A new, bionic tool for treating macular degeneration has been at the University of California, Davis: a telescope smaller than a pea that's implanted directly into the eye.
It's barely detectable at first, but a close look at a patient with the implant reveals a slightly luminescent spot where the pupil would be. That lens holds a world of promise for patients with end-stage macular degeneration, a retinal disorder that limits vision to a cloudy warp of reality.
Advanced macular degeneration affects 2 million people in the United States, with 500,000 new cases diagnosed each year. The genetic disease is the leading cause of legal blindness nationwide in adults 60 and older.
For the aging wave of baby boomers, the miniature telescope represents a breakthrough treatment for a casualty of old age, akin to the hip and knee replacements that have now become commonplace.
As age-related macular degeneration progresses, patients frequently develop scarring in the macula, said Dr. Jennifer Li, one of the UC Davis surgeons on the forefront of using the new device. Along with that comes a decline in the ability to see fine detail and a loss of central vision, leaving clear only the peripheral vision.
Until now, Li said, end-stage patients with the so-called dry form of macular degeneration have had no lasting medical or surgical treatment available. Often they've had to rely on hand-held magnifiers and bulky telescopes attached to glasses, increasing the chance of an accident or fall.
The miniature telescope is the first medical device to be implanted inside the eye, said a spokeswoman for VisionCare, the California firm that manufactures the device.
It was approved by the U.S. Food and Drug Administration in 2010.
The product is priced at $15,250, VisionCare's spokeswoman said, and Medicare has said it will cover the cost.
Virginia Bane, 89, of Pollock Pines, Calif., is the first patient in Northern California to undergo the surgery. Dr. Mark Mannis, a UC Davis eye surgeon who partnered with Li to perform the surgery, said Bane was carefully selected to pioneer the treatment.
"Virginia approaches this with enthusiasm and analytical thinking," Mannis said. "It's courageous to be the first person to do this."
Bane, who received her implant in May, is also one of the first 50 people in the United States to undergo the surgery. In an interview, she said the procedure was painless but weeks of occupational therapy were needed to train the brain to use the device to full benefit.
After surgery, you begin to see wonderful things happen because of the scope," Bane said. "You can see the faces of your friends. And it's wonderful to be able to read again."