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By John Schieszer
Medical Minutes 

New procedure shows promise to improve reading vision

And other health updates

 


No more reading glasses?

It may now be possible to get rid of your reading glasses permanently. The U.S. Food and Drug Administration has now approved a new inlay procedure that can correct presbyopia. This is a condition that develops around age 40 and involves the gradual loss of your eyes’ ability to focus on nearby objects.

Until now, you had to wear reading glasses, bifocals or undergo surgical procedures. The problem with the surgical procedures were that they could compromise a person’s distance vision and they often offered no guarantee of lasting success. The new procedure is called the KAMRA inlay and it is pretty simple. It involves inserting a tiny black ring into the eye. The ring focuses light properly onto the retina and creates sharper near vision.

Dr. Tom Tooma, who is the founder of NVISION Eye Centers, helped pioneer this new technique. He has been performing it in both California and Oregon. He said the KAMRA inlay is smaller and thinner than a contact lens and can be inserted in an outpatient procedure performed in approximately 15 minutes. Implanted in a pocket within the cornea, the KAMRA inlay relies on small aperture optics designed to increase depth-of-focus.

Dr. Tooma said as this new simple technique becomes widely available look for reading glasses to become a thing of the past, much like rotary telephones and cassette tapes. According to the American Academy of Ophthalmology, more than 1 billion people worldwide suffer from presbyopia. Within the U.S., research estimates by 2020 more than 123 million people, including the entire Baby Boomer generation will suffer from presbyopia.

Life expectancy climbing worldwide

If you think people around the world are living much longer, you are right. A new study just published in The Lancet has found that global life expectancy has risen by more than six years since 1990 as healthy life expectancy grows.

Researchers conducted an analysis of all major diseases and injuries in 188 countries. They found that thanks to marked declines in death and illness caused by HIV/AIDS and malaria in the past decade and significant advances made in addressing communicable, maternal, neonatal, and nutritional disorders, health has improved significantly around the world. Global life expectancy at birth for both sexes rose by 6.2 years (from 65.3 in 1990 to 71.5 in 2013), while healthy life expectancy (HALE), at birth rose by 5.4 years (from 56.9 in 1990 to 62.3 in 2013).

HALE takes into account not just mortality but also the impact of nonfatal conditions and summarizes years lived with disability and years lost due to premature mortality. The increase in healthy life expectancy has not been as dramatic as the growth of life expectancy, and as a result, people are living more years with illness and disability.

The study was conducted by an international consortium of researchers and led by the Institute for Health Metrics and Evaluation (IHME) at the University of Washington in Seattle. It shows that ischemic heart disease, lower respiratory infections and stroke cause the most health loss around the world.

“The world has made great progress in health, but now the challenge is to invest in finding more effective ways of preventing or treating the major causes of illness and disability,” said the study’s lead author Professor Theo Vos of IHME.

People in countries such as Nicaragua and Cambodia have experienced dramatic increases in healthy life expectancy since 1990: 14.7 years for Nicaragua and 13.9 years for Cambodia. The reverse was true for people in Botswana and Belize, which saw declines of 2 years in Botswana and 1.3 years in Belize. The differences between countries with the highest and lowest healthy life expectancies is stark. In 2013, Lesotho had the lowest, at 42 years, and Japan had the highest globally, at 73.4 years.

Men with low risk prostate cancer may benefit from active surveillance

A new study is suggesting that many men with low-risk prostate cancer will not succumb to the disease and it may be best to go with active surveillance (involves only monitoring) versus surgery or radiation. This study is important because many men opt for treatment and it may not be the best approach.

The study was conducted at the Brady Urological Institute at Johns Hopkins in Baltimore and the researchers analyzed survival statistics up to 15 years on 1,298 men.

“Our study should reassure men that carefully selected patients enrolled in active surveillance programs for their low risk prostate cancers are not likely to be harmed by their disease,” says H. Ballentine Carter, M.D., the Bernard L. Schwartz Distinguished Professor of Urologic Oncology and director of adult urology at Johns Hopkins.

Dr. Carter said most of the men in the study were Caucasian, and he cautioned that these outcomes may not apply to African-American men, who tend to have more aggressive prostate cancers. Overall, the researchers calculated that men in the active surveillance program were 24 times more likely to die from a cause other than prostate cancer over a 15-year span. After 10 and 15 years of follow-up, survival free of prostate cancer death was 99.9 percent, and survival without metastasis was 99.4 percent in the group.

Overtreatment of prostate cancer has been a significant concern. Dr. Carter estimates that 30 percent to 40 percent of U.S. men with eligible prostate cancers opt for active surveillance, compared with Scandinavian countries, where use of the option is as high as 80 percent. He said one of the benefits of active surveillance is a reduction in the rates of complications and costs of prostate cancer treatments. In a recent report, 20 percent of men undergoing a prostate cancer treatment (radiation or surgery) were readmitted to the hospital within five years of treatment for a complication related to the original treatment.

John Schieszer is an award-winning national journalist and radio and podcast broadcaster of The Medical Minute. He can be reached at medicalminutes@gmail.com.

 
 

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