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USU Chemists Seek Kinder, Gentler Cataract Surgery

Thursday, Sep. 16, 2010

USU chemist Steve Aust, right, and undergraduate Kenny Turley
USU chemist Steve Aust, right, and undergraduate Kenny Turley are conducting research on ways to make cataract surgery safer.
cataract surgery
Phacoemulsification for the removal of cataracts is one of the most frequently performed surgeries in the United States. Photo courtesy of Journalist 2nd Class Sarah Langdon, U.S. Navy.
Utah State University chemist Steven Aust and his students are studying ways to make an increasingly common surgical procedure among the 50 and older-set safer and more effective.
Modern surgery to remove cataracts from the eyes has come a long way from the days of baby boomers’ childhoods, when patients were subjected to a lengthy in-hospital procedure. A patient’s recovery included days of lying completely still with one’s head wedged between sandbags lest the incision’s fragile sutures be disturbed. Once up and about, the patient had to contend with awkward Coke-bottle glasses that offered less than satisfactory correction.
In most cases, that ordeal has been happily discarded along with Pat Boone 45’s and Brylcreem.
Most of today’s cataract sufferers can benefit from a 20-minute outpatient procedure known as phacoemulsification with aspiration and an artificial lens transplant. The ‘divide and conquer’ approach involves a tiny incision through which an ultrasonic probe breaks up the leather-tough cataract. Mixed with an irrigation solution, the broken pieces are sucked out of the eye’s lens capsule. Through the same opening, the surgeon inserts replacement fluid with a synthetic lens that unfolds into the evacuated space. No sutures are needed to close the slight hole, which heals within weeks. Best of all, vision is markedly clearer.
But even with this much improved procedure or “phaco” as it’s popularly known, the delicate eye is subjected to potentially damaging effects of high-powered ultrasonic movement. 
“The procedure can result in the generation of free radicals and oxidative stress,” says Aust, emeritus professor of biochemistry.
The consequences of free-radical reactions can leave the patient with complications ranging from irritation, swelling and infection to Chronic Dry Eye Syndrome and even DNA damage.
With funding from Alcon, Inc., a manufacturer of phacoemulsification systems, Aust and his students are testing equipment manufactured by Alcon, along with equipment made by Alcon’s competitors, to reduce unwanted side effects from cataract surgery. The research team is determining ways to quantify free radicals produced during phaco by experimenting with various irrigating solutions and conditions used in cataract surgery.
What they’re discovering, he says, is that free radical production is dependent on both the level of ultrasonic power and the type of irrigating solution used during the procedure.
“We found that solutions containing organic molecules can minimize oxidative stress and help prevent unwanted side effects,” says Aust, who received the university’s highest research honor, the D. Wynne Thorne Career Research Award, in 2003 and the state of Utah Governor’s Science Medal in 2002.
In addition to making phacoemulsifcation safer, research efforts could reduce the cost of the procedure.
“Cataracts are caused by ultraviolet exposure from the sun, which especially affects people in equatorial regions,” he says. “Many of the nations concentrated in these areas are developing countries where needed health care isn’t always readily available and affordable.”
Reducing the cost of phaco could have a significant impact on millions of people.
“Sadly, blindness caused by untreated cataracts is extremely common in many of the world’s poorer countries,” Aust says. “Imagine the positive social and economic outcomes of making this surgery accessible worldwide.”
Related links:
Contact: Steven Aust, 435-797-2730, steve.aust@usu.edu
Writer: Mary-Ann Muffoletto, 435-797-3517, maryann.muffoletto@usu.edu

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