NEW PROCEDURE MAY BE FIX FOR AGING EYES.

Byline: Steve Carney Staff Writer

It happens to everybody - after about age 40, the menu, the phone book, the newspaper all get too blurry to read.

But a new procedure that just began clinical trials at the University of California, Los Angeles, promises to reverse this inevitable consequence of aging.

Researchers said Friday that by inserting tiny plastic implants in the eyeball during an outpatient procedure, they can restore the close-focusing ability that everyone loses as they get older.

``I'm just incredibly excited about this,'' said Dr. Brian Boxer Wachler, director of the Laser Refractive Center at UCLA, one of six research centers nationwide testing the procedure. ``It's really the last frontier in the field of vision correction.''

Doctors already can permanently correct nearsightedness, farsightedness and other problems. Those conditions affect about one-third of the population, but eventually aging causes 100 percent of the population to lose its ability to focus close-up - a condition called presbyopia.

``Their arms are either too short, or they have to turn to glasses,'' said Dr. Gene Zdenek, director of the Zdenek Eye Institute in Reseda.

The procedure to reverse presbyopia has been done about 350 times in other countries since it was introduced in 1998, he said, and the clinical trials are part of a two-year process to win approval from the Food and Drug Administration for use in the United States.

Zdenek has performed the procedure on about 50 patients, including his wife, Betty.

``The fine print had gotten pretty fine,'' she said. Now 50, she had the procedure done in June 1998. ``For me, it was nice to get rid of those little reading glasses and not have to worry about where they are.

``It's a really nice feeling. You look at the chart and my first thought was, `Wow! I can't believe I'm reading this,' '' she said. ``I think this will be a really nice breakthrough once the FDA approves it.''

Near- and farsightedness are caused by changes in the shape of the eyeball. Presbyopia is unrelated, and occurs because the eyeball continues to grow as people get older, Zdenek said.

At about age 40, the eye grows to a point that it creates slack in the threads connecting the eye muscles to the eye socket. The lack of tension in those threads - which only gets worse as people age and their eyes continue enlarging - keeps the eye muscles from focusing on close objects.

The Presbyopia Reversal Technique inserts four plastic slivers in the white of the eye, just under the surface, like spokes around the colored iris. These spacers take up the slack in the threads, restoring the close-focusing ability.

``It's like a mini, ocular Fountain of Youth,'' Zdenek said. ``The impact it's going to have on society and people is going to be monumental.''

The first patient at UCLA was Carolyn Remley, 51, of Long Beach, a pediatric nurse at Harbor-UCLA Medical Center in Torrance. She had the procedure done Thursday, and was napping and recuperating Friday, said her husband, Michael.

``She's very, very happy,'' he said. Her presbyopia ``was pretty frustrating, working with kids. Anytime she had to read to the kids, she'd have to hunt for her glasses.''

``We helped support the local drug store chains'' by continually buying reading glasses, he added. ``She had about eight or nine pairs lying around the house, and they were always getting stepped on or broken.''

She had inquired at the UCLA Laser Refractive Center about surgery to correct her farsightedness, but was told that her aging eyes would make the procedure almost pointless - she would still need reading glasses for her presbyopia. But the institute called her Tuesday and asked whether she wanted to participate in the presbyopia research.

Awake, with only a local anesthesia for the 45-minute procedure, Remley was able to read immediately afterward.

``She sat right up and it was amazing,'' said Boxer Wachler, who performed the surgery. ``I was very impressed.''

And doctors said the surgery is more than just a vanity procedure for people who want to ditch their glasses.

``If someone forgets their reading glasses, they're pretty disabled,'' Boxer Wachler said. And one New York eye surgeon said people wouldn't forgo knee surgery just because they have working wheelchairs.

So far Remley is the only patient for the UCLA trials, which needs a total of five. The research has no outside funding, Boxer Wachler said, so patients pay $3,000 for the operation.

After six months of observation on that first round of patients, the second phase of the trials will expand research to 10 centers, including the Zdenek Institute. Each will have 10 patients under a year of scrutiny. The third and final phase will last another year or two, and researchers hope it will lead to FDA approval.

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Anyone interested in participating in the clinical trials should call the UCLA Laser Refractive Center at the Jules Stein Eye Institute, [phone].

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