserted in its place.
"This is dramatically different than what I was trained to do in the seventies," Dr. Brierley notes.
Even the replacement of the natural lens with a synthetic one wasn't an option then, adds Dr. Brent<fl>MacInnis, chief of ophthalmology at Ottawa Hospital.
"We were taking the lens out and not replacing it with anything." he remarks.
Problems with past procedures meant putting off cataract surgery as long as possible, living with compromised vision to avoid a possibly worsened situation with treatment. No more. "Because the technology is so much better," Dr. MacInnis reports, "we tend to offer this surgery at an earlier stage."
While cataract operations are today a gold standard in ophthalmology, there are other procedures also being affected by the development of new technologies. And, notes MEDEC, such technologies are proliferating. Founded in 1973 and based in Toronto, MEDEC - Canada's Medical Device Technology Companies - represents more than 120 manufacturers and distributors of medical devices and diagnostic products. MEDEC serves as the industry's primary source for monitoring, interpreting and shaping the public-policy environment in which its members operate. Having a strong association of this kind in the field is significantly linked to the ongoing development of diagnostic and treatment advances, notably in surgery.
"The innovations of our member companies have helped transform the delivery of healthcare in Canada," said Peter Goodhand, President of MEDEC.
"Everyday, advances in medical technology make possible less invasive procedures, speedier recoveries, and a quicker return to productivity and independent living."
The refinement of scanning devices developed both in Canada and abroad, for example, illustrates how technological advances can change health outcomes.
"These are exciting times," declares ophthalmologist David Wong of St. Michael's Hospital in Toronto. "How to see back in the eye well is a challenge that has really been revolutionized," he continues. "Instead of moving around piecemeal, we now have a bird's-eye view. We have a camera system we can put into the eye which is less than a millimetre wide. We can see how the structures work."
Diagnosing and monitoring the presence and progress of a number of eye diseases has long been a real obstacle, a prime example being the advance of macular edema caused by diabetic retinopathy.
"Even in cataract surgery with the insertion of a synthetic lens," notes Dr. Brierley, "some of the advances have been fairly dramatic in terms of our ability to measure what implant is going to be optimal. When I look at my results now compared to what I was getting in 1983 or 1985, there's no comparison."
