Medicine doesn’t change by the century, year, month, or even day; it changes by the minute. In particular, the field of ophthalmology has undergone transformative advances since becoming the first medical specialty in the mid-1800s. These 5 recent medical breakthroughs—along with related developments in the pipeline—represent the past, present, and future of ophthalmology.
Five Ophthalmological Advancements in Recent History
- Multifocal Intraocular Lenses
- Corneal Transplantation Advances
- Anti-angiogenic Agents
- Combination Glaucoma Drops
LASIK received a US patent in 1989 as a surgical procedure to modify the eye’s corneal curvature by cutting a flap in the cornea, pulling it back, ablating the unexposed surface of the corneal bed, and replacing the flap. The very first LASIK surgery was performed just 1 year later. Whereas LASIK did not receive FDA approval until a full decade after the granting of the patent, this elective surgery has since become immensely popular because of its immediate results and manageable side effects. Since its formal FDA approval in 1999, nearly 30 million LASIK surgeries have been performed around the globe.
Nearly 22 million Americans over the age of 40 have cataracts, so it’s no surprise that cataract removal reigns as the country’s most common refractive surgical procedure. When artificial intraocular lenses (IOLs) debuted a half-century ago, they offered groundbreaking distance-vision correction for people suffering from cataracts; however, patients still required correction for near vision following the surgery. The debut of multifocal IOLs in the mid-2000s completely reinvented cataract surgery outcomes. Delivering both distance- and near-vision solutions, multifocal IOLs significantly reduce—and in some cases even eliminate—dependence on glasses and contacts. Femtosecond laser refractive cataract surgery, another promising technique, offers enhanced accuracy and precision through computer-guided lasers.
When the first successful full-thickness corneal transplant was performed at the beginning of the 20th century, it represented a landmark accomplishment in the field of ophthalmology. Just under 110 years later, ophthalmologists are now replacing just the thin inner layer of endothelial cells in an advanced transplant technique that is not only safer and less invasive, but also promotes faster recovery. Furthermore, patients have the chance of attaining 100% vision just weeks after the surgery compared to a rate of just 90% to 95% perfect vision for full-thickness transplantations.
Millions of Americans suffer from vision loss due to age-related macular degeneration (ARMD), the prevalent cause of legal blindness in older Americans. The wet form of macular degeneration is particularly insidious due to severe vision loss and quick progression. When anti-angiogenic drug therapy in the form of monthly injections directly into the eye debuted in the mid-2000s, it offered an unprecedentedly effective measure for slowing the progression of the disease. However, the treatment also resulted in many complications, such as increased inflammation and eye pressure, as well as retinal tears and traumatic cataracts. Currently in development at Harvard, next-generation anti-angiogenic compounds offer the promise of even better vision without serious side effects. They may even be administrable in drop form.
In 2013, the FDA approved new beta-blocker–free combination drops for the treatment of glaucoma, a chronic disease that affects more than 2.3 million Americans over the age of 40. This fixed-combination medication is expected to become first-line therapy in the treatment of glaucoma due to its ability to reduce the number of daily doses, lessen intraocular pressure, and vastly improve effectiveness when compared to 2 or more different medication drops taken in succession.
Advances in ophthalmology over the years have pushed the boundaries of science while offering new hope to patients for improved vision. While we may not be able to predict what’s coming next in the field of ophthalmology, we can anticipate a future that’s as dynamic as the past.
- Armitage WJ, Tullo AB, Larkin DFP. The first successful full-thickness corneal transplant: a commentary on Eduard Zirm’s landmark paper of 1906. Br J Ophthalmol. 2006;90(10):1222-1223. http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1857444/.
- Eye health statistics at a glance. American Academy of Ophthalmology website. http://www.aao.org/newsroom/upload/Eye-Health-Statistics-April-2011.pdf.
- FDA approves combination glaucoma drop without beta-blocker. Drug Topics website. http://drugtopics.modernmedicine.com/drug-topics/news/fda-approves-combination-glaucoma-drop-without-beta-blocker?page=full.
- Majka CP, Carlson AN. Ophthalmic pearls: cataract. American Academy of Ophthalmology website. http://www.aao.org/publications/eyenet/200609/pearls.cfm.
- Stuart A. A look at LASIK past, present and future. American Academy of Ophthalmology website. http://www.aao.org/publications/eyenet/200906/feature.cfm.