Sun, 10 Dec 2023

A cataract is the world's most common cause of blindness, contributing to 50% of blindness reasons globally. Surgery has been the only option for many years in treating cataracts, but there may be a time when we no longer have to lean on it alone.

According to a study published in the Investigative Ophthalmology and Visual Science (IOVS) journal, a chemical compound can mitigate cataract-clouded lenses in mice without resorting to surgery. This chemical compound is oxysterol. It is a cholesterol derivative that plays a role in regulating cholesterol levels and transporting it.

How exactly can it cure cataracts? Let's find out.

How can a person develop a cataract?

To better understand how oxysterol can cure cataracts, it is essential to know how people can develop the condition.

Cataracts occur when the tissues that make up the eye's lens change due to aging or injury. Vision becomes hazy or cloudy when proteins and fibers in the lens break down.

Several inherited genetic disorders can increase a person's risk of cataracts. Also, past eye surgery, steroids, and medical conditions such as diabetes can cause cataract development.

How a cataract forms

Cataracts are cloudy eye lenses. You will find the lens behind the colored portion of your eye (iris).

Lenses focus light that enters the eye, resulting in clear, sharp images on the retina - which functions similarly to a film in a camera. Over time, the lenses in your eyes lose their flexibility and become less transparent and thicker.

Several medical conditions and the aging process can cause the proteins and fibers in the lenses to break down and clump together. When that happens, our eye lenses become cloudy.

Clouding becomes denser as the cataract progresses. Then, as light passes through the lens, a cataract scatters and blocks it, preventing a sharply defined image from reaching the retina. Consequently, your vision becomes blurred.

It is common for cataracts to develop in both eyes, but they do not always grow at the same pace. One eye may have a more advanced cataract than the other, resulting in a difference in vision.

Surgery as the primary method of removing cataracts

The surgeon removes the clouded lens during cataract surgery and replaces it with an artificial lens implant. The new lens is clear and fits your eye perfectly. Furthermore, they are customized to meet your vision requirements.

It usually takes about an hour to remove a cataract. You will receive local anesthesia to numb the area around the eye, then an eyedrop to numb the eyeball itself. During the procedure, you will be awake but won't feel or see anything.

What are the different types of cataract surgery?

To remove cataracts, two types of surgical procedures are available:

Phacoemulsification cataract surgery

Phacoemulsification is the most common procedure for surgically removing cataracts. Through this method, your ophthalmologist will make a small incision on your eye to reach the clouded lens.

Afterward, your ophthalmologist will use ultrasound or a laser to break the lens apart. The doctor will then suction lens fragments from your eye and replace them with a new plastic lens.

Extracapsular cataract surgery

If phacoemulsification is not an option for you, your doctor might recommend the extracapsular procedure. For instance, you have an advanced cataract that is too dense to break apart using phacoemulsification easily. In that case, your doctor will opt for extracapsular surgery.

Your ophthalmologist performs extracapsular cataract surgery by making a larger opening in the eye. Moreover, instead of breaking up the lens and then removing it, your doctor removes the lens in one piece. Once removed, the surgeon then inserts the manufactured lens into the eye.

These two procedures have been the go-to treatment for cataracts for many years. However, like many other surgeries, they can be expensive, especially without Medicare coverage. You may check this Hella Health's blog post to learn more about what Medicare covers for people with cataracts.

Aside from the price, the significant downtime after the surgery is also considerable. Not to mention there are possible risks and complications too. That is why scientists are continuously searching for non-surgical treatments for cataracts.

Non-surgical treatment for cataracts: is it promising?

As mentioned before, scientists are looking into a compound called oxysterol and its efficacy in treating cataract patients without needing surgical intervention.

Researchers examined an assortment of 35 wild mice and mice genetically altered to develop lens cloudiness by changing the αA-crystallin or αB-crystallin proteins. To study the effects of oxysterols on ocular surfaces, the researchers administered a single drop of VP1-001 directly to the right eye surface of 26 mice. In the meantime, they administered a neutral drop of cyclodextrin to their left eyes. Then, as a control group, nine mice were left untreated.

The treatment aims to target αA- and αB-crystallin mutations, which often cause cataracts when aging. Surprisingly, the VP1-001 administered to the mice enhanced the lens opacity on 61% of them. Specifically, the treatment caused a 1.0 improvement in their eyes' opacity grade.

However, Dr. Haci Ugur Celik, an assistant professor of Clinical Ophthalmology at the University of Rochester Medical Center in New York, expressed his concern about the value of this possible treatment to clinical practice. He said it was spectacular, but it doesn't have that much significance because it only targets one cause of cataracts.

Similarly, Professor Barbara Pierscionek, the lead author of the study from Anglia Ruskin University, also thinks there is still so much to be done before finding a drug that can cure cataracts without surgery. According to her, despite the compound's positive effects as an anti-cataract drug, it has never been tested on lens optics before.

Compared to eyes without the compound, those treated with the compound showed a remarkable improvement in optics. However, there is a possibility that the drug may not be a total panacea for cataracts. Some types did not respond as well as expected, which may explain some failures in previous studies.

Animal studies will always require more work, including testing whether the exact mechanisms work in humans. But, the hope remains that we will one day find a non-surgical treatment for cataracts.

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