Farsighted continued
patients , with state-of-the-art procedures and equipment .”
New implant procedure replaces corneal transplant Keratoconus , a disease characterized by distorted vision caused by a thinning of the cornea , affects one in every 1,000 people each year . It ’ s usually treated with glasses first , and then hard contact lenses . If neither measure works , the next step has traditionally been corneal transplant surgery . However , Dr . Fulcher recently brought a state-of-the-art procedure to Central Texas to help a patient with this problem without doing transplant surgery . He surgically implanted tiny crescentshaped acrylic pieces , called Intacs ring implants , into the cornea ( the transparent layer at the front of the eye that covers the iris and pupil ). This procedure is offered by few ophthalmologists around the country .
“ The implants flatten the bulge that ’ s created in the cornea and allow the patient to see clearly with glasses or contact lenses ,” says Dr . Fulcher . He performed the outpatient surgery for the first time in November 2008 . “ It worked perfectly — according to plan ,” he says .
Insights into a common condition “ Macular degeneration is the leading cause of legal blindness in the United States ,” says Dr . Rosa , the institute ’ s specialist for treating this disease . Dr . Rosa says one in three to four Americans over the age of 75 will develop the problem . Also called agerelated macular degeneration ( AMD ), it affects almost two million patients in the
United States , usually people age 50 and older . The National Eye Institute estimates that , given the rapid aging of the US population , almost three million people will have AMD by the year 2020 .
AMD is a degeneration of the retina in the macular region , which is located near the center of the retina on the back wall of the eye . The macula receives light signals , is the center of fine vision in the retina , and is essential for reading , driving and recognizing faces , says Dr . Rosa . Macular degeneration can lead to loss of central vision and legal blindness .
There are two types of macular degeneration . The dry type , which accounts for 80 percent of AMD cases , is caused by the formation of yellow spots , called drusen , beneath the macula . Wet AMD is caused when weak new blood vessels leak fluid beneath the retina . Although this type is not as common as dry AMD , Dr . Rosa says there are more than 200,000 new cases of wet AMD every year in the United States .
Several behaviors can reduce the risk of AMD . Smoking is a significant risk factor ,
Dr . Rosa says . Patients also are advised to start eating green leafy vegetables — including collard greens , kale , brussels sprouts and spinach — and fish that is high in omega-3 fatty acids . Studies have shown that people who eat these foods have a lower incidence of the more severe types of AMD , Dr . Rosa says . But the Eye Institute team is working to find other solutions to care for patients affected by AMD .
Macular degeneration research The most common treatment for dry AMD is a vitamin supplement containing betacarotene , vitamin A , vitamin C , vitamin E , zinc and copper . A clinical trial completed in the early 1990s showed that this combination of vitamins and minerals can reduce the progression of dry AMD , Dr . Rosa says .
The team hopes to glean insights into the disease so they will be able to help patients and better inform future generations of ophthalmologists , some of whom are training now in an ophthalmology residency program at Scott & White .
Dr . Samuel F . Fulcher is director of the Division of Corneal and External Disease at the Scott & White Eye Institute . Dr . Robert H . Rosa , Jr , is director of the Division of Ophthalmic Pathology at the Scott & White Eye Institute .
10 THE CATALYST Fall 09 | sw . org