In Patricia Waugh’s eyes is the love and admiration she feels for her husband William.

Wednesday, April 19, 2000

In Patricia Waugh’s eyes is the love and admiration she feels for her husband William. Incidentally, there also are the little pieces of plastic he helped to implant there.

William Waugh, an Albert Lea ophthalmologist who also has an office in Austin, assisted in a procedure to implant the four tiny plastic reading implants in Patricia’s right eye to correct her Presbyopia, a condition that causes the need for reading glasses.

"When people reach their 40s, they have trouble seeing up close and they need some help. Most people need bifocals," William said.

The theory regarding Presbyopia has been around since 1855, but some doctors, Waugh included, have a different theory on the aging eye’s inability to focus on close objects. The challenge was not only in finding a way to correct the condition, but to convince other doctors to rethink a 145-year-old theory.

William first heard of the alternative thinking about five years ago at an American Society of Contemporary Ophthalmology seminar. Dr. Ronald Schachar presented a theory that went completely against what William and other ophthalmologists have been taught.

The original theory is that the lens of the eye gets stiff with age and is unable to focus on close objects.

"But the lens actually grows, just like your hair and fingernails," William explained. "The lens outgrows the space so the muscles can’t work against the lens.

"We can’t make the lens smaller, but we can make the area around it expand," he added.

That’s exactly what the implants in Patricia’s right eye do: They elevate the sclera, the white part of the eye, to allow the area in the eye to expand.

For reasons doctors can’t explain, the eye without the implant also shows improvement. It’s not as good as the eye that has the implant – usually the dominant eye – but it’s close.

Patricia is using an implant that was born out of the Schachar research, but invented by a different doctor. Howard Straub of the Colorado Eye Institute designed the reading implants surgically implanted in Patricia’s eye.

It’s made of the same type of plastic used for intraocular lenses in cataract surgery. So it’s a proven material, William said.

The implants are 4.5 millimeters long and less than 1 millimeter wide. It’s shaped to follow the curve of the eye. Four of them are placed in the eye.

William assisted in Patricia’s procedure, which was performed by Straub. But with 11 years of cataract surgery experience, William said he’s ready to do the rather simple procedure.

"This is just a twist on things I already do. I’m ready to do my first one, but no one from Albert Lea has signed up yet," William said. He took the surgical reversal of Presbyopia course in January 1998.

Because the procedure, which is reversible, hasn’t received approval by the federal Food and Drug Administration yet, ophthalmologists are not allowed to implant the devices here. Patricia, like a dozen other Americans, had the procedure done in an American hospital in Puerta Vallarta, Mexico.

"People who are interested could be involved outside of the study," he said.

Because he and his colleagues are seeking FDA approval, studies will be conducted soon in the United States. William is confident Albert Lea will be chosen as one of those study sites, giving residents a chance to have the procedure done in town.

A topical anesthetic is applied, and Patricia said there is absolutely no pain. She said she could see 20/20 immediately after the surgery.

"I have excellent distance (sight)," said Patricia, who really wanted to get rid of the half-dozen reading glasses she had around the house.

"Last week we were gone for five days, and I read two books – without glasses," she boasted. Since she had the procedure in December, Patricia has had no use for her reading glasses, and can’t even remember where they are stored.

William remains enthusiastic for the future of the reading implants.

"This could help essentially 100 percent of the population," he said. "Everyone can see 20/20 right off the operating table."

William is currently designing the standardized testing method that will be used both preoperatively and post-op. Standardized testing methods are required to ensure the FDA testing is successful.

William said he’s excited to be a part of the process. He’s given several seminars himself and brought Patricia with him to a conference in Europe.

"I was in Portugal, and I spent three days in a slip lamp," Patricia said. "All I saw was ‘Look here, look here,’" she continued, indicating doctors’ instructions to look to the left and right.

But the European conference was important to speed the FDA process in America.

"We’re starting to train doctors in Europe," William said. The approval process is generally only six months, little time compared to the years of FDA studies required here.

William and his colleagues will be able use the data from the European tests in their studies. Plus, once approved in Europe, the surgical reversal of Presbyopia will be approved in Canada. Again, it helps the FDA study along.

Albert Lea should be a part of the study by the end of the year, William said.

William Waugh has been practicing for 11 years and covers eight offices in southern Minnesota and northern Iowa.