My adjustable lens means I can see in HD: How a revolutionary operation gave one spectacle-wearer perfect vision
21:00 GMT, 11 August 2012
Two years ago, Antonia, Lady Riley couldn’t function without her spectacles. In fact, she had been reliant on them since the age of five, when she was diagnosed as being severely short-sighted and having astigmatism, a condition that causes blurred vision due to the front of the eye being an irregular shape.
Activities she loved such as skiing and sailing became more difficult and she also developed cataracts, in which the lens in the eye becomes yellow and cloudy.
But now her vision is perfect – thanks to an operation she had two years ago to have an innovative type of artificial lens implanted in her eyes.
Clear view: Antonia can sail again thanks to the revolutionary new procedure
‘For the first time ever, I can actually see the detailed edges of clouds, which are like delicate lace,’ says the 59-year-old. ‘It’s incredible.’
Developed by a Nobel Prize-winning US scientist, the Light Adjustable Lens (LAL) can be fine-tuned to give a patient perfect vision after it has been inserted into the eye. It can be customised to an individual patient’s needs, whether they wear glasses for reading, distance or both, or whether they have cataracts or astigmatism.
Consultant ophthalmic surgeon Mr Bobby Qureshi was the first surgeon in the UK to use the LAL at the London Eye Hospital in Harley Street.
He explains: ‘We all have a lens inside our eyes, which helps focus light on to the retina. As we get older this lens starts changing. As it ages, it starts becoming yellow and developing cloudy patches in it – at that stage, we say a cataract has formed.’
Left untreated, cataracts can eventually lead to blindness. The solution, says Mr Qureshi, is to take out the natural cloudy lens and replace it with a new artificial one.
‘Traditionally, cataract surgery involves the insertion of monofocal lenses. These improve distance vision but have only a single focus, so patients will still need glasses for reading afterwards,’ says Mr Qureshi.
A newer solution, he says, is the use of multifocal implants, which offer patients better vision for near and distance. But even these can’t offer perfect vision, causing lights to glare at night and failing to correct intermediate vision. They are also not able to correct astigmatism completely. The LAL, however, is able to address these issues. Indeed, the procedure can remove the need for glasses altogether.
‘The LAL is similar to current implants, but embedded within the lens are unique materials called macromers,’ he explains. ‘These are sensitive to a particular wavelength of ultraviolet [UV] light. And when we shine that UV light in the eye, controlled by a very sophisticated computer, the macromers come together in a process called photopolymerisation.
‘This causes the lens to change shape. In a very accurate and precise manner we can remodel the lens within the eye enabling us to correct long or short sight or astigmatism, or even make the lens multifocal.’
Antonia, a former Lecturer of American Studies in Washington and now a British Airways cabin-crew member, lives in Hamble, Hampshire, with her husband Sir Henry Riley, a retired RAF pilot who now advises a German defence company.
Though Antonia’s cataracts didn’t emerge until her 50s, her eyesight was deteriorating rapidly until it got to the point when her optician told her he couldn’t do anything to help her. In December 2009, she made an appointment to see Mr Qureshi. The procedure, carried out under local anaesthetic, takes a few minutes.
Delicate procedure: The fragmented lens is removed from the eye through a tube, before the LAL is rolled up and inserted into the eye through the same incision
Mr Qureshi performs the operation using a special laser, controlled by a computer, which not only makes an incision in the eye but also breaks up the damaged natural lens.
‘The machine makes a three-dimensional picture of the eye at a micron level of accuracy, which the computer then uses to guide the laser,’ he says. ‘The laser carries out most of the operation in about 30 seconds and the patient doesn’t feel a thing.’
The fragmented lens is removed from the eye through a tube, before the LAL is rolled up and inserted into the eye through the same incision, where it then unfolds and is positioned. ‘I then cover the eye with a protective patch,’ says Mr Qureshi. ‘In just a couple of hours it’s possible for patients to notice a difference in their vision.’
In 2010, Antonia had her left eye operated on and, two weeks later, her right. Her vision was evaluated and the adjustments with UV light were made to the lens. The lens is then ‘locked’ into position, also with UV light. It should last for life.
Until the lens is locked in, patients must wear UV protective glasses and use anti-inflammatory and antibiotic eye drops for four to six weeks.
‘With every adjustment, my vision became clearer and less blurred,’ says Antonia. ‘It’s as if I have high-definition vision now. I can ride a horse without my glasses jumping around on my nose, and when I sail I can see boats on the horizon long before my husband, who has perfect vision. This operation has been truly life-changing.’
LAL implants cost from 4,500. londoneyehospital.com