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Medical Edge Newspaper Column from Mayo Clinic

NEW EYE PROCEDURE CAN CORRECT MYOPIA

DEAR MAYO CLINIC: My 36-year-old daughter is very nearsighted and also has significant astigmatism. She was evaluated for LASIK surgery and told she wasn’t a good candidate. I’ve recently read about a new FDA-approved procedure called phakic intraocular lenses that will correct very poor vision. Is this procedure safe and effective? What are the risks and benefits? — Port Richey, Fla.

ANSWER: During an intraocular lens procedure, a plastic lens is placed inside the eye to correct vision. IOLs have long been successfully used to replace damaged natural lenses removed due to cataracts.

The term “phakic” refers to an eye that still has its natural lens. Instead of replacing the lens, a phakic IOL is implanted in front of it to retain the eye’s natural focusing ability.

The Food and Drug Administration-approved phakic IOL you heard about, called the Artisan lens, corrects for nearsightedness (myopia). In a study of 662 patients implanted with this lens, 92 percent had 20/40 vision or better after three years.

One concern was that the study participants experienced loss of endothelial cells in their corneas. The cornea is the layer of clear tissue that covers the iris and pupil and provides most of an eye’s focusing power. Its endothelial cells help keep the cornea clear. If enough endothelial cells are lost over a prolonged time, it could increase the risk of corneal edema, a condition that can lead to the need for a corneal transplant. Additionally, the phakic IOLs may increase the risk of premature cataract formation.

Another consideration is that the phakic IOL lens has a relatively small diameter that can cause a halo effect or glare when driving at night, especially in individuals who have large pupils.

The new IOL does not correct for astigmatism, a defect in the cornea that causes images to be blurred or smeared. Your daughter may be able to have her astigmatism corrected by another method. She should talk with her eye-care professional about her astigmatism to determine if a combination of procedures might work for her, as well as to assess the overall benefits and risks of phakic IOLs for her long-term visual health.

— Leo Maguire, M.D., Department of Ophthalmology, Mayo Clinic, Rochester, Minn.

Additional Resources:
Ophthalmology
Appointment Information
More Information on Eye Treatment

READERS: A yogurt a day may not mean fewer doctor visits, but there are plenty of health reasons to make this dairy food a regular in your diet.

— One 8-ounce cup of plain low-fat yogurt provides around 400 mg of calcium, more than the an 8-ounce glass of milk (300 mg).

— Yogurt has as much potassium as a banana and as much protein as an egg or ounce of meat.

— The live bacteria in yogurt help in digestion and protect you against other harmful bacteria.

In fact, some of yogurt’s health reputation relies on the presence of live bacteria. To make yogurt, warm milk is fermented or cultured with two types of bacteria — Lactobacillus bulgaricus and Streptococcus thermophilus. Although many bacteria can make you sick, these bacteria are beneficial. They can help break down the lactose (sugar naturally occurring in milk), making yogurt more digestible than milk for people with lactose intolerance.

Some yogurt makers heat the yogurt after it’s cultured to increase the shelf life or reduce tartness, but kill the bacteria in the process. When shopping, look for the official National Yogurt Association’s seal on the container that says “Live and Active Cultures.” Another shopping tip: Choose a brand that’s low in calories and fat, with as few additives as possible.

Yogurt, in its many forms, is great for snacks, lunch boxes and on the go. Whether you take your yogurt with a spoon, a straw or squeeze it from a tube, enjoy. It’s good for you.
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Medical Edge from Mayo Clinic is an educational resource and doesn’t replace regular medical care. To e-mail a question, go to www.mayoclinic.org, or write: Medical Edge from Mayo Clinic, c/o TMS, 2225 Kenmore Ave., Suite 114, Buffalo, N.Y., 14207. For health information, visit www.mayoclinic.com.