xml:space="preserve">
xml:space="preserve">
Advertisement
Advertisement

Eyedrops a flawed substitute for cataract surgery

Every medical therapy must weigh both risks and benefits ("Genetics study points towards eyedrop cataract treatment," July 22). While eye drop therapy to treat cataracts sounds enticing, I am not sure its use is worth the potential development costs and risks.

Although no person wants surgery, cataract surgery is one of the most frequently performed operations in the United States. Recent advances have made it routine and incredibly effective with a 98 percent success rate.

Advertisement

There are many potential problems if one is to begin using these drops at a young age in eyes that have no disease. The first is that even our most popular and commonly-used eyedrops can cause red eyes, lash growth, lid pigmentation and atrophy of the tissue surrounding the eye. Many of these adverse events were not discovered until a decade after Food and Drug Administration approval and widespread usage.

Second, most ophthalmic medications falter with formulation — developing a safe and effective method of getting the medication to the target organ, in this case, the lens. Getting a comfortable eye drop through the cornea and into the lens capsule is no small task as an almost impenetrable barrier surrounds the lens. This would require continued repetitive application of a medication for the entire life of a patient, even one who has not suffered symptoms. At best case scenario, many studies in both ophthalmology and other systemic diseases find that at least 20 percent of patients do not keep followup appointments, 40 percent of patients do not fill their initial prescription and 60 percent of patients do not persist with their therapies for even one year. Eye drops aren't easy to use. Our group's work has found that 17 percent of patients are reliant on others to instill a drop and less than 60 percent of patients were able to actually instill a single drop in their eyes successfully.

Advertisement

Add to these caveats the fact that the cost of cataract surgery is relatively low and that the cost of such a medication might be quite high. Why then proceed with this line of research? Shouldn't our research dollars be spent on other diseases without excellent therapies?

Dr. Alan L. Robin, Baltimore

The writer is a professor at the University of Maryland and University of Michigan and associate professor at the Johns Hopkins School of Medicine and Bloomberg School of Public Health.

Recommended on Baltimore Sun

Advertisement
Advertisement