Local woman to have telescope implanted in eye
By: Amy Armour
Marion Aselage loves to watch baseball. Unfortunately for the 82-year-old St. Charles woman, the macular degeneration in her eyes makes it difficult to even see the ball.
“When I watch baseball on television, I can see the batters and position players, but I can’t see the ball,” said Aselage. “And I can’t read without a magnifier.”
Aselage has suffered with macular degeneration for more than 20 years.
“At first you don’t notice it. As you age it gets worse. Right now, my vision is such that things are hazy,” said Aselage, who also has trouble distinguishing faces.
But her vision may get clearer next month. Aselage will undergo a highly specialized surgery to implant a telescope in her left eye on Oct. 9. The FDA-approved implant, called the CentraSight telescopic implant, improves visual acuity by reducing the impact of the central vision blind spot caused by end-stage age-related macular degeneration (AMD).
Cornea specialist Mujtaba Qazi, MD, director of Clinical Studies at Pepose Vision Institute and Clinical Instructor of Ophthalmology at Washington University and Barnes-Jewish Hospital, performed three telescope implant surgeries in mid-June at Barnes-Jewish Hospital in St. Peters. Those patients now are undergoing months of rehabilitation to train their brain how to use the implant.
“I am happy to report that all patients have healed well from their surgery and are now undergoing extensive visual rehabilitation to help train their ability to coordinate and focus on the magnified images produced by the internal telescope,” Qazi said.
Smaller than a pea, the CentraSight telescope implant uses micro-optical technology to magnify images that would normally be seen in one’s “straight ahead” or central vision. The images are then projected onto the healthy portion of the retina not affected by the disease, making it possible for patients to see or discern the central vision object of interest.
“There are treatments that doctors can use to prevent vision loss from wet age-related macular degeneration for patients who are just beginning to lose vision. However, for patients who have already lost central vision, the CentraSight telescope may be the patient’s best hope for reading and seeing faces again,” said Retina Specialist Nancy Holekamp, MD, director of Retina Diseases and the Center for Macular Degeneration at Pepose Vision Institute.
Aselage is excited, and nervous, about her upcoming surgery.
“I’m uncertain about the outcome and it’s going to be a struggle to learn to use the telescope. I know it will take several months,” Aselage said.
Qazi said it will take about a month for the eye to heal from surgery and then another two months to remove stitches from the eye.
“Then another three to six months of visual rehab. The visual rehab usually begins a month after surgery and becomes more intensive after a couple of months post operatively,” Qazi said.
The risks, as with any surgery, are infection, bleeding, and further loss of vision, said Qazi.
“For IMT (implantable miniature telescope) surgeries, we are also concerned about whether the larger (than normal cataract implants) Telescope Implant will fit into the eye properly, so some patients who otherwise could benefit would not be IMT candidates, as IMT implantation in these cases can cause persistent swelling and scar tissue formation,” said Qazi. “Another risk is that the magnified image of the telescope may affect depth perception.”
Prior to surgery, candidates are able to simulate how they may see once the telescope is implanted to determine if the possible improvement will meet their expectations.
“Prior to surgery, we help patients clarify expectations and give them an idea of what it is like to see a magnified image with the candidate eye using a simulated telescope. We also prepare them for the loss of peripheral vision that occurs by having them wear an eye patch on the eye that will receive the implant,” said Monica Perlmutter, OTD, OTR/L, SCLV, lead occupational therapist in the Low Vision Community Practice in the Program in Occupational Therapy. “After surgery, we work with the patients to use their IMT eye for near activities, such as reading and writing, and to use the other eye for mobility.”
The telescope procedure, which is covered by Medicare for patients meeting eligibility requirements, is performed on an outpatient basis. Doctors said the telescope implant is not a cure for end-stage AMD, but it can improve quality of life.
“Patients with the IMT are able to recognize faces, see colors better, and read large print where many were unable to perform these tasks prior to surgery,” Qazi said.
Aselage said she is looking forward to better, clearer vision.
“My goals are to be able to read, and recognize people and walk better so I don’t miss a step,” said Aselage.