Probably the most unique approach to the problem of presbyopia-correcting IOLs is the mechanism used in the NuLens®. This lens tries to mimic the natural process that occurs in some water birds such as penguins. These birds’ eyes have a rigid iris and a soft lens. To increase the power of the lens these birds have a muscle that pushes the soft lens up against the iris resuling in a protrusion of the lens through the iris. This central bulging results in a greater power of the lens.
One way to picture how this works is with a peanut butter sandwich. If you are generous with your peanut butter and press the two slices of bread together the peanut butter will ooze out the sides of the bread. Now instead, imagine that you have created a central hole in the middle of the top slice of bread (the iris).If you push on the bottom slice of bread the peanut butter (the lens) will bulge forward through the central hole. This is essentially how the lens of a water bird works.
The NuLens® is essentially a very small peanut butter sandwich with the peanut butter replaced by a silicon gel and the bread replaced by a rigid clear material. Initial studies in monkeys have been very promising. However, it will be awhile before this is approved for use in humans.
The recession will be over long before the FDA gives its blessing so it is not going to be an option for you if you need cataract surgery in the next couple of years. Nevertheless, the technology is exciting and many baby boomers will have quite a few awesome choices when it is time for them to have cataract surgery.
© 2009 David Richardson, MD
Agreed. Most likely we won’t see this IOL technology before 2015. One thing is certain: the options available for patients with cataracts are going to explode over the next decade – just in time for the baby boomers.
David D. Richardson, M.D.
Medical Director
San Gabriel Valley Eye Associates, Inc.
Do you know exactly how much the Nu-lens has progressed recently ?
They haven’t updated there homepage since 2007, and the last document mentions that they plan to sell it in a few years, which doesn’t sound realistic.
They are actively researching this design and it does appear to have real potential. However, given its radical departure from standard IOL designs I would anticipate a very long time from submission to the FDA to actual approval. Since the IOL is not yet ready for even the submission stage I would not expect to see it before 2013.
David D. Richardson, M.D.
Medical Director
San Gabriel Valley Eye Associates, Inc.
Do you know the actual stage they have reached ?
I read about some implantations in spanish people, who had macular degeneration, but that’s about it. No news about further tests since that.
Do you mean it would start FDA approval at 2013, or be approved at that time (if all goes well) ?
That’s correct. These lenses have been implanted in patients with macular disease in order to measure the ability of the IOL to accommodate. Assuming the manufacturer can get the IOL ready for prime time in the next year I would think it would take at least three years for the FDA to approve it for general use. Mind you, that’s just a guess and it could take even longer than that but I would be amazed if this IOL was available in the US prior to 2013.
David D. Richardson, M.D.
Medical Director
San Gabriel Valley Eye Associates, Inc.
Given the lack of public information from Nu-lens, I would be surprised if it was ready during next year, but 3 years for FDA to approve is probably right.
I really hope there will be some information soon.