Implant offers hope for AMD sufferers

Mon., March 31, 2014

Anika Reed McClatchy-Tribune

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• Medicare plans are required by law to cover the cost of the surgery. There is a potential co-payment for the procedure.

• Patients have to be at least 75 years old to receive the intraocular telescope.

• One to two years after surgery, approximately 75 percent of patients had an improvement in their distance visual acuity of 2 lines or more on the eye chart, while 60 percent improved by 3 lines or more and 43 percent improved by 4 lines or more.

• Approximately 52 percent of patients reported improvement in their vision-related quality of life.

• One risk is that surgeons may not be able to implant the intraocular telescope once surgery starts. Approximately 5 percent of patients had this problem, but surgeons implanted intraocular lenses instead.

• There is a significant risk of vision worsening over time, with approximately 48 percent of patients in the study reporting their vision-related quality of life either stayed the same of got worse after the surgery.

The sense of sight is a gift often taken for granted until it is lost. But for one 76-year-old, a unique surgery gave her another chance at seeing.

Suffering for years from age-related macular degeneration, Patty Gajewski’s vision deteriorated as the progressive eye disease attacked her eye’s macula, where the sharpest central vision occurs, and left her with only the outermost, peripheral vision.

Gajewski received assistance through the darkness from her adult children – mainly her daughter Linda Tedesco, who discovered online an alternative treatment surgery for her mother’s AMD.

The Food and Drug Administration-approved surgery, which is only for those suffering from end-stage AMD and who are age 75 and older, places a telescope implant in the eye to sharpen central vision.

Although the telescope implant decreases peripheral vision, it is only implanted in one eye so patients do not lose their peripheral vision entirely.

This telescope implant is part of CentraSight ( www.centrasight.com), a larger treatment program that includes the initial evaluation for the implant, the coordination of the surgery and the post-operative rehabilitation.

“Patients are given a style of vision that they have not really seen before, and they need to be taught some of the tricks and principles of how to use it to their advantage,” said Dr. Kirk Packo, professor and chairman of the Department of Ophthalmology at Rush University Medical Center in Chicago.

Gajewski and Tedesco met with specialists in New York City who approved Gajewski for the surgery after extensive evaluation. The CentraSight program has trained doctors all across the country, thus making it easier for the mother and daughter to find information about the treatment.

The outpatient procedure went well for the Schenectady, N.Y., resident, whose first words after the February 2013 surgery were, “Oh, I can see!”

“With these scars, these people lose the ability to perform very everyday things,” Packo said. “(As a doctor) you’re able to provide smiles to patients once again, which is really nice.”

Prior to undergoing the telescopic surgery, Tedesco described her mother as “very secluded” due to the fact that she could no longer identify faces.

“What macular degeneration took away, surgery put back,” Tedesco said.

For Gajewski, her newfound freedom allowed her to return to doing the things she loved the most before she lost her sight. She looks forward to attending her grandchildren’s upcoming recitals, a feat she could not manage pre-surgery.

“I do my own sewing, I do my own laundry, I go down to the (YMCA) with the ladies,” Gajewski said.

Tedesco recommends the treatment for those who are going through end-stage AMD, but cautions that a strong support system is important to undergo the surgery and subsequent therapy.

“It’s not an overnight fix,” Tedesco said. “It takes time to get acclimated all over again. You need someone behind you to help you get through all this.”

“The best thing that happened is that my mother is back,” Tedesco said. “It has really given her her life back.”