Electronic Precinct - February 1999

New Cure for Blindness

John Barr from Pickering, Yorkshire, whose vision was restored by the new surgical technique.

A surgical technique developed by the Department of Medicine in collaboration with St Paul's Eye Unit in the Royal Liverpool University Hospital has given hope to many thousands of people suffering from macular degeneration, the commonest cause of blindness in the western world.

In the first procedure of its kind to be performed in the UK, the technique was used by ophthalmic surgeon David Wong to save the sight of retired dentist John Barr, who lost the sight in his right eye six years ago and recently began to lose vision in his left eye. The day after the operation Mr Barr could see out of the diseased eye and he can now see well enough to read with it.

Macular degeneration, as the name suggests, is a degeneration of the retina. Until now the only treatment was laser therapy, which can limit the damage caused by degeneration but does not improve sight.

In the operation carried out by Mr Wong and his surgical team, vision is transferred from a worn part of the retina to a healthier site so that vision can be restored. 'Put simply, it is like moving a carpet which has a worn patch and tucking the worn part away,'said Mr Wong.

Professor Ian Grierson, Head of the Foundation for the Prevention of Blindness at the Royal Liverpool University Hospital and a member of staff in the Department of Medicine, said: 'The macula is a small spot in the retina where most of the light that enters the eye is focused. It is this region t hat is involved with our most acute vision, our central vision. The elderly in our population are prone to a condition called Age-Related Macular Degeneration, or ARMD, where problems arise in the nutritional and support tissue of the macula so that it can no longer function. The risk of the dise ase gets greater the older we get (40% of the over 70s are affected). People either gradually lose vision in a form of the disease called dry ARMD, or lose vision more rapidly and suddenly in the wet form of the disease. ARMD has been one of those diseases where treatment options have been extrem ely limited.

'Some years ago David Wong (a Liverpool graduate), Simon Harding and I set up a University/Hospital collaboration to advance our knowledge of ARMD and develop new treatment options. The research includes fundamental, laboratory-based transplantation procedures to provide support cells for the macul a; we are involved in a multicentre trial into a photodestructive approach to treatment and, via Mr Wong and his retinal team, we have been working towards a purely surgical approach to treatment. It is in the surgical area that we have had this dramatic breakthrough. It is the wet form of the di sease that the current surgical treatment developed by Mr Wong which is designed to place the macula on healthy support tissue and move the diseased tissue out of the way.

'The down side is that it may only be a small proportion of ARMD patients who might benefit from this new surgery. On the other hand these are patients who would otherwise be severely visually handicapped. I have recently written a draft of a book on eyes in which I say that there is little in th e way of treatment for ARMD and I am delighted to be proven wrong especially as this is due to developments here in Liverpool.'