Noninvasive Technique to Correct Vision Shows Promise in Early Trials

A potentially safer and more effective solution to a widespread problem.

But, while vision correction surgery has a relatively high success rate, it is an invasive procedure, subject to post-surgical complications, and in rare cases permanent vision loss. In addition, laser-assisted vision correction surgeries such as laser in situ keratomileusis (LASIK) and photorefractive keratectomy (PRK) still use ablative technology, which can thin and in some cases weaken the cornea.

Columbia Engineering researcher Sinisa Vukelic has developed a new non-invasive approach to permanently correct vision that shows great promise in preclinical models. His method uses a femtosecond oscillator, an ultrafast laser that delivers pulses of very low energy at high repetition rate, for selective and localized alteration of the biochemical and biomechanical properties of corneal tissue. The technique, which changes the tissue’s macroscopic geometry, is non-surgical and has fewer side effects and limitations than those seen in refractive surgeries. For instance, patients with thin corneas, dry eyes, and other abnormalities cannot undergo refractive surgery. The study, which could lead to treatment for myopia, hyperopia, astigmatism, and irregular astigmatism, was published May 14 in Nature Photonics.

“We think our study is the first to use this laser output regimen for noninvasive change of corneal curvature or treatment of other clinical problems,” says Vukelic, who is a lecturer in discipline in the department of mechanical engineering. His method uses a femtosecond oscillator to alter biochemical and biomechanical properties of collagenous tissue without causing cellular damage and tissue disruption. The technique allows for enough power to induce a low-density plasma within the set focal volume but does not convey enough energy to cause damage to the tissue within the treatment region.

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“Refractive surgery has been around for many years, and although it is a mature technology, the field has been searching for a viable, less invasive alternative for a long time,” says Leejee H. Suh, Miranda Wong Tang Associate Professor of Ophthalmology at the Columbia University Medical Center, who was not involved with the study. “Vukelic’s next-generation modality shows great promise. This could be a major advance in treating a much larger global population and address the myopia pandemic.”

Vukelic’s group is currently building a clinical prototype and plans to start clinical trials by the end of the year. He is also looking to develop a way to predict corneal behavior as a function of laser irradiation, how the cornea might deform if a small circle or an ellipse, for example, were treated. If researchers know how the cornea will behave, they will be able to personalize the treatment — they could scan a patient’s cornea and then use Vukelic’s algorithm to make patient-specific changes to improve his/her vision.

“What’s especially exciting is that our technique is not limited to ocular media — it can be used on other collagen-rich tissues,” Vukelic adds. “We’ve also been working with Professor Gerard Ateshian’s lab to treat early osteoarthritis, and the preliminary results are very, very encouraging. We think our non-invasive approach has the potential to open avenues to treat or repair collagenous tissue without causing tissue damage.”

Inhumane Avarice as Inherited Vision Loss Treatment to Cost $850,000

The extremely high cost means that only the wealthy will be able to afford the vision loss treatment. This is especially pernicious because *inherited* vision loss is something that those affected by the ailment were born with. It isn’t as a result of anything wrong they did themselves.

The $850,000 cost is also pernicious because the development of Luxturna benefited significantly from tax breaks and government research investments. It’s therefore yet another twisted case of public costs and privatized profits.

In December, the FDA approved a treatment from the pharmaceutical company Spark Therapeutics to treat a rare form of inherited vision loss. And January 3rd, the company put a price tag on the groundbreaking treatment. The Luxturna gene therapy will cost $850,000 — or $425,000 per eye.

Originally, the price of the treatment was estimated at $1 million. But even with the slightly lower cost, Luxturna is still one of the priciest treatments in the world.

Luxturna is the first gene therapy approved in the U.S. for an inherited disease, and patients only need to receive the treatment one time. The therapy was created to treat patients with retinal dystrophy, an inherited form of vision loss that causes the destruction of retinal cells. Luxturna works by injecting each eye with a normal copy of the gene responsible for vision loss. Retinal dystrophy affects between 1,000 and 2,000 Americans.

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Medical advancements over the past decade have been amazing, and Luxturna has the potential to benefit thousands of people. But the reality is that most people probably won’t be able to afford this treatment, meaning it will only be accessible to the incredibly wealthy. And for people who can’t access health insurance, regular trips to the doctor are difficult to afford, let alone life-altering medications like Luxturna. We urge pharmaceutical companies to make groundbreaking treatments available for all people — not just the 1 percent.

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Source: Public Citizen