Wayne County man becomes first in Utah to receive vision-restoring implant

Published: Monday, Dec. 30 2013 7:07 p.m. MST

A telescope smaller than a pea is implanted in the eye of Craig Chappell, 86, on Dec. 26, 2013, by Dr. Majid Moshirfar, director of the Moran Eye Center's Refractive Surgery Program and Cornea Program. Nearly a decade ago, Chappell was diagnosed with advanced age-related macular degeneration.

University of Utah

SALT LAKE CITY — Craig Chappell used to take trips to Fish Lake when he could see well enough to drive.

He would watch "Hee Haw" and "Dancing with the Stars" reruns without binoculars.

He was able to fix sprinklers and easily distinguish family members' facial features.

Nearly a decade ago, Chappell was diagnosed with advanced, age-related macular degeneration, which is the leading cause of vision loss for Americans 60 and older, according to the National Eye Institute. The disease blurs a person's central vision and makes it difficult to do things like reading and driving.

Though legally blind, the 86-year-old Wayne County man hopes to see again soon, thanks to an innovative surgery performed for the first time in Utah the day after Christmas at the University of Utah.

A telescope smaller than a pea was implanted in Chappell's eye on Dec. 26 by Dr. Majid Moshirfar, director of the Moran Eye Center's Refractive Surgery Program and Cornea Program. The surgery has been performed more than 400 hundred times in the U.S.

"You're never too old to see," Moshirfar said. "These patients are desperate. They have no other hope. … I'm happy we can offer that to our patients."

The telescope implant treatment was approved by the FDA in 2010, according to CentraSight, which is behind the treatment program. The $5,000 to $7,000 cylindrical implant, covered by Medicare, replaces the biological lens in one eye.

At 13.7 mm long and 6 mm thick, it's a miniature of Galileo's two-lens telescope, with 2.7 times magnification.

"The images that are at a distant will also come closer to them, so when they are looking at the exit sign, the exit sign is not all the way out there. It's magnified with the telescope, so it comes closer to them," Moshirfar said.

The other eye provides the side, or peripheral, vision to the person. Moshirfar said it takes awhile to get used to, but the brain is good at adapting.

"We don't see with our eyes. We see with our brain. Let's not forget that," he said. "And these patients will learn with the help of the occupational therapist to actually use one eye and suppress the other one whenever they want to."

The 50-minute procedure requires a larger incision than cataract surgery, as the telescope implant is four times the size of a regular implant for cataract.

"These telescopes are going to get even better. I mean, right now, they are fixed," Moshirfar said. "Imagine if you could actually zoom in and out with them. Imagine if they become high-definition. What if you could use them for other purposes, for other diseases?"

Chappell, of Fremont, is one of about 8 million Americans affected by age-related macular degeneration, a number expected to double by 2050, according to Moshirfar.

"I think the disease is very common and actually will increase," Moshirfar said. "Almost one-third of people over the age of 75 suffers from macular degeneration."

Of the 2 million who have an advanced form of the condition, 1.75 million could be candidates for the telescope implant, he said. However, they must go through a rigorous screening process.

To qualify for the telescope implant, candidates must have very stable age-related macular degeneration for the past year and successfully complete training with an external telescope.

Previous cataract surgery automatically disqualifies a person, though Moshirfar said he expects that to change in the future.

Moshirfar said it's not easy to find a suitable candidate. The center has processed close to 60 patients over the past four years, and only four or five have qualified for the surgery so far.

Chappell is the first, but a few others are queued up to receive the implant, including one surgery planned for next month, Moshirfar said.

"Some of these patients can actually improve to the point that you may call them legally able to drive during the day, although we don't recommend these patients because the other eye is still limited," he said.

Chappell told Moshirfar the day after surgery that he already noticed improved vision, though it could take up to six months of training for complete results.

"I hope to see what I can see a little better," Chappell said in a news release. "I live in such a beautiful place. I would love to be able to see the mountains and enjoy them again."

Email: madbrown@deseretnews.com

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