在过去的三十年里，莫兰眼科中心的 Nick Mamalis，医学博士, Liliana Werner，医学博士, have vetted some of the most innovative devices in eye care.

Intraocular lenses (IOLs) replace the eye’s own natural lens for more than 6 million people—most of them cataract patients—around the globe each year. There’s hardly one on the market that hasn’t been tested 在 duo’s nonprofit 山间眼科研究中心 在 约翰一. 莫兰眼科中心.

而人工晶体的发明可以追溯到20世纪40年代, the device is still going through myriad refinements: companies worldwide send the center a steady stream of prototypes and materials in an industry projected to reach $4.70亿美元.S. by 2020. The race to develop the "perfect" IOL has created a complex landscape of choices for both doctors and their patients, but the latest technology to arrive in the Mamalis Werner lab—laser-assisted Refractive Index Shaping (RIS)—could change all that, 和更多的. 把握RIS的革命性, one must understand the challenges of IOLs from a surgeon’s perspective.

“大发娱乐还是在和人类打交道”

在美国.S. 仅白内障手术就占了3%.每年有200万例门诊手术, it’s one of the safest and most effective surgeries available. Even so, ophthalmologists must help patients choose the IOL that’s right for them.

Surgeons like Mamalis want to give their patients both distance and near 愿景 after surgery. 为那, selecting a so-called multifocal or ‘premium’ IOL might be best, although unwanted visual side effects such as glare can occur. Choose a monofocal IOL, the patient must commit to wearing eyeglasses after surgery.

除了选择人工晶状体类型, calculating how powerful its refractive properties should be isn’t an exact science.

"Although techniques for measuring the length and shape of the eye and the formulas for calculating the power of the IOLs themselves are getting better, 它仍然不完美,Mamalis说。. "The problem is that even when we use the best measurements, 最好的公式, 大发娱乐还是在和人类打交道. That means there are still going to be some people that end up not having the proper result."

In some cases, an IOL can later shift its position inside of the eye. 脱臼可能是由眼部外伤引起的, eye diseases that weaken the tissues holding the lens in place, 甚至是其他眼科手术的并发症. Removing an IOL isn’t optimal: the procedure carries a higher risk for complications.

下一个大飞跃

But what if physicians had several opportunities to adjust the IOL power and type weeks and even years after placing it into a patient’s eye—all without making a single incision?

Therein lies the appeal of RIS, laser technology owned by California-based Perfect Lens, LLC. The RIS Perfector laser uses ultra-short pulses to induce a chemical reaction that changes the IOL in just 23 seconds and produces no cuts or ablations on the eye. 其结果可能是令人难以置信的精确视觉. A 2016 study by Mamalis and Werner found RIS to be both biocompatible and extremely accurate, 产生人工晶状体的能量 .它的目标屈光度为01. That translates into a level of accuracy better than eyeglasses can produce.

可能性还不止于此.

"Let’s say a patient already has a multifocal lens, but doesn’t like it," said Werner. "With this technology, you could erase what’s already on the lens and switch to something else."

什么时候患者可以使用RIS? Mamalis和Werner现在正在进行第二次实验, six-month biocompatibility study that could lead to FDA approval to take RIS into clinical trials at Moran.

工业的“破坏者”

The driving motivation for ophthalmologists to adopt RIS is improving sight—for patients, 这可能是他们的钱包. U.S. health insurers that cover cataract surgery don’t often foot the bill for anything other than a monofocal IOL.Those who can afford it pay thousands out of pocket for premium lenses with additional features, 包括多焦点iol.

Perfect Lens CEO Steven Smathers said RIS could reduce costs, 允许病人选择基本的, 低成本人工晶状体由保险公司支付. Then, they’d pay a few hundred dollars to have its power and features adjusted through RIS.

"It’s game-changing technology for the industry," said Smathers, "but attractive for patients."

RIS可能会改变儿科患者的生活

在她早产四个月后, Isabella Garcia has already undergone cataract surgery in one eye.

现在, 莫兰儿科专家, 利亚欧文, MD, 博士学位, 在教伊莎贝拉的母亲吗, Klarita加西亚, 如何在宝宝的眼睛里放置一个微型隐形眼镜.

"Isabella’s eye will grow a lot before she reaches school age, 当大发娱乐可以植入人工晶体时,欧文解释道。. "But since we can’t change the IOL power once it’s in the eye, 大发娱乐必须“控制”人工晶状体，这样她才能长得进去."

That means multiple contact lens changes and strong glasses. "All these moving parts must be constantly assessed because it’s a very important time for the brain to learn 愿景,”欧文说。.

RIS would enable Owen to easily adjust the IOL as Isabella grows. The idea that her daughter could grow up with better 愿景 and face fewer eye surgeries as an adult is an amazing prospect for Klarita加西亚.

"I’m so glad technology is advancing and that this could be a possibility," she said. "Getting such good care and medical treatment is why our daughter is here with us today."